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Trautmann S, Muehlhan M, Berking M, Miethe S, Wigger J, Dragan M. Emotion regulation and psychopathology: Investigating differential associations between emotion regulation skills and psychological symptoms using a network approach. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2025; 64:265-280. [PMID: 39282950 DOI: 10.1111/bjc.12493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/24/2024] [Indexed: 05/08/2025]
Abstract
OBJECTIVES Emotion regulation plays an important role in the development and maintenance of psychopathology. However, the question whether specific ER skills are related to specific psychological symptoms has rarely been studied, but has important implications for targeted interventions. This analysis aims to explore potential differential associations between various ER skills and psychological symptoms using a network analysis approach. METHODS Routine data from a transdiagnostic clinical sample of 716 patients (460 females, 256 males) from an outpatient clinic for psychotherapy were analysed. Nine ER skills were assessed with the Emotion Regulation Skills Questionnaire, and nine symptom dimension scores were obtained using the Brief Symptom Inventory. A regularized partial correlation network models including ER skills and individual symptom domains were calculated. Bridge expected influence was calculated to estimate the strength of association of each ER skill with psychological symptoms. RESULTS Only the following ER skills were most strongly related to psychological symptoms (bridge expected influence): Tolerance, Confrontation and Modification. All other ER skills were indirectly connected to symptom severity through these four skills. The strongest direct edges between ER skills and symptoms were Modification-Depression, Confrontation-Obsession-Compulsion and Tolerance-Interpersonal Sensitivity, which were significantly stronger than the vast majority of other associations between ER skills and psychological symptoms. CONCLUSIONS These exploratory findings provide valuable targets for future studies to investigate specific associations between ER skills and psychological symptoms which could help to improve outcome monitoring and efficacy of interventions targeting ER.
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Affiliation(s)
- Sebastian Trautmann
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Markus Muehlhan
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, University of Erlangen-Nuremberg, Nuremberg, Germany
| | - Sandra Miethe
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Janna Wigger
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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Amos J, Moase J, Sladeczek IE. A scoping review of school-based expressive writing implementation reporting practices: missed opportunities and new research directions. DISCOVER MENTAL HEALTH 2025; 5:27. [PMID: 40035928 PMCID: PMC11880461 DOI: 10.1007/s44192-025-00151-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 02/19/2025] [Indexed: 03/06/2025]
Abstract
BACKGROUND Expressive writing (EW) interventions are an effective, flexible, and cost-efficient option for mental health promotion, making them ideally suited for resource-limited school settings. However, the effectiveness of EW interventions varies greatly across studies, which may be partly explained by how EW interventions are implemented. As school-based EW interventions become increasingly popular and more widely used, rigorous reporting of implementation can help advance this emerging field by informing how variation in implementation across studies influences intervention outcomes. PURPOSE The purpose of this scoping review was to evaluate the implementation reporting practices of EW interventions in school settings as they can profoundly impact EW effectiveness. METHODS The present scoping review assessed the current state of fidelity of implementation (implementation) reporting in the school-based EW literature and identified areas where more rigorous reporting is needed. Out of an initial sample of 367 studies, 19 were eligible for inclusion in the review. Data were analyzed for critical issues and themes derived from Cargo et al.'s (2015) Checklist for Implementation (Ch-IMP). RESULTS Overall, the results of this scoping review indicate that researchers who implement EW in school settings have not consistently assessed key implementation domains such as dose received and fidelity. CONCLUSIONS To address this problem, the present review adds a unique contribution to the literature by identifying how rigorous reporting of implementation can strengthen the evidence base for school-based EW interventions. Specifically, researchers can support the use of EW interventions in schools through increased implementation reporting to better understand how variability in fidelity of implementation affects treatment outcomes.
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Affiliation(s)
- Janet Amos
- Department of Educational and Counselling Psychology, McGill University, 3700 Rue McTavish Suite 614, Montreal, QC, H3A 1Y2, Canada.
| | - Justin Moase
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Ingrid E Sladeczek
- Department of Educational and Counselling Psychology, McGill University, 3700 Rue McTavish Suite 614, Montreal, QC, H3A 1Y2, Canada
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Foster S, Albright A, Bock J. The role of emotional suppression and emotional beliefs in explaining the honor-suicide link. Suicide Life Threat Behav 2024; 54:690-701. [PMID: 38568006 DOI: 10.1111/sltb.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/13/2024] [Accepted: 03/24/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION Prior research has established individuals living in cultures of honor to be at higher risk for suicide. However, research has yet to examine how emotion regulation may play a role in explaining this link. The current research intended to address if those who endorse honor norms, who are keen to protect their reputation, might engage in emotional suppression as a way to avoid being seen as weak, thus heightening their risk for suicide. METHOD Data were collected using a survey design across three studies (total N = 988). Studies 1 and 2 were cross-sectional designs with MTurk and undergraduate samples. Study 3 was conducted longitudinally using CloudResearch. RESULTS Results demonstrated those higher in honor endorsement engage in emotional suppression to avoid being seen as weak (Study 1), that emotional suppression and subsequent depression indirectly explain the relationship between honor endorsement and suicide attempts (Study 2), and that relationships between honor endorsement and changes in suicidal ideation are explained by emotional suppression and depressive symptomology (Study 3). CONCLUSION Findings provide needed insight into the daily emotional experiences of honor endorsers and how it may influence suicidality, providing a point of entry for clinicians to construct meaningful honor-oriented intervention programs.
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Affiliation(s)
- Stephen Foster
- Department of Psychology, Penn State York, York, Pennsylvania, USA
| | - Austin Albright
- Center for Survey Research, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | - Jarrod Bock
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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Spikol E, McGlinchey E, Robinson M, Armour C. Flexible emotional regulation typology: associations with PTSD symptomology and trait resilience. BMC Psychol 2024; 12:79. [PMID: 38365706 PMCID: PMC10874029 DOI: 10.1186/s40359-024-01573-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Multiple factors influence posttraumatic stress disorder (PTSD) risk in trauma exposed individuals. An established association exists between trait resilience and decreased PTSD distress and between emotion regulation (ER) ability/flexibility and trait resilience. Typologies in ER ability/flexibility, associated with trait resilience and PTSD experience, could explain the difference in risk. This study aimed to explore the relationship between ER ability, ER flexibility, context sensitivity, resilience, and PTSD. METHODS Data from N = 563 trauma exposed UK residents was used in a latent profile analysis (LPA) and membership in the resultant profiles was explored in a logistic regression of sociodemographics, resilience, and PTSD symptomology. RESULTS Analysis showed 2 latent profiles (High Flexibility, Low Flexibility) typified by emotion regulation ability and context sensitivity. Members of the Low Flexibility profile were more likely to be younger, male, endorsing less trait resilience, and experiencing negative cognition/mood and hyperarousal PTSD symptomology. CONCLUSIONS Difficulties in ER ability and flexibility could be improved with targeted learning in a therapeutic or home setting, potentially increasing trait resilience after trauma exposure and reducing PTSD distress.
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Affiliation(s)
- Eric Spikol
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK
| | - Emily McGlinchey
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK
| | - Martin Robinson
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK
| | - Cherie Armour
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK.
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, BT9 5BN, Belfast, Northern Ireland, UK.
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Moreels T, Van de Velde D, Goethals J, Vanden Wyngaert K, De Baets S, Nagler E, Leune T, De Vriendt P, Van Biesen W. Self-Management Interventions for Facilitating Life Participation for Persons with Kidney Failure: A Systematic Review. Clin J Am Soc Nephrol 2024; 19:189-201. [PMID: 37943537 PMCID: PMC10861108 DOI: 10.2215/cjn.0000000000000347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/28/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND For persons with kidney failure, life participation is a critically important outcome, strongly linked to quality of life and mortality. To support patients' self-management abilities, three domains are typically emphasized: medical management, emotional management, and management of everyday life ( i.e. , role management). Although role management is strongly linked to life participation, there is currently limited research on interventions designed to support it. We explored existing self-management interventions that aim to support everyday life functioning, rather than only medical management. METHODS In this systematic review and qualitative meta-synthesis, we searched MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and CENTRAL up to April 2022 for interventional studies involving self-management interventions designed, at least partly, to support management of everyday life. The guidelines by Sandelowski and Barosso were used to analyze and synthesize the results. A taxonomy of everyday self-management strategies was used to further explore intervention content. Study quality was assessed using the Cochrane Collaboration risk-of-bias tools. Evidence of effectiveness was summarized, and a meta-analysis of eligible outcomes was conducted. RESULTS Of 22,667 records, 53 studies were included in the meta-synthesis. Most self-management interventions focused on medical management. Included interventions involved strategies to support eight domains: Activities of daily living, Work and school life, Meaningful occupations, Leisure activities, Mobility and travel, Interpersonal relationships, Role functioning, and Social participation. Major interventions focused on providing education, skill training, counseling, and cognitive behavioral therapy. Evidence of effectiveness was reported across a wide range of patient-reported outcomes, including (health-related) quality of life, depression, and self-efficacy. Studies were geographically concentrated and were of moderate to low quality. CONCLUSIONS Despite its well-recognized importance, research on interventions to improve life participation mostly consisted of pilot and feasibility studies and studies of low quality. Interventions were reported heterogeneously, limiting comparability, and were restricted to specific regions and cultures, limiting generalizability.
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Affiliation(s)
- Timothy Moreels
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Justine Goethals
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Karsten Vanden Wyngaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Center for Nursing Excellence, Ghent University Hospital, Ghent, Belgium
| | - Stijn De Baets
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Frailty in Ageing (FRIA) Research Group, Department of Gerontology and Mental Health and Wellbeing (MENT) Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium
| | - Evi Nagler
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Tamara Leune
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Patricia De Vriendt
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Frailty in Ageing (FRIA) Research Group, Department of Gerontology and Mental Health and Wellbeing (MENT) Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium
- Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Wim Van Biesen
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
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Rawn KP, Keller PS. Child emotion lability is associated with within-task changes of autonomic activity during a mirror-tracing task. Psychophysiology 2023; 60:e14354. [PMID: 37246804 DOI: 10.1111/psyp.14354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/30/2023]
Abstract
Adaptive biological and emotional stress responding are both critical for healthy human development. However, the complex associations between the two are not fully understood. The current study addresses this gap in research by studying associations of child emotion regulation and lability with within-task changes in the biological stress response during a mirror-tracing task. Participants were 59 families including two parents and a child between 5 and 12 years old (52.2% female). Parents reported on family demographics and completed the Emotion Regulation Checklist. Child skin conductance level (SCL) and respiratory sinus arrhythmia (RSA) were recorded during a baseline task and during a 3-minute mirror-tracing task. Within-task patterns of SCL and RSA during the task were estimated with multilevel modeling (measures within persons). The emotion regulation subscale was unrelated to any facet of SCL/RSA time courses. However, lower emotion lability was related to SCL patterns that changed less during the task and were overall lower. For RSA, lower emotion lability was related to higher initial RSA that significantly decreased during the task. These findings suggest that higher child emotion lability may promote increased physiological arousal of target organs during challenging activities.
