Don't hide your happiness! Positive emotion dissociation, social connectedness, and psychological functioning

It is now clear that positive emotion leads to enhanced psychological functioning. What is less clear, however, is just why this is so. Drawing on a social-functional perspective, we argue that positive emotional behavior that accurately signals to others the individual's internal state will enhance social connectedness. Positive emotional behavior that does not accurately signal a person's experience--such as a smile that is not felt--may impede social connectedness and, in turn, psychological functioning. This perspective suggests that (a) the degree to which experience and behavior are dissociated during positive emotional episodes, over and above level of positive behavior, should predict worse psychological functioning and (b) the effect of dissociation should be mediated by social connectedness. To test these hypotheses, we conducted a short-term prospective longitudinal study, with a baseline assessment of depressive symptoms and well-being at Time 1. Six months later, at Time 2, we used a novel within-individual laboratory paradigm to measure the degree to which positive emotional behavior was dissociated from (vs. coherent with) a participant's positive emotional experience. We also assessed level of positive behavior and experience. Then, another 6 months later, we assessed social connectedness as a mediator and depressive symptoms and well-being as outcomes at Time 3. Even when controlling for baseline functioning and for level of positive emotion behavior and experience, we found that greater positive experience-behavior dissociation at Time 2 predicted higher levels of depressive symptoms and lower levels of well-being at Time 3. As predicted, these associations were mediated by social connectedness.     

Individual Differences in Cognitive Emotion Regulation: Implications for Subjective and Psychological Well-Being

Although research has extensively examined the link between cognitive emotion regulation and psychopathological symptoms, scant attention has been given to the relationship between dispositional use of cognitive emotion regulation strategies and individuals’ positive functioning. In a cross-sectional study on 470 adults, we examined whether individual differences in the use of nine cognitive strategies were associated with subjective and psychological well-being. Results show that positive reappraisal and refocus on planning are positively related to both subjective and psychological well-being. Rumination, catastrophizing and self-blame are linked to poorer well-being, while positive refocusing, putting into perspective, and acceptance show few significant associations. These results suggest that cognitive emotion regulation strategies may be differently effective in promoting individual’s well-being.     

The Effects of Anxiety and Depressive Symptoms on Daily Positive Emotion Regulation

Individuals with anxiety and depressive symptoms exhibit disturbances in positive emotion regulation, which may hinder full recovery. By comparison, individuals with strong beliefs regarding their capacity to “savor” or maintain positive emotions (i.e., savoring beliefs) display more adaptive positive emotion regulation. The present daily diary study explores three momentary processes involved in positive emotion regulation, namely positive emotion reactivity, regulatory goals, and regulatory effectiveness, and examines the comparative effects of baseline anxiety and depressive symptoms versus savoring beliefs on such processes in real-life contexts. A sample of 164 nonclinical undergraduates provided baseline measures of anxiety and depressive symptom severity and savoring beliefs prior to completing 14 daily assessments of positive emotions and emotion regulatory responses to daily positive events. Results indicated that higher baseline anxiety and depressive symptom severity were associated with decreased positive emotion reactivity and increased down-regulation of positive emotions; higher baseline savoring beliefs were associated with increased positive emotion reactivity, decreased down-regulation and increased up-regulation of positive emotions. Potential clinical implications are discussed.     

Emotion Regulation in Youth with Emotional Disorders: Implications for a Unified Treatment Approach

Given the relationship between internalizing disorders and deficits in emotion regulation in youth, the emotion science literature has suggested several avenues for increasing the efficacy of interventions for youth presenting with anxiety and depression. These possibilities include the identification and addition of emotion-regulation skills to existing treatment packages and broadening the scope of those emotions addressed in cognitive-behavioral treatments. Current emotion-focused interventions designed to meet one or both of these goals are discussed, and the developmental influences relevant to the selection of emotion-focused treatment goals are explored using the framework of a modal model of emotion regulation. These various lines of evidence are woven together to support the utility of a novel emotion-focused, cognitive-behavioral intervention, the Unified Protocol for the Treatment of Emotional Disorders in Youth, a transdiagnostic treatment protocol that aims to treat the range of emotional disorders (i.e., anxiety and depression) simultaneously. Avenues for future directions in treatment outcome and assessment of emotion regulation are also discussed.     

