Look before you regulate: differential perceptual strategies underlying expressive suppression and cognitive reappraisal

Successful emotion regulation is important for maintaining psychological well-being. Although it is known that emotion regulation strategies, such as cognitive reappraisal and expressive suppression, may have divergent consequences for emotional responses, the cognitive processes underlying these differences remain unclear. Here we used eye-tracking to investigate the role of attentional deployment in emotion regulation success. We hypothesized that differences in the deployment of attention to emotional areas of complex visual scenes may be a contributing factor to the differential effects of these two strategies on emotional experience. Eye-movements, pupil size, and self-reported negative emotional experience were measured while healthy young adult participants viewed negative IAPS images and regulated their emotional responses using either cognitive reappraisal or expressive suppression. Consistent with prior work, reappraisers reported feeling significantly less negative than suppressers when regulating emotion as compared to a baseline condition. Across both groups, participants looked away from emotional areas during emotion regulation, an effect that was more pronounced for suppressers. Critically, irrespective of emotion regulation strategy, participants who looked toward emotional areas of a complex visual scene were more likely to experience emotion regulation success. Taken together, these results demonstrate that attentional deployment varies across emotion regulation strategies and that successful emotion regulation depends on the extent to which people look toward emotional content in complex visual scenes.     

Effect of a positive emotional state on interpretation bias for threat in children with anxiety disorders

The authors examined the effect of a positive emotional state on interpretation bias for threat in children with anxiety disorders. Participants were 34 children with anxiety disorders and 34 children without any psychological disorders who were randomly assigned to either a positive or neutral emotion induction condition. Consistent with the broaden-and-build theory, children with anxiety disorders exhibited an interpretation bias for threat, but not when they were in a positive emotional state. Furthermore, results indicated that positive emotional state made a unique prediction of interpretation bias score, whereas state anxiety did not. Findings are discussed with reference to theory, clinical implications, and suggestions for future research.     

A Unified,Transdiagnostic Treatment for Adolescents With Chronic Pain and Comorbid Anxiety and Depression

Chronic pain disorders represent a significant public health concern, particularly for children and adolescents. High rates of comorbid anxiety and unipolar mood disorders often complicate psychological interventions for chronic pain. Unified treatment approaches, based on emotion regulation skills, are applicable to a broad range of emotional disorders and suggest the possibility of extending these interventions to chronic pain and pain-related dysfunction. This case report describes the use of a unified protocol for treatment of an adolescent boy with chronic daily headache and social anxiety and an adolescent girl with whole body pain and depression. Following weekly, 50-minute individual treatment sessions, the boy demonstrated notable improvement in emotional symptoms, emotion regulation skills, somatization, and functional disability. The girl showed some improvement on measures of anxiety and depression, although there appeared to be a worsening of pain symptoms and somatization. However, both patients demonstrated improvement over follow-up. This case study illustrates the potential utility of a unified treatment approach targeting pain and emotional symptoms from an emotion regulation perspective in an adolescent population.     

Understanding and taking stock of positive emotion disturbance

The prevailing view on positive emotions is that they correlate with and confer psychological health benefits for the individual, including improved social, physical and cognitive functioning. Yet an emerging wave of scientific work suggests that positive emotions are also related to a range of suboptimal psychological health outcomes, especially when the intensity, duration, or context do not optimize the individual's goals or meet current environmental demands. This paper provides an overview of the “other side” of positive emotion, by describing and reviewing evidence supporting the emerging field of positive emotion disturbance (PED). We review relevant emotion processes and key themes of PED and apply this framework to example emotional disorders, and discuss implications for psychological change and future research agendas.     

