Language and the Symptoms of Mental Illness Connection via Abstract Representations of the Self and the World

Abstract

The aim of the present study is to provide additional knowledge about the mediatory processes through which language contributes to the symptoms of mental illness. Although recent studies have provided insight about the relationship between language and the indicators of mental illness, the role of intervening variables in this connection has been ignored. The present investigation tested a structural equation model in which the need for the absolute truth about self and worry mediated the relationship of the gap between inner psychological experience and language with anxiety and depression. The results have provided support for the model and showed that the gap predicts both the need for absolute truth and worry which, in turn, predict the levels of anxiety and depression. The results have been discussed in the light of previous research, and implications for future research have also been considered.     

Daily dynamics of personal identity and self‐concept clarity

We examined the daily dynamics among self‐concept clarity and identity processes, and their effects on distress, among a sample of 580 Dutch adolescents. Participants completed measures of identity, self‐concept clarity, anxiety and depression at annual intervals; and daily single‐item measures of self‐concept clarity, identity commitments and reconsideration across three 5‐day weeks. We examined (a) cross‐lagged associations of self‐concept clarity to identity commitment and reconsideration and (b) associations of daily fluctuations in self and identity processes to later anxiety and depression. Results indicated that self‐concept clarity and identity commitments influence one another reciprocally across days, and that day‐to‐day fluctuations in identity predicted later anxiety and depression. Results are discussed in terms of self and identity processes and their effects on distress. Copyright © 2010 John Wiley & Sons, Ltd.     

Breathing Characteristics and Symptoms of Psychological Distress: An Exploratory Study

In this exploratory study of the relationship between characteristics of breathing and 3 common psychological issues (i.e., symptoms of anxiety, alexithymia, and depression), 79 college‐age adults were examined using self‐report, rater observation, and physiological measures. Results indicated significant positive relationships between dysfunctional breath characteristics and symptoms of both anxiety and alexithymia. A significant positive correlation was found between self‐reported symptoms of dysfunctional breathing and symptoms of depression, but no significant relationships existed between symptoms of depression and either rater‐observed breath characteristics or physiological measures.     

Self‐reported emotional intelligence: Construct similarity and functional dissimilarity of higher‐order processing in Iran and the United States

This study employed the Trait Meta‐Mood Scale (TMMS) to assess self‐reported emotional intelligence cross‐culturally as an input (attention to emotions), process (clarity of emotions), and output (repair of emotions) information‐processing system. Iranian (N = 231) and American (N = 220) university students responded to the TMMS along with measures of alexithymia, public and private self‐consciousness, depression, anxiety, self‐esteem, and perceived stress. Negative correlations with alexithymia and expected linkages with all other variables documented the validity of the TMMS in both cultures. Most of the other measures correlated similarly in the two samples. However, private and public self‐consciousness displayed a stronger positive association in Iran. These two scales were also more predictive of adjustment in Iran and of maladjustment in the United States. This difference perhaps reflected a poorer integration of the two dimensions of self‐consciousness within a presumably more individualistic American society. Confirmatory factor analyses and measurement invariance procedures revealed cross‐cultural similarities in the fit of an a priori higher‐order factor structure to the obtained data, but subsequent structural equation modelling techniques uncovered cross‐cultural dissimilarities in the actual processing of emotional information. Specifically, the higher‐order factors of emotional intelligence were similar, but the interrelationships among those higher‐order factors were not. As expected, Iranians displayed positive relationships among the input, processing, and output activities of the information‐processing model. For the Americans, however, greater input was associated with diminished processing and output. This unanticipated relative contrast seemed congruent with speculation that the historical American emphasis on the self and individualism promotes positive, optimistic thinking. Overall, these data most importantly suggested that subtle cultural differences might exist in the processing of emotional information.     

