The Relationships among Childhood Maltreatment,Emotion Regulation,and Sexual Risk Taking in Men from Urban STD Clinics

This study sought to examine the relationships among emotion regulation difficulties, childhood maltreatment, and risky sexual behavior in a sample of 320 heterosexual men recruited from urban sexually transmitted disease clinics. Overall childhood maltreatment and several specific types of child abuse were significantly associated with emotion dysregulation, number of sexual partners, and sexually transmitted infection (STI) diagnosis. There was evidence of an additive effect of multiple forms of maltreatment on difficulties with emotion regulation and sexual risk taking. Impulse control difficulties and access to emotion regulation strategies, two components of emotion dysregulation, were related to measures of risky sexual behavior. Furthermore, limited access to emotion regulation strategies mediated the relationship between frequency of childhood sexual abuse and a greater number of lifetime sexual partners. This study has important implications for developing effective interventions to reduce the spread of STIs and HIV by expanding affect regulation and distress tolerance strategies among men who have experienced childhood maltreatment.     

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.     

Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence

Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating 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.     

The Relationship Between Perceived Parenting Style and Emotion Regulation Abilities in Adulthood

Emotion regulation abilities are very important for psychological and social wellbeing during the whole course of life. By contrast, emotion dysregulation is a significant risk factor for several psychological disorders. According to developmental research, an optimal parenting style, described as warmth and affectionate, promotes the development of an adequate emotion regulation in children and adolescents. However, little research has examined the relationship between parenting style and emotion regulation in adulthood. In the present study, we tested the relationship between perceived experiences with parents, in terms of parental care and parental overprotection, during childhood, and emotion regulation abilities in a sample of adults. One hundred participants completed the Parental Bonding Instruments, the Emotion Regulation Questionnaire, and the Difficulties in Emotion Regulation Scale. Hierarchical multiple regression analyses revealed that perceived parental care was more related to emotion regulation abilities than perceived parental overprotection. In particular, perceived paternal care was strictly linked to several difficulties in emotion regulation. By contrast, perceived maternal care was negatively associated with the use of maladaptive emotion regulation strategies, and a specific emotion dysregulation dimension, that is lack of emotional awareness. In summary, perceived parental care seemed to have a key role to protect individuals from emotion dysregulation. These results demonstrate that parenting styles still exert their influence on emotion regulation abilities also in adulthood. Limitations and directions for future research are discussed.     

Emotion Regulation and the Anxiety Disorders: An Integrative Review

The construct of emotion regulation has been increasingly investigated in the last decade, and this work has important implications for advancing anxiety disorder theory. This paper reviews research demonstrating that: 1) emotion (i.e., fear and anxiety) and emotion regulation are distinct, non-redundant, constructs that can be differentiated at the conceptual, behavioral, and neural levels of analysis; 2) emotion regulation can augment or diminish fear, depending on the emotion regulation strategy employed; and 3) measures of emotion regulation explain incremental variance in anxiety disorder symptoms above and beyond the variance explained by measures of emotional reactivity. The authors propose a model by which emotion regulation may function in the etiology of anxiety disorders. The paper concludes with suggestions for future research.     

Attachment in Adolescence and Borderline Personality Disorder

Borderline personality disorder (BPD) has been conceptualized as a constellation of symptoms related to problems in self-functioning, emotion regulation, and interpersonal relationships. Its etiology has been connected to individuals’ early childhood environment, caregiving relationships, and traumatic life events. Recent literature has noted the potential presence of BPD beginning in adolescence, or even earlier in childhood. Attachment theory offers a lens for understanding the symptoms of borderline personality disorder and identifying potential aspects of treatment that may be specifically valuable for adolescent patients. Adolescence marks a time when the attachment system has increased relevance due to the importance of identity formation, peer relationships, body representations and the development of autonomy at this time, in the face of physical changes and academic challenges. This article will summarize research on attachment, body representations, personality disorders, and features of development in adolescence, in order to enhance clinical understanding of patients who presenting with these types of difficulties.     

Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity

Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable "lack of clarity of emotions." Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.     

Sex differences in the indirect effects of cognitive processes on anxiety through emotion regulation difficulties

Drawing on a gender roles theory of emotion regulation, we examined the specific facets of emotion regulation difficulties through which higher-order cognitive abilities may be related to anxiety. Participants (N = 225) completed self-report measures of emotion regulation difficulties and anxiety, and were administered neuropsychological tests assessing abstract reasoning and inhibition. PROCESS (Hayes, 2012) was used to estimate the direct and indirect effects of both inhibition and abstract reasoning on anxiety symptoms, with six dimensions of emotion regulation difficulties serving as multiple mediators operating in parallel. Results suggest that the relation between higher-order cognitive abilities and anxiety operate through distinct, sex-dependent emotion dysregulation mechanisms. For females, higher levels of inhibition and abstract thinking were associated with poorer clarity of emotions, which in turn, was associated with higher levels of anxiety symptoms. As such, over-attentiveness to, or over-analysis of, emotions may be particularly detrimental among females who have relatively higher abstract reasoning abilities. For males, higher inhibition was associated with greater perceived effectiveness in regulating negative emotions, which in turn, was associated with lower levels of anxiety symptoms. This finding suggests that mood regulation expectancies may be particularly important in understanding the pathogenesis of anxiety in males.     