Eating Disorders—The Regulation of Positive as well as Negative Emotion Experience

Disordered eating behaviors are often conceptualized as maladaptive emotion regulation strategies. The present study investigated links between emotional experience, schematic belief systems, and psychological themes associated with eating disorders. In contrast to the majority of studies, which focus on just one or two emotions and use nonclinical samples, this study compared the full range of emotional experience in women with eating disorders to a control group. Measures used include the Differential Emotional Scale-IV, Youngs Early Maladaptive Schema Questionnaire, and Eating Disorder Inventory-2. The study provides the first empirical evidence that women diagnosed with eating disorders report experiencing pleasant as well as unpleasant emotions more frequently than do controls. A surprising finding was that pleasant emotions (joy, interest, surprise) correlated with eating disorder themes (EDI-2 subscales) more consistently than unpleasant emotions in the eating disorder group, while the reverse was true of the control group. Also of note, eating-disordered women reported significantly less anger and similar levels of fear vs. controls. While eating-disordered women scored more highly than do controls on all maladaptive schema (suggesting high levels of distress in women with eating disorders), the pattern of correlations between schema and emotion experience was distinctly different for each group and counterintuitive for the eating disorder group. In particular, pleasant emotion was highly correlated with maladaptive schema in the eating-disordered group but not in the control group. These marked group differences in the pattern of relationships between emotion experience, eating disorder themes, and belief systems suggest that it is not valid to draw conclusions about eating disorders from research that employs only nonclinical samples. The authors discuss these findings, and suggest that women with eating disorders are proficient at using disordered eating behaviors to manipulate their experience of both positive and negative emotional states, and that this dynamic should be recognized as an important maintenance factor.     

Emotion Regulation Therapy: An Integrative Approach to Treatment-Resistant Anxiety Disorders

Cognitive-behavioral, psychodynamic, and experiential approaches have historically been characterized by differing definitions of emotions and beliefs concerning their role in psychopathological process and treatment. However, given recent advances in the basic psychological sciences of emotion and emotion regulation, theoretical orientations are converging on similar viewpoints as to the functional role of emotions in conceptualizing and treating of a variety of disorders. One such area where emotions and their regulation may play a significant role is in chronic, complex, and treatment-resistant forms of anxiety disorders such as generalized anxiety disorder (GAD). A review of the historical approaches to emotions in the major theoretical orientations is presented. Following this, a model of emotion disruption and dysregulation is presented as it relates to anxiety disorders and GAD, in particular. Finally, a new treatment for GAD, emotion regulation therapy, aimed at ameliorating dysfunctional affective processes, is described.     

青少年情绪弹性的影响因素研究

影响青少年情绪弹性的个体变量主要包括性别、年龄等背景变量和其他心理变量。研究对830名中学生的情绪弹性进行了调查,结果表明,性别与年龄变量对青少年情绪弹性不产生实质性影响,说明青少年情绪弹性具有相对稳定的心理特性;心理弹性、人格特质、情绪调节能力及自我效能与青少年情绪弹性存在显著相关,并对后者产生显著的预测效应;负性情绪认知调节能力和神经质是影响青少年情绪弹性的两个主要心理变量,神经质还以负性情绪认知调节能力为中介变量对青少年情绪弹性产生间接影响。     

Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory

The ascendance of emotion theory, recent advances in cognitive science and neuroscience, and increasingly important findings from developmental psychology and learning make possible an integrative account of the nature and etiology of anxiety and its disorders. This model specifies an integrated set of triple vulnerabilities: a generalized biological (heritable) vulnerability, a generalized psychological vulnerability based on early experiences in developing a sense of control over salient events, and a more specific psychological vulnerability in which one learns to focus anxiety on specific objects or situations. The author recounts the development of anxiety and related disorders based on these triple vulnerabilities and discusses implications for the classification of emotional disorders.     

Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders

Emotion dysregulation is believed to be a key factor in anxiety disorders. However, the empirical basis for this view is limited, particularly in children and adolescents. This study aimed to examine whether anxious children display negative emotional hyper-reactivity and deficits in emotion regulation, using a new task that presents ambiguous situations with potentially threatening meanings. Forty-nine children diagnosed with either generalized anxiety disorder, social anxiety, or separation anxiety disorder, were compared with 42 non-anxious controls. Relative to controls, anxious children demonstrated (a) greater intensity and frequency of negative emotional responses, (b) deficits in using reappraisal in negative emotional situations and corresponding deficits in reappraisal self-efficacy, and (c) greater reliance on emotion regulation strategies that increase the risk of functional impairment, intense negative emotion, and low emotion regulation self-efficacy. Implications for the assessment and treatment of childhood anxiety are discussed.     

Recognition of Facial Expressions of Emotion by Children with Emotional and Behavioral Disorders

Interpreting and responding appropriately to facial expressions of emotion are important aspects of social skills. Some children, adolescents, and adults with various psychological and psychiatric disorders recognize facial expressions less proficiently than their peers in the general population. We wished to determine if such deficits existed in a group of 133 children and adolescents with emotional and behavioral disorders (EBD). The subjects were receiving in-patient psychiatric services for at least one of substance-related disorders, adjustment disorders, anxiety disorders, mood disorders or disruptive behavior disorders. After being read stories describing various emotional reactions, all subjects were tested for their ability to recognize the 6 basic facial expressions of emotion depicted in Ekman and Friesen's (1976) normed photographs. Overall, they performed well on this task at levels comparable to those occurring in the general population. Accuracy increased with age, irrespective of gender, ethnicity, or clinical diagnosis. After adjusting for age effects, the subjects diagnosed with either adjustment disorders, mood disorders, or disruptive behavior disorders were significantly more accurate at identifying anger than those without those diagnoses. In addition, subjects with mood disorders identified sadness significantly more accurately than those without this diagnosis, although the effect was greatest with younger children.     

Emotion Dysregulation in Comorbid Posttraumatic Stress Disorder and Substance Use Disorders: A Narrative Review

Co-occurrence of substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) is extremely common and is associated with elevated dropout and relapse rates. Given that PTSD/SUD co-occurrence rates among veterans have been found to be as high as 55?75%, it is important to identify mechanisms that may affect the interplay of both disorders. Emotion dysregulation (ED) presents a candidate mechanism that may underlie poor treatment response in co-occurring PTSD/SUD. This article proposes a transdiagnostic emotion regulation framework that considers ED conceptualized as a combination of low ability to tolerate emotional distress (low distress tolerance) and difficulties in the goal-directed use of emotion regulation strategies as a key risk factor in co-occurring PTSD/SUD. The authors review empirical findings from self-report and laboratory-based studies of ED in PTSD. They describe psychological explanations of the emotion-substance relationship and review studies documenting ED in SUDs and in co-occurring PTSD/SUD. The literature on ED in PTSD/SUD suggests that (a) patients with PTSD may resort to substances to cope with trauma-related symptoms due to ED, and (b) ED may maintain SUD symptoms and interfere with psychological treatment. Longitudinal studies on bidirectional relationships between ED and substance use in PTSD are needed, particularly research examining the course of ED in PTSD patients who use substances versus those who do not.     

Emotion Regulation in Youth with Emotional Disorders: Implications for a Unified Treatment Approach

Given the relationship between internalizing disorders and deficits in emotion regulation in youth, the emotion science literature has suggested several avenues for increasing the efficacy of interventions for youth presenting with anxiety and depression. These possibilities include the identification and addition of emotion-regulation skills to existing treatment packages and broadening the scope of those emotions addressed in cognitive-behavioral treatments. Current emotion-focused interventions designed to meet one or both of these goals are discussed, and the developmental influences relevant to the selection of emotion-focused treatment goals are explored using the framework of a modal model of emotion regulation. These various lines of evidence are woven together to support the utility of a novel emotion-focused, cognitive-behavioral intervention, the Unified Protocol for the Treatment of Emotional Disorders in Youth, a transdiagnostic treatment protocol that aims to treat the range of emotional disorders (i.e., anxiety and depression) simultaneously. Avenues for future directions in treatment outcome and assessment of emotion regulation are also discussed.     