Just the way you are. Understanding emotion regulation strategies in youth from temperamental differences

High negative emotionality (NE), low positive emotionality (PE), and low effortful control (EC) have repeatedly been independently associated with youth depressive symptoms. Less research examined the joint contributions of these traits on such symptoms and, despite of clinical relevance, no study investigated how these traits jointly contribute to emotion regulation problems. The present study examined temperamental profiles in youth as well as their link with depressive symptoms and emotion regulation strategies in 1098 Flemish youth (60% girls, 7–17 years). Latent profile analyses identified a 4-profile solution (resilient, vulnerable, average, reactive-undercontrolled) to best fit the data. Meaningful associations emerged between these temperamental profiles, symptoms, and one’s preferred emotion regulation repertoire, including profile-specific emotion regulation deficits.     

Individual differences in two emotion regulation processes: implications for affect,relationships, and well-being

Five studies tested two general hypotheses: Individuals differ in their use of emotion regulation strategies such as reappraisal and suppression, and these individual differences have implications for affect, well-being, and social relationships. Study 1 presents new measures of the habitual use of reappraisal and suppression. Study 2 examines convergent and discriminant validity. Study 3 shows that reappraisers experience and express greater positive emotion and lesser negative emotion, whereas suppressors experience and express lesser positive emotion, yet experience greater negative emotion. Study 4 indicates that using reappraisal is associated with better interpersonal functioning, whereas using suppression is associated with worse interpersonal functioning. Study 5 shows that using reappraisal is related positively to well-being, whereas using suppression is related negatively.     

Lonely adolescents exhibit heightened sensitivity for facial cues of emotion

Contradicting evidence exists regarding the link between loneliness and sensitivity to facial cues of emotion, as loneliness has been related to better but also to worse performance on facial emotion recognition tasks. This study aims to contribute to this debate and extends previous work by (a) focusing on both accuracy and sensitivity to detecting positive and negative expressions, (b) controlling for depressive symptoms and social anxiety, and (c) using an advanced emotion recognition task with videos of neutral adolescent faces gradually morphing into full-intensity expressions. Participants were 170 adolescents (49% boys; M_age?=?13.65 years) from rural, low-income schools. Results showed that loneliness was associated with increased sensitivity to happy, sad, and fear faces. When controlling for depressive symptoms and social anxiety, loneliness remained significantly associated with sensitivity to sad and fear faces. Together, these results suggest that lonely adolescents are vigilant to negative facial cues of emotion.     

Introduction

A dynamic model of affect suggests that positive and negative affect (PA and NA) are normally relatively independent of one another, whereas the heightened apprehensiveness and narrowed cognitive attention in persons with anxiety may contribute to a more unidimensional affect structure. This possibility was examined in a sample of 230 patients seeking treatment for anxiety and depressive disorders in the Netherlands. Two methods, a multiple-group confirmatory factor analysis (CFA) and Fisher's z test of correlations, were used to test these predicted relationships within a sample of persons diagnosed with either a depressive or an anxiety disorder. Both methods supported these predictions, with the depressed group exhibiting relatively independent PA and NA while the anxious group's affects were more strongly inversely correlated.     

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

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

Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders

Emotion dysregulation is believed to be a key factor in anxiety disorders. However, the empirical basis for this view is limited, particularly in children and adolescents. This study aimed to examine whether anxious children display negative emotional hyper-reactivity and deficits in emotion regulation, using a new task that presents ambiguous situations with potentially threatening meanings. Forty-nine children diagnosed with either generalized anxiety disorder, social anxiety, or separation anxiety disorder, were compared with 42 non-anxious controls. Relative to controls, anxious children demonstrated (a) greater intensity and frequency of negative emotional responses, (b) deficits in using reappraisal in negative emotional situations and corresponding deficits in reappraisal self-efficacy, and (c) greater reliance on emotion regulation strategies that increase the risk of functional impairment, intense negative emotion, and low emotion regulation self-efficacy. Implications for the assessment and treatment of childhood anxiety are discussed.     