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Affiliation(s)
- Kyle P Rawn
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Peggy S Keller
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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Kircher JA, Charles ST, Sin NL, Almeida DM. Chronic Pain and Affective Experiences Associated with Daily Stressors and Uplifts. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2023:1-16. [PMID: 37361622 PMCID: PMC10173238 DOI: 10.1007/s41042-023-00101-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 06/28/2023]
Abstract
People with chronic pain often report greater reactivity to stress than those without pain. This finding is consistent with the kindling hypothesis, which states that continued exposure to stressors only heightens negative affect and dampens positive affect. Yet, people with chronic pain may also respond more positively to enjoyable activities, or uplifts, as well. Chronic pain is related to lower levels of well-being, and the fragility of positive affect model explains how individuals with lower levels of well-being often exhibit stronger, more positive responses to daily uplifts than their less distressed peers. Our study used the National Study of Daily Experiences to assess daily stressors, positive uplifts, and positive and negative affect across eight days among those with and without chronic pain. Participants (nChronicPain=658, nNoPain=1,075) were predominately Non-Hispanic White (91%), 56% female, and averaged 56 years old. Results revealed that people with chronic pain had lower levels of daily positive affect and higher levels of negative affect, yet the two groups did not vary in their stressor-related negative and positive affect. In contrast, having chronic pain was related to a greater increase in positive affect and greater decreases in negative affect on days with positive uplifts. Findings suggest that intervention efforts focusing on uplifts may be particularly helpful for people who report chronic pain.
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Affiliation(s)
- Julie A. Kircher
- Department of Psychological Science, University of California, Irvine, United States
| | - Susan T. Charles
- Department of Psychological Science, University of California, Irvine, United States
| | - Nancy L. Sin
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, Pennsylvania, United States
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Johnson EA, Survase S, Gray PB. Examining the Impact of Virtual Animal Stimuli on College Students' Affect and Perception of their Academic Advising Experience. Animals (Basel) 2023; 13:ani13091522. [PMID: 37174559 PMCID: PMC10177355 DOI: 10.3390/ani13091522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The benefits of animal-assisted interventions (AAI) involving animals in therapy are widely accepted. The presence of animals in therapy can decrease a patient's reservation about therapy and promote a sense of comfort and rapport during the therapy process. Using survey data from college students (n = 152) attending a large public four-year institution, this study is the first to investigate the benefits of virtual animal stimuli during academic advising appointments. It posits that exposure to virtual animal stimuli can influence positive mental health and well-being in academic advising settings. Specifically, the research questions explored how different types of video content influence students' affect and how virtual animal stimuli impact students' perception of their advisor and university. College students were randomly assigned to watch one of four types of virtual stimuli (wild animals, companion animals, nature, and a control) prior to their advising session. Subjective measures were collected at baseline and after the advising session. Results indicated animal stimuli increase positive affect, and companion animal stimuli influence the student's perception of the advisor. This study supports the notion that companion animal videos positively impact students' well-being and interactions with their advisors and may have broader implications beyond the academic setting.
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Affiliation(s)
| | - Sheetal Survase
- School of Public Policy and Leadership, University of Nevada, Las Vegas, NV 89154, USA
| | - Peter B Gray
- Department of Anthropology, University of Nevada, Las Vegas, NV 89154, USA
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Eadeh HM, Breaux R, Boyd-Rogers C, Priest JB, Nikolas MA. Self-regulation in Gender and Sexual Orientation Diverse Adults: Exploring Patterns of Risk and Resilience Using a Person-centered Approach. JOURNAL OF LGBTQ ISSUES IN COUNSELING 2023. [DOI: 10.1080/26924951.2022.2093310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Hana-May Eadeh
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Rosanna Breaux
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Caroline Boyd-Rogers
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Jacob B. Priest
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, USA
| | - Molly A. Nikolas
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
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10
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Wedell E, Tuthill SD, Herchenroeder L, Prince MA, Bravo AJ. Sexual Minority Status, Affect Lability, and Suicide Ideation: Buffering Role of Trait Mindfulness. Arch Suicide Res 2022; 26:1926-1943. [PMID: 34269638 PMCID: PMC9486760 DOI: 10.1080/13811118.2021.1950587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Emotion regulation has been proposed as a mechanism driving sexual orientation disparities in suicide ideation (SI), but little research has examined the role of affect lability in the association of sexual minority identity and SI. As prior research has found trait mindfulness to be associated with lower SI, the objective of the present study was to examine the buffering role of mindfulness in the associations of sexual orientation, affect lability, and SI. METHOD The present study used a moderated mediation model to examine a cross-sectional dataset consisting of heterosexual (n = 1511) and sexual minority (n = 355) U.S. college students (N = 1866), to examine whether five facets of mindfulness moderated the indirect association of sexual minority identity on SI via affect lability. RESULTS As predicted, sexual minority identity was associated with higher affect lability, which in turn was associated with higher SI. Acting with awareness (i.e., attending to the present activities), describing (i.e., the ability to verbalize inner experiences), and non-judging (i.e., refraining from judging inner experiences) buffered the indirect association of sexual minority identity on SI via affect lability, such that the indirect association weakened at higher levels of those mindfulness facets. CONCLUSIONS Our results provide a better understanding of the emotion regulation mechanisms underlying the higher risk of SI among sexual minorities. Future research is needed to examine mindfulness facets as buffers against SI among other communities, and to examine the efficacy of emotion regulation and mindfulness interventions in reducing suicide ideation and other aspects of suicidality (i.e., plans/attempts).HighlightsSexual orientation disparities in suicide ideation (SI) and affect lability.Sexual minority identity linked to higher SI via higher affect lability.Three mindfulness facets attenuated indirect association of identity on SI.
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Affiliation(s)
- Emma Wedell
- Department of Psychological Sciences, William & Mary, USA
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Matko K, Berghöfer A, Jeitler M, Sedlmeier P, Bringmann HC. Who Benefits Most? Interactions between Personality Traits and Outcomes of Four Incremental Meditation and Yoga Treatments. J Clin Med 2022; 11:4553. [PMID: 35956171 PMCID: PMC9369882 DOI: 10.3390/jcm11154553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 02/04/2023] Open
Abstract
Mind-Body Medicine (MBM) includes a broad range of interventions with proven preventive and clinical value, such as yoga and meditation. However, people differ in their preferences and response to different MBM treatments and it remains unclear who benefits most from what type of practice. Thus, finding moderators of treatment outcome seems to be a promising approach. This was the aim of the present study. We conducted a single-case multiple-baseline study investigating the outcomes and moderators of four different MBM treatments. Fifty-seven healthy participants with no prior experience were randomly assigned to three baselines (7, 14, and 21 days) and four eight-week treatments: mantra meditation alone, meditation plus physical yoga, meditation plus ethical education and meditation plus yoga and ethical education. We analysed the data using effect size estimation, multiple regression and cluster analyses. High anxiety, high absorption, low spirituality, low openness and younger age were associated with a range of positive outcomes, such as increased wellbeing or decentering and decreased mind wandering. Receiving ethical education consistently improved wellbeing, while engaging in physical yoga reduced mind wandering. In the cluster analysis, we found that participants with a more maladaptive personality structure enhanced their emotion regulation skills more. Consequently, people do differ in their response to MBM interventions and more vulnerable people, or those high in absorption, seem to benefit more. These findings could support the development of custom-tailored MBM interventions and help clinicians to make scientifically sound recommendations for their patients.
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Affiliation(s)
- Karin Matko
- Institute of Psychology, Chemnitz University of Technology, 09120 Chemnitz, Germany
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Peter Sedlmeier
- Institute of Psychology, Chemnitz University of Technology, 09120 Chemnitz, Germany
| | - Holger C. Bringmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Psychiatry and Psychotherapy, Krankenhaus Spremberg, 03130 Spremberg, Germany
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Smith SN, Almirall D, Choi SY, Koschmann E, Rusch A, Bilek E, Lane A, Abelson JL, Eisenberg D, Himle JA, Fitzgerald KD, Liebrecht C, Kilbourne AM. Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan. Implement Sci 2022; 17:42. [PMID: 35804370 PMCID: PMC9264291 DOI: 10.1186/s13012-022-01211-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools increasingly provide mental health services to students, but often lack access to implementation strategies to support school-based (and school professional [SP]) delivery of evidence-based practices. Given substantial heterogeneity in implementation barriers across schools, development of adaptive implementation strategies that guide which implementation strategies to provide to which schools and when may be necessary to support scale-up. METHODS A clustered, sequential, multiple-assignment randomized trial (SMART) of high schools across Michigan was used to inform the development of a school-level adaptive implementation strategy for supporting SP-delivered cognitive behavioral therapy (CBT). All schools were first provided with implementation support informed by Replicating Effective Programs (REP) and then were randomized to add in-person Coaching or not (phase 1). After 8 weeks, schools were assessed for response based on SP-reported frequency of CBT delivered to students and/or barriers reported. Responder schools continued with phase 1 implementation strategies. Slower-responder schools (not providing ≥ 3 CBT components to ≥10 students or >2 organizational barriers identified) were re-randomized to add Facilitation to current support or not (phase 2). The primary aim hypothesis was that SPs at schools receiving the REP + Coaching + Facilitation adaptive implementation strategy would deliver more CBT sessions than SPs at schools receiving REP alone. Secondary aims compared four implementation strategies (Coaching vs no Coaching × Facilitation vs no Facilitation) on CBT sessions delivered, including by type (group, brief and full individual). Analyses used a marginal, weighted least squares approach developed for clustered SMARTs. RESULTS SPs (n = 169) at 94 high schools entered the study. N = 83 schools (88%) were slower-responders after phase 1. Contrary to the primary aim hypothesis, there was no evidence of a significant difference in CBT sessions delivered between REP + Coaching + Facilitation and REP alone (111.4 vs. 121.1 average total CBT sessions; p = 0.63). In secondary analyses, the adaptive strategy that offered REP + Facilitation resulted in the highest average CBT delivery (154.1 sessions) and the non-adaptive strategy offering REP + Coaching the lowest (94.5 sessions). CONCLUSIONS The most effective strategy in terms of average SP-reported CBT delivery is the adaptive implementation strategy that (i) begins with REP, (ii) augments with Facilitation for slower-responder schools (schools where SPs identified organizational barriers or struggled to deliver CBT), and (iii) stays the course with REP for responder schools. TRIAL REGISTRATION ClinicalTrials.gov, NCT03541317 , May 30, 2018.