Facets of Emotion Regulation and Emotional Disorder Symptom Dimensions: Differential Associations and Incremental Validity in a Large Clinical Sample

A growing literature suggests robust associations between dimensions of emotion regulation and emotional disorder psychopathology. However, limited research has investigated associations of emotion regulation dimensions across several emotional disorders (transdiagnostic associations), or the incremental validity of emotion regulation versus the higher-order construct of neuroticism. The current study used exploratory structural equation modeling and a large clinical sample (N = 1,138) to: (a) develop a multidimensional emotion regulation measurement model, (b) evaluate the differential associations between latent emotion regulation dimensions and five latent emotional disorder symptom dimensions (social anxiety, depression, agoraphobia/panic, obsessions/compulsions, generalized worry), and (c) determine the incremental contribution of emotion regulation in predicting symptom dimensions beyond neuroticism. The best-fitting measurement model of emotion regulation included four dimensions: Problematic Responses, Poor Recognition/Clarity, Negative Thinking, and Emotional Inhibition/Suppression. Although many zero-order associations between the four latent emotion regulation dimensions and five latent symptom dimensions were significant, few associations remained significant in a structural regression model that included neuroticism. Specifically, Negative Thinking and Problematic Responses incrementally predicted depression symptoms, while Emotional Inhibition/Suppression predicted both social anxiety and depression symptoms. Associations between neuroticism and the emotional disorder dimensions were similar regardless of whether the emotion regulation dimensions were held constant. These results suggest that self-reported emotion regulation dimensions are associated with the severity and expression of a range of emotional disorder symptoms, but that some emotion regulation dimensions have limited incremental validity after accounting for general emotional reactivity. Studies of emotion regulation should assess neuroticism as a key covariate.     

不同情绪背景下来源记忆的ERPs研究*

使用事件相关电位(ERP)技术和测试来源记忆的多键范式,探讨不同情绪效价背景下来源提取的认知神经机制。学习阶段,同时呈现汉字和3种效价情绪图片(重叠);测验阶段,只呈现汉字,要求被试进行四键判断：旧字且背景为中性,旧字且背景为正性,旧字且背景为负性,新字。结果发现：在提取阶段,刺激呈现后300~500 ms,3种情绪背景下来源判断正确项目和来源判断错误项目都比新项目诱发了更正的ERPs(即都存在新旧效应),这一结果反映出刺激呈现后300~500 ms 是一个早期的项目提取阶段,它独立于来源提取。并且,在中性背景下,两种新旧效应没有差别;而在正性和负性背景下,来源判断正确项目的新旧效应显著大于来源判断错误项目。说明相比于中性背景,情绪背景下被试可能更早对来源信息产生熟悉感。在500~650 ms,3种情绪背景下都存在来源判断正确项目的新旧效应,在来源判断错误项目和新项目之间没有显著差异,来源正确与来源错误有显著的新旧效应差异,但二者在头皮分布上是类似的,这反映了晚期的来源提取过程。同时来源正确的新旧效应在这两个时段有显著不同的头皮分布,表明这两个时段有不同加工过程。另外,在500~650 ms,存在显著的情绪效应,正性背景下正确判断来源诱发的ERPs比中性和负性背景下的更正,而且来源判断错误条件下没有情绪效应。综上所述,来源正确和来源错误可能仅仅反映了大脑激活在量上的不同,并不能推断两者存在质的差异;大脑神经活动的早期不仅反映了对记忆项目的熟悉性,而且也受情绪效应的影响,500 ms之后大脑神经活动反映的是对记忆项目回想的过程,这一回想过程也与情绪效应有关,受到情绪效应的调节。     

