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.     

Does the Amount of Participation in Afterschool Programs Relate to Developmental Outcomes? A Review of the Literature

Contrary to the findings from previous reviews we found little support for the general notion that greater amounts of participation in afterschool programs was related to academic, behavioral, or socio-emotional outcomes. However, some relationships did emerge depending on how participation was conceptualized and measured, and the methodology used to assess the relationship between participation and outcomes. For example, some benefits occurred when participants with high levels of participation were compared to non-participants, not when they were compared to other program participants. Several suggestions are offered to improve future research on the relationship between aspects of participation and developmental outcomes.     

Using Mindfulness- and Acceptance-Based Treatments With Clients From Nondominant Cultural and/or Marginalized Backgrounds: Clinical Considerations,Meta-Analysis Findings,and Introduction to the Special Series: Clinical Considerations in using Acceptance- and Mindfulness-based Treatments With Diverse Populations

A growing body of research suggests that mindfulness- and acceptance-based principles can increase efforts aimed at reducing human suffering and increasing quality of life. A critical step in the development and evaluation of these new approaches to treatment is to determine the acceptability and efficacy of these treatments for clients from nondominant cultural and/or marginalized backgrounds. This special series brings together the wisdom of clinicians and researchers who are currently engaged in clinical practice and treatment research with populations who are historically underrepresented in the treatment literature. As an introduction to the series, this paper presents a theoretical background and research context for the papers in the series, highlights the elements of mindfulness- and acceptance-based treatments that may be congruent with culturally responsive treatment, and briefly outlines the general principles of cultural competence and responsive treatment. Additionally, the results of a meta-analysis of mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds are presented. Our search yielded 32 studies totaling 2,198 clients. Results suggest small (Hedges' g = .38, 95% CI = .11 – .64) to large (Hedges' g = 1.32, 95% CI = .61 – 2.02) effect sizes for mindfulness- and acceptance-based treatments, which varied by study design.     

The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university

Despite the theoretical emphasis on the role of emotion dysregulation in deliberate self-harm (DSH), few studies have examined this relationship. The present study sought to examine the role of emotion dysregulation in DSH by extending the findings of Gratz (2006) regarding the environmental (i.e. childhood maltreatment) and individual (i.e. emotional inexpressivity and affect intensity/reactivity) factors associated with DSH among 249 female undergraduates. Specifically, the present study examined whether emotion dysregulation (a) is associated with DSH above and beyond these other risk factors and (b) mediates the relationship between these risk factors and DSH. Findings indicate that overall emotion dysregulation distinguished women with frequent DSH from those without a history of DSH, adding reliably to the prediction of DSH status above and beyond maltreatment, inexpressivity, and affect intensity/reactivity. Moreover, among self-harming women, emotion dysregulation accounted for a significant amount of additional variance in DSH frequency and mediated the relationship between emotional inexpressivity and DSH frequency. Results also suggest the particular relevance of two specific dimensions of emotion dysregulation to DSH: limited access to effective emotion regulation strategies and a lack of emotional clarity, each of which reliably improved the prediction of DSH status and accounted for unique variance in DSH frequency among self-harming women above and beyond the other risk factors in the models. Results suggest the potential utility of teaching self-harming women more adaptive ways of responding to their emotions, including nonavoidant strategies for modulating emotional arousal and the ability to identify, label, and differentiate among emotional states.     

Emotion regulation difficulties associated with the experience of uncued panic attacks: evidence of experiential avoidance, emotional nonacceptance, and decreased emotional clarity

Emotion regulation difficulties among nonclinical uncued panickers were examined in two studies. In Study 1, participants with a recent history of uncued panic attacks (n  =  91), compared to a nonpanic sample (n  =  91), reported significantly greater levels of experiential avoidance, lack of emotional acceptance, and lack of emotional clarity. In Study 2, a subset of uncued panickers and nonpanickers from Study 1 (n = 17 per group) viewed positive and negative emotion-eliciting film clips. Despite comparable levels of self-reported distress and physiological arousal, panickers reported using more emotionally avoidant regulation strategies during both film clips. Panic participants also responded with greater negative emotion to the positive emotion-eliciting clip. Results are discussed in terms of their research and clinical implications.     

The role of fear of emotion in distress, arousal, and cognitive interference following an emotional stimulus

Diverse theories of psychopathology suggest that reactions to internal experiences, such as emotion, are important in the development and maintenance of psychological distress and symptomatology. This study examines the relationships between one type of reaction to emotion, fear of emotion, and reactivity to, recovery from, and interference of emotional material. As predicted, fear of emotion was related to greater increases in distress, negative affect, and skin conductance in reaction to an emotional film clip, and to greater interference of film-related material in a modified emotional Stroop task. These relationships remained when variance contributed by general negative affect was removed. Findings provide preliminary evidence that fear of emotion may be related to emotional distress and physiological arousal, and that this relationship may exist beyond shared variance due to self-report response style and general negative affectivity.     

Mindfulness and Emotion Regulation Difficulties in Generalized Anxiety Disorder: Preliminary Evidence for Independent and Overlapping Contributions

Diminished levels of mindfulness (awareness and acceptance/nonjudgment) and difficulties in emotion regulation have both been proposed to play a role in symptoms of generalized anxiety disorder (GAD); the current studies investigated these relationships in nonclinical and clinical samples. In the first study, among a sample of 395 individuals at an urban commuter campus, self-reports of both emotion regulation difficulties and aspects of mindfulness accounted for unique variance in GAD symptom severity, above and beyond variance shared with depressive and anxious symptoms, as well as variance shared with one another. In the second study, individuals with GAD (n = 16) reported significantly lower levels of mindfulness and significantly higher levels of difficulties in emotion regulation than individuals in a nonanxious control group (n = 16). Results are discussed in terms of directions for future research and potential implications for treatment development.     

Effect of Exposure to an American Indian Mascot on the Tendency to Stereotype a Different Minority Group

Numerous findings have documented the adverse effects of stereotypes on those negatively portrayed by the stereotypes. Less is known about the ramifications of stereotype exposure on those who are not the objects of the stereotypic depictions. Two studies examined the effect of exposure to an American Indian sports mascot on the stereotype endorsement of a different minority group. Study 1 used an unobtrusive prime, while Study 2 used a more engaged prime. Study 2 also investigated the effect among those unfamiliar with the controversy regarding American Indian sports mascots. Results from both studies show that participants primed with an American Indian sports mascot increased their stereotyping of a different ethnic minority group.     

An examination of worry in relation to anxious responding to voluntary hyperventilation among adolescents

This study examined the association between worry and fearful responding to a 3-min voluntary hyperventilation procedure. Participants were 160 adolescents (71 females) between the ages of 12 and 17 years (M=14.92 years). After accounting for the significant effects of state anxiety and anxiety sensitivity, results indicated that pre-challenge levels of worry indexed by the Penn State Worry Questionnaire-Child Version predicted post-challenge anxiety and intensity of panic symptoms. Results are discussed in terms of the role of worry in relation to panic-relevant emotional vulnerability among youth.