Positive emotion dysregulation across mood disorders: How amplifying versus dampening predicts emotional reactivity and illness course

Maladaptive regulation of positive emotion has increasingly been associated with psychopathology. Little is known, however, about how individual strategies used to manage positive emotion predict concurrent emotional responding and prospective illness course across mood disorders. The present study examined the concurrent and prospective influence of amplification and dampening regulation strategies of positive emotion (i.e., self-focused positive rumination, emotion-focused positive rumination, and dampening) among remitted individuals with bipolar I disorder (BD; n = 31) and major depressive disorder (MDD; n = 31). Rumination over positive emotional states concurrently predicted increased positive emotion across both mood disordered groups during an experimental rumination induction. However, dampening positive emotion concurrently predicted increased emotional reactivity (i.e., heart rate and negative affect) and prospective increases in manic and depressive symptoms for the BD group only. This suggests that amplifying positive emotion transdiagnostically increases positive emotion across mood disordered groups, while attempts to dampen positive emotion may paradoxically exacerbate emotional reactivity and illness course in BD. For individuals with BD, negative thinking about one's positive emotion (via dampening) may be particularly maladaptive.     

A test of the bidirectional association between sleep and mood in bipolar disorder and insomnia

The present study investigates sleep, mood, and the proposed bidirectional relationship between the two in psychiatric disorders. Participants with interepisode bipolar disorder (n = 49), insomnia (n = 34), and no psychiatric history (n = 52) completed seven consecutive days of sleep diaries and mood measures. The interepisode bipolar and insomnia participants exhibited greater sleep disturbance than the healthy control individuals. Negative mood was equally heightened in both interepisode bipolar disorder and insomnia, and there were no differences between the three groups in positive mood. Total wake time was associated with next morning negative mood in bipolar disorder, whereas evening negative mood was associated with subsequent total wake time in both bipolar disorder and insomnia. Additionally, positive mood was associated with subsequent total wake time for the insomnia group. Results support the theory that disruptions in nighttime sleep and daytime mood may be mutually maintaining and suggest the potential importance of transdiagnostic or universal processes.     

Attentional bias in euthymic bipolar I disorder

Little is known about the nature of the relation between information-processing biases and affective traits in bipolar disorder. The present study was designed to investigate whether attentional biases are evident in persons diagnosed with bipolar disorder when they are in a positive mood state, and whether biases are related to indices of emotion regulation and to prior history of mood episodes. Ninety adults diagnosed with bipolar I disorder and 81 controls with no lifetime mood disorder underwent a positive mood induction and then completed an emotion face dot-probe task; participants in the bipolar disorder group also completed a self-report measure of responses to positive affect. Attentional bias was not related to a diagnosis of bipolar disorder or to symptom severity. Consistent with hypotheses, analyses within the bipolar group indicated that greater dampening of positive affect related to significantly less attention paid to the positively valenced faces. Discussion focuses on the potential role of affective traits in shaping attentional bias in bipolar disorder.     

When trying is not enough: Emotion regulation and the effort-success gap in bipolar disorder

Bipolar disorder (BD) is presumed to involve difficulties in emotion regulation. Little is known, however, about the specific emotion regulation profile associated with this disorder. The present study examined the use of specific emotion regulation strategies among individuals with BD (n = 37) and healthy controls (n = 38). Participants' spontaneous use of reappraisal and suppression, as well as their associated effort and success at regulating their emotions, was measured in the context of three emotionally evocative films (neutral, happy, sad). Results indicated that the BD participants made greater use of spontaneous suppression and reappraisal across all films compared to the control group. BD participants also reported greater effort, but less success, when spontaneously regulating emotions. These findings suggest that bipolar disorder is associated with less success when regulating emotions despite a widespread engagement of regulatory efforts. Discussion focuses on the disjunction between troubled emotion functioning in bipolar disorder and sustained efforts to modify intense emotions. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

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 effects of worry and rumination on affect states and cognitive activity

The effects of worry and rumination on affective states and mentation type were examined in an unselected undergraduate sample in Study 1 and in a sample of individuals with high trait worry and rumination, high rumination, and low worry/rumination in Study 2. Participants engaged in worry and rumination inductions, counterbalanced in order across participants to assess main and interactive effects of these types of negative thinking. During mentation periods, the thought vs. imaginal nature and the temporal orientation of mentations were assessed 5 times. Following mentation periods, negative and positive affect, relaxation, anxiety, and depression were assessed. Both worry and rumination produced increases in negative affect and decreases in positive affect. Worry tended to generate greater anxiety, and rumination tended to generate greater depression. Interactive effects were also found indicating that worry may lessen the anxiety experienced during subsequent rumination. Moreover, worry lessened the depressing effects of rumination. Worry was associated with significantly greater thought than imagery, compared to rumination. Rumination involved a progression from mentation about the past to mentation about the future over time. Implications for understanding the generation of negative affect and comorbid anxiety and depression are discussed.     

