Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial

This study further evaluates the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). A diagnostically heterogeneous clinical sample of 37 patients with a principal anxiety disorder diagnosis was enrolled in a randomized controlled trial (RCT) involving up to 18 sessions of treatment and a 6-month follow-up period. Patients were randomly assigned to receive either immediate treatment with the UP (n=26) or delayed treatment, following a 16-week wait-list control period (WLC; n=11). The UP resulted in significant improvement on measures of clinical severity, general symptoms of depression and anxiety, levels of negative and positive affect, and a measure of symptom interference in daily functioning across diagnoses. In comparison, participants in the WLC condition exhibited little to no change following the 16-week wait-list period. The effects of UP treatment were maintained over the 6-month follow-up period. Results from this RCT provide additional evidence for the efficacy of the UP in the treatment of anxiety and comorbid depressive disorders, and provide additional support for a transdiagnostic approach to the treatment of emotional disorders.     

Understanding the mediating role of toxic emotional experiences in the relationship between negative emotions and adverse outcomes

Research has demonstrated that experiencing negative emotions at work can have adverse consequences for individuals and organizations. However, little research has explored why negative emotions can be associated with detrimental effects. To address this gap, the authors argue that it is critical to consider how emotions are experienced. Across two field studies (N= 876 and N= 136), the authors investigate the mediating role of toxic emotional experiences (TEEs) in the relationship between negative emotions and adverse outcomes. The three TEEs dimensions (i.e., psychologically recurring, disconnecting, and draining) are examined as well as the composite score. Results indicated that the TEEs composite mediated the relationship between negative emotions and psychological health, attitudes towards the organization, performance, and helping behaviours. Mixed results were found for the three TEEs dimensions. A number of theoretical implications are explored including the differential roles of negative emotions versus TEEs, the distinct effects associated with each of the TEEs dimensions, and the importance of exploring how emotions are experienced at work. Practical implications related to effectively managing negative emotions and preventing ‘toxic' experiences are also discussed.     

Responses to formal performance appraisal feedback: the role of negative affectivity

This study examined the effects of performance appraisal feedback on job and organizational attitudes of tellers (N = 329) in a large international bank. Negative affectivity moderated the link between favorable appraisal feedback and job attitudes. Among the higher rated performers, attitudes were improved 1 month after being notified of favorable appraisal results (Time 2). Improved attitudes persisted 6 months after the performance appraisal (Time 3) among tellers with low negative affectivity but not among those with high negative affectivity. Among the lower rated performers, mean levels of attitudes did not change significantly during the study.     

The role of negative affectivity in pay-at-risk reactions: a longitudinal study

In this article, the authors examine the moderating role of negative and positive affectivity on the relationship of bonus size with bonus satisfaction and distributive justice in a company that had installed an unpopular pay-at-risk (PAR) compensation system. Extending the met expectations hypothesis, the authors predict that those low in negative affectivity will show a more pronounced positive relationship between size of PAR bonus and bonus reactions than those high in negative affectivity. Conversely, the authors expect positive affectivity to be unrelated to pay reactions. The results support their hypotheses. Implications are discussed.     

The role of age on reactivity and memory for emotional pictures

The purpose of this study was to investigate subjects' reactivity to emotional pictures and their recollection of these pictures, and to examine these two factors as they relate to age. Adolescents and young adults were shown emotionally arousing scenic pictures for long (4-s) and very brief (50-ms) durations. Recognition of the pictures and recall and recognition of words presented along with the pictures were assessed both immediately after the presentation and six weeks later. The results showed that very negative pictures are retained better than neutral or even positive pictures, and that very negative pictures reduce memory for associated information. It was also found that adolescents show a somewhat lower reactivity to very negative pictures and a higher degree of retention of these pictures than adults. The results are discussed in relation to (a) habituation effects, (b) strategies that subjects might develop to block emotional involvement, and (c) the notion that watching violence might serve as a powerful prime to socially undesirable behaviour.     