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Affiliation(s)
- Shawna N Smith
- Department of Health Management and Policy, School of Public Health, University of Michigan, SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, USA.
| | - Daniel Almirall
- Survey Research Center, Institute of Social Research, University of Michigan, Ann Arbor, USA
- Department of Statistics, University of Michigan, Ann Arbor, USA
| | - Seo Youn Choi
- Department of Health Management and Policy, School of Public Health, University of Michigan, SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Elizabeth Koschmann
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - Amy Rusch
- Department of Health Management and Policy, School of Public Health, University of Michigan, SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Emily Bilek
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - Annalise Lane
- Department of Health Management and Policy, School of Public Health, University of Michigan, SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - James L Abelson
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - Daniel Eisenberg
- Department of Health Policy and Management, UCLA, Los Angeles, USA
| | - Joseph A Himle
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, USA
- School of Social Work, University of Michigan, Ann Arbor, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York City, USA
| | - Celeste Liebrecht
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - Amy M Kilbourne
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
- Quality Enhancement Research Initiative (QUERI), US Department of Veterans Affairs, Washington, D.C., USA
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De France K, Hollenstein T. Emotion Regulation Strategy Use and Success During Adolescence: Assessing the Role of Context. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:720-736. [PMID: 34459061 DOI: 10.1111/jora.12672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/31/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
This study evaluated the role of situational factors in emotion regulation (ER) strategy choice and perceived ER success within a sample of adolescents (n = 178, Mage = 13.93, 42.2% female). Experience-sampling results showed that emotion type and intensity, but not situational control, were associated with strategy use. Instances of anxiety and situational control were associated with higher levels of ER success, while intensity was associated with lower levels of ER success. Finally, situational factors moderated the reappraisal-success and engagement-success associations. These results provide the first assessment of multiple contextual factors on strategy selection and regulatory success during naturalistic emotional evocations and suggest that context is influential for strategy selection, regulatory success, as well as associations between these two highly researched elements of ER.
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Brodbeck J, Berger T, Biesold N, Rockstroh F, Schmidt SJ, Znoj H. The Role of Emotion Regulation and Loss-Related Coping Self-efficacy in an Internet Intervention for Grief: Mediation Analysis. JMIR Ment Health 2022; 9:e27707. [PMID: 35522459 PMCID: PMC9123547 DOI: 10.2196/27707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/30/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Internet interventions for mental disorders and psychological problems such as prolonged grief have established their efficacy. However, little is known about how internet interventions work and the mechanisms through which they are linked to the outcomes. OBJECTIVE As a first step in identifying mechanisms of change, this study aimed to examine emotion regulation and loss-related coping self-efficacy as putative mediators in a randomized controlled trial of a guided internet intervention for prolonged grief symptoms after spousal bereavement or separation or divorce. METHODS The sample comprised older adults who reported prolonged grief or adaptation problems after bereavement, separation, or divorce and sought help from a guided internet intervention. They were recruited mainly via newspaper articles. The outcome variables were grief symptoms assessed using the Texas Revised Inventory of Grief and psychopathology symptoms assessed using the Brief Symptom Inventory. A total of 6 module-related items assessed loss-focused emotion regulation and loss-related coping self-efficacy. In the first step, path models were used to examine emotion regulation and loss-related coping self-efficacy as single mediators for improvements in grief and psychopathology symptoms. Subsequently, exploratory path models with the simultaneous inclusion of emotion regulation and self-efficacy were used to investigate the specificity and relative strength of these variables as parallel mediators. RESULTS A total of 100 participants took part in the guided internet intervention. The average age was 51.11 (SD 13.60) years; 80% (80/100) were separated or divorced, 69% (69/100) were female, and 76% (76/100) were of Swiss origin. The internet intervention increased emotion regulation skills (β=.33; P=.001) and loss-related coping self-efficacy (β=.30; P=.002), both of which correlated with improvements in grief and psychopathology symptoms. Path models suggested that emotion regulation and loss-related coping self-efficacy were mediators for improvement in grief. Emotion regulation showed a significant indirect effect (β=.13; P=.009), whereas coping self-efficacy showed a trend (β=.07; P=.06). Both were confirmed as mediators for psychopathology (β=.12, P=.02; β=.10; P=.02, respectively). The path from the intervention to the improvement in grief remained significant when including the mediators (β=.26, P=.004; β=.32, P≤.001, respectively) in contrast to the path from the intervention to improvements in psychopathology (β=.15, P=.13; β=.16, P=.10, respectively). CONCLUSIONS Emotion regulation and loss-related coping self-efficacy are promising therapeutic targets for optimizing internet interventions for grief. Both should be further examined as transdiagnostic or disorder-specific putative mediators in internet interventions for other disorders. TRIAL REGISTRATION ClinicalTrials.gov NCT02900534; https://clinicaltrials.gov/ct2/show/NCT02900534. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-016-1759-5.
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Affiliation(s)
- Jeannette Brodbeck
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.,School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Nicola Biesold
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Franziska Rockstroh
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, Bern, Switzerland
| | - Stefanie J Schmidt
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Hansjoerg Znoj
- Department of Health Psychology, University of Bern, Bern, Switzerland
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Lonigro A, Longobardi E, Laghi F. The interplay between expressive suppression, emotional self-efficacy and internalizing behavior in middle adolescence. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09685-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Background
Maladaptive emotion regulation strategies are predictive of negative outcomes in adolescence which, in turn, may impact on later well-being.
Objective
The current study aimed at testing the moderating role of emotional self-efficacy on the relation between expressive suppression and the engagement in internalizing behavior, controlling for gender effect.
Method
A total of 526 adolescents (Mage = 14.7 years, age range = 14–17 years) filled out self-report questionnaires evaluating expressive suppression, emotional regulatory self-efficacy, and internalizing behavior, respectively.
Results
Suppressors with lower positive emotion self-efficacy were more likely to engage in internalizing behavior than suppressors with higher positive emotion self-efficacy.
Conclusions
Despite several limitations, the study provided preliminary insights on the role played by emotional self-efficacy in the relation between expressive suppression and internalizing behavior in middle adolescence.
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16
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Lancaster K, Thomson SJ, Chiaravalloti ND, Genova HM. Improving mental health in Multiple Sclerosis with an interpersonal emotion regulation intervention: a prospective, randomized controlled trial. Mult Scler Relat Disord 2022; 60:103643. [DOI: 10.1016/j.msard.2022.103643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/27/2021] [Accepted: 01/29/2022] [Indexed: 01/10/2023]
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17
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Eadeh HM, Breaux R, Nikolas MA. A Meta-Analytic Review of Emotion Regulation Focused Psychosocial Interventions for Adolescents. Clin Child Fam Psychol Rev 2021; 24:684-706. [PMID: 34275057 PMCID: PMC8600935 DOI: 10.1007/s10567-021-00362-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 01/19/2023]
Abstract
Emotion regulation (ER) is the ability to monitor, evaluate, and modify one's emotional responses to be appropriate for environmental demands. Poor ER has been considered a transdiagnostic risk factor for a range of internalizing and externalizing disorders and overall decreased well-being in adolescents. A range of evidence-based interventions exist which may improve ER. However, much of the intervention research to date does not include a measure of ER to assess change pre and post treatment, with limited information about the efficacy of these interventions in youth across a range of sample types. There is a clear need for a comprehensive review of the literature examining ER-focused interventions in adolescents with a wide range of presenting disorders. A literature search was originally conducted in January 2020 and an updated search was conducted in February 2021 which elicited 1245 articles, of which 605 were duplicates and were removed. Abstracts of the remaining 640 articles were screened with 121 articles being reviewed in full. Of note, 16 additional articles were identified through references and other sources during this process and were also included in the full review. Of the 137 articles reviewed in full, 41 studies were ultimately included in the present review. The present paper provides a descriptive review of intervention approaches and findings from community prevention programs, programs for war-affected youth, programs for clinical populations, and programs for incarcerated and delinquent adolescents. The overall pooled effect was significantly different from zero based on the pre/post effects [Hedge's g = 0.29, 95% CI (0.22, 0.36)] and the intervention/control effects [Hedge's g = 0.19, 95% CI (0.06-0.32)]. Although neither sex nor age significantly accounted for heterogeneity in effect sizes, there were significant findings for population type (clinical vs. community), with community samples having significantly lower effect sizes on average. Impacts of the different ER measures used and significant methodological variability (e.g., use of control groups, length of intervention) across included studies are discussed. Implications and suggestions for future research are reviewed, specifically, that additional understanding of moderators of effects are needed and that measures used to assess change in ER, both dysregulation and adaptive skill use, may need to more directly align with the intervention's focus and the strategies taught as part of the intervention.
