Dialectical Behavior Therapy: An Emotion-Focused Treatment for Borderline Personality Disorder

Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment for borderline personality disorder (BPD) that is based on the theory that emotion dysregulation is the core feature of BPD. This article focuses on aspects of DBT theory and techniques that specifically address emotion. The dialectical and biosocial theories that underlie DBT are reviewed with an emphasis on how each relates to emotional experiencing in BPD. Selected treatment strategies that address emotion dysregulation and their hypothesized mechanisms of change are also described. Relevant research findings are incorporated throughout to provide an empirical foundation for the DBT theories and strategies that are discussed.     

Treatment for Deliberate Self-Harm: Integrating Emotion-Focused Therapy

This article proposes that Emotion-Focused Therapy (EFT) can be effectively utilized as a treatment modality for deliberate self-harm or integrated with existing treatment approaches. A brief literature review examines evidence suggesting that attachment and emotion regulation are important etiological variables associated with deliberate self-harm. EFT addresses these variables by emphasizing the importance of the therapeutic relationship and assisting clients in the regulation and transformation of negative, maladaptive emotions. The article describes the basic tenets of EFT, comparing and contrasting this approach with therapeutic models most commonly used in the treatment of deliberate self-harm. Finally, it is recommended that future outcome research utilize randomized clinical trials to evaluate the effectiveness of EFT and compare it with other treatment modalities.     

Emotion-Focused Therapy: An Interview with Leslie Greenberg

Over the past 30 years Leslie Greenberg has developed and refined the Emotion-Focused Therapy (EFT) approach. This therapy model stands apart from other, humanistic-based approaches in its focus on empiricism. In addition, EFT is one of the few therapy models that is truly integrative in nature, combining client-centered, gestalt, and cognitive principles. This paper includes a recent interview with Greenberg in which he describes the development of EFT and his views regarding future directions of EFT, as well as his views on the field of psychotherapy more generally.     

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.     

Emotion-Focused Therapy for Couples in the Treatment of Depression: A Pilot Study

Emotion-focused therapy (EFT) for couples was compared to pharmacotherapy in the treatment of major depressive disorder. Eighteen distressed couples in which the female partner met diagnostic criteria for major depressive disorder were randomly assigned to 16 weekly sessions of emotion-focused therapy or pharmacotherapy with desipramine, trimipramine, or trazadone. Twelve couples completed the study. Both interventions were equally effective in symptom reduction. There was some evidence that females receiving EFT made greater improvement after the conclusion of treatment than those receiving pharmacotherapy. The results suggest EFT might be useful in the treatment of comorbid major depressive disorder and relational distress.     

Emotion-Focused Therapy for Autism Spectrum Disorder: A Case Conceptualization Model for Trauma-Related Experiences

People with autism spectrum disorder (ASD) report painful experiences through emotional misunderstandings with typically developing peers. There are limited intervention methodologies for ASD on the impact of emotional injuries and how to work with resulting trauma. This paper presents a rational-empirical model of trauma-related experiences with the first presentation of a new case conceptualization model for emotion-focused therapy for ASD. It describes the transformation of problematic emotion schemes through a sequence of emotional processing steps illustrated with a case example. These steps include: overcoming differentiation of core painful feelings (such as loneliness, shame, and fear); autobiographical memory recall of distanced trauma, using a novel method of video Interpersonal Process Recall; and articulation of the unmet needs contained in core painful feelings. This is followed by the expression of an emotional response to those feelings/needs; typically, self-soothing, protective anger and compassion responses offered interpersonally by group members. These emerging adaptive emotions facilitate mentalization of self and other that strengthens intrapersonal and interpersonal agency. This rational-empirical case conceptualization acts as a hypothesis for testing in subsequent trials.     

Cognition and Emotion Lecture at the 2010 SPSP Emotion Preconference

One of the most fundamental distinctions in the field of emotion is the distinction between emotion generation and emotion regulation. This distinction fits comfortably with folk theories, which view emotions as passions that arise unbidden and then must be controlled. But is it really helpful to distinguish between emotion generation and emotion regulation? In this article, we begin by offering working definitions of emotion generation and emotion regulation. We argue that in some circumstances, the distinction between emotion generation and emotion regulation is indeed useful. We point both to citation patterns, which indicate that researchers from across a number of sub-areas within psychology are making this distinction, and to empirical studies, which indicate the utility of this distinction in many different research contexts. We then consider five ways in which the distinction between emotion generation and emotion regulation can be problematic. We suggest that it is time to move beyond debates about whether this distinction is useful to a more specific consideration of when and in what ways this distinction is useful, and in this spirit, we offer recommendations for future research.     

