Emotional eating as a mediator between anxiety and cholesterol in population with overweight and hypertension

Although the relationship between cholesterol and mood states (especially anxiety) has been well studied, few researches have included the role of eating styles in this relationship. This study explored the associations among eating styles, negative emotional symptoms, and levels of cholesterol (and other medical variables) in a population with hypertension and overweight or obesity, analyzing the possible mediation mechanisms involved. A cross-sectional study was conducted in 68 adults with hypertension and overweight/obesity, and stepwise multiple regression analysis and mediation analyses were carried out to test the hypothesis that eating styles mediate the relationship between negative emotional symptoms and cholesterol. Several significant correlations among age, anthropometric, medical, and psychological variables (eating styles and negative emotional symptoms) were found. There was a significant indirect effect of anxiety on total cholesterol and LDL cholesterol through emotional eating. Results suggest that emotional eating has a relevant role in the rise in total and LDL cholesterol, acting as a mediator in the relationship between anxiety and cholesterol. This finding could have important implications, since it introduces a new variable in the relationship between emotions and cholesterol and, therefore, changes the way of understanding this relationship, and of treating high cholesterol in a hypertensive sample.     

Illness perception clusters and relationship quality are associated with diabetes distress in adults with Type 2 diabetes

This report aims to augment what is already known about emotional distress in Type 2 diabetes, by assessing the predictive value of illness perception clusters and relationship quality on four subcategories of Diabetes Distress.162 individuals with Type 2 diabetes responded to a postal questionnaire assessing demographics, depression, diabetes distress, illness perceptions and relationship quality. Long-term blood glucose was retrieved from participants’ General Practitioner. Three illness perception clusters emerged from the data, capturing three subgroups of participants sharing similar illness perception schemas. Regression analyses were performed across each diabetes distress subscale, with demographics, illness perception clusters, and relationship variables entered into three blocks. Covariates explained 51.1% of the variance in emotional burden, 41% of the variance in regimen-related distress, 20% of the variance in interpersonal distress, and 8.6% of the variance in physician-related distress. Cluster membership was strongly associated with emotional burden, regimen-related distress, and to a lesser degree interpersonal distress, but was not associated with physician-related distress. Relationship quality most strongly predicted regimen-related distress. Illness perception schemas and interpersonal issues influence emotional adjustment in diabetes. This study provides direction for the content of a novel approach to identifying and reducing diabetes distress in people with Type 2 diabetes.     

The relationship between beliefs about emotions and quality of life in irritable bowel syndrome

Suppression of undesirable emotions, as well as beliefs about the unacceptability of experiencing and expressing emotions, have both been shown to be related to poorer health-related outcomes in several clinical groups. Potential models through which these variables relate have yet to be tested in those with irritable bowel syndrome (IBS) and are therefore examined in the current article. Online questionnaires were administered to people with IBS (n = 84) to test a mediation model in which beliefs about the unacceptability of emotions are associated with greater emotional suppression, which in turn relates to increased affective distress and consequently poorer quality of life. An alternate model to test the direction of effect along with two further models using support-seeking as mediators of the same predictor and outcome were also tested. Emotional suppression and affective distress (in that particular order) mediate the relationship between beliefs about emotions and quality of life IBS. The models using support-seeking as mediators of the relationship between beliefs about emotions and the two outcomes were not supported. These findings suggest a role for emotional processing in medically unexplained symptoms and imply the need to address such beliefs about emotions in psychological therapies.     

Psychosocial safety climate (PSC) and enacted PSC for workplace bullying and psychological health problem reduction