The role of positive and negative emotions in life satisfaction judgment across nations

This study examined how the frequency of positive and negative emotions is related to life satisfaction across nations. Participants were 8,557 people from 46 countries who reported on their life satisfaction and frequency of positive and negative emotions. Multilevel analyses showed that across nations, the experience of positive emotions was more strongly related to life satisfaction than the absence of negative emotions. Yet, the cultural dimensions of individualism and survival/self-expression moderated these relationships. Negative emotional experiences were more negatively related to life satisfaction in individualistic than in collectivistic nations, and positive emotional experiences had a larger positive relationship with life satisfaction in nations that stress self-expression than in nations that value survival. These findings show how emotional aspects of the good life vary with national culture and how this depends on the values that characterize one's society. Although to some degree, positive and negative emotions might be universally viewed as desirable and undesirable, respectively, there appear to be clear cultural differences in how relevant such emotional experiences are to quality of life.     

Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients

Anger may have greater effects on chronic pain severity than other negative emotions and may do so by increasing muscle tension near the site of injury (symptom-specific reactivity). For patients with chronic low back pain (CLBP), relevant muscles are lower paraspinals (LP). Ninety-four CLBP patients and 79 controls underwent anger and sadness recall interviews. EMG and cardiovascular activity were recorded. Patients exhibited greater LP tension increases during anger and slower recovery than controls. Only patients showed greater LP reactivity during anger than sadness. For both groups, trapezius reactivity during anger and sadness did not differ. LP reactivity to anger correlated with everyday pain severity for patients. Anger-induced symptom-specific LP reactivity may be linked to chronic pain aggravation among CLBP patients.     

The role of avoidance of emotional material in the anxiety disorders

Many psychotherapeutic traditions have conceptualized clinical levels of anxiety as resulting from the avoidance of threatening or emotional material. In this paper, we examine behavioral models of avoidance of emotions and emotional material, integrating findings that support established behavioral theories of emotional avoidance and anxiety, and that extend these theories to further explain the intense, intrusive, and interfering nature of clinical anxiety. Research on the suppression and avoidance of emotional material suggests that emotional avoidance and thought suppression may not only hinder the learning process and maintain anxious responding, but may also (a) paradoxically heighten anxious responding to threatening cues and (b) interfere with emotion functionality, thereby further impeding adaptive responding. Findings are discussed in terms of future research and implications for clinical treatment of anxiety disorders.     

The role of intergroup disgust in predicting negative outgroup evaluations

We introduce intergroup disgust as an individual difference and contextual manipulation. As an individual difference, intergroup disgust sensitivity (ITG-DS) represents affect-laden revulsion toward social outgroups, incorporating beliefs in stigma transfer and social superiority. Study 1 (5 samples, N = 708) validates the ITG-DS scale. Higher ITG-DS scorers demonstrated greater general disgust sensitivity, disease concerns, authoritarian/conservative ideologies, and negative affect. Greater ITG-DS correlated with stronger outgroup threat perceptions and discrimination, and uniquely predicted negative outgroup attitudes beyond well-established prejudice-predictors. Intergroup disgust was experimentally manipulated in Study 2, exposing participants (n = 164) to a travel blog concerning contact with a disgust-evoking (vs. neutral) outgroup. Manipulated disgust generated negative outgroup evaluations through greater threat and anxiety. This mediation effect was moderated: Those higher (vs. lower) in ITG-DS did not experience stronger disgust, threat, or anxiety reactions, but demonstrated stronger translation of aversive reactions (especially outgroup threat) into negative attitudes. Theory development and treatment implications are considered.     

Deservingness and emotions: Testing a structural model that relates discrete emotions to the perceived deservingness of positive or negative outcomes

A study is described that tested a model (Feather in Eur Rev Soc Psychol 17:38–73, 2006) relating emotions to the appraisal of outcome deservingness for self or other person. Outcome deservingness was assumed to depend on the evaluative structure of action/outcome relations (Feather in Values, achievement, and justice: studies in the psychology of deservingness. Kluwer/Plenum Publishers, New York, 1999b). The study tested predictions about relations between this structure and the emotions of pleasure, admiration, pride, resentment, anger, sadness, sympathy, guilt, regret, disappointment, and surprise. The study used a hypothetical scenario involving an applicant for a position in an organization where the applicant could either be other or self. Results that focused on planned comparisons and the action by focus interactions supported the analysis for both the positive outcome and the negative outcome conditions and they were consistent with the hypothesis that the appraisal of outcome deservingness would mediate at least in part the type of emotion that was reported when a positive or negative outcome followed a positive or negative action. Results were discussed in relation to the social psychology of justice and the emotions.     