School-Based Acceptance and Commitment Therapy for Adolescents With Anxiety: A Pilot Trial

Anxiety disorders are one of the most prevalent diagnoses in youth, often resulting in impaired social and school functioning. Research on treatments for youth anxiety is primarily based in traditional clinical settings. However, integrating youth psychotherapies into the school environment improves access to evidence-based care. The present study is a pilot, randomized waitlist-controlled trial of a school-based, group Acceptance and Commitment Therapy–based (ACT) intervention for adolescents with anxiety. Students at two separate schools (N = 26) with elevated anxiety were randomized to a 12-week waitlist or to immediate treatment. Participants in the immediate treatment condition reported statistically significant decreases in anxiety and class absences at posttreatment and follow-up compared to the waitlist group. No statistically significant differences were found between groups for depression, psychological flexibility, positive mental health, and student well-being. However, medium within-condition effect sizes were seen in the treatment group for all outcomes. Participants reported the treatment as favorable with good acceptance ratings. Overall, this study supports ACT as a viable intervention for schools and other clinical settings providing services to adolescents with anxiety.     

Transdiagnostic and Transcultural: Pilot Study of Unified Protocol for Depressive and Anxiety Disorders in Japan

Unified protocol (UP) is a transdiagnostic cognitive behavior therapy for emotional disorders. It remains unknown whether UP is applicable for use in non-Western countries and for depressive disorders. We therefore examined its feasibility for a Japanese clinical population using this clinical trial design, which is multicentered, open-labeled, and single-armed (Clinical registry: UMIN000008322). The primary outcome was severity of anxiety symptoms, as assessed using Structured Interview Guide for the Hamilton Anxiety Rating Scale. Secondary outcomes were depressive symptoms, clinical global impression, functioning, quality of life, affectivity, emotion regulation, and adverse events. Of the 28 prospective participants, 17 were eligible and enrolled (depressive disorders = 9, anxiety disorders = 8). Severity of anxiety symptoms, which decreased significantly after the intervention, remained low for 3 months (Hedges’ g = 1.29, 95% CI = 0.56–2.06). Similar tendencies were observed for secondary outcome measures. No severe adverse event occurred. Two participants dropped out of the intervention. High treatment adherence and interrater reliability were confirmed. Results suggest the feasibility of UP in the Japanese context sufficient to warrant a larger clinical trial.     

The Role of Emotion Regulation in the Treatment of Child Anxiety Disorders

In this review, we examine the role of emotion regulation in the treatment of children with anxiety disorders. Cognitive-behavioral therapy (CBT) has been shown to “work” for children with anxiety disorders and it has been categorized as an evidence-based treatment. However, most studies have shown that the treatment is effective for about 60–70% of children, leaving the remaining children symptomatic and oftentimes with persisting psychological disorders. Of importance, it has also been shown that many children with anxiety disorders demonstrate poor emotion regulation skills. Despite these findings, little attention has been directed toward incorporating emotion regulation strategies into these relatively effective cognitive-behavioral treatments. It is possible that CBT programs do not work as well for a portion of children because their emotion regulation deficits, if present, are not being targeted sufficiently. In this review, it is suggested that adding an emotion regulation component could increase treatment efficacy. In addition, strategies aimed at improving emotion regulation at the individual level and at the family level are introduced. Details of how improved emotion regulation skills could be beneficial in bringing about change are discussed. Finally, issues of measurement and the clinical implications for research and practice are considered.     

Improved Perceptions of Emotion Regulation and Reflective Functioning in Parents: Two Additional Positive Outcomes of Parent-Child Interaction Therapy

The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children’s externalizing behaviors and parenting problems, was associated with improvements in parents’ emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children’s improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents’ self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents’ self-report of children’s symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children’s symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents’ perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children’s externalizing behaviors.     

A discrete emotions approach to positive emotion disturbance in depression

Converging findings suggest that depressed individuals exhibit disturbances in positive emotion. No study, however, has ascertained which specific positive emotions are implicated in depression. We report two studies that compare how depressive symptoms relate to distinct positive emotions at both trait and state levels of assessment. In Study 1 (N=185), we examined associations between depressive symptoms and three trait positive emotions (pride, happy, amusement). Study 2 compared experiential and autonomic reactivity to pride, happy, and amusement film stimuli between depressive (n=24; DS) and non-depressive (n=31; NDS) symptom groups. Results indicate that symptoms of depression were most strongly associated with decreased trait pride and decreased positive emotion experience to pride-eliciting films. Discussion focuses on the implications these findings have for understanding emotion deficits in depression as well as for the general study of positive emotion.     