Bullying at work has profound effects on both the individual and organization. We aimed to determine if organizational psychosocial safety climate (PSC; a climate specific to worker psychological health) could reduce workplace bullying and associated psychological health problems (i.e., distress, emotional exhaustion, depression) if specific procedures were implemented (PSC enactment). We theorized that the PSC enactment mechanism works via psychosocial processes such as bullying mistreatment climate (anti-bullying procedures), work design (procedures reduce stress through work redesign), and conflict resolution (procedures to resolve conflict). We used two-wave national longitudinal interview data from 1,062 Australian employees (Australian Workplace Barometer project) and structural equation modelling to explore relationships over 4 years. PSC Time 1 predicted enacted PSC and reduced bullying 4 years later. PSC Time 1 was indirectly negatively related to poor psychological health Time 2 through enacted PSC and bullying. Bullying Time 1 also gave rise to procedures which in turn reduced bullying Time 2. Our findings suggest a multi-component approach to prevent or reduce bullying. Procedures (to reduce psychosocial hazards) that emerge in a high PSC context are more comprehensive than those triggered by bullying (reactive procedures), and can therefore be more effective in reducing worker mistreatment. Building PSC and a strong climate for psychological health, and enacting PSC is fundamental to bullying prevention.     

Resilience and suicide ideation: Coping mediator-moderator effects among adolescent learners

The current study aimed to investigate the influence of coping on the relationship between resilience and adolescent suicide ideation among secondary learners in the Free State Province, South Africa (n = 495; female = 61.6%; black = 55%, white = 27%, other = 18%; mean age = 13.99 years; SD = 0.83 years). The learners completed the Suicide Ideation Questionnaire (SIQ), the Revised Coping Schema Inventory (RCSI), and the Resiliency Scale for Children and Adolescents (RSCA). Hierarchical multiple regression analyses were conducted to predict resilience-mediated suicide ideation from coping. Results suggested higher resilience scores on sense of mastery (SoM) and sense of relatedness (SoR) to predict lower suicide ideation risk among the teenagers. By contrast, higher scores on emotional reactivity (ER) predicted higher risk for suicide ideation. Religious coping (RC) moderated the relationship between resilience (sense of relatedness) and suicide ideation so that RC scores with SoM were associated with lower suicide ideation scores. Personal dispositions seem to explain risk for suicide ideation among adolescents.     

The lack of dominance and choice deferral: Choosing to defer to cope with the feeling of being out of control

The present study aimed to explore whether emotional dominance can also account for choice deferral. This research manipulated emotional dominance through the difference in attractiveness among current alternatives in Experiment 1 and the readability of fonts for describing current options in Experiment 2, to investigate the role of dominance in choice deferral. The results revealed that increasingly submissive decision environments were related to more choice of deferral options. Mediation analyses indicated that dominance could mediate the effects of experimental manipulations on choice deferral, and that the actual choice of a deferral option was associated with more increase in dominance of retrospective emotion. The results indicate that dominance plays an important role in choice deferral and that choosing to defer can minimize the explicit confrontation of being out of control.     

FROM EXTENSION TO REVOLUTIONARY CHANGE IN CLINICAL PSYCHOANALYSIS: THE RADICAL INFLUENCE OF BION AND WINNICOTT

This paper addresses the radical departure of late Bion's and Winnicott's clinical ideas and practices from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis. The profound significance and implications of their thinking are explored, and in particular Bion's conception of transformation in O and Winnicott's clinical‐technical revision of analytic work, with its emphasis on regression in the treatment of more disturbed patients. The author specifically connects the unknown and unknowable emotional reality‐O with unthinkable breakdown (Winnicott) and catastrophe (Bion). The author suggests that the revolutionary approach introduced by the clinical thinking of late Bion and Winnicott be termed quantum psychoanalysis. She thinks that this approach can coexist with classical psychoanalysis in the same way that classical physics coexists with quantum physics.     

ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double‐envelope containment of the co‐therapists’ group and play leader, consequent diffraction of the transference‐determining portrayal, gradual integration, and initial figuration of coexisting split‐off fragments. Drawing on in‐depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play.     

The caregiving relationship under stress: foster carers’ experience of loss of the sense of self

This paper is an account of a piece of research which involved interviewing six foster carers who had ended a placement with a child under the age of five with an early experience of abuse and neglect. The paper describes one of the themes that emerged from the data analysis, the loss of the sense of self in the foster carers, and argues that the experience of attempting to provide care for these children led to internal shifts in the carers that reverberated throughout the network around the child. The paper suggests that knowing about the external reasons for placement breakdown is not enough without taking into account the impact on the internal world of the foster carers and the emotional impact of attempting to provide care for a child who has experienced abuse and neglect.