Internalizing Symptoms in Female Adolescents: Associations with Emotional Awareness and Emotion Regulation

The transition into adolescence involves a number of changes that for many adolescents result in increased negative affect and internalizing symptoms, especially for females. In the current study we examined the direct and indirect effects of emotional awareness on internalizing symptoms by exploring the extent to which certain emotion regulation strategies influence this relationship. Participants were 123 female adolescents aged 13–16 years (M = 14.51 years) who completed measures of emotional awareness, emotion regulation (emotional reappraisal and expressive suppression), and symptoms of depression and social anxiety. Two multiple indirect effect models were conducted including both reappraisal and suppression (one for each of the dependent variables, depression and social anxiety) via the bootstrapping method. Results found that reappraisal accounted for the effect of emotional awareness on depressive symptoms but suppression accounted for the effect of emotional awareness on social anxiety symptoms. Results suggest that emotion regulation strategies play an important role in determining depressive and social anxiety symptoms and are associated with an adolescent’s level of emotional awareness.     

Roles of Religious Commitment,Emotion Regulation and Social Support in Preoperative Anxiety

Surgery is a relatively commonplace medical procedure in healthcare settings. The mental health status of the person undergoing surgery is vital, but there is dearth of empirical studies on the mental health status of surgery patients, particularly with regard to the factors associated with anxiety in surgical conditions. This study investigated the roles of religious commitment, emotion regulation (cognitive reappraisal and expressive suppression) and social support in preoperative anxiety in a sample of 210 surgical inpatients from a Nigerian tertiary healthcare institution. A cross-sectional design was adopted. Before the surgery, respondents completed the state anxiety subscale of State-Trait Anxiety Inventory, Religious Commitment Inventory, Emotion Regulation Questionnaire and Multidimensional Scale of Perceived Social Support. After controlling for relevant demographic factors, regression results showed that cognitive reappraisal, social support and interpersonal religious commitment were negatively associated with preoperative anxiety, while expressive suppression was positively associated with preoperative anxiety. The emotion regulation strategies made robust and significant explanation of variance in preoperative anxiety. Appropriate interventions to promote interpersonal religious commitment, encourage cognitive reappraisal and enhance social support quality may improve mental health outcomes in surgery.

     

Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?

Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination partially mediating this association. Finally, based on factor analysis, expressive suppression and cognitive reappraisal appear to be independent constructs. Overall, expressive suppression, much more so than cognitive reappraisal, may play an important role in the experience of stress-related symptoms. Further, given their independence, there are potentially relevant clinical implications, as interventions that shift one of these emotion regulation strategies may not lead to changes in the other.     

不同民族文化对负性情绪调节的影响:来自ERPs的证据

采用认知重评和表达抑制策略考察不同民族文化对负性情绪调节主观体验和事件相关电位活动的影响。结果发现,汉族和少数民族文化个体在两种策略下均呈现负性情绪感受显著降低,并且汉族表达抑制的情绪体验得分低于少数民族。此外,负性情绪图片相比中性图片诱发了更大的P2成分,表达抑制相比认知重评在额-中区诱发了更大的P3成分。更重要的是,900~1200ms时间窗内,汉族个体认知重评和表达抑制后LPP波幅均降低,但少数民族文化个体仅在认知重评条件表现出LPP波幅的显著下降。以上结果表明不同民族文化背景下负性情绪调节的效果不同。     

Effects of emotion regulation strategies on anxiety during job interviews in Chinese college students

