Transdiagnostic emotion regulation processes in bipolar disorder and insomnia

Research and treatment have traditionally adopted a 'disorder-focused' approach by targeting one specific disorder, aiming to understanding its cause, maintenance and treatment. The aim of the present study was to contribute to the burgeoning interest in examining common, or 'transdiagnostic,' processes across disorders. Three candidate transdiagnostic processes involved in emotion regulation - rumination, worry, and automatic negative thoughts - were examined in euthymic bipolar I disorder (n=21) and insomnia (n=19), and a non-clinical control group (n=20). Rumination and worry were endorsed to a larger degree by the bipolar and insomnia groups compared to the control group. However, while the bipolar group had more negative automatic thoughts than the control group, there were no significant differences in negative automatic thoughts between the bipolar and insomnia groups or the insomnia and control groups. These results suggested that rumination and worry, but not negative automatic thoughts, might be common across bipolar disorder and insomnia. However, these findings no longer remained significant when current symptoms of anxiety and depression were controlled for. Prospective and experimental studies are needed to test the extent to which these processes contribute to the etiology or maintenance of insomnia and bipolar disorder.     

Spontaneous emotion regulation to positive and negative stimuli

The ability to regulate one’s emotions is an integral part of human social behavior. One antecedent emotion regulation strategy, known as reappraisal, is characterized by cognitively evaluating an emotional stimulus to alter its emotional impact and one response-focused strategy, suppression, is aimed at reducing behavioral output. People are capable of using these specific emotion regulation strategies when instructed to do so; however, it is equally important to investigate natural and self-selected strategy use. This study was designed to determine to what extent people spontaneously regulate their emotions and the emotion regulation strategies they choose to achieve their regulatory goals. Participants were given no instructions to regulate their emotions before they were shown a negative and a positive film clip, but were instead asked afterwards about the specific strategies that they had used. Participants reported regulating their emotions more to the negative film than to the positive film. Reappraisal was more frequently selected as an emotion regulation strategy than suppression. As expected, participants with high baseline respiratory sinus arrhythmia (RSA) adopted reappraisal strategies more than those with low RSA but, surprisingly, RSA was not associated with facial expressivity. Suggestions for future research in this relatively young field of spontaneous emotion regulation are offered.     

The time course of positive and negative emotion in dysphoria

Prior research has demonstrated attenuated reactivity to positive stimuli among depressed and dysphoric individuals, and inconsistent evidence regarding attenuated reactivity to negative stimuli. However, such research has measured experiential reactivity to emotion stimuli in one static moment, which may obscure important information regarding the time course and dynamics of emotion. The current study employed continuous measurement of experiential emotion during and following the presentation of emotion eliciting film clips. Results revealed that dysphoric individuals (n = 16), as compared to nondysphoric controls (n = 31), were equally responsive to positive and negative film clips in terms of peak reactivity during and following the clip. The most striking difference between groups was that dysphoric individuals showed a shortened time course of positive emotion. These emotion dynamics suggest that perhaps the most important aspect of positive emotion regulation in the context of depressed mood is not the inability to initially react to a positive experience, but rather the inability to maintain positive emotion. Possible underlying mechanisms of positive emotion regulation are discussed, and implications for intervention are highlighted.     

Ecstasy and agony: activation of the human amygdala in positive and negative emotion

Considerable evidence indicates that the amygdala plays a critical role in negative, aversive human emotions. Although researchers have speculated that the amygdala plays a role in positive emotion, little relevant evidence exists. We examined the neural correlates of positive and negative emotion using positron emission tomography (PET), focusing on the amygdala. Participants viewed positive and negative photographs, as well as interesting and uninteresting neutral photographs, during PET scanning. The left amygdala and ventromedial prefrontal cortex were activated during positive emotion, and bilateral amygdala activation occurred during negative emotion. High-interest, unusual photographs also elicited left-amygdala activation, a finding consistent with suggestions that the amygdala is involved in vigilance reactions to associatively ambiguous stimuli. The current results constitute the first neuroimaging evidence for a role of the amygdala in positive emotional reactions elicited by visual stimuli. Although the amygdala appears to play a more extensive role in negative emotion, it is involved in positive emotion as well.     