When “who we are” and “who I desire to be” appear disconnected: Introducing collective/personal self‐discrepancies and investigating their relations with minority students' psychological health

According to Self‐Discrepancy Theory research, perceiving mismatches between personal aspects of the self‐concept is associated with negative psychological consequences, including depression and anxiety. However, the impact of perceiving mismatches between collective and personal self‐aspects is still unknown. In a first step to address this gap, we introduce collective/personal self‐discrepancies—perceived mismatches between a desired self‐aspect and a collective identity. For cultural minority group members (n = 147), collective/personal self‐discrepancies were associated with more severe anxiety and depression symptoms. Bootstrapping analyses suggest that these relations are mediated by self‐discrepancies experienced at the personal level, but only for group members presenting average or high levels of ethnic identification. This study reaffirms the importance of collective identities, especially as potential antecedents of personal aspects of the self‐concept. The findings are further discussed in terms of their significance for cultural minority group members, who often highly identify with their minority groups.     

The Role of Relationships in Understanding the Alexithymia–Depression Link

Alexithymia is associated with increased depressive symptoms in both clinical and community samples. One way that alexithymia may lead to depression is through its impact on interpersonal relationships. Individuals with alexithymia report lower perceived social support, intimacy, and relationship satisfaction. Furthermore, poor relationship functioning is a clear risk factor for depressive symptoms. Given the established alexithymia–depression link and marital dysfunction–depression link, a logical next step is to examine whether relationship dysfunction (low social support, intimacy, negative relationship behaviours, and relationship dissatisfaction) mediates the association between alexithymia and depressive symptoms. The hypothesized mediation model was assessed in a sample of 104 community couples with two analytical approaches—first with cross‐sectional measures using path analysis and second with daily diary measures collected over a seven‐day period using a multilevel modelling approach. Poor relationship functioning mediated the association between alexithymia and depressed mood in the daily diary data and partially mediated that association with the cross‐sectional measures. These results identify alexithymia as an important variable in understanding the marital functioning–depression association, and this finding has implications for treatment. Copyright © 2012 European Association of Personality Psychology     

Emotional variability and clarity in depression and social anxiety

Recent research has underscored the importance of elucidating specific patterns of emotion that characterise mental disorders. We examined two emotion traits, emotional variability and emotional clarity, in relation to both categorical (diagnostic interview) and dimensional (self-report) measures of major depressive disorder (MDD) and social anxiety disorder (SAD) in women diagnosed with MDD only (n?=?35), SAD only (n?=?31), MDD and SAD (n?=?26) or no psychiatric disorder (n?=?38). Results of the categorical analyses suggest that elevated emotional variability and diminished emotional clarity are transdiagnostic of MDD and SAD. More specifically, emotional variability was elevated for MDD and SAD diagnoses compared to no diagnosis, showing an additive effect for co-occurring MDD and SAD. Similarly diminished levels of emotional clarity characterised all three clinical groups compared to the healthy control group. Dimensional findings suggest that although emotional variability is associated more consistently with depression than with social anxiety, emotional clarity is associated more consistently with social anxiety than with depression. Results are interpreted using a threshold and dose–response framework.     

Differences in alexithymia and emotional awareness in exhaustion syndrome and chronic fatigue syndrome

Symptoms of Exhaustion Syndrome (ES) and Chronic Fatigue Syndrome (CFS) are overlapping and create difficulties of differential diagnosis. Empirical studies comparing ES and CFS are scarce. This study aims to investigate if there are any emotional differences between ES and CFS. This cross‐sectional study compared self‐reported alexithymia and observer‐rated emotional awareness in patients with ES (n = 31), CFS (n = 38) and healthy controls (HC) (n = 30). Self‐reported alexithymia was measured with the Toronto Alexithymia Scale‐20 (TAS‐20) and emotional awareness with an observer‐rated performance test, the Level of Emotional Awareness Scale (LEAS). Additionally, depression and anxiety were scored by the Hospital Anxiety and Depression Scale (HADS). Results show that patients with ES expressed higher self‐reported alexithymia in the TAS‐20 compared to HC, but had similar emotional awareness capacity in the observer‐rated performance test, the LEAS. Patients with CFS expressed more difficulties in identifying emotions compared to HCs, and performed significantly worse in the LEAS‐total and spent more time completing the LEAS as compared to HC. Correlation and multiple regressions analyses revealed that depression and anxiety positively correlated with and explained part of the variances in alexithymia scores, while age and group explained the major part of the variance in LEAS. Findings of this study indicate that emotional status is different in patients with ES and CFS with respect to both self‐reported alexithymia and observer‐rated emotional awareness. Emotional parameters should be approached both in clinical investigation and psychotherapy for patients with ES and CFS.     

Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.     

Academic self‐handicapping: Relationships with learning specific and general self‐perceptions and academic performance over time

Background. Academic self‐handicapping (ASH) tendencies, strategies students employ that increase their chances of failure on assessments while protecting self‐esteem, are correlated with classroom goal structures and to learners' general self‐perceptions and learning strategies. In particular, greater ASH is related to poorer academic performance but has yet to be examined with respect to learners' performance across a series of tests. Aims. This research was designed to examine the relationship between students' ASH tendencies and their self‐concept clarity, learning strategies, and performance on a series of tests in a university course. Sample. A total of 209 (153 female; 56 male) Canadian university psychology students participated in this study. Methods. Participants' ASH tendencies, self‐concept clarity, approaches to learning, and self‐regulatory learning strategies were assessed along with expected grades and hours of study in the course from which they were recruited. Finally, students' grades were obtained for the three tests for the course from which they were recruited. Results. Students reporting greater self‐handicapping tendencies reported lower self‐concept clarity, lower academic self‐efficacy, greater test anxiety, more superficial learning strategies, and scored lower on all tests in the course. The relationships of ASH scores and learner variables with performance varied across the three performance indices. In particular, ASH scores were more strongly related to second and third tests, and prior performances were accounted for. ASH scores accounted for a relatively small but significant proportion of variance for all three tests. Conclusions. These results showed that ASH is a unique contributing factor in student performance outcomes, and may be particularly important after students complete the initial assessment in a course.     

Autobiographical memories and views of the future: In relation to dysphoria

The present study investigated dysphoric individuals' self‐referential processing of autobiographical memories and future personal events, in relation to specificity and response latency. Dysphoric individuals (n  =  17) and nondysphoric controls (n  =  17) were selected from a larger sample based on self‐reported depression. Participants completed an autobiographical memory task (AMT) and a future event task (FET), using pleasant and unpleasant (anxiety‐relevant, depression‐relevant) emotional word cues. In response to each emotional cue, participants were required to access and write down a specific personal memory and future event, respectively. Consistent with the hypotheses, dysphoric individuals were less specific in describing pleasant and unpleasant experiences (particularly pleasant), irrespective of time condition. As expected, dysphoric individuals' specificity for distinct depression‐relevant and anxiety‐relevant experiences did not differ significantly. As predicted, all participants were less specific in describing future personal events than in recalling personal memories. As predicted, dysphoric individuals took longer to think of pleasant memories and pleasant future experiences than controls but, as expected, groups did not differ significantly on mean reaction times for past and future unpleasant experiences. Overall, the data showed a degree of consistency in participants' past and future‐oriented processing of self‐referential material. Although considerable research has investigated autobiographical memories in relation to emotional disturbance, the present findings suggest that constructing future emotional experiences is also an important aspect of mental health.     

Self‐concept clarity and relationship satisfaction at the dyadic level

Self‐concept clarity is an individual resource that is associated with couple relationship well‐being. In two dyadic studies, the authors investigated whether and how self‐concept clarity has implications for both partners' relationship satisfaction. Study 1 tested and supported the hypothesis that self‐concept clarity concurrently predicts own and partner's relationship satisfaction through couple identity in a sample of 202 dating couples. Study 2 tested and supported the hypothesis that self‐concept clarity predicts longitudinal change in own and partner's relationship satisfaction through positive (i.e., supportive and common) dyadic coping behaviors in a sample of 97 married couples. The findings clarify and expand the benefits of self‐concept clarity for partners' relational well‐being.     