The role of discrete emotions in health outcomes: A critical review

Global aspects of emotion have been central to psychosocial theories of health and health behavior for several decades. A growing body of research has documented key roles for several broad affective constructs – notably anxiety, depression, and anger/hostility – in areas ranging from basic physiological processes, health behaviors, and symptom reporting, to screening and detection behaviors and decision making. Despite this growth, however, the emotions-health literature remains scattered. Mechanisms are poorly understood and several key emotions – embarrassment, disgust, guilt and hope – have scarcely been examined. In presenting the advantages of a discrete emotions perspective, the current report reviews and critiques data describing the relations between discrete emotions and health. It presents a developmental-functionalist framework within which to more systematically consider the links between emotions and health. It is suggested that discrete emotions perspectives provide guidance for understanding the physiological, motivational, and cognitive pathways linking emotions and health and thus their impact on health outcomes.     

Health complaints, stress, and distress: exploring the central role of negative affectivity

Most current models in health psychology assume that stress adversely affects physical health. We re-examined this assumption by reviewing extensive data from the literature and from six samples of our own, in which we collected measures of personality, health and fitness, stress, and current emotional functioning. Results indicate that self-report health measures reflect a pervasive mood disposition of negative affectivity (NA); self-report stress scales also contain a substantial NA component. However, although NA is correlated with health compliant scales, it is not strongly or consistently related to actual, long-term health status, and thus will act as a general nuisance factor in health research. Because self-report measures of stress and health both contain a significant NA component, correlations between such measures likely overestimate the true association between stress and health. Results demonstrate the importance of including different types of health measures in health psychology research.     

Continuance commitment and turnover: Examining the moderating role of negative affectivity and risk aversion

This paper examines the moderating role of negative affectivity and risk aversion in the relationships of two bases of continuance organizational commitment (continuance–sacrifices and continuance–alternatives) to turnover, within a stress–coping perspective. More specifically, we propose that (a) the perspective of leaving is a source of stress for those who stay due to the fear of losing valued advantages (i.e. high continuance–sacrifices commitment) and (b) staying is perceived to be stressful by individuals who remain based on a lack of employment alternatives (i.e. high continuance–alternatives commitment). We argue that these perceptions are magnified by negative affectivity and risk aversion, resulting in individuals who present these traits to use avoidance–withdrawal strategies in coping with these situations. Accordingly, based on a sample of 509 human resource management professionals, we found (a) negative affectivity and risk aversion to strengthen the negative relationship of continuance–sacrifices commitment to turnover and (b) continuance–alternatives commitment to relate positively to turnover among individuals with high negative affectivity. We discuss the implications of these findings for our understanding of how commitment mindsets and personality traits affect turnover decisions.     

Exploring the utility of emotional awareness and negative affect in predicting body satisfaction and body distortion

In a sample of 304 female college students, the present study examined how body image is associated with (a) clarity of emotion; (b) attention to emotion; and (c) negative affect. Two separate facets of body image were examined: body satisfaction and body distortion. Greater clarity of emotion was associated with greater body satisfaction and less body distortion, and these associations could not be accounted for by negative affect. Body satisfaction was significantly predicted by the three-way interaction of clarity of emotion, attention to emotion, and negative affect. Attention to emotion moderated the association between clarity of emotion and body satisfaction only among high negative affect individuals. Specifically, greater clarity of emotion was associated with greater body satisfaction in all participants except those who were high in both negative affect and attention to emotion.     

Suicide schema in schizophrenia: the effect of emotional reactivity, negative symptoms and schema elaboration

Suicide risk is thought to increase with a greater potential for activation of suicide-related schemas. Suicide schemas are less likely to be activated with reductions of emotional range associated with certain negative symptoms of schizophrenia. The study tested whether suicide risk would increase in patients with recent onset schizophrenia with increased potential for suicide schema activation as indicated by lower levels of specific negative symptoms that reflected emotional reactivity, namely emotional withdrawal and blunted affect. A logistic regression analysis of baseline data of 278 recent onset schizophrenic patients with a measure of suicide behaviour as the dependent variable and negative symptoms, delusions, hallucinations, depression, gender, episode, ethnicity, education, age, duration of untreated psychosis and substance use as independent variables was carried out. Emotional withdrawal, but not blunted affect was significant and negatively associated, and depression positively associated with suicide behaviour. There was evidence to indicate that restricted emotions are associated with reduced suicide risk as predicted.     