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.     

Emotion regulation and biological stress responding: associations with worry,rumination, and reappraisal

ABSTRACT

Individual differences in the habitual use of emotion regulation strategies may play a critical role in understanding psychological and biological stress reactivity and recovery in depression and anxiety. This study investigated the relation between the habitual use of different emotion regulation strategies and cortisol reactivity and recovery in healthy control individuals (CTL; n?=?33) and in individuals diagnosed with social anxiety disorder (SAD; n?=?41). The tendency to worry was associated with increased cortisol reactivity to a stressor across the full sample. Rumination was not associated with cortisol reactivity, despite its oft-reported similarities to worry. Worry and rumination, however, were associated with increased cortisol during recovery from the stressor. The only difference between CTL and SAD participants was observed for reappraisal. In the CTL but not in the SAD group, reappraisal predicted recovery, such that an increased tendency to reappraise was associated with greater cortisol recovery. These results suggest an important role of the habitual use of emotion regulation strategies in understanding biological stress reactivity and recovery.     

Associations of trait positive emotion regulation with everyday emotions: An experience sampling approach

Positive emotion regulation is important for enhancing psychological well-being. Previous studies have adopted a cross-sectional design to examine the relationships between positive emotion regulation strategies and psychological functioning. Relatively little is known about the role of positive emotion regulation strategies in positive and negative emotions in everyday life. This study examines associations between perceived capability of savoring and trait positive rumination and everyday emotions. Among 300 Hong Kong Chinese (age 18–77 years), perceived capability of savoring the moment and positive rumination predicted higher positive emotions during positive-valenced events. Perceived capability of savoring the moment predicted lower negative emotions during positive-valenced events and higher positive emotions during negative-valenced events. Positive links between positive valence ratings of events and positive emotions were stronger among individuals who reported higher levels of perceived capability of savoring through reminiscence and greater trait emotion-focused rumination. Positive links between negative valence ratings of events and negative emotions were significant only among individuals who reported low/medium levels of perceived capability of savoring through anticipation. These findings suggest that: (a) perceived capability of savoring and trait positive rumination are key mechanisms for increasing positive emotions and (b) perceived capability of savoring fosters adaptive adjustment to stress during negative events.     

Eveningness and Seasonality are Associated with the Bipolar Disorder Vulnerability Trait

Trait theories of vulnerability to bipolar disorder (BD) are increasingly common in the literature, yet poorly understood. The aim of the current study was to complement existing knowledge of trait theories by investigating two biological rhythm features often associated with BD – eveningness and seasonality – in a sample assessed as vulnerable to the disorder. Two hundred and thirteen participants completed an online survey consisting of the General Behavior Inventory, Seasonal Pattern Assessment Questionnaire, and Morningness-Eveningness Questionnaire. Hierarchical regressions controlling for sex and age showed that greater levels of seasonality and a tendency towards an eveningness chronotype were weak, but significant predictors of the BD vulnerability trait. When the traits of vulnerability to depression and mania were investigated separately, seasonality and eveningness were significant predictors of the former, but only seasonality was a significant predictor of the latter. The Autumn/Winter pattern of seasonality was a weak predictor of trait vulnerability to mania but not depression. The current findings advance understanding of the BD vulnerability trait, and may have consequences for the behavioural management of those who are considered to be ‘at risk’ of the disorder.     

Neural correlates of rumination in adolescents with remitted major depressive disorder and healthy controls

The aim of the present study was to use fMRI to examine the neural correlates of engaging in rumination among a sample of remitted depressed adolescents, a population at high risk for future depressive relapse. A rumination induction task was used to assess differences in the patterns of neural activation during rumination versus a distraction condition among 26 adolescents in remission from major depressive disorder (rMDD) and in 15 healthy control adolescents. Self-report depression and rumination, as well as clinician-rated depression, were also assessed among all participants. All of the participants recruited regions in the default mode network (DMN), including the posterior cingulate cortex, medial prefrontal cortex, inferior parietal lobe, and medial temporal gyrus, during rumination. Increased activation in these regions during rumination was correlated with increased self-report rumination and symptoms of depression across all participants. Adolescents with rMDD also exhibited greater activation in regions involved in visual, somatosensory, and emotion processing than did healthy peers. The present findings suggest that during ruminative thought, adolescents with rMDD are characterized by increased recruitment of regions within the DMN and in areas involved in visual, somatosensory, and emotion processing.     