Background and objectives: Few studies related to the impact of different emotion regulation strategies on anxiety have used externally and ecologically valid emotion-eliciting stimuli or Eastern populations. The present study compares the effects of reappraisal, suppression, and acceptance on anxiety induced by a simulated job interview in a Chinese sample. Methods: Eighty-two subjects were randomly assigned to one of four instructions: reappraisal, suppression, acceptance, or no-regulation strategies during a simulated job interview. Anxiety was assessed with an observer-based behavior rating scale during the interview and the State Anxiety Inventory before, during, and after the interview. Results: A repeated-measures MANOVA indicated a significantly greater reduction in anxiety in the reappraisal and acceptance groups compared to the control group during the interview (reappraisal: d = 1.42; acceptance: d = 1.30; each p < .001), but not during the recovery stage. The suppression and control group did not differ in any stage. Suppression led to a higher (p_max < .04) anxiety than reappraisal/acceptance in the anticipation (d = 0.65/0.68), interview (d = 0.87/0.79), and recovery stages (d = 0.94/1.03). No significant differences were found between reappraisal and acceptance. Conclusions: In Chinese students reappraisal and acceptance seem to be more effective anxiety regulation strategies than suppression.     

Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study

A pilot study of a brief group-based Acceptance and Commitment Therapy (ACT) intervention (12 two-hour sessions) was conducted with clients of public mental health services meeting four or more criteria for borderline personality disorder (BPD). Participants were randomly assigned to receive the ACT group intervention in addition to their current treatment (ACT + TAU; N = 21) or to continue with treatment as usual alone (TAU; N = 20). There was significantly more improvement from baseline for the ACT + TAU condition than the TAU condition on the primary outcome variable—self-rated BPD symptoms. The ACT + TAU gain was both clinically and statistically significant. The ACT + TAU condition also had significantly more positive change on anxiety and hopelessness, and on the following ACT consistent process variables: psychological flexibility, emotion regulation skills, mindfulness, and fear of emotions. For all but anxiety, the improvements for the ACT + TAU condition were significant, while the TAU condition had no significant changes on any measure. Follow-up was possible for only a small number of participants. The improvements gained by the ACT + TAU participants were maintained except for fear of emotions. Anxiety continued to improve, becoming significantly different from baseline at follow-up. Examination of mediators found that psychological flexibility, emotion regulation skills and mindfulness, but not less fear of emotions, mediated BPD symptoms. Psychological flexibility and emotion regulation skills also mediated hopelessness. There is a need for a larger trial, for comparison with other established treatments for BPD, and for conducting a trial of a longer intervention. Nonetheless, this pilot study suggests that a brief group-based ACT intervention may be a valuable addition to TAU for people with BPD symptoms in the public sector.     

Interactions between emotion regulation strategies and affective style: Implications for trait anxiety versus depressed mood

Affective style reflecting approach and inhibition is thought to be associated in distinct ways with anxious versus depressed mood; relatively few studies, however, consider how the interaction between affective style and the strategies individuals use to regulate mood and emotion might influence these associations. Sixty-seven non-disordered adults self-reported on their use of two emotion regulation strategies (cognitive reappraisal and expressive suppression), behavioral approach (BAS) and behavioral inhibition sensitivity (BIS) dimensions of affective style, and anxious and depressed mood (trait anxiety and symptoms of depression). Trait anxiety versus depressed mood was associated with unique interactive patterns of emotion regulation and affective style: enhanced use of reappraisal was linked to less depressed mood in those reporting low BAS, whereas high suppression was linked to greater trait anxiety in those reporting low BIS. The implications of findings for typical emotional processes and for clinical disorders and interventions are discussed.     

Évaluation de deux stratégies de régulation émotionnelle : la suppression expressive et la réévaluation cognitive

The main purposes of this study were first to validate a French version of the Emotion Regulation Questionnaire [Journal of Personality and Social Psychology 85 2003 348–362], and second to access whether there are some interindividual differences on emotion regulation (sex and anxiety profile differences). A sample of 591 male and female adults completed a French translation of the ERQ, the Positive and Negative Affective Schedule, and the State-Trait Anxiety Inventory. In the same way as in the original version, explanatory and confirmatory factor analyses showed that a two-factor model explained the data collected with the French version. Internal reliability scores (Cronbach’s alpha) were 0.76 for the cognitive reappraisal and 0.72 for the expressive suppression. In addition, the findings confirmed that men used more suppression than did women. For anxiety, high suppression and low reappraisal was related to trait-anxiety. Studying these two emotion regulation strategies have a strong interest for several domains such as health, work or education.     