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Affiliation(s)
- Hana-May Eadeh
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Ave, Iowa City, IA, 52242, USA.
| | - Rosanna Breaux
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Ave, Iowa City, IA, 52242, USA
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18
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Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and Behavior Change. Harv Rev Psychiatry 2021; 28:371-394. [PMID: 33156156 PMCID: PMC7647439 DOI: 10.1097/hrp.0000000000000277] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
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Khatib M, Badillo N, Kahar P, Khanna D. The Risk of Chronic Diseases in Individuals Responding to a Measure for the Initial Screening of Depression and Reported Feelings of Being Down, Depressed, or Hopeless. Cureus 2021; 13:e17634. [PMID: 34646682 PMCID: PMC8486358 DOI: 10.7759/cureus.17634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/01/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Feeling down, depressed, or hopeless may provide a comprehensive measure for physicians to utilize, allowing a possible way to assess risk for chronic diseases. Methods A face-to-face, in-home, validated survey was conducted on participants aged 16 and older. Trained interviewers administered the questionnaire through the Computer-Assisted Personal Interview (CAPI) system. Through this measure, responses such as feelings of depression, diagnosis of high cholesterol, high blood pressure, diabetes, asthma, being overweight, coronary heart disease, and cancer or malignancy were recorded. Statistical analysis was conducted by descriptive analysis, Chi-Square test, and multinomial regression analysis. Results: Data are presented as a mean ± SD and percentage. A total of 10560 individuals participated in the survey. Of participants reporting feeling down, depressed, or hopeless almost every day, 54.3% reported high blood pressure (χ2=116.108, p= 0.000), 44.1% with high cholesterol level (χ2=54.89, p= 0.000), 22.9% with diabetes (χ2=91.09, p= 0.000), 25.0% with asthma (χ2=93.83, p= 0.000), 49.5% had a doctor tell them they were overweight (χ2=59.32, p= 0.000), 8.2% had coronary heart disease (χ2=32.39, p= 0.000), and 11.4% that had cancer or malignancy (χ2=7.73, p= 0.655). This is compared to individuals who reported no feelings of depression, with 34.2% having high blood pressure, 32.2% with high cholesterol, 12.9% with diabetes, 14.1% told they had asthma, 14.1% told they were overweight, 3.9% with coronary heart disease, and 9.4% who had cancer or malignancy. Conclusion The assessment of feeling down, depressed, or hopeless is significantly associated with the risk of certain chronic diseases, with those who reported feelings of depression nearly every day at the highest risk.
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Affiliation(s)
- Mohammed Khatib
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Nathan Badillo
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Payal Kahar
- Department of Health Sciences, Florida Gulf Coast University, Fort Myers, USA
| | - Deepesh Khanna
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
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Düsing R, Radtke EL, Kuhl J, Konrad C, Vandekerckhove M, Quirin M. Emotion regulation ability compensates for the depression-related negativity bias. Acta Psychol (Amst) 2021; 220:103414. [PMID: 34547591 DOI: 10.1016/j.actpsy.2021.103414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/31/2022] Open
Abstract
Emotion regulation ability (ERA) enables individuals to disengage from negative stimuli. In this study, we investigated the role of ERA in the depression-related negativity bias. Seventy-four individuals with major depressive disorder and eighty-three nonclinical individuals were screened for depressiveness using the Beck Depression Inventory. ERA was assessed using the Action Orientation After Failure Subscale of the Action Control Scale. We used a classical Stroop task variant, wherein the color words were preceded by either a self-relevant positive (success-related), negative (failure-related), or neutral word prime. The expected depressiveness × emotional prime interaction did not reach significance but the expected ERA × emotional prime interaction did. The latter effect was qualified by a three-way interaction between ERA, depressiveness, and emotional prime. Specifically, ERA predicted the negativity bias in individuals with high depressiveness scores. Using the Johnson-Neyman technique, we found that this effect was significant at the level of mild to moderate depression and beyond. Thus, poor ERA in individuals with depression may cause the depression-related negativity bias, whereas (at least) moderate ERA may protect individuals with depression from this bias. Future studies should assess ERA in individuals with depressive symptomatology and investigate how it influences their everyday functioning and treatment outcomes.
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21
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Merkle N, Ullrich J, Gfrörer T, Brown RC. Schulbasiertes Training für Jugendliche zur Emotionsregulation. KINDHEIT UND ENTWICKLUNG 2021. [DOI: 10.1026/0942-5403/a000360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Trainingsprogramme zur Emotionsregulation für Jugendliche sind notwendig, da eine Dysregulation der Emotionen die Entwicklung von psychischen Störungen begünstigen kann. Fragestellung: Ziel dieser systematischen Literaturübersicht ist es, einen Überblick über aktuelle Publikationen zu Trainingsprogrammen von 2015 – 2020 zu geben. Methode: Im Rahmen der Literaturrecherche konnten sechs Publikationen eingeschlossen werden. Ergebnisse: Es zeigten sich positive Effekte bei der Programmdurchführung durch externe Personen, vor allem durch Fachpersonen und keine bis negative Effekte bei der Durchführung durch das Schulpersonal. Ein positiver Einfluss durch die Einbeziehung der Eltern konnte in einem Trainingsprogramm vermutet werden, wobei die Ergebnisse statistisch nicht signifikant waren. Schlussfolgerung: Es zeigt sich die Notwendigkeit weiterer Evaluation von Trainingsprogrammen, welche sich vor allem auch mit dem Einbezug der Bezugspersonen beschäftigen und untersuchen, inwiefern Trainer_inneneffekte auch bei Studien mit einer besseren Vergleichbarkeit vorliegen.
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Affiliation(s)
- Nadja Merkle
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Ulm
| | - Janice Ullrich
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Ulm
| | - Thomas Gfrörer
- Hector-Institut für Empirische Bildungsforschung, Universität Tübingen
| | - Rebecca C. Brown
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Ulm
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22
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Gutiérrez-Hermoso L, Velasco-Furlong L, Sánchez-Román S, Berzal-Pérez E, Alcocer-Castillejos N, Quiroz-Friedman P. The effect of treatment and coping on the quality of life in breast cancer patients: a moderated mediation model. Qual Life Res 2021; 31:147-158. [PMID: 34024017 DOI: 10.1007/s11136-021-02885-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Breast cancer involves complicated emotional processes. One of the factors that impacts the psychological symptoms and decreases QoL is the side effects of treatment. The purpose of this study is to explore the effect of the main medical treatment (chemotherapy or hormone therapy) on the three domains of quality of life. For this, coping strategies were considered as psychological variables that mediate the relationship based on high or low alexithymia as a moderating variable. METHODS This study had a cross-sectional design. The participant sample comprised 129 women with breast cancer in early stage (I to III) (63 receiving chemotherapy and 66 hormone therapy) and were evaluated from September 2015 to September 2019. Physical, emotional and social functioning were measured by the Quality of Life Questionnaire for cancer patients (EORTC-QLQ-C30), coping strategies were measured by Mental Adjustment to Cancer Questionnaire (MAC) and alexithymia was evaluated by the Alexithymia Toronto Scale (TAS-20). RESULTS Treatment had a significant negative effect on physical domain in both patients receiving chemotherapy and hormone therapy. Moderated mediation analysis show that this relationship was significant when it was mediated by helplessness. Furthermore, this model is only significant when there are high levels of alexithymia. No significant effect direct was found on emotional and social functioning of quality of life. CONCLUSIONS Results confirmed that coping based on helplessness and stable emotional variables such as alexithymia can have an effect, mediator or moderator, respectively, in the decrease of the physical functionality of women with breast cancer. Our findings highlight the need to include psychological therapy to help patients alleviate their psychological state because it can affect their physical condition.
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Affiliation(s)
| | | | - Sofía Sánchez-Román
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | | | - Natasha Alcocer-Castillejos
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Paulina Quiroz-Friedman
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
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23
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Hoge EA, Acabchuk RL, Kimmel H, Moitra E, Britton WB, Dumais T, Ferrer RA, Lazar SW, Vago D, Lipsky J, Schuman-Olivier Z, Cheaito A, Sager L, Peters S, Rahrig H, Acero P, Scharf J, Loucks EB, Fulwiler C. Emotion-related constructs engaged by mindfulness-based interventions: A systematic review and meta-analysis. Mindfulness (N Y) 2021; 12:1041-1062. [PMID: 34149957 PMCID: PMC8210838 DOI: 10.1007/s12671-020-01561-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined. METHODS Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. RESULTS Seventy-two studies (N=7,378) were included (MBSR k=47, MBCT k = 21, Modified k=4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d=0.58; k =36), and in all constructs assessed: depression (d=0.66; k=26), anxiety (d =0.63; k=19), combined mental health (d =0.75; k=7 ) and stress (d =0.44; k=11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population-type did not moderate results, but MBI-type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. CONCLUSIONS This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.
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Affiliation(s)
- Elizabeth A. Hoge
- Department of Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Ave NW Suite 200, Washington, DC 20007, USA
| | - Rebecca L. Acabchuk
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, 06269, USA
| | - Hannah Kimmel
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Willoughby B. Britton
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Travis Dumais
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Rebecca A. Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - David Vago
- Osher Center for Integrative Medicine, Vanderbilt University, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA
| | - Jonah Lipsky
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Zev Schuman-Olivier
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
| | - Aya Cheaito
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Lauren Sager
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Sarah Peters
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Hadley Rahrig
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Pamela Acero
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Jodi Scharf
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Eric B. Loucks
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Carl Fulwiler
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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Exploring relations between teacher emotions, coping strategies, and intentions to quit: A longitudinal analysis. J Sch Psychol 2021; 86:64-77. [PMID: 34051918 DOI: 10.1016/j.jsp.2021.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 12/23/2020] [Accepted: 03/26/2021] [Indexed: 11/22/2022]
Abstract
Although previous research has indicated that emotions have a substantial impact on teacher well-being, research is lacking concerning the relationships between teachers' emotions, coping strategies, and quitting intentions. This current five-month, two-wave longitudinal study investigated the relations between these variables in a sample of 1086 Canadian teachers (female: 81.3%; Mage = 42). Results from cross-lagged analyses revealed that teachers' trait emotions corresponded with coping strategies and that trait emotions and coping strategies both corresponded with intentions to quit the teaching profession. Mediational latent change analyses further showed that baseline levels of teachers' anxiety corresponded with greater emotion-focused disengagement coping that, in turn, led to stronger intentions to quit the teaching profession. Finally, decreases in teachers' anxiety over time additionally corresponded with decreases in disengagement coping. Limitations and practical implications concerning the importance of providing meaningful support to teachers for reducing anxiety, improving coping, and reducing quitting intentions are discussed.
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Sheftall AH, Bergdoll EE, James M, Bauer C, Spector E, Vakil F, Armstrong E, Allen J, Bridge JA. Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Study. Child Psychiatry Hum Dev 2020; 51:792-800. [PMID: 32488436 PMCID: PMC7529823 DOI: 10.1007/s10578-020-01010-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Parental history of suicidal behavior is associated with an increased risk of early onset suicidal behavior in their offspring. The objective of this pilot study was to compare clinical characteristics, temperament, and emotion regulation in children, aged 6-9 years, with (PH+) and without (PH-) a maternal history of suicidal behavior to determine which factors could be markers of early vulnerability. At baseline, PH+ children, compared to PH- children, demonstrated more difficulties with temperament, emotion regulation, and experienced more life events in the year prior to their baseline appointment. At study follow-ups, however, no differences were found between PH+ and PH- children. Results suggest there are some signals of early vulnerability present in children with a maternal history of suicidal behavior and recruitment/retention of this group of youth is feasible.