不同抑郁症状青少年调节不同强度情绪时策略选择的差异

最新研究发现,情绪强度会影响健康个体的情绪调节策略选择。然而,至今尚未有研究考察情绪强度对不同抑郁症状青少年策略选择的影响。对此,本研究通过流调中心用抑郁量表划分出无抑郁、阈下抑郁和抑郁症青少年,进而考察其在面对高-低强度积极-消极日常情绪事件时选择认知重评和认知沉浸的差异。结果发现：当面对高强度积极情绪、低强度积极情绪和低强度消极情绪时,三组被试的策略选择均无显著差异;当面对高强度消极情绪时,无抑郁青少年比阈下抑郁和抑郁症青少年更多选择认知重评而更少选择认知沉浸,但阈下抑郁和抑郁症青少年之间无显著差异。结果表明：不同抑郁症状青少年在面对不同强度和效价情绪时的情绪调节策略选择存在差异,表现为高强度消极情绪下抑郁症状越多的青少年越少选择认知重评而越多选择认知沉浸。这一发现有助于识别和干预青少年的抑郁症状。     

Rumination, negative cognition, and their interactive effects on depressed mood

Response styles theory posits that rumination represents a trait vulnerability to depression. Recent evidence has suggested that rumination predicts changes in depression more strongly among individuals with high levels of negative cognition. Three studies evaluated this model of interactive vulnerabilities. Study 1 provided empirical support for the distinction between rumination and negative cognitive content. The next 2 studies investigated the interactive model in the laboratory. Study 2 randomly assigned participants to either ruminate or distract following a sad mood induction. This study found that rumination was more strongly associated with dysphoria among individuals who report high levels of negative cognition. Similarly, Study 3 found that rumination and negative cognition interact to predict changes in dysphoria across a no-task delay period following a sad mood induction. These studies provide support for an interactive model in which rumination amplifies the deleterious effects of negative cognition.     

Working memory capacity and spontaneous emotion regulation in generalised anxiety disorder

Researchers have postulated that deficits in cognitive control are associated with, and thus may underlie, the perseverative thinking that characterises generalised anxiety disorder (GAD). We examined associations between cognitive control and levels of spontaneous state rumination following a stressor in a sample of healthy control participants (CTL; n?=?27) and participants with GAD (n?=?21). We assessed cognitive control by measuring working memory capacity (WMC), defined as the ability to maintain task-relevant information by ignoring task-irrelevant information. To this end, we used an affective version of the reading span task with valenced (negative or neutral) distractors. Lower WMC in the presence of negative distractors was associated with greater state rumination in the GAD group, but not in the CTL group. These findings suggest that difficulty maintaining task-relevant information due to interference from negative distractors contributes to perseverative thinking in GAD.     

Trait rumination and response to negative evaluative lab-induced stress: neuroendocrine,affective, and cognitive outcomes

Theoretical models of depression posit that, under stress, elevated trait rumination predicts more pronounced or prolonged negative affective and neuroendocrine responses, and that trait rumination hampers removing irrelevant negative information from working memory. We examined several gaps regarding these models in the context of lab-induced stress. Non-depressed undergraduates completed a rumination questionnaire and either a negative-evaluative Trier Social Stress Test (n?=?55) or a non-evaluative control condition (n?=?69), followed by a modified Sternberg affective working memory task assessing the extent to which irrelevant negative information can be emptied from working memory. We measured shame, negative and positive affect, and salivary cortisol four times. Multilevel growth curve models showed rumination and stress interactively predicted cortisol reactivity; however, opposite predictions, greater rumination was associated with blunted cortisol reactivity to stress. Elevated trait rumination interacted with stress to predict augmented shame reactivity. Rumination and stress did not significantly interact to predict working memory performance, but under control conditions, rumination predicted greater difficulty updating working memory. Results support a vulnerability-stress model of trait rumination with heightened shame reactivity and cortisol dysregulation rather than hyper-reactivity in non-depressed emerging adults, but we cannot provide evidence that working memory processes are critical immediately following acute stress.     

Suicidality in Bipolar Disorder: The Role of Emotion‐Triggered Impulsivity

A growing body of research suggests that impulsive responses to emotion more robustly predict suicidality than do other forms of impulsivity. This issue has not yet been examined within bipolar disorder, however. Participants diagnosed with bipolar I disorder (n = 133) and control participants (n = 110) diagnosed with no mood or psychotic disorder completed self‐report measures of emotion‐triggered impulsivity (Negative and Positive Urgency Scales) and interviews concerning lifetime suicidality. Analyses examined the effects of emotion‐triggered impulsivity alone and in combination with gender, age of onset, depression severity, comorbid anxiety, comorbid substance use, and medication. A history of suicide ideation and attempts, as well as self‐harm, were significantly more common in the bipolar disorder group compared with the control group. Impulsive responses to positive emotions related to suicide ideation, attempts, and self‐harm within the bipolar group. Findings extend research on the importance of emotion‐triggered impulsivity to a broad range of key outcomes within bipolar disorder. The discussion focuses on limitations and potential clinical implications.     