Role of event centrality and emotion regulation in posttraumatic stress disorder symptoms among internally displaced persons

Background: Event centrality and emotion regulation in relation to posttraumatic stress disorder (PTSD) have been documented in various global samples especially in Western cultures; but internally displaced persons (IDPs) still constitute an underrepresented population in psychotraumatology literature. This study tested the roles of event centrality and emotion regulation strategies (cognitive reappraisal and expressive suppression) in PTSD symptoms among IDPs in Nigeria.

Design: The multi-group cross-sectional design was adopted.

Methods: Tiv language versions of the Centrality of Events Scale, Emotion Regulation Questionnaire, and Harvard Trauma Questionnaire were completed by 859 IDPs in two camps located in Benue State, North-central region of Nigeria.

Results: Hierarchical multiple linear regression results indicated that event centrality positively predicted PTSD symptoms. Cognitive reappraisal was a negative predictor of PTSD symptoms while expressive suppression was a positive predictor of PTSD symptoms. Bonferroni corrections indicated that expressive suppression was the strongest predictor of total PTSD symptoms, avoidance/numbing symptoms, and hyper-arousal symptoms; but event centrality was the most robust predictor of PTSD intrusion/re-experiencing symptoms.

Conclusion: The findings underscore recent developments in psychotraumatology indicating that the extent to which individual differences impact the development of PTSD is essential in clinical psychology research and practice.     

对恐怖情绪的调节：认知重评优于表达抑制 ——一样ERP研究

摘要 本研究采用事件相关电位（ERP）技术,通过测量由视觉诱发的脑电成分晚正波（LPP）来比较情绪调节策略在生理电特征上的差异,进一步探讨认知重评和表达抑制的优劣。实验结果表明：（1）从波幅的角度来比较：在400-600ms时间窗口内,认知重评条件下恐怖图片诱发的LPP波幅显著小于在自由观看条件下的波幅,而表达抑制和自由观看组所诱发的LPP波幅差异较小。（2）从时间进程的角度来比较：认知重评与自由观看组的差异发生在400ms并持续到600ms,甚至以后;而表达抑制和自由观看之间的差异发生在450ms但是只持续到550ms。这表明认知重评相较于表达抑制,对负性情绪起调节作用开始较早,并且持续时间较长。这为认知重评优于表达抑制策略提供了神经生理学上的证据。     

Spontaneous emotion regulation during evaluated speaking tasks: associations with negative affect, anxiety expression, memory, and physiological responding

In these studies, the correlates of spontaneously using expressive suppression and cognitive reappraisal during stressful speeches were examined. Spontaneous emotion regulation means that there were no instructions of how to regulate emotions during the speech. Instead, participants indicated after the speech to what extent they used self-motivated expressive suppression or reappraisal during the task. The results show that suppression is associated with less anxiety expression, greater physiological responding, and less memory for the speech while having no impact on negative affect. In contrast, reappraisal has no impact on physiology and memory while leading to less expression and affect. Taken together, spontaneous emotion regulation in active coping tasks has similar consequences as experimentally induced emotion regulation in passive tasks.     

Emotion Regulation: Antecedents and Well-Being Outcomes of Cognitive Reappraisal and Expressive Suppression in Cross-Cultural Samples

Habitual emotional state is a predictor of long-term health and life expectancy and successful emotion regulation is necessary for adaptive functioning. However, people are often unsuccessful in regulating their emotions. We investigated the use of cognitive reappraisal and expressive suppression in 489 university students in Norway, Australia, and the United States and how these strategies related to measures of well-being (affect, life satisfaction, and depressed mood). Data was collected by means of selfadministered questionnaires. The major aims of the study were to begin to explore the prevalence of use of cognitive reappraisal and expressive suppression across gender, age and culture, possible antecedents of emotion regulation strategies, and the influence of emotion regulation upon well-being. Results showed that the use of emotion regulation strategies varied across age, gender and culture. Private self-consciousness (self-reflection and insight) was found to be a central antecedent for the use of cognitive reappraisal. Use of emotion regulation strategies predicted well-being outcomes, also after the effect of extraversion and neuroticism had been controlled for. Generally, increased use of cognitive reappraisal predicted increased levels of positive well-being outcomes, while increased use of expressive suppression predicted increased levels of negative well-being outcomes.