Individual differences in attachment and dispositional mindfulness: The mediating role of emotion regulation

Recent interest in the relationship between individual differences in attachment and dispositional mindfulness has led to empirical investigations into this association. Although several studies have demonstrated an association between attachment and mindfulness, little is known as to why these two seemingly distinct constructs are related. In a sample of 572 individuals we explored whether the relationship between attachment and mindfulness was mediated by emotion regulation difficulties. Difficulties in emotion regulation fully mediated the association between attachment anxiety and mindfulness, and between attachment avoidance and mindfulness. Thus, the mechanism by which attachment and mindfulness are related is through emotion regulation difficulties. Theoretical and clinical implications are discussed.     

Emotional reactivity and cognitive regulation in anxious children

Recent models of anxiety disorders emphasize abnormalities in emotional reactivity and regulation. However, the empirical basis for this view is limited, particularly in children and adolescents. The present study examined whether anxious children suffer both negative emotional hyper-reactivity and deficits in cognitive emotion regulation. Participants were 49 children aged 10-17 with generalized anxiety disorder, social anxiety, or separation anxiety disorder as their primary diagnosis, as well as 42 age- and gender-matched non-anxious controls. After completing a diagnostic interview and self-report questionnaires, participants were presented with pictures of threatening scenes with the instructions either to simply view them or to use reappraisal, a cognitive emotion regulation strategy, to decrease their negative emotional response. Emotion ratings, content analysis of reappraisal responses, and reports of everyday use of reappraisal were used to assess negative emotional reactivity, reappraisal ability, efficacy and frequency. Relative to controls, children with anxiety disorders (1) experienced greater negative emotional responses to the images, (2) were less successful at applying reappraisals, but (3) showed intact ability to reduce their negative emotions following reappraisal. They also (4) reported less frequent use of reappraisal in everyday life. Implications for the assessment and treatment of childhood anxiety disorders are discussed.     

Emotion Dysregulation Mediates the Link between Childhood Emotional Maltreatment and Young Adult Romantic Relationship Satisfaction

This study examined the mediating role of emotion dysregulation in the relation between retrospective reports of childhood emotional maltreatment and current satisfaction in a romantic relationship. Participants included 492 (135 male, 357 female) young adults in current romantic relationships. Results indicated that total emotion regulation difficulties mediated the relation between childhood emotional maltreatment and romantic relationship satisfaction. Multiple mediator analyses indicated that nonacceptance of emotional responses, impulse control difficulties, and lack of emotional clarity uniquely mediated this relation when controlling for other emotion regulation difficulties. These findings contribute to increasing research examining the interpersonal relationships among maltreated individuals, and guide future research by elucidating the factors that increase the risk for future maladaptation.     

Emotion regulation of fear and disgust: differential effects of reappraisal and suppression

Although excessive fear has been central to traditional conceptualisations of the anxiety disorders, recent research suggests that disgust may also play a role in the development of some anxiety disorders. While dysregulation of emotion may confer risk for the development of anxiety disorders, it remains unclear if there are differences in the extent to which fear and disgust can be effectively regulated. To fill this important gap in the literature, unselected participants (N?=?95) experienced fear or disgust via video exposure, and they were instructed to employ either reappraisal or suppression to regulate their emotional experience while viewing the videos. For those exposed to fear-relevant content, change in emotional distress did not significantly differ between those that suppressed and those that reappraised. However, significantly less emotional distress was observed for those that reappraised compared to those that suppressed when exposed to disgust-relevant content. Although physiological arousal varied over time as a function of the emotional content of the videos, it did not vary as a function of emotion regulation strategy employed. These findings suggest that reappraisal may be especially effective in regulating verbal distress when exposed to disgusting cues in the environment. The implications of these findings for the treatment of anxiety disorders that are characterised by excessive disgust reactions will be discussed.     

依恋对情绪调节过程的影响

以依恋理论为基础的研究已证明依恋对情绪调节的影响,但这些研究忽视了情绪调节作为一个过程的复杂性和多样性,因此现有研究无法回答依恋为何会对情绪调节产生影响。扩展过程模型将情绪调节分为三个阶段,并清晰地描述了情绪调节的过程以及过程中各因素之间的关系。从该模型来看,在情绪调节的三个阶段均可发现与依恋有关的个体差异,并且依恋对于情绪调节早期阶段的影响可能是导致后期阶段产生个体差异的原因。未来的研究应在探讨依恋对情绪调节的影响的同时关注环境因素的影响;设计新的实验范式以证实情绪调节三阶段的连续性并探索依恋影响情绪调节的潜在机制;探讨依恋对情绪调节灵活性的影响。此外,未来的干预研究应设计更具针对性的干预措施来改善非安全依恋个体的情绪调节。     

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.     