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Affiliation(s)
- Arielle H Sheftall
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Pediatrics at The Ohio State University College of Medicine, Columbus, OH, USA.
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Big Lots Behavioral Health Pavilion, 2nd Floor, 444 Butterfly Gardens Dr, Columbus, OH, 43215, USA.
| | - Emory E Bergdoll
- Department of Counseling, Xavier University, Cincinnati, OH, USA
| | - Monaé James
- The Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Connor Bauer
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Fatima Vakil
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Emily Armstrong
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Jakob Allen
- John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeffrey A Bridge
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Departments of Pediatrics and Psychiatry & Behavioral Health at The Ohio State University College of Medicine, Columbus, OH, USA
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Schensul JJ, Salvi A, Ha T, Reisine S, Li J, Moni Y. Building a new scale to measure worries about oral hygiene self-management in vulnerable older adults. Gerodontology 2020; 37:361-373. [PMID: 32410346 DOI: 10.1111/ger.12471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 03/18/2020] [Accepted: 04/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This paper describes a new scale to measure worries about self-management of oral hygiene in low-income older adults. BACKGROUND Oral hygiene that prevents oral diseases and worsening of chronic conditions improves with instruction, but other cognitive/emotional factors impede oral hygiene practice especially among older adults. Many scales measure dental anxiety, but none measures oral hygiene self-management worries. MATERIALS AND METHODS Formative research with diverse older adults 55-95 in low-income housing identified scale items. A 23-item scale was tested in a pilot intervention study (n = 84) and formalised with a new sample (N = 331). RESULTS In both studies, PCA/factor analysis produced two subscales: (a) worries about cleaning teeth and (b) consequences of cleaning. Chronbach's alpha coefficient evaluated internal consistency, and Pearson's r and Kendall tau/Spearman's rho evaluated scale predictability, convergent and divergent validity. The scale and subscales showed good internal consistency in both studies (over 0.90) and stability T0 0.90; T1: 0.90). In the larger sample, statistically significant correlations between the scale, subscales; plaque score, and similar scales (perceived risk of oral health problems, and fears of oral diseases) demonstrated convergent validity. For divergent validity, the worries scale, not the GOHAI, a similar scale measuring oral health life quality, was associated with Plaque Score. Each scale was associated with different mediators suggesting different constructs. CONCLUSION The overall scale has good internal consistency, test-retest reliability, predictability and convergent and divergent validity. It captures a psycho-emotional construct useful in oral health research and hygiene education with older adults.
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Affiliation(s)
| | - Apoorva Salvi
- Institute for Community Research, Hartford, Connecticut
| | - Toan Ha
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Susan Reisine
- University of Connecticut School of Dental Medicine, Farmington, Connecticut
| | - Jianghong Li
- Institute for Community Research, Hartford, Connecticut
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Lee M, Lee ES, Jun JY, Park S. The effect of early trauma on North Korean refugee youths' mental health: Moderating effect of emotional regulation strategies. Psychiatry Res 2020; 287:112707. [PMID: 32193008 DOI: 10.1016/j.psychres.2019.112707] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/23/2019] [Accepted: 11/24/2019] [Indexed: 01/02/2023]
Abstract
Research shows that North Korean refugee youths are exposed to early traumatic events and are, therefore, vulnerable to mental health problems. We investigated the relationship between early trauma and emotion regulation strategies with symptoms of depression and attention-deficit hyperactivity disorder (ADHD) among North Korean refugee youths. In 2017-2018, we surveyed youths attending alternative schools for North Korean refugees in Seoul. One hundred and fifty-seven students (54 boys, 103 girls; 18.66 ± 2.82 years) completed questionnaires assessing early trauma experiences, emotion regulation strategies, depressive symptoms, and ADHD symptoms. Descriptive, correlation, and moderation analyses were conducted. Early trauma experience directly and negatively affected both the depressive and ADHD symptoms of North Korean refugee youths. The use of expressive suppression strategy significantly aggravated these effects of early trauma on both depressive and ADHD symptoms, indicating that it might be a risk factor for mental health problems among them. Contrarily, cognitive reappraisal seemed to buffer the effect of the expressive suppression strategy on depressive symptoms. A tailored intervention promoting emotion regulation strategies to prevent depressive and ADHD symptoms among this group is necessary.
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Affiliation(s)
- Minji Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, 04933, Korea
| | - Eun-Sun Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, 04933, Korea
| | - Jin Yong Jun
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, 04933, Korea
| | - Subin Park
- Department of Psychiatry, National Center for Mental Health, Seoul, 04933, Korea.
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Xiao Y, He L, Chen Y, Wang Y, Chang W, Yu Z. Depression and deliberate self-harm among Chinese left-behind adolescents: A dual role of resilience. Asian J Psychiatr 2020; 48:101883. [PMID: 31786362 DOI: 10.1016/j.ajp.2019.101883] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 12/22/2022]
Abstract
Existing literature supports the association between depression and deliberate self-harm (DSH), a prominent risk factor of suicide. Our major aim was to evaluate the possible moderation and mediation of resilience in depression-DSH association, an issue which has never been extensively discussed among Chinese left-behind children (LBC). We implemented a population-based cross-sectional study of 2,619 LBC aged from 10 to 17. Multivariate logistic regression model which incorporated the cross-product term of resilience and depression was used to determine the moderation effect of resilience in depression-DSH association, whereas the mediating role of resilience was measured by path analysis. We found that depression was positively associated with DSH whereas resilience was negatively associated with DSH. Resilience in general was a prominent effect moderator in depression-DSH association, meanwhile, resilience also played as a significant mediator in this association, accounted for 26.8 % of the total effect. Our findings indicated that resilience was important moderator and mediator in the association between depression and DSH among Chinese LBC. Building up resilience of LBC may be an ideal choice in preventing depression related DSH.
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Affiliation(s)
- Yuanyuan Xiao
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
| | - Liping He
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Ying Chen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yeying Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Wei Chang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Zhen Yu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
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29
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Domlyn AM, Jiang Y, Harrison S, Qiao S, Li X. Stigma and psychosocial wellbeing among children affected by parental HIV in China. AIDS Care 2019; 32:500-507. [PMID: 31690083 DOI: 10.1080/09540121.2019.1687834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Parental HIV infection presents unique psychosocial challenges for families. Affected children are vulnerable to stigma-related distress from a parent's HIV status and are more likely to experience symptoms of depression and low self-esteem than unaffected peers. This study examined whether HIV-related stigma predicted poorer mental health among children affected by parental HIV and whether psychosocial assets mediated this relationship. METHODS A sample of 790 children (ages 6-17) affected by parental HIV in Henan, China reported on HIV-related stigma, social support, emotional regulation, future outlook, and mental health symptoms. Structural equation modeling was used to examine the direct and indirect effects of stigma on mental health. RESULTS Results indicated that stigma was associated with psychosocial resources, which in turn were associated with mental health symptoms. The indirect pathways from stigma to mental health symptoms through psychosocial resources were consistent across age and gender. CONCLUSION The experience of HIV-related stigma was associated with poorer overall mental health among children affected by parental HIV in China. Children's psychosocial resources, including social support, emotional regulation, and future outlook, mediated the relationship between HIV-related stigma and mental health symptoms. Future interventions may wish to target these modifiable aspects of wellbeing to improve social and behavioral outcomes in this vulnerable population.
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Affiliation(s)
- Ariel M Domlyn
- Department of Psychology, University of South Carolina, Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Yanping Jiang
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sayward Harrison
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Xiao Y, Chen Y, Meng Q, Tian X, He L, Yu Z, Wang Y. Suicide ideation and suicide plan in Chinese left-behind children: Prevalence and associated factors. J Affect Disord 2019; 257:662-668. [PMID: 31377602 DOI: 10.1016/j.jad.2019.07.072] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/05/2019] [Accepted: 07/29/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Suicide ideation (SI) and suicide plan (SP) can be seen as immediate precursors of suicide. The major aim of this study is to estimate the severity of SI and SP among LBC, and explore their associated factors. METHOD A population-based random sampling survey of 2898 LBC was performed. Self-developed structured questionnaire was used to collect relevant information. The prevalence of one-week and lifetime SI and SP was estimated, univariate and multivariate logistic regression model were used to analyze the associated factors of SI in LBC, as well as the associated factors of SP in LBC who reported SI. RESULTS For surveyed LBC, the one-week prevalence rates of SI and SP were 6.76% (95%CI: 5.30-8.00%) and 2.31% (95%CI: 1.80-2.93%), the lifetime prevalence rates of SI and SP were 20.8% (95%CI: 17.2-25.0%) and 7.69% (95%CI: 4.84-11.0%). Girls reported higher prevalence of SI, while SP severity showed insignificant gender difference. Sex, grade, SH behaviors, depression and psychological resilience were consistently associated with both one-week and lifetime SI. Age and depression were prominent influencing factors of SP in one-week suicide ideators, grade, self-harm history, depression, mother's education level were associated factors of SP in lifetime suicide ideators. CONCLUSIONS The prevalence of SI and SA in Chinese LBC is high. Girls, junior high school students, self-harmed, depressed, less psychologically resilient individuals were observed increased prevalence of SI, depression may play a significant role in facilitating the transition from SI to SP.
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Affiliation(s)
- Yuanyuan Xiao
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, United States.
| | - Ying Chen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Qiong Meng
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xin Tian
- The First Affiliated School of Clinical Medicine, Kunming Medical University, China
| | - Limei He
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Zhen Yu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yeying Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
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Hoge EA, Philip SR, Fulwiler C. Considerations for mood and emotion measures in mindfulness-based intervention research. Curr Opin Psychol 2019; 28:279-284. [DOI: 10.1016/j.copsyc.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/29/2019] [Accepted: 02/03/2019] [Indexed: 10/27/2022]
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Doucet MH, Farella Guzzo M, Groleau D. Brief report: A qualitative evidence synthesis of the psychological processes of school-based expressive writing interventions with adolescents. J Adolesc 2018; 69:113-117. [PMID: 30286329 DOI: 10.1016/j.adolescence.2018.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/14/2018] [Accepted: 09/23/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Expressive writing interventions consist of brief writing sessions on thoughts and emotions and are known to yield positive benefits on adolescents' mental health. However, the psychological mechanisms explaining these effects are not clear. METHOD This review explored the psychological processes underlying school-based expressive writing interventions with adolescents. A thematic synthesis of qualitative research consisted of identifying, appraising and summarizing the qualitative evidence of eligible studies. RESULTS Only six of the 510 identified studies met the inclusion criteria of this review. Results provide some validation for cognitive-processing, emotion-regulation, and disinhibition as psychological mechanisms underlying school-based expressive writing with adolescents. CONCLUSIONS However, these conclusions are still preliminary because of the paucity of the qualitative evidence found, both in quantity and quality. We recommend that more rigorous and in-depth qualitative research be undertaken to: 1) explore adolescents' subjective experience about the expressive writing intervention, using in-depth individual interviews; 2) thoroughly assess the content of students' texts written during the intervention; and 3) document the process of expressive writing interventions through observational methods. The results of such investigations would support the development and implementation of school-based expressive writing-type of interventions adapted to adolescents.