Assessing Emotion Regulation in Social Anxiety Disorder: The Emotion Regulation Interview

Social anxiety disorder (SAD) is thought to involve emotional hyper-reactivity and emotion dysregulation. However, the precise nature of the emotion dysregulation in SAD has not been well characterized. In the present study, the Emotion Regulation Interview (ERI) was developed to quantify the frequency and self-efficacy of five emotion regulation strategies specified by Gross’s (Review of General Psychology 2: 271–299, 1998) process model of emotion regulation. Forty-eight individuals with SAD and 33 healthy controls (HCs) were interviewed about responses during (a) a laboratory speech task and (b) two recent social anxiety-evoking situations. Individuals with SAD reported greater use of avoidance and expressive suppression than HCs, as well as lesser self-efficacy in implementing cognitive reappraisal and expressive suppression. These regulation deficits were not accounted for by differences in emotional reactivity. These findings highlight specific emotion regulation deficits in SAD, and support the idea that the Emotion Regulation Interview may be usefully applied to other clinical disorders.     

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors

Background and objectives: Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type.

Methods: A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N?=?62; HSA) and low (N?=?52; LSA) on social anxiety.

Results: Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity.

Conclusions: Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.     

Perfectionism and emotion regulation in coaches: A test of the 2 × 2 model of dispositional perfectionism

The manner in which coaches regulate their emotions has implications for their performance and well-being. Drawing on research that has found perfectionism to predict emotion regulation in other settings, this study adopted the 2 × 2 model of perfectionism to examine whether subtypes of perfectionism among coaches were associated with variation in the use of emotion regulation strategies. Coaches (N = 238, M age = 23.92, SD = 10.32) from various sports completed measures of perfectionism (personal standards and evaluative concerns) and emotion regulation strategies (expressive suppression, cognitive reappraisal, and control of anger directed inwards and outwards). Moderated hierarchical regression provided mixed support for the 2 × 2 model. As expected, pure personal standards perfectionism (high standards/low concerns) was generally associated with the highest capacity for emotion regulation and pure evaluative concerns perfectionism (low standards/high concerns) with the lowest. Unexpectedly, mixed perfectionism (high standards/high concerns) was associated with the highest level of expressive suppression, suggesting that in some instances standards might exacerbate rather than attenuate concerns.     

Interactions of emotion regulation and perceived stress in predicting emerging adults’ subsequent internalizing symptoms

Emotion regulation is consistently linked to subsequent wellbeing, but little research has examined the moderating role of emotion regulation in longitudinal associations between mental health and other relevant factors. This study examines two specific emotion regulation strategies interacting with perceived stress to predict subsequent internalizing symptoms among emerging adults transitioning to college, a population for whom emotion regulation may be particularly important. A sample of 1130 college students provided data at three time points. Results indicated that cognitive reappraisal buffered against negative effects of stress, whereas expressive suppression was an independent risk factor for internalizing symptoms. Findings underscore the importance of emotion regulation, highlighting cognitive reappraisal as a protective factor against stress and further demonstrating the direct negative impacts of expressive suppression.     