Narrative identity in female patients with remitted bipolar disorder: a negative past and a foreshortened future

The present study examined narrative identity and subjective well-being in outpatients with remitted bipolar disorder (BD) and a healthy control group. Fifteen female outpatients with remitted BD and 15 healthy control participants identified past and future chapters in their life stories, gave their age for the beginning and end of each chapter, rated emotional tone as well as positive and negative self-event connections associated with the chapters, and for future chapters rated the probability of the chapter. The BD patients reported less positive emotional tone and self-event connections for past chapters, but not for future chapters. However, the patients did describe fewer future chapters with shorter temporal projection into the future, and reported lower probability of future chapters. These characteristics of chapters were related to lower subjective well-being. The study suggests that a more negative narrative identity with a foreshortened future perspective may contribute to lower subjective well-being in patients with BD.     

Social anxiety and emotion regulation in daily life: spillover effects on positive and negative social events

To minimize the possibility of scrutiny, people with social anxiety difficulties exert great effort to manage their emotions, particularly during social interactions. We examined how the use of two emotion regulation strategies, emotion suppression and cognitive reappraisal, predict the generation of emotions and social events in daily life. Over 14 consecutive days, 89 participants completed daily diary entries on emotions, positive and negative social events, and their regulation of emotions. Using multilevel modeling, we found that when people high in social anxiety relied more on positive emotion suppression, they reported fewer positive social events and less positive emotion on the subsequent day. In contrast, people low in social anxiety reported fewer negative social events on days subsequent to using cognitive reappraisal to reduce distress; the use of cognitive reappraisal did not influence the daily lives of people high in social anxiety. Our findings support theories of emotion regulation difficulties associated with social anxiety. In particular, for people high in social anxiety, maladaptive strategy use contributed to diminished reward responsiveness.     

Differential attentional guidance by unattended faces expressing positive and negative emotion

Four experiments were conducted to evaluate whether focal attention can be guided by an analysis of the emotional expression in a face. Participants searched displays of 7, 11, 15, and 19 schematic faces for the location of a unique face expressing either a positive or a negative emotion located among distractor faces expressing a neutral emotion. The slopes of the search functions for locating the negative face were shallower than the slopes of the search functions for locating the positive face (Experiments 1A and 2A). When the faces were inverted to reduce holistic face perception, the slopes of the search functions for locating positive and negative faces were not different (Experiments 1B and 2B). The results suggest that the emotional expression in a face can be perceived outside the focus of attention and can guide focal attention to the location of the face.     

Differential attentional guidance by unattended faces expressing positive and negative emotion

Four experiments were conducted to evaluate whether focal attention can be guided by an analysis of the emotional expression in a face. Participants searched displays of 7, 11, 15, and 19 schematic faces for the location of a unique face expressing either a positive or a negative emotion located among distractor faces expressing a neutral emotion. The slopes of the search functions for locating the negative face were shallower than the slopes of the search functions for locating the positive face (Experiments 1A and 2A). When the faces were inverted to reduce holistic face perception, the slopes of the search functions for locating positive and negative faces were not different (Experiments 1B and 2B). The results suggest that the emotional expression in a face can be perceived outside the focus of attention and can guide focal attention to the location of the face.     

Humour as emotion regulation: the differential consequences of negative versus positive humour

Humour is often seen as an adaptive coping strategy; however, the empirical literature is inconclusive. One possible explanation is that different types of humour have different adaptive consequences. In the present research, we predicted that positive (good-natured) humour would be more effective at regulating negative emotions than negative (mean-spirited) humour. In Study 1, participants were shown negative pictures two times. First, they simply viewed the pictures and rated their levels of positive and negative emotions. Second, they were instructed to: (a) view; (b) use positive humour; or (c) use negative humour, and then rate their reactions. Compared to negative humour, positive humour was more successful at down-regulating negative and up-regulating positive emotion. In Study 2, we replicated these findings and showed that these effects cannot be explained by differences in difficulty between the two humour conditions, participants' expectations, or social desirability. Taken together, these findings suggest that positive (but not negative) humour may be an effective form of emotion regulation.     