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Affiliation(s)
- Marie-Hélène Doucet
- Division of Social and Transcultural Psychiatry, McGill University, 1033, Des Pins West, Montreal, QC H3A 1A1, Canada.
| | - Maria Farella Guzzo
- Division of Social and Transcultural Psychiatry, McGill University, 1033, Des Pins West, Montreal, QC H3A 1A1, Canada.
| | - Danielle Groleau
- Division of Social and Transcultural Psychiatry, McGill University, 1033, Des Pins West, Montreal, QC H3A 1A1, Canada; Jewish General Hospital, Lady Davis Institute, 4333 Côte St-Catherine Road, Montreal, QC H3T 1E4, Canada.
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Kilbourne AM, Smith SN, Choi SY, Koschmann E, Liebrecht C, Rusch A, Abelson JL, Eisenberg D, Himle JA, Fitzgerald K, Almirall D. Adaptive School-based Implementation of CBT (ASIC): clustered-SMART for building an optimized adaptive implementation intervention to improve uptake of mental health interventions in schools. Implement Sci 2018; 13:119. [PMID: 30185192 PMCID: PMC6126013 DOI: 10.1186/s13012-018-0808-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background Depressive and anxiety disorders affect 20–30% of school-age youth, most of whom do not receive adequate services, contributing to poor developmental and academic outcomes. Evidence-based practices (EBPs) such as cognitive behavioral therapy (CBT) can improve outcomes, but numerous barriers limit access among affected youth. Many youth try to access mental health services in schools, but school professionals (SPs: counselors, psychologists, social workers) are rarely trained adequately in CBT methods. Further, SPs face organizational barriers to providing CBT, such as lack of administrative support. Three promising implementation strategies to address barriers to school-based CBT delivery include (1) Replicating Effective Programs (REP), which deploys customized CBT packaging, didactic training in CBT, and technical assistance; (2) coaching, which extends training via live supervision to improve SP competence in CBT delivery; and (3) facilitation, which employs an organizational expert who mentors SPs in strategic thinking to promote self-efficacy in garnering administrative support. REP is a relatively low-intensity/low-cost strategy, whereas coaching and facilitation require additional resources. However, not all schools will require all three strategies. The primary aim of this study is to compare the effectiveness of a school-level adaptive implementation intervention involving REP, coaching, and facilitation versus REP alone on the frequency of CBT delivered to students by SPs and student mental health outcomes. Secondary and exploratory aims examine cost-effectiveness, moderators, and mechanisms of implementation strategies. Methods Using a clustered, sequential multiple-assignment, randomized trial (SMART) design, ≥ 200 SPs from 100 schools across Michigan will be randomized initially to receive REP vs. REP+coaching. After 8 weeks, schools that do not meet a pre-specified implementation benchmark are re-randomized to continue with the initial strategy or to augment with facilitation. Discussion EBPs need to be implemented successfully and efficiently in settings where individuals are most likely to seek care in order to gain large-scale impact on public health. Adaptive implementation interventions hold the promise of providing cost-effective implementation support. This is the first study to test an adaptive implementation of CBT for school-age youth, at a statewide level, delivered by school staff, taking an EBP to large populations with limited mental health care access. Trial registration NCT03541317—Registered on 29 May 2018 on ClinicalTrials.gov PRS Electronic supplementary material The online version of this article (10.1186/s13012-018-0808-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amy M Kilbourne
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA. .,U.S. Department of Veterans Affairs, Quality Enhancement Research Initiative, Washington D.C., USA.
| | - Shawna N Smith
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Seo Youn Choi
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Elizabeth Koschmann
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Celeste Liebrecht
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Amy Rusch
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James L Abelson
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel Eisenberg
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Joseph A Himle
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.,School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Kate Fitzgerald
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel Almirall
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Volkaert B, Wante L, Vervoort L, Braet C. 'Boost Camp', a universal school-based transdiagnostic prevention program targeting adolescent emotion regulation; evaluating the effectiveness by a clustered RCT: a protocol paper. BMC Public Health 2018; 18:904. [PMID: 30031383 PMCID: PMC6054752 DOI: 10.1186/s12889-018-5754-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents' emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included. METHODS The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up. DISCUSSION Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent's ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634].
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Affiliation(s)
- Brenda Volkaert
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, Ghent, Belgium
| | - Laura Wante
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, Ghent, Belgium
| | - Leentje Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, Ghent, Belgium
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Mocanu E, Mohr C, Pouyan N, Thuillard S, Dan-Glauser ES. Reasons, Years and Frequency of Yoga Practice: Effect on Emotion Response Reactivity. Front Hum Neurosci 2018; 12:264. [PMID: 30022932 PMCID: PMC6039555 DOI: 10.3389/fnhum.2018.00264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/08/2018] [Indexed: 01/23/2023] Open
Abstract
Yoga practice, even in the short term, is supposed to enhance wellbeing and counteract psychopathology through modification of emotion reactivity. Yoga teaches that emotional responses may be less pronounced with longer and more frequent practice, and potentially when people perform yoga for mental rather than physical reasons. We tested 36 yoga practitioners of varying experience (between 6 months and 11 years of practice). We assessed participants' self-reported emotional experience and peripheral physiological reactions (heart rate, skin conductance, respiration) when seeing positive and negative pictures. Results were analyzed as a function of the years of, frequency of, and reasons for yoga practice. We found a heart rate increase with the degree participants performed yoga for mental reasons. In addition, years of yoga practice were significantly associated with reduced abdominal respiratory rate when facing negative pictures, speaking in favor of reduced arousal with yoga experience. Finally, regarding frequency of practice, a higher frequency in the last month was linked to less negative and positive experiences as well as a reduced abdominal respiratory amplitude when viewing positive pictures. Altogether, these results demonstrate that intense short-term yoga practice might relate to a (i) decrease in the intensity of self-reported emotional experiences and (ii) deepened respiration. Short-term effects might be shaped by what participants expect as practice benefits. However, several years of practice might be needed to decrease respiratory arousal in the face of negative situations, which likely is a manifestation of an evolution in the emotion regulation process.
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Lelorain S, Cattan S, Lordick F, Mehnert A, Mariette C, Christophe V, Cortot A. In which context is physician empathy associated with cancer patient quality of life? PATIENT EDUCATION AND COUNSELING 2018; 101:1216-1222. [PMID: 29409676 DOI: 10.1016/j.pec.2018.01.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/03/2018] [Accepted: 01/30/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE In cancer settings, physician empathy is not always linked to a better patient emotional quality of life quality of life (eQoL). We tested two possible moderators of the inconsistent link: type of consultation (bad news versus follow-up) and patient emotional skills (emoSkills, i.e., the way patients process emotional information). METHODS In a cross-sectional design, 296 thoracic and digestive tract cancer patients completed validated questionnaires to assess their physician empathy, their emoSkills and eQoL. Moderated multiple regressions were performed. RESULTS In follow-up consultations, physician empathy was associated with a better eQoL in patients with low or average emotional skills. Those with high emotional skills did not benefit from physician empathy. Their eQoL was nonetheless very good. In bad news consultations, the pattern was reversed: only patients with average or high emotional skills benefited from physician empathy. Those with low emotional skills were not sensitive to it and presented a poor eQoL. CONCLUSION Medical empathy is important in all consultations. However, in bad news consultations, patients with low emoSkills are at risk of psychological distress even with an empathetic doctor. PRACTICE IMPLICATIONS Accordingly, physicians should be trained to detect patients with low emoSkills in order to refer them to supportive care.
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Affiliation(s)
- Sophie Lelorain
- Univ. Lille, CNRS, CHU Lille, UMR 9193, SCALab, Cognitive and Affective Sciences, Lille, France; SIRIC (French comprehensive cancer center), ONCOLille, France.
| | - Stéphane Cattan
- Univ. Lille, Department of Digestive Diseases, Claude Huriez University Hospital, Lille, France
| | - Florian Lordick
- University Medicine Leipzig, University Cancer Center Leipzig (UCCL), Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Germany
| | - Christophe Mariette
- SIRIC (French comprehensive cancer center), ONCOLille, France; Univ. Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France; Univ. Lille, UMR-S 1172, JPARC, Research Center Jean-Pierre AUBERT Neurosciences and Cancer, Lille, France
| | - Véronique Christophe
- Univ. Lille, CNRS, CHU Lille, UMR 9193, SCALab, Cognitive and Affective Sciences, Lille, France; SIRIC (French comprehensive cancer center), ONCOLille, France
| | - Alexis Cortot
- Univ. Lille, Department of Thoracic Oncology, Albert Calmette University Hospital, Lille, France
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Jensen-Johansen MB, O’Toole MS, Christensen S, Valdimarsdottir H, Zakowski S, Bovbjerg DH, Jensen AB, Zachariae R. Expressive writing intervention and self-reported physical health out-comes - Results from a nationwide randomized controlled trial with breast cancer patients. PLoS One 2018; 13:e0192729. [PMID: 29474441 PMCID: PMC5825018 DOI: 10.1371/journal.pone.0192729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/24/2018] [Indexed: 11/18/2022] Open
Abstract
The objective was to examine the effect of Expressive Writing Intervention (EWI) on self-reported physical symptoms and healthcare utilization in a nationwide randomized controlled trial with Danish women treated for primary breast cancer, and to explore participant characteristics related to emotion regulation as possible moderators of the effect. Women who had recently completed treatment for primary breast cancer (n = 507) were randomly assigned to three 20 min. home-based writing exercises, one week apart, focusing on emotional disclosure (EWI) of a distressing experience (their cancer or a non-cancer topic) or a non-disclosing topic (control). Outcomes were self-reported physical symptoms and healthcare utilization (visits and telephone contacts with GP) 3 and 9 months post-intervention. Potential moderators were repressive coping, alexithymia, rumination, social constraints, and writing topic. Results revealed no group by time interaction effects for any outcomes. Moderation analyses showed that 1) low alexithymic women in the EWI group showed larger decreases in GP telephone calls over time than both high alexithymic women and controls and 2) women in the EWI group writing about their own cancer, but not women writing about other topics, showed a larger decrease than controls. The results from this large randomized trial are concordant with previous findings showing that EWI is unlikely to be a generally applicable intervention to improve health-related outcomes in cancer patients and cancer survivors. However, written disclosure might have a beneficial impact for individuals who write about their own cancer, as well as for those low in alexithymia.