Processing mode influences the relationship between trait rumination and emotional vulnerability

Watkins (2004) found that the mode of processing adopted during expressive writing following a failure influenced emotional recovery from the failure as a function of level of trait rumination. At higher levels of trait rumination, negative mood 12 hours after the failure was greater, but only in an abstract, evaluative writing condition and not in a concrete, process-focused condition. The current study examined whether this interaction of trait rumination with processing mode would generalize to emotional vulnerability to a subsequent negative stressor. Participants repeatedly focused on both positive and negative scenarios in either a concrete, process-focused or an abstract, evaluative mode, before a failure experience. As predicted, after the failure experience, higher levels of trait rumination were associated with lower levels of positive affect, but only for participants in the abstract, evaluative condition and not for participants in the concrete, process-focused condition. This finding is consistent with processing mode influencing the relationship between trait rumination and emotional vulnerability.     

Comparison of ruminative responses with negative rumination as a vulnerability factor for depression

Several studies have shown that the ruminative responses, which are defined as a coping pattern that focuses on the symptoms of depression and on the possible causes and consequences of these symptoms, are associated with depression. Recently, negative rumination, which is defined as the tendency to continue to think about something bad, harmful, or unhopeful for a long time, has been proposed as a vulnerability factor for depression. The purpose of this study was to compare depression scores associated with negative rumination and ruminative responses. We expected to find depression associated with negative rumination. The sample consisted of 188 Japanese undergraduate students (83 men: M age= 19.0 yr., SD= 1.1; 105 women: M age = 19.1 yr., SD = 1.7) taking a human sciences course at a Japanese university. Subjects participated in an 8-mo. longitudinal study. Logistic analysis indicated that negative rumination was a significant predictor of depression. However, ruminative responses as a whole were not a significant predictor of depression after controlling for negative rumination. These findings suggest that it is important to distinguish whether rumination is focused on negative or nonnegative subject matter.     

Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses

Contemplative practices are believed to alleviate psychological problems, cultivate prosocial behavior and promote self-awareness. In addition, psychological science has developed tools and models for understanding the mind and promoting well-being. Additional effort is needed to combine frameworks and techniques from these traditions to improve emotional experience and socioemotional behavior. An 8-week intensive (42 hr) meditation/emotion regulation training intervention was designed by experts in contemplative traditions and emotion science to reduce "destructive enactment of emotions" and enhance prosocial responses. Participants were 82 healthy female schoolteachers who were randomly assigned to a training group or a wait-list control group, and assessed preassessment, postassessment, and 5 months after training completion. Assessments included self-reports and experimental tasks to capture changes in emotional behavior. The training group reported reduced trait negative affect, rumination, depression, and anxiety, and increased trait positive affect and mindfulness compared to the control group. On a series of behavioral tasks, the training increased recognition of emotions in others (Micro-Expression Training Tool), protected trainees from some of the psychophysiological effects of an experimental threat to self (Trier Social Stress Test; TSST), appeared to activate cognitive networks associated with compassion (lexical decision procedure), and affected hostile behavior in the Marital Interaction Task. Most effects at postassessment that were examined at follow-up were maintained (excluding positive affect, TSST rumination, and respiratory sinus arrhythmia recovery). Findings suggest that increased awareness of mental processes can influence emotional behavior, and they support the benefit of integrating contemplative theories/practices with psychological models and methods of emotion regulation.     

不同抑郁症状青少年日常情绪调节策略使用的差异

为了考察无抑郁、阈下抑郁和抑郁青少年日常情绪调节策略使用的差异,采用流调中心用抑郁量表和青少年日常情绪调节问卷测量了766名青少年的抑郁症状及其情绪调节策略使用。结果发现：青少年抑郁症状越多,使用认知重评越少,使用认知沉浸、表达抑制和表达宣泄越多。当调节积极情绪时,青少年抑郁症状越多,使用认知重评越少,使用认知沉浸和表达抑制越多,但使用表达宣泄无显著差异;当调节消极情绪时,青少年抑郁症状越多,使用认知重评越少,使用认知沉浸、表达抑制和表达宣泄越多。并且,阈下抑郁青少年的情绪调节策略使用均介于无抑郁和抑郁青少年之间。结果表明,青少年抑郁症状越多,使用认知重评等适应性情绪调节策略越少,使用认知沉浸等非适应性情绪调节策略越多,但具体情绪调节策略的使用可能会受所调节情绪效价的影响。同时,相比无抑郁和抑郁青少年,阈下抑郁青少年的情绪调节策略使用更具识别和干预的价值。