Trends in geriatric psychiatry relevant to pastoral counselors

This article is a general overview of mental disorders in the aged that stresses the complementary roles that religious and mental health professionals can play in meeting the psychological and spiritual needs of elders. Chaplains and pastoral counselors should be competent in recognizing serious psychiatric disorders in older adults and able to differentiate them from the more common and benign emotional disturbances. Both counseling and biological treatments have distinct but often overlapping roles in the treatment of mental disorders in the aged. When treating emotionally disturbed elders, religious professionals should be aware of new trends in psychotherapy and biological psychiatry that are now making the integration of secular and religious techniques more and more feasible.Funding for this study was provided by the Center for the Study of Aging and Human Development at Duke University Medical Center and by the Geriatric Research, Education, and Clinical Center of the Veterans Administration Medical Center in Durham, North Carolina.     

The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach

A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.     

Using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders With Youth Exhibiting Anger and Irritability

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C and UP-A) are evidence-based treatment programs with cognitive-behavioral and third-wave behavior therapy elements, aimed at extinguishing distress to intense emotion states and reducing unhelpful action tendencies in such states among youth with emotional disorders. A growing body of literature demonstrates the high prevalence of problematic anger and irritability among youth with emotional disorders, yet evidence-based treatments to address anger and irritability are typically developed more exclusively for youth with externalizing disorders. Given this need, a clinical case example of the UP-C applied to a child with anger and irritability is presented. Application of transdiagnostic theory to both conventional anxiety concerns and to irritability concerns is discussed. We demonstrate the flexibility and utility of a transdiagnostic approach like the UP-A and UP-C for addressing concerns across a range of emotions.     

大学生依恋与心理弹性——情绪调节与元情绪的多重中介

对982名大学生的依恋、情绪调节策略、元情绪及心理弹性进行测查,考察依恋与心理弹性间关系的内在机制。结构方程模型分析结果显示：（1）依恋、情绪调节与元情绪均能显著预测心理弹性;（2）依恋焦虑通过认知重评和元情绪间接预测心理弹性;（3）依恋回避不但直接负向预测心理弹性,还会通过认知重评和元情绪间接预测心理弹性。本研究结果显示,情绪调节策略和元情绪能够解释依恋与心理弹性间关系的内在机制。     

The Role of Emotion Regulation in the Treatment of Child Anxiety Disorders

In this review, we examine the role of emotion regulation in the treatment of children with anxiety disorders. Cognitive-behavioral therapy (CBT) has been shown to “work” for children with anxiety disorders and it has been categorized as an evidence-based treatment. However, most studies have shown that the treatment is effective for about 60–70% of children, leaving the remaining children symptomatic and oftentimes with persisting psychological disorders. Of importance, it has also been shown that many children with anxiety disorders demonstrate poor emotion regulation skills. Despite these findings, little attention has been directed toward incorporating emotion regulation strategies into these relatively effective cognitive-behavioral treatments. It is possible that CBT programs do not work as well for a portion of children because their emotion regulation deficits, if present, are not being targeted sufficiently. In this review, it is suggested that adding an emotion regulation component could increase treatment efficacy. In addition, strategies aimed at improving emotion regulation at the individual level and at the family level are introduced. Details of how improved emotion regulation skills could be beneficial in bringing about change are discussed. Finally, issues of measurement and the clinical implications for research and practice are considered.     

Is the glass half empty or half full and does it even matter? Cognition,emotion, and psychopathology

ABSTRACT

This contribution examines the outcomes of recent decades of research on the interaction between cognition and emotion and how it has informed our understanding and treatment of emotional disorders with a special focus on depression. The review identifies important challenges to this work including the dynamic nature of cognitive processes and emotional responding, the bidirectional relation of cognition and emotion, the need for new tasks and for studies conducted outside of the laboratory, and the consideration of context such as interpersonal factors. Examining interactions between cognition and emotion and integrating basic research on cognition into the scientific understanding of emotional difficulties in psychopathology has contributed in many ways to what the field currently knows about the origins and the treatment of emotional disorders. Important challenges lie ahead – especially the integration of this work into the development of novel treatment approaches.