Emotion-Focused Cognitive-Behavioral Therapy for Youth with Anxiety Disorders: A Randomized Trial

Difficulties with emotion regulation are a core feature of anxiety disorders (ADs) in children and adults. Interventions with a specific focus on emotion regulation are gaining empirical support. Yet, no studies to date have compared the relative efficacy of such interventions to existing evidence-based treatments. Such comparisons are necessary to determine whether emotion-focused treatments might be more effective for youth exhibiting broad emotion-regulation difficulties at pretreatment. This study examined an emotion-focused cognitive-behavioral therapy (ECBT) protocol in comparison to traditional cognitive-behavioral therapy (CBT) in a sample of children with a primary anxiety disorder diagnosis. Moderation analyses examined whether children with higher levels of emotion dysregulation at pretreatment would show greater levels of improvement in ECBT than CBT. Ninety-two youth ages 7 to 12 years (58% male) with a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia were included. Participants were randomly assigned to ECBT or CBT. Results showed that youth in both conditions demonstrated similar improvements in emotion regulation and that pretreatment levels of emotion dysregulation did not moderate treatment outcomes. Additional analyses showed that ECBT and CBT were similarly effective on diagnostic, severity, and improvement measures. Future work is needed to further explore the ways that emotion regulation is related to treatment outcome for anxious youth.     

Showing and telling about emotions: Interrelations between facets of emotional competence and associations with classroom adjustment in Head Start preschoolers

In this study of low income preschoolers (N?=? 60), we examined relations between three facets of emotional competence: emotion knowledge, level of negative emotion expression, and emotion regulation; and their associations with indicators of classroom adjustment. Emotion knowledge was positively related to positive emotion regulation but was not related to negative emotion expression or negative dysregulation. Negative emotion expression related to emotion regulation variables in expected directions. Negative emotion expression was associated with aggression and social skills after covarying verbal ability, age, and emotion knowledge. Negative dysregulation was related in expected directions to aggression, anxiety, and social skills after covarying verbal ability, age, emotion knowledge, and negative emotion expression. Positive emotion regulation was related negatively to anxiety and positively to social skills after covarying all other variables in the model. Results are discussed with regard to using the emotional competence domain to understand how emotion processing relates to early childhood adjustment.     

Utilizing an Ability-Based Measure to Detect Emotion Regulation Deficits in Generalized Anxiety Disorder

In recent years, the field of emotion regulation has advanced current conceptualizations of many forms of psychopathology. Difficulties with emotion regulation have been detected via self-report in several anxiety and depressive disorders, and in particular, generalized anxiety disorder (GAD). However, there is a paucity of research examining emotion regulation ability in this population, leaving open the possibility that self-report measures reflect an individual’s perception of his/her emotion regulation skills rather than skills themselves. The present study examined the utility of an ability-based measure of emotional intelligence in the assessment of emotion-related deficits in GAD as well as the concordance between the ability-based measure and self-reports of emotion regulation skills. Results revealed that individuals with GAD demonstrated significantly more difficulty regulating their emotions than control participants did on both ability-based and self-report measures. Further, these measures showed a moderate concordance with each other. Findings suggest it will be important to integrate ability-based measurement of emotion-related deficits with other assessment modalities.     

心理预期与认知方式对负面情绪的交互调节

近年来, 研究发现对负性事件发生之前预先的心理准备, 即心理预期, 能有效降低负性事件发生后的情绪影响, 但预期过程本身却导致情绪相关神经环路的激活与主观焦虑体验。因此, 采用适应性认知调节方式克服预期过程本身的负面情绪效应, 以充分发挥事先预期的情绪调控优势, 成为情绪调节领域亟待解决的问题。另一方面, 过度负性预期--对潜在负性事件不仅作负面心理预期同时以情绪化的认知方式应对该事件, 是焦虑障碍的核心特征。因此, 对焦虑症患者进行适应性认知方式的训练以消除其情绪化应对方式, 最终减弱该人群对未知事件的过度负面预期, 可能是焦虑障碍干预的重要途径。因此, 有必要综合行为学, 多导外周生理记录与神经成像手段以揭示认知方式与心理预期对负面情绪的交互调节效应; 旨在探求发挥心理预期情绪调节优势, 减弱其情绪代价的方法; 并为焦虑症的临床治疗提供新的思路。     

Identification of emotional facial expressions among behaviorally inhibited adolescents with lifetime anxiety disorders

The current study examined differences in emotion expression identification between adolescents characterised with behavioural inhibition (BI) in childhood with and without a lifetime history of anxiety disorder. Participants were originally assessed for BI during toddlerhood and for social reticence during childhood. During adolescence, participants returned to the laboratory and completed a facial emotion identification task and a clinical psychiatric interview. Results revealed that behaviorally inhibited adolescents with a lifetime history of anxiety disorder displayed a lower threshold for identifying fear relative to anger emotion expressions compared to non-anxious behaviorally inhibited adolescents and non-inhibited adolescents with or without anxiety. These findings were specific to behaviorally inhibited adolescents with a lifetime history of social anxiety disorder. Thus, adolescents with a history of both BI and anxiety, specifically social anxiety, are more likely to differ from other adolescents in their identification of fearful facial expressions. This offers further evidence that perturbations in the processing of emotional stimuli may underlie the aetiology of anxiety disorders.