Gossip and the Self

The relationship between self‐reported gossip, evaluative conversation about other people, and the self was examined with 243 university students completing questionnaires measuring gossip from 2 theoretical viewpoints: as an individual‐difference characteristic, or as having social functions. The self was examined using several perspectives: self‐concept clarity, self‐efficacy, locus of control, and self‐monitoring. Using structural equation modeling, gossip was related to external locus of control, high‐self‐monitoring, low self‐concept clarity, and low self‐efficacy. The final model is that high self‐monitoring and locus of control mediate the relationship between self‐clarity/efficacy and gossip. The study demonstrates the important role of self‐monitoring and locus of control in gossip and that negative gossip may be associated with a more externalized, unclear sense of self.     

The relationship between self‐harm and alexithymia

This paper presents a systematic review of the literature concerning the relationship between alexithymia and self‐harm. Fifteen studies were selected following a systematic search of relevant databases. Results indicate significantly higher levels of alexithymia in women who self‐harm compared with women who do not self‐harm. Studies of men were less conclusive and require further investigation. A subsample of the studies found that childhood abuse and bullying were more likely to be associated with self‐harm if alexithymia was present as a mediator. Other studies found that depression mediated between alexithymia and self‐harm. The results indicate that the poor emotional cognition and expression associated with alexithymia may increase vulnerability to self‐harm, particularly in women.     

The Moderating Effects of Age on the Relationships of Self‐Compassion,Self‐Esteem,and Mental Health

This study investigated the interactive effects of self‐compassion, self‐esteem, and age on mental health. Numerous previous studies have found that self‐compassion has a significant positive association with well‐being but most of these studies were conducted with young adults represented by college students. This study extended the previous findings by comparing its distinctive functions in different age groups. A total of 1,813 adults whose age ranged from twenties to fifties (M = 39.28 years, SD = 11.27) completed a questionnaire measuring self‐compassion, self‐esteem, subjective well‐being, and depression. The results of hierarchical regression analysis indicated that the positive relationship between self‐compassion and subjective well‐being was rendered stronger with older adults. In addition, self‐compassion moderated the relationship between self‐esteem and depression regardless of age. These results imply that self‐compassion may be complimentary to self‐esteem in improving mental health, especially for older adults.     

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS

Symptoms of depression negatively impact on mother?infant relationships and child outcomes. We evaluated a novel, 10‐session mother?infant therapeutic playgroup—Community HUGS (CHUGS)—which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother?infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait‐list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self‐Efficacy subscale; J. Gibaud‐Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self‐efficacy, p < .001, all showed improvements, as did observer‐rated mother?infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait‐list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self‐efficacy, depression, anxiety, stress, and mother?infant interactions that supported the program's acceptability and the utility of further rollout.     

Coping strategies and perceived social support in fibromyalgia syndrome: Relationship with alexithymia

Fibromyalgia (FM ) is a chronic pain syndrome characterized by high levels of psychological distress and alexithymia, a personality disposition affecting emotional self‐awareness. The main aim of the present study was to investigate for the first time the relationship between alexithymia and coping strategies on the one hand, and alexithymia and perceived social support on the other, in a sample of FM patients. To reach this aim, 153 FM patients completed a battery of tests assessing coping strategies, perceived social support, alexithymia, psychological distress and pain intensity. Four regression analyses were performed to assess whether alexithymia was still a significant predictor of coping strategies and perceived social support, after controlling for psychological distress. High levels of both psychological distress and alexithymia were found in our sample of FM patients. Regarding coping strategies, FM patients reported higher scores on problem‐focused coping, with respect to the other two coping strategies. The regression analyses showed that the externally‐oriented thinking factor of alexithymia significantly explained both problem‐ and emotion‐focused coping, while the difficulty‐describing feelings factor of alexithymia proved to be a significant predictor of perceived social support. Only the variance of dysfunctional coping ceased to be uniquely explained by alexithymia (difficulty identifying feelings factor), after controlling for psychological distress, particularly anxiety. These results highlight a negative relationship between alexithymia and both the use of effective coping strategies and the levels of perceived social support in FM patients. An adequate assessment of both alexithymia and psychological distress should therefore be included in clinical practice with these patients.     

Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents

Adolescents can be at heightened risk for anxiety and depression, with accumulating research reporting on associations between anxiety and depression and cognitive impairments, implicating working memory and attentional control deficits. Several studies now point to the promise of adaptive working memory training to increase attentional control in depressed and anxious participants and reduce anxiety and depression symptoms, but this has not been explored in a non‐clinical adolescent population. The current study explored the effects of adaptive dual n‐back working memory training on sub‐clinical anxiety and depression symptomology in adolescents. Participants trained on either an online adaptive working memory task or non‐adaptive control task for up to 20 days. Primary outcome measures were self‐reported anxiety and depression symptomology, before and after intervention, and at 1‐month follow‐up. Self‐reported depression (p = 0.003) and anxiety (p = 0.04) decreased after training in the adaptive n‐back group relative to the non‐adaptive control group in the intention‐to‐treat sample (n = 120). These effects were sustained at follow‐up. Our findings constitute proof of principle evidence that working memory training may help reduce anxiety and depression vulnerability in a non‐clinical adolescent population. We discuss the findings’ implications for reducing risk of internalizing disorders in youth and the need for replication.     

Self‐Concept Clarity and the Management of Social Conflict

ABSTRACT: In 4 studies we examined the relationship between self‐concept clarity and conflict management. Individuals with higher self‐concept clarity were overall more active and showed more cooperative problem‐solving behavior than people with low self‐concept clarity. There were no relationships with contending or yielding. The positive relationship with cooperative behavior was mediated by less rumination (Study 2) and moderated by conflict intensity (Study 3). Specifically, it applied to relatively mild conflicts (Study 3). Finally, Study 4 extended these findings to the group level: Dyad members with higher self‐concept clarity engaged in problem solving, whereas dyad members with lower self‐concept clarity did not. We conclude that higher self‐concept clarity associates with proactive problem solving in social conflict.     

Rational emotive behaviour therapy in high schools to educate in mental health and empower youth health. A randomized controlled study of a brief intervention

Rational emotive behaviour therapy (REBT) is effective in reducing distress in several target groups. No other study has tested the mental health effects on adolescents in a high school setting while expanding a Cognitive Behaviour-based therapy, REBT, into the concept of mental health literacy. The format of the ABC model, which is an important element of REBT, functioned as a working manual in and between three sessions. This study tested whether knowledge and practical use of the ABC model increased self-esteem and hope, and reduced symptoms of anxiety and depression, and dysfunctional thinking. Sixty-two high school students with subclinical levels of anxiety and depression were randomly allocated into three groups; three individual REBT sessions, or three individual attentional placebo (ATP) sessions or no sessions (control). However, dysfunctional thinking, self-esteem and hope were not measured in the control group. Repeated measures with ANOVA and t-tests were conducted. Both REBT and ATP significantly reduced symptoms of anxiety and depression, but only REBT was significantly different from the control group at the six-month follow-up. Only REBT significantly reduced dysfunctional thinking, and both REBT and ATP significantly increased self-esteem and hope. REBT had both an immediate and a long-term effect. The findings show the potential positive effects of educating well-documented psychological techniques as ordinary education in school. Further research might contribute to decide whether or not to change the school system by enclosing mental health literacy classes for all students.