Parent Socialization of Coping and Child Emotion Regulation Abilities: A Longitudinal Examination

This study examined the hypothesis that parent socialization of coping (SOC) would have a longitudinal relation with child emotion regulation abilities. Participants included a sample of 256 parents of 5- to 12-year-old children (child M age = 8.36, SD = 2.03, 54.7% male; parent M age = 34.49, SD = 6.20, 59% female). Data on demographic information, parenting behaviors, and child emotion regulation abilities were collected via online questionnaires at baseline and 12 months. Results from longitudinal structural equation modeling (SEM) analyses suggested that parent SOC, measured at baseline, predicted child adaptive and maladaptive emotion regulation, measured 12 months later. More specifically, parental engagement coping suggestions predicted child's adaptive emotion regulation, whereas parental disengagement coping suggestions predicted child's maladaptive emotion regulation. Further, child gender emerged as a moderator in the longitudinal association between socialization of engagement coping and child adaptive emotion regulation: Whereas this association was small and marginally significant for girls, it was large and statistically significant for boys. Results highlight the importance of parent SOC as potentially contributing to emotion regulation abilities of 5- to 12-year-olds.     

A relational theory of self-deception

The authors argue that the fragmentary model of consciousness implied in the term ‘self-deception’ has provided the chief metaphor for explaining the apparent discrepancies that can arise between the evaluation of a motivated observer and the evaluation of a less interested external observer. Though self-deception models have explained these discrepancies in terms of both a dualistic opaque consciousness and in terms of cognitive and affective processes, all of these accounts seem to rest on the same essential fragmentation of the psyche. The authors argue that a relational model of consciousness, one that claims the indissolubility of cognition and affect, object and perception, and of past, present, and future can account for the apparent discrepancies involved in the paradigmatic cases of self-deception in a more parsimonious and phenomenologically faithful way than more objectivist and fragmented accounts of self-deception.     

Emotion-focused Therapy: The Transforming Power of Affect

Emotion-focused therapy (EFT) is an empirically supported humanistic treatment that views emotion as fundamental to experience, as contributing to both adaptive and maladaptive functioning, and as essential to therapeutic change. EFT combines both following and guiding the client’s experiential process, emphasizing the importance of both relationship and intervention skills. Utilizing markers of particular emotional processing difficulties at the core of client problems, therapists intervene with matched interventions aimed to resolve the emotional processing difficulty. This process helps clients access new adaptive emotional resources, transform maladaptive emotional responses, address emotional interruption and regulation, make sense of experience, and construct new meaning and self-narrative.     

Measurement invariance of the Emotion Regulation Questionnaire (ERQ). A cross-national validity study

The goal of this research was to examine the measurement invariance of the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) across two European nations. Participants were Italian and German undergraduate students. First, confirmatory factor analysis was used to test for the two-factor structure of the ERQ; subsequently, measurement invariance was analysed. The results showed acceptable fit indices for the German and Italian sample; however, results with regard to the Italian sample showed lower fit indices than results regarding the German one. Measurement invariance of the ERQ across Italy and Germany was confirmed. Despite the fact that we assumed measurement invariance of the ERQ, future research is needed to deal with the lower fit regarding the Italian version.     

Emotion colors time perception unconsciously

Emotion modulates our time perception. So far, the relationship between emotion and time perception has been examined with visible emotional stimuli. The present study investigated whether invisible emotional stimuli affected time perception. Using continuous flash suppression, which is a kind of dynamic interocular masking, supra-threshold emotional pictures were masked or unmasked depending on whether the retinal position of continuous flashes on one eye was consistent with that of the pictures on the other eye. Observers were asked to reproduce the perceived duration of a frame stimulus that was concurrently presented with a masked or unmasked emotional picture. As a result, negative emotional stimuli elongated the perceived duration of the frame stimulus in comparison with positive and neutral emotional stimuli, regardless of the visibility of emotional pictures. These results suggest that negative emotion unconsciously accelerates an internal clock, altering time perception.     

The conscious awareness of time distortions regulates the effect of emotion on the perception of time

This study examined how the awareness of emotion-related time distortions modifies the effect of emotion on time perception. Before performing a temporal bisection task with stimulus durations presented in the form of neutral or emotional facial expressions (angry, disgusted and ashamed faces), some of the participants read a scientific text providing either correct or incorrect information on the emotion–time relationship. Other participants did not receive any information. The results showed that the declarative knowledge allowed the participants to regulate (decrease) the intensity of emotional effects on the perception of time, but did not trigger temporal effects when the emotional stimuli did not automatically induce emotional reactions that distorted time.     

A preliminary investigation of sex differences in associations between emotion regulation difficulties and higher-order cognitive abilities

The present study sought to clarify the cognitive correlates of emotion regulation difficulties (ERD). Further, because prior evidence suggests sex differences in emotion regulation, sex was examined as a moderator of associations between cognitive abilities and ERD. Participants (N = 154) completed self-report measures of ERD, and were administered neuropsychological tests assessing crystallized and fluid intelligence, as well as various components of executive functioning. Bivariate correlations and results from regression analyses suggested sex-dependent associations among cognitive processes and ERD. For men, inhibition of dominant response tendencies was associated with lower ERD, whereas for women, a host of executive abilities (e.g., greater inhibition, cognitive flexibility, semantic processing, abstract reasoning) were associated with greater ERD. Implications for the neurocognitive conceptualization of emotion dysregulation will be discussed.     