Emotion regulation in social anxiety: a systematic investigation and meta-analysis using self-report,subjective, and event-related potentials measures

Recent models of social anxiety disorder emphasise the role of emotion dysregulation; however, the nature of the proposed impairment needs clarification. In a replication and extension framework, four studies (N?=?193) examined whether individuals with social anxiety (HSAs) are impaired in using cognitive reappraisal and expressive suppression. Self-reports and lab-based tasks of suppression and reappraisal were utilised among individuals with high and low levels of social anxiety. A meta-analysis of these studies indicated that, compared to controls, HSAs reported less frequent and effective use of reappraisal and more frequent and effective use of suppression. Counter to most models and our hypotheses, HSAs were more successful than controls in lab-based reappraisal of shame-arousing pictures as measured by subjective ratings, but not by event-related potentials. HSAs were less successful than controls in lab-based suppression of shame-arousing pictures as measured by subjective ratings, but not by event-related potentials. The results held even when participants were under social stress (impromptu speech anticipation). Overall, subjective reports of HSAs reveal strong deficits in emotion regulation whereas lab-based measures provided less conclusive evidence of such deficits. These results suggest that individuals with social anxiety experience difficulties implementing their reappraisal abilities in daily life.     

Wellness,Emotion Regulation,and Relapse During Substance Use Disorder Treatment

Using a cross-sectional study design, the authors investigated the impact of wellness and emotion regulation on relapse in 179 individuals currently enrolled in substance use disorder treatment. An integration of the indivisible self model of wellness (Myers & Sweeney, 2004) and the covert antecedents model of relapse (Marlatt, 1985) informed the study hypothesis that emotion regulation mediates the wellness-relapse relationship. Binomial logistic regressions revealed that Creative Self wellness (odds ratio [OR] = 1.09, p = .002), reappraisal (OR = 1.08, p = .008), difficulties in emotion regulation (OR = 1.03, p = .007), and Physical Self wellness (OR = 0.95, p < .001) were associated with the odds of relapse on any given day during treatment. Sobel tests indicated 2 occurrences of full mediation, including that difficulties in emotion regulation mediated the relationship between Coping Self wellness and relapse (OR = 0.97, p = .015).     

Emotion regulation and the temporal dynamics of emotions: Effects of cognitive reappraisal and expressive suppression on emotional inertia

The tendency for emotions to be predictable over time, labelled emotional inertia, has been linked to low well-being and is thought to reflect impaired emotion regulation. However, almost no studies have examined how emotion regulation relates to emotional inertia. We examined the effects of cognitive reappraisal and expressive suppression on the inertia of behavioural, subjective and physiological measures of emotion. In Study 1 (N = 111), trait suppression was associated with higher inertia of negative behaviours. We replicated this finding experimentally in Study 2 (N = 186). Furthermore, in Study 2, instructed suppressors and reappraisers both showed higher inertia of positive behaviours, and reappraisers displayed higher inertia of heart rate. Neither suppression nor reappraisal were associated with the inertia of subjective feelings in either study. Thus, the effects of suppression and reappraisal on the temporal dynamics of emotions depend on the valence and emotional response component in question.     

Emotion Regulation Strategies,Secondary Traumatic Stress,and Compassion Satisfaction in Healthcare Providers

The aim of the present study is to examine the relationships between two emotion regulation strategies (cognitive reappraisal and expressive suppression), secondary traumatic stress, and compassion satisfaction in a sample of 190 healthcare providers. Another aim of this study is to examine if the relations between emotion regulation strategies and traumatic stress symptoms are moderated by compassion satisfaction. The respondents volunteered to take part in the research and completed self-reporting measures describing the use of emotional regulation strategies, the symptoms of secondary traumatic stress, and the compassion satisfaction. The results revealed negative associations between cognitive reappraisal and secondary traumatic stress, while expressive suppression is positively associated with arousal. Moreover, cognitive reappraisal is positively related to compassion satisfaction, while secondary traumatic stress symptoms are negatively correlated with compassion satisfaction. Furthermore, the relationship between expressive suppression and intrusions is moderated by compassion satisfaction. The implications of these results for enhancing professional quality of life in the context of secondary exposure to traumatic life events are discussed.