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Affiliation(s)
| | - Mia S. O’Toole
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Science, University of Aarhus, Aarhus, Denmark
- * E-mail:
| | - Søren Christensen
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Science, University of Aarhus, Aarhus, Denmark
| | - Heiddis Valdimarsdottir
- Reykjavik University, Reykjavik, Iceland
- Mount Sinai School of Medicine, New York, United States of America
| | - Sandra Zakowski
- Illinois School of Professional Psychology, Argosy University, Chicago, United States of America
| | - Dana H. Bovbjerg
- Biobehavioral Oncology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, United States of America
- Departments of: Psychiatry, Psychology, Behavioral Community Health Sciences and Health & Community Systems, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Anders B. Jensen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Science, University of Aarhus, Aarhus, Denmark
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Baudry AS, Grynberg D, Dassonneville C, Lelorain S, Christophe V. Sub-dimensions of trait emotional intelligence and health: A critical and systematic review of the literature. Scand J Psychol 2018; 59:206-222. [PMID: 29388210 DOI: 10.1111/sjop.12424] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/06/2017] [Indexed: 11/28/2022]
Abstract
Despite a growing number of studies on the role of the multidimensional construct of trait emotional intelligence (EI) in health, most have focused on global EI, without examining the role of the sub-dimensions. The present systematic review aimed to highlight the current knowledge about self-reported health associated with trait-EI sub-dimensions in general and clinical populations. We searched for the articles including valid self-report scales of trait-EI and health (mental or physical or general) in general and clinical samples. Based on 42 studies, the majority of studies was based on mental health with cross-sectional designs and the TMMS scale, in the general population. Few studies have been focused on physical health and clinical population. The description of studies results revealed that trait-EI sub-dimensions are associated to a greater extent with better mental health, rather than with physical and general health. Furthermore, intrapersonal dimensions, and especially emotion regulation, have stronger effects on health than interpersonal dimensions. Finally, patients with a clinical disorder present lower trait-EI sub-dimensions than the general population. This review supports the importance of focusing on the sub-dimensions of trait-EI to understand better the role of EI in health. The use of scales exclusively based on emotional competences in health contexts is recommended. Developing interventions targeting emotional competences according to the emotional profiles and contexts of individuals could be beneficial to improve health and disease adjustment.
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Affiliation(s)
- Anne-Sophie Baudry
- Univ. Lille, CNRS, UMR 9193 SCALab - Sciences Cognitives et Sciences Affectives, Lille, France and SIRIC ONCOLille, Lille, France
| | - Delphine Grynberg
- Univ. Lille, CNRS, UMR 9193 SCALab - Sciences Cognitives et Sciences Affectives, Lille, France and SIRIC ONCOLille, Lille, France
| | - Charlotte Dassonneville
- Univ. Lille, CNRS, UMR 9193 SCALab - Sciences Cognitives et Sciences Affectives, Lille, France and SIRIC ONCOLille, Lille, France
| | - Sophie Lelorain
- Univ. Lille, CNRS, UMR 9193 SCALab - Sciences Cognitives et Sciences Affectives, Lille, France and SIRIC ONCOLille, Lille, France
| | - Véronique Christophe
- Univ. Lille, CNRS, UMR 9193 SCALab - Sciences Cognitives et Sciences Affectives, Lille, France and SIRIC ONCOLille, Lille, France
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LeBlanc S, Uzun B, Pourseied K, Mohiyeddini C. Effect of an Emotion Regulation Training Program on Mental Well-Being. Int J Group Psychother 2017; 67:108-123. [PMID: 38475633 DOI: 10.1080/00207284.2016.1203585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to develop and validate a brief emotion regulation training program that improved mental well-being. The program was preventative in nature, designed to build resilience while fostering more satisfying personal and professional relationships in a community sample. It was developed and piloted with 10 graduate students during Study 1; for Study 2, a community sample of 75 adults were randomly allocated to either a treatment (n = 38) or control (n = 37) group. In the pilot program, the social validity of the program was confirmed, while study 2 demonstrated significant changes in positive coping techniques (i.e., reappraisal) at one-year follow-up in the treatment group when compared with the control. These findings may have broad implications in the health sector due to the brevity, scalability, and cost-effectiveness of this newly designed intervention.
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Conley CC, Bishop BT, Andersen BL. Emotions and Emotion Regulation in Breast Cancer Survivorship. Healthcare (Basel) 2016; 4:healthcare4030056. [PMID: 27517969 PMCID: PMC5041057 DOI: 10.3390/healthcare4030056] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/19/2016] [Accepted: 08/04/2016] [Indexed: 01/10/2023] Open
Abstract
Emotional distress in cancer patients is an important outcome; however, emotional experience does not begin and end with emotion generation. Attempts to regulate emotions may lessen their potentially negative effects on physical and psychological well-being. Researchers have called for the study of emotion regulation (ER) in health psychology and psycho-oncology. Thus, this review has three aims. First, we discuss current understandings of emotion and ER across the cancer trajectory, including the principles of ER and methods for its assessment. Second, we present a model for examining the mediating effects of ER on psychosocial outcomes. Third, we “round out” the discussion with an example: new data on the role of ER in recurrent breast cancer. Taken together, these aims illustrate the impact of affective regulatory processes on cancer patients’ long-term outcomes. As survival rates increase, long-term follow-up studies are needed to characterize the dynamic, reciprocal effects of emotion and ER for cancer survivors. Further research on ER may help women with breast cancer better manage the challenges associated with diagnosis and treatment.
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Affiliation(s)
- Claire C Conley
- Department of Psychology, The Ohio State University, 225 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210, USA.
| | - Brenden T Bishop
- Department of Psychology, The Ohio State University, 225 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210, USA.
| | - Barbara L Andersen
- Department of Psychology, The Ohio State University, 225 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210, USA.
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Abstract
OBJECTIVE Many psychosocial factors have been associated with coronary heart disease (CHD), including hostility, anger, and depression. We tested the hypothesis that these factors may have their basis in emotion regulation abilities. Our aim was to determine whether poor emotional control predicted long-term risk of CHD. METHODS This Swedish national study includes 46,393 men who were conscripted for military service in 1969 and 1970. The men were aged 18 to 20 years at the time of conscription. Psychologists used a brief semistructured interview to retrospectively assess the conscripts' level of emotional control in childhood and adolescence. The outcome measure was a first fatal or nonfatal event of CHD. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for poor and adequate versus good emotional control. RESULTS After 38 years of follow-up (1971-2009), 2456 incident cases of CHD had occurred. Poor emotional control increased the risk of CHD (HR = 1.31, 95% CI = 1.18-1.45), adjusting for childhood socioeconomic position, anxiety, depression, and parental history of CHD. Further adjustment for life-style-related factors, for example, smoking and body mass index, attenuated the HR to 1.08 (95% CI = 0.97-1.21). In stratified analyses, the fully adjusted association between poor emotional control with CHD remained significantly elevated among men with a parental history of CHD (HR = 1.49, 95% CI = 1.11-2.01, p interaction = .037). CONCLUSIONS In the overall study population, poor emotional control had no direct effect on CHD beyond life-style-related factors. However, in men with a parental history of CHD, poor emotional control in adolescence remained significantly predictive of long-term CHD risk even when adjusting for life-style-related factors.
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Hamama-Raz Y, Pat-Horenczyk R, Perry S, Ziv Y, Bar-Levav R, Stemmer SM. The Effectiveness of Group Intervention on Enhancing Cognitive Emotion Regulation Strategies in Breast Cancer Patients: A 2-Year Follow-up. Integr Cancer Ther 2015; 15:175-82. [PMID: 26420778 DOI: 10.1177/1534735415607318] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose To evaluate the long-term effect of group intervention on enhancing cognitive emotion regulation (CER) strategies in female patients with early-stage breast cancer. Methods The sample included 174 patients who were diagnosed with early-to-mid stage breast cancer, completed adjuvant therapy, and agreed to fill out demographic and cognitive emotion regulation questionnaires (CERQ). About half of the patients (86, 49.4%) chose to participate in an 8-session group intervention (intervention group) while the others (88, 50.6%) did not (comparison group). The structured intervention for enhancing coping strategies with special emphasis on emotion regulation was conducted at the oncology unit at Rabin Medical Center by 2 experienced therapists. Preliminary effects on CER evaluated 6, 12, and 24 months postintervention were compared to the CER of a group of patients that opted not to participate in the group intervention. Results In the intervention group, the long-term effect (from baseline to 24 months) was assessed using the mix models module. Significant interaction effects were found for both the Negative CER scales (F(3, 268 ,404) = 3.66, P = .01) and for the Positive CER scales (F(3, 271 ,660) = 5.12, P = .002). No statistically significant differences in socio-demographic characteristics and medical variables were observed between the intervention and comparison groups. Conclusion Our findings indicate that a group intervention aimed at empowerment of coping strategies had positive long-term outcomes that reinforce adaptive coping strategies and improve less effective strategies of cognitive emotion regulation.