情绪调节方式及其发展趋势

本研究探讨了四个年龄阶段12种具体情绪感受频率和四种情绪调节方式(评价忽视、表情抑制、评价重视、表情宣泄)使用频率及其发展趋势.334名初中、高中、大学本科、成年被试填写了本研究的具体情绪量表(DES-IV)和情绪调节方式问卷.结果表明(1)四个年龄阶段在12种具体情绪感受频率的顺序上基本一致,快乐和兴趣较多,内疚和羞愧较多.(2)正情绪调节以重视和宣泄为主,负情绪以忽视和抑制为主.原因调节多于反应调节.(3)成年之后,惊奇、羞愧、厌恶、悲伤、内疚有下降的发展趋势,负情绪的忽视和抑制、正情绪抑制也有增强的发展趋势.(4)情绪和情绪调节存在着一定的性别差异.本文对社会文化因素在发展趋势和性别差异中的可能影响进行了初步讨论.     

Risky driving and lapses on the road: An exploration on self-regulatory dysfunction in Australian drivers

Self-regulatory ability has been linked to a) the tendency to engage in risky behaviours, and b) the ability to focus attention. This study investigated the relationships between metacognitions, emotion regulation difficulties, risky driving behaviours, and attentional lapses on the road, among an online sample of Australian drivers (N = 255). Firstly, group comparisons showed that although females reported greater self-regulatory dysfunction, males reported a higher frequency of risky driving behaviours. Alternatively, older drivers reported being better self-regulators, and less-frequent risky driving behaviours and attentional lapses on the road. Secondly, correlations demonstrated that metacognitions were associated with difficulties in regulating emotions, the engagement of risky driving behaviours, and the quantity of attentional lapses experienced on the road. Emotion regulation difficulties and risky driving behaviours were also shown to be positively related to the frequency of attentional lapses. Structural equation modelling confirmed a hierarchical model in predicting attentional lapses, with self-regulatory components representing higher-order factors over risky behavioural components. Finally, metacognitions demonstrated mediative effects toward the relationship between prior speeding experiences and future intentions to speed. This study has provided preliminary evidence for the application of metacognitions in the engagement of risky driving behaviours, and therefore the potential for informing future interventions.     

Relational Diagnosis: A Retrospective Synopsis

This article highlights and summarizes efforts that have been made primarily during the past 20 years to bring the significance of relational diagnosis to the attention of the entire mental health community, and either (1) to have dysfunctional relational interactive patterns classified and codified and accepted for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, or (2) if this is not feasible, to have a nosology of relational diagnoses, which have been clearly defined with accompanying risks specified for mental illnesses that might develop, and criteria sets delineated and adequately field tested to warrant and lead to publication of a separate but equal Diagnostic Manual of Relational Disorders and Dysfunctional Interactional Patterns.     

The disappointing gift: dispositional and situational moderators of emotional expressions

Inferences about emotions in children are limited by studies that rely on only one research method. Convergence across methods provides a stronger basis for inference by identifying method variance. This multimethod study of 116 children (mean age = 8.21 years) examined emotional displays during social exchange. Each child received a desirable gift and later an undesirable gift after performing tasks, with or without mother present. Children’s reactions were observed and coded. Children displayed more positive affect with mother present than with mother absent. Independent ratings of children by adults revealed that children lower in the personality dimension of Agreeableness displayed more negative emotion than their peers following the receipt of an undesirable gift. A curvilinear interaction between Agreeableness and mother condition predicted negative affect displays. Emotional assessment is discussed in terms of links to social exchange and the development of expressive behavior.     

A Synopsis of Rational-Emotive Behavior Therapy (REBT); Fundamental and Applied Research

The article presents a synopsis on rational-emotive behavior therapy (REBT), its fundamental theoretical framework, its applications, and future directions. The paper is organized according to the following structure: in part one, REBT fundamental/basic research is discussed; in the second part clinical/applied research in REBT is presented, including aspects of efficacy and effectiveness, discrimination of disorders for which REBT works most effectively, and its relations to other therapies. Uses and misuses of REBT and their impact on research and future developments are presented as well. While it is true that REBT research has many shortcomings, the overgeneralization and/or magnification of the negative, and the minimization of the positive are dysfunctional beliefs that maintain the false idea in the field that REBT has few empirical studies and that REBT research is in serious trouble. A balanced approach, analyzing both the strengths and weakness, suggest that REBT has hundreds of research articles and that high-quality studies tend to support REBT’s basic theory and efficacy. However, to strengthen this conclusion and to fully explore the potential of REBT, shortcomings of REBT research need to be corrected, and high-quality studies promoted. This is particularly important since, although effective, cognitive-behavioral psychotherapies have not yet reached “the desired standard” of efficacy and effectiveness, as about 30–40% of people are still nonresponsive to these interventions Thus, REBT could be a platform of reinvigorating empirical studies on the efficacy/effectiveness and theory of cognitive-behavioral models of psychopathology and human functioning. Mount Sinai School of Medicine, Biobehavioral and Integrative Medicine Programs, New York, USA.