Predictors and consequences of sudden gains in transdiagnostic cognitive-behavioural therapy for anxiety disorders

Sudden gains—substantial stable symptom improvements between consecutive therapy sessions—are a common phenomenon. As condensed points of change, examination of sudden gains can provide insight into mechanisms of therapeutic change. This study investigated the association between sudden gains and cognitive change, therapeutic alliance, and/or client engagement in transdiagnostic group cognitive-behavioural therapy for anxiety disorders. Of 58 treatment initiators, 21% (n = 12) exhibited a sudden gain. Consistent with previous research, sudden gainers demonstrated significantly greater pre- to post-treatment symptom improvement than non-sudden gainers. Observational coding of therapy sessions found that sudden gains were associated with elevated levels of cognitive change and client engagement in the pre-gain session, and elevated levels of cognitive change and therapeutic alliance in the post-gain session. However, these results varied by use of within- and between-subject control comparisons, highlighting the value using a dual control methodology. In context of previous research, the results on cognitive change replicate previous findings in depressive populations, and clarify mixed findings in anxiety populations. The results on therapeutic alliance replicate previous findings for the first time in an anxiety sample, although the between-subject control comparisons revealed complexity previously undetected. This study was also the first to investigate and thus establish the relation between client engagement and sudden gains.     

The personality of the Scottish police officer: The issue of positive and negative affectivity

During the past 20 years, interest has arisen concerning the existence of a specific police personality. Much of the early studies had significant methodological difficulties. The present study aimed to examine the personality traits of ‘Positive and Negative Affectivity’ in a group (n = 699) of serving Scottish police officers. The PANAS scale (Watson, Clark & Tellegen, Journal of Personality and Social Psychology, 54, 1063–1070, 1988) suggested that the sample did not differ from the norm on either of these indices. No differences were found according to age or length of service, which brings into question previous assertions made concerning the role of the police organisation in the development of police personality. However, the complexity of the issue was demonstrated, as differences in affectivity were observed according to gender, marital status, rank, working location and job satisfaction level.     

Assessment of emotional reactivity produced by exposure to virtual environments in patients with eating disorders.

The aim of this study was to assess the usefulness of virtual environments representing situations that are emotionally significant to subjects with eating disorders (ED). These environments may be applied with both evaluative and therapeutic aims and in simulation procedures to carry out a range of experimental studies. This paper is part of a wider research project analyzing the influence of the situation to which subjects are exposed on their performance on body image estimation tasks. Thirty female patients with eating disorders were exposed to six virtual environments: a living-room (neutral situation), a kitchen with high-calorie food, a kitchen with low-calorie food, a restaurant with high-calorie food, a restaurant with low-calorie food, and a swimming-pool. After exposure to each environment the STAI-S (a measurement of state anxiety) and the CDB (a measurement of depression) were administered to all subjects. The results show that virtual reality instruments are particularly useful for simulating everyday situations that may provoke emotional reactions such as anxiety and depression, in patients with ED. Virtual environments in which subjects are obliged to ingest high-calorie food provoke the highest levels of state anxiety and depression.     

The role of disgust emotions in the observer response to facial disfigurement

Social intrusions by observers are commonly reported by those with disfiguring conditions. This study examined the role of disgust emotions in the observer response. A group of students (N = 48) completed quantitative questionnaires measuring extent of disfigurement, whilst viewing images of faces with varying disfigurements. Another group of students (N = 84) completed quantitative questionnaires measuring level of disgust elicited by the same images. Disgust sensitivity was measured using the Disgust Scale Revised. Observers reported greater levels of disgust (p < .01) with increasing severity of facial disfigurement. Individuals with a higher disgust sensitivity reported increased levels of disgust in response to faces of mild (p = .03), moderate (p = .02) and severe (p < .01) disfigurement compared to those with a lower disgust sensitivity. This provides an explanatory framework for the avoidance reactions of observers and may be important in understanding variability in adjustment following disfigurement.