Prevention of depression with primary care patients: A randomized controlled trial

The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well-being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implementing such research in a public sector setting serving low-income, predominantly minority individuals: 150 primary care patients free from depression or other major mental disorders were randomized to an experimental cognitive-behavioral intervention or to a control condition. The experimental intervention group reported a significantly greater reduction in depressive levels. Decline in depressive levels was significantly mediated by decline in the frequency of negative conditions. Group differences in the number of new episodes (incidence) of major depression did not reach significance during the 1-year trial. We conclude that depression prevention trials in public sector primary care settings are feasbile, and that depressive symptoms can be reduced even in low-income, minority populations. To conduct randomized prevention trials that can test effects on incidence with sufficient statistical power, subgroups at greater imminent risk have to be identified.     

Interpersonal functioning and depressive symptoms in childhood: Addressing the issues of specificity and comorbidity

Research has supported linkages between depression and social impairment in youngsters, but has often focused on depressive symptoms in isolation. We collected data on depressive, anxiety, and externalizing symptoms in 161 school children. Information about interpersonal competence was gathered from several sources, including children, teachers, and behavioral observations. Depressive symptoms were found to be related to difficulties in multiple areas of competence, including maladaptive social problem-solving styles, conflict-negotiation and affect-regulation deficits, and peer rejection. Comparisons of the relative contributions made by depressive and anxiety symptoms to the prediction of functioning yielded some evidence for a specific relation between depressive symptoms and impairment. Children with cooccurring internalizing and externalizing symptoms generally suffered from the most social dysfunction. If replicated in clinical samples, findings such as these may help to guide intervention efforts with depressed children.We thank Daphne Isenberg, Margie Limon, Leslie Scher, and Jennifer Silverman for their assistance in various aspects of this study. We would also like to express our appreciation to the participating children and teachers and to the UCLA Bruin Kids Day Camp.     

Do interpersonal features of social anxiety influence the development of depressive symptoms?

This study is a prospective examination of possible interpersonal features of social anxiety that might predict increases in depressive symptoms. It was hypothesised that social anxiety would be associated with avoidance of expressing emotion, lack of assertion, and interpersonal dependency and that these dysfunctional interpersonal styles would predict depressive symptoms one year later while controlling for Time 1 depressive symptoms. One hundred and two undergraduates completed interview and self-report measures of these interpersonal styles in addition to measures of social anxiety and depressive symptoms. Results indicated that social anxiety was associated with all three interpersonal styles. However, only avoidance of expressing emotions predicted Time 2 depressive symptoms. Theoretical implications of these results are discussed.     

Cognitive dysfunction in depression: neurocircuitry and new therapeutic strategies

Major depressive disorder (MDD) is a disabling medical condition associated with significant morbidity, mortality and public health costs. However, neurocircuitry abnormalities underlying depression remain incompletely understood and consequently current treatment options are unfortunately limited in efficacy. Recent research has begun to focus specifically on cognitive aspects of depression and potential neurobiological correlates. Two fundamental types of cognitive dysfunction observed in MDD are cognitive biases, which include distorted information processing or attentional allocation toward negative stimuli, and cognitive deficits, which include impairments in attention, short-term memory and executive functioning. In this article, we present a selective review of current research findings in these domains and examine neuroimaging research that is beginning to characterize the neurocircuitry underlying these biases and deficits. We propose that deficient cognitive functioning, attention biases and the sustained negative affect characteristic of MDD can be understood as arising in part from dysfunctional prefrontal-subcortical circuitry and related disturbances in the cognitive control of emotion. Finally, we highlight potential new pharmacological and non-pharmacological therapeutic strategies for MDD based on an evolving mechanistic understanding of the disorder.     

Resource diary: A positive writing intervention for promoting well-being and preventing depression in adolescence

Depression in adolescence is a widespread problem and leads to extensive psychosocial impairments. For these reason, a resource diary has been developed as a four-week positive writing intervention. The aims of this intervention were to enhance well-being, to promote emotion regulation and resource realization, as well as to prevent symptoms of depression in adolescence. Seventy-seven students of 8th form were randomized either to a positive writing group (n = 38) or to a neutral writing group (n = 39). At the post-test, the positive writing group showed a lower dysphoric mood, fewer worries and less rumination in comparison with the neutral writing group. No effects on resource realization were detected. This study provides the first evidence of the beneficial effects of positive writing on indicators of well-being and depressive symptoms. In conclusion, the resource diary represents an economical intervention for preventing depression in adolescence.