The effects of rumination and negative cognitive styles on depression: a mediation analysis

Research on cognitive models of depression has identified negative cognitive styles and rumination as risk factors for depression. The present study examined the hypothesis that rumination mediates the effect of negative cognitive styles on depression. Specifically, we evaluated the differential effects of two aspects of rumination, characterized by brooding and reflection, on the relationship between negative cognitive styles and level of depressive symptoms. A total of 115 college students and 38 patients suffering from depressive disorders completed a battery of questionnaires measuring levels of depressive symptoms, brooding, reflection, and negative cognitive styles. The results support the notion that there exist two distinct dimensions of rumination and that, of the two, it is brooding and not reflection that mediates the relationship between negative cognitive styles and depression and contributes to its negative outcomes.     

Effects of incidental positive emotion and cognitive reappraisal on affective responses to negative stimuli

Previous studies have identified two powerful ways to regulate emotional responses to a stressor: experiencing incidental positive emotions and using cognitive reappraisal to reframe the stressor. Several cognitive and motivational theories of positive emotion support the formulation that incidental positive emotions may facilitate cognitive reappraisal. To test the separate and interacting effects of positive emotions and cognitive reappraisal, we first adapted an established picture-based reappraisal paradigm by interspersing blocks of positive emotion inducing and neutral pictures. Across two pre-registered studies (Studies 1, 2), reappraisal effectively decreased self-reported negative emotions and increased self-reported positive emotions; however, experiencing incidental positive emotions did not facilitate reappraisal success. In another preregistered study (Study 3), we employed a more powerful positive emotion induction via virtual reality (VR), used a social stress anticipation task, and instructed participants to reappraise the anticipated stressor positively. Although there was a robust effect of the positive emotion induction (relative to the neutral induction) on feeling more positive emotions throughout stress anticipation, the results again indicated that incidental positive emotions did not facilitate cognitive reappraisal. We propose that incidental positive emotions and cognitive reappraisal may constitute separate pathways of influence when regulating one's responses to negative events.     

Failing and feeling bad: how we think about experiencing negative emotions during setbacks

Motivation and Emotion - The current research explored appraisals of the negative emotions that arise in the context of setbacks. We proposed that experiencing negative emotions could be appraised...     

On feeling and emotion in religious experience and understanding

Although most if not all human activities may be matters of passionate pursuit, it is less clear that emotions and feelings are inherently implicated in such pursuit: on the contrary, chemistry, cookery, sculpture or football might be effectively pursued without any significant or substantial emotional involvement. On the other hand, it seems less easy to see how religious experience or even religious understanding might be an entirely dispassionate or emotionally disengaged affair. That said, it is far from easy to identify the role of emotion and feeling in religious faith or understanding on some familiar conceptions of religious knowledge and discourse. This paper sets out to explore the place of feeling and emotion in religious experience and understanding via specific attention to the basically narratival form of religious discourse and its connections to wider forms of literary expression.     

Intrusive memories and rumination in patients with post-traumatic stress disorder: a phenomenological comparison

The aim of the study was to investigate the phenomenological differences between intrusive memories and rumination in PTSD. The study population consisted of 31 patients with PTSD referred for cognitive behavioural therapy to specialist services. A semi-structured interview was used to examine the characteristics of the most prominent intrusive memory and rumination. Intrusive memories were predominantly sensory experiences of short duration, whereas rumination was predominantly a thought process of longer duration. Shame was associated more with rumination than with intrusive memories. Anxiety, helplessness, numbness, and threat were greater at the time of the trauma than when experiencing the intrusive memory. In contrast, feelings like anger and sadness were greater when experiencing intrusive memories than at the time of the event. The distinction between intrusive memories and rumination is of clinical importance as intrusive memories usually decrease with imaginal reliving of the trauma, whereas rumination may require different therapeutic strategies, such as rumination-focused or mindfulness-based cognitive therapy.     

The relationship of positive and negative expressiveness to the processing of emotion information

The tendency to express emotions non-verbally is positively related to perception of emotions in oneself. This study examined its relationship to perception of emotions in others. In 40 healthy adults, EEG theta synchronization was used to indicate emotion processing following presentation of happy, angry, and neutral faces. Both positive and negative expressiveness were associated with higher emotional sensitivity, as shown by cortical responses to facial expressions during the early, unconscious processing stage. At the late, conscious processing stage, positive expressiveness was associated with higher sensitivity to happy faces but lower sensitivity to angry faces. Thus, positive expressiveness predisposes people to allocate fewer attentional resources for conscious perception of angry faces. In contrast, negative expressiveness was consistently associated with higher sensitivity. The effects of positive expressiveness occurred in cortical areas that deal with emotions, but the effects of negative expressiveness occurred in areas engaged in self-referential processes in the context of social relationships.     

Carers' attributions about positive events in psychosis relate to expressed emotion

Background

Relapse is increased in people with psychosis who live with carers with high expressed emotion (EE). Attributional style has been used to understand EE at a psychological level. Previous studies have investigated carer appraisals for negative events in the patient's life. We therefore aimed to examine spontaneous carer attributions for both negative and positive events. Further, we distinguished between high EE based on critical comments, and that based on emotional-overinvolvement.

Method

Audiotapes of the Camberwell Family Interview (CFI) (N = 70) were rated using the Leeds Attributional Coding System (LACS). Raters were blind to previous ratings of EE.

Results

In our sample, low EE carers made significantly more attributions about positive events, and less about negative events than high EE carers. This is because criticism, but not overinvolvement, was strongly associated with responsibility attributions for negative events, while overinvolvement, but not criticism, was inversely associated with responsibility attributions for positive events.

Conclusion

Carers' attributions for both positive and negative events may be a useful target for improving family interventions in psychosis.     

Reflective and ruminative processing of positive emotional memories in bipolar disorder and healthy controls

Recent evidence suggests that reflective (i.e., distanced-why), as compared to ruminative (i.e., immersed-why), processing of negative memories is associated with reductions in negative affect. The present study extended this line of work by examining the effect of these two processing conditions on positive memories among persons with bipolar disorder (BD; n = 27) and a healthy control group (CT; n = 27). After a resting baseline period, participants were instructed to recall a happy autobiographical memory. Using a within-subjects design, participants were asked to process the happy memory in two different experimental conditions (reflective, ruminative) while their experiential, behavioral, and autonomic responses were measured. Consistent with hypotheses, reflective processing was associated with lower self-reported positive affect, positive thoughts, and heart rate compared to ruminative processing for all participants. When current symptoms were controlled for, BD participants reported greater positive affect across both conditions relative to CT participants. Prospective studies are needed to test the extent to which processing of positive emotion contributes to the course of symptoms in bipolar disorder.     

The role of emotion control and emotional rumination in stress management training

The present paper reports on three outcome studies evaluating the effectiveness of a new stress management training program. In contrast to conventional stress management, which tends to emphasize life-events, the symptoms of stress and relaxation, the new program is based on emotional rumination, emotion control, and attention control. The training developed from a series of experimental studies on the role of emotional inhibition and rumination in prolonging physiological recovery from stress, and the findings reported here were obtained from a series of applied studies involving police officers from a police force in the North of England. The first two studies employed both self-reported and objective measures of change to demonstrate that the training produced significant increases in job satisfaction and reduced absenteeism, while the results of the final study showed that the benefits of the program were enhanced by follow-up training.