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Affiliation(s)
| | - Ruth Pat-Horenczyk
- Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel Israel Center for the Treatment of Psychotrauma, Herzog Hospital, Jerusalem, Israel
| | - Shlomit Perry
- Davidoff Center, Rabin Medical Center, Petach-Tikva, Israel
| | - Yuval Ziv
- Israel Center for the Treatment of Psychotrauma, Herzog Hospital, Jerusalem, Israel
| | - Ruth Bar-Levav
- Davidoff Center, Rabin Medical Center, Petach-Tikva, Israel
| | - Salomon M Stemmer
- Davidoff Center, Rabin Medical Center, Petach-Tikva, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Evaluating guilt and shame in an expressive writing alcohol intervention. Alcohol 2015; 49:491-8. [PMID: 26074424 DOI: 10.1016/j.alcohol.2015.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 03/24/2015] [Accepted: 05/01/2015] [Indexed: 11/23/2022]
Abstract
Expressive writing interventions have shown positive physical and psychological health benefits over time, with the presumed mechanism being emotional disclosure. However, work utilizing expressive writing in behavior change has been minimal. The current research applied the expressive writing paradigm to reduce drinking intentions among college students, and evaluated the role of event-related guilt and shame in intervention effects. College students (N=429) completed a baseline survey and were randomly assigned to one of three conditions: Negative (write about a heavy drinking event that was negative); Positive (write about a heavy drinking event that was positive); or Neutral (write about their first day of college). After writing, readiness to change and future drinking intentions were assessed. Results revealed intervention effects on intended drinks per week and intended number of drinks during peak and typical drinking occasions. Participants in the negative condition also displayed higher levels of event-related guilt and shame. Results showed that guilt mediated intervention effects on readiness to change, which also mediated the association between guilt-reparative behavior and drinking intentions. Results provide initial support for an expressive writing intervention on alcohol use and underscore the importance of eliciting emotions associated with reparative behavior when considering negative past experiences and future behavior change.
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Messina I, Bianco S, Sambin M, Viviani R. Executive and semantic processes in reappraisal of negative stimuli: insights from a meta-analysis of neuroimaging studies. Front Psychol 2015. [PMID: 26217277 PMCID: PMC4499672 DOI: 10.3389/fpsyg.2015.00956] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Neuroimaging investigations have identified the neural correlates of reappraisal in executive areas. These findings have been interpreted as evidence for recruitment of controlled processes, at the expense of automatic processes when responding to emotional stimuli. However, activation of semantic areas has also been reported. The aim of the present work was to address the issue of the importance of semantic areas in emotion regulation by comparing recruitment of executive and semantic neural substrates in studies investigating different reappraisal strategies. With this aim, we reviewed neuroimaging studies on reappraisal and we classified them in two main categories: reappraisal of stimuli (RS) and reappraisal via perspective taking (RPT). We applied a coordinate-based meta-analysis to summarize the results of fMRI studies on different reappraisal strategies. Our results showed that reappraisal, when considered regardless of the specific instruction used in the studies, involved both executive and semantic areas of the brain. When considering different reappraisal strategies separately, in contrast, we found areas associated with executive function to be prominently recruited by RS, even if also semantic areas were activated. Instead, in RPT the most important clusters of brain activity were found in parietal and temporal semantic areas, without significant clusters in executive areas. These results indicate that modulation of activity in semantic areas may constitute an important aspect of emotion regulation in reappraisal, suggesting that semantic processes may be more important to understand the mechanism of emotion regulation than previously thought.
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Affiliation(s)
- Irene Messina
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua Padova, Italy ; Department of Psychiatry and Psychotherapy III, University of Ulm Ulm, Germany
| | - Simone Bianco
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua Padova, Italy
| | - Marco Sambin
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua Padova, Italy
| | - Roberto Viviani
- Department of Psychiatry and Psychotherapy III, University of Ulm Ulm, Germany ; Institute of Psychology, University of Innsbruck Innsbruck, Austria
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PATE T, RUTAR M, BATTELINO T, DROBNIČ RADOBULJAC M, BRATINA N. Support Group for Parents Coping with Children with Type 1 Diabetes. Zdr Varst 2015; 54:79-85. [PMID: 27646912 PMCID: PMC4820171 DOI: 10.1515/sjph-2015-0012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/14/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Type 1 diabetes is one of the most common chronic diseases in childhood. Active parental involvement, parental support in the diabetes management and family functioning are associated with optimal diabetes management and glycemic control. The purpose of this study was to assess parental satisfaction with participation in the group and their perceptions of the impact of the intervention on living and coping with childrens T1D. METHODS A sample of 34 parents of children with T1D participated in this trend study. The participants' experience and satisfaction with support group was measured by a self- evaluation questionnaire, designed for the purpose of the present study. RESULTS Quantitative data show that parents were overall satisfied with almost all measured items of the evaluation questionnaire (wellbeing in the group, feeling secure, experiencing new things, being able to talk and feeling being heard) during the 4-year period. However, parents from the second and third season, on average, found that the support group has better fulfilled their expectations than the parents from the first season (p = 0,010). The qualitative analysis of the participants' responses to the open-ended questions was underpinned by four themes: support when confronting the diagnosis, transformation of the family dynamics, me as a parent, exchange of experience and good practice and facing the world outside the family. DISCUSSION The presented parent support group showed to be a promising supportive, therapeutic and psychoeducative space where parents could strengthen their role in the upbringing of their child with T1D.
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Affiliation(s)
- Tanja PATE
- University of Ljubljana, Faculty of Theology, Poljanska cesta 4, 1000 Ljubljana, Slovenia
- Franciscan Family Institute, Presernov trg 4, 1000 Ljubljana, Slovenia
- Corresponding author: Tel: +386 1 200 67 60; E-mail:
| | - Miha RUTAR
- University Medical Centre Ljubljana, University Children’s Hospital, Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Bohoriceva 20, 1000 Ljubljana, Slovenia
| | - Tadej BATTELINO
- University Medical Centre Ljubljana, University Children’s Hospital, Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Bohoriceva 20, 1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Maja DROBNIČ RADOBULJAC
- University Psihiatric Hospital Ljubljana, Center for Mental Health, Unit for Adolescent Psychiatry, Zaloska 29, 1000 Ljubljana, Slovenia
| | - Nataša BRATINA
- University Medical Centre Ljubljana, University Children’s Hospital, Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Bohoriceva 20, 1000 Ljubljana, Slovenia
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Chew BH, Shariff-Ghazali S, Fernandez A. Psychological aspects of diabetes care: Effecting behavioral change in patients. World J Diabetes 2014; 5:796-808. [PMID: 25512782 PMCID: PMC4265866 DOI: 10.4239/wjd.v5.i6.796] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/05/2014] [Accepted: 11/19/2014] [Indexed: 02/05/2023] Open
Abstract
Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient’s psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation, self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors, coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relation to DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM.
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Adolescents' emotions prior to sexual activity and associations with sexual risk factors. AIDS Behav 2014; 18:1615-23. [PMID: 24558097 DOI: 10.1007/s10461-014-0716-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study examined the link between the emotional context of sexual situations and sexual risk, specifically by examining the relationship of teens' recall of their affective states prior to sex with their sexual risk behaviors and attitudes. Adolescents (ages 13-19) attending therapeutic schools due to emotional and behavioral difficulties (n = 247) completed audio computer-assisted self-interviews regarding sexual behavior, including ratings of their emotions prior to last sexual activity. Positive emotions were most commonly endorsed (43-57 % of participants), however, significant proportions (8-23 %) also endorsed negative emotions prior to last sex. Both positive and negative emotions were significantly related to risk attitudes and behavior in regression analyses. The affective contexts of sexual experiences may be important predictors of risk in adolescence.
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Hadley W, Houck CD, Barker DH, Garcia AM, Spitalnick JS, Curtis V, Roye S, Brown LK. Eliciting affect via immersive virtual reality: a tool for adolescent risk reduction. J Pediatr Psychol 2013; 39:358-68. [PMID: 24365699 DOI: 10.1093/jpepsy/jst092] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE A virtual reality environment (VRE) was designed to expose participants to substance use and sexual risk-taking cues to examine the utility of VR in eliciting adolescent physiological arousal. METHODS 42 adolescents (55% male) with a mean age of 14.54 years (SD = 1.13) participated. Physiological arousal was examined through heart rate (HR), respiratory sinus arrhythmia (RSA), and self-reported somatic arousal. A within-subject design (neutral VRE, VR party, and neutral VRE) was utilized to examine changes in arousal. RESULTS The VR party demonstrated an increase in physiological arousal relative to a neutral VRE. Examination of individual segments of the party (e.g., orientation, substance use, and sexual risk) demonstrated that HR was significantly elevated across all segments, whereas only the orientation and sexual risk segments demonstrated significant impact on RSA. CONCLUSIONS This study provides preliminary evidence that VREs can be used to generate physiological arousal in response to substance use and sexual risk cues.
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Affiliation(s)
- Wendy Hadley
- PhD, Bradley/Hasbro Children's Research Center, One Hoppin Street, Suite 204, Providence, RI 02903, USA.
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Young CM, Rodriguez LM, Neighbors C. Expressive writing as a brief intervention for reducing drinking intentions. Addict Behav 2013; 38:2913-7. [PMID: 24064189 DOI: 10.1016/j.addbeh.2013.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 08/15/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022]
Abstract
The present study examined the effectiveness of expressive writing in reducing drinking behavior. We expected that students prompted to write about negative drinking experiences would show greater decreases in future drinking intentions compared to the neutral and the positive writing conditions. We also expected that decreases in drinking intentions following the writing prompts might differ based on current drinking and AUDIT scores. Participants included 200 (76% female) undergraduates who completed measures of their current drinking behavior. They were then randomly assigned to either write about: a time when they had a lot to drink that was a good time (Positive); a time when they had a lot to drink that was a bad time (Negative); or their first day of college (Neutral), followed by measures assessing intended drinking over the next three months. Results revealed that participants intended to drink significantly fewer drinks per week and engage in marginally fewer heavy drinking occasions after writing about a negative drinking occasion when compared to control. Interactions provided mixed findings suggesting that writing about a positive event was associated with higher drinking intentions for heavier drinkers. Writing about a negative event was associated with higher intentions among heavier drinkers, but lower intentions among those with higher AUDIT scores. This research builds on previous expressive writing interventions by applying this technique to undergraduate drinkers. Preliminary results provide some support for this innovative strategy but also suggest the need for further refinement, especially with heavier drinkers.
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Affect management for HIV prevention with adolescents in therapeutic schools: the immediate impact of project balance. AIDS Behav 2013; 17:2773-80. [PMID: 23975475 DOI: 10.1007/s10461-013-0599-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Adolescents in therapeutic schools are at greater risk for HIV and other STIs than their peers due to earlier higher rates of sexual risk and difficulty managing strong emotions. HIV prevention programs that incorporate techniques for affect management (AM) during sexual situations may be beneficial. This paper determined the immediate impact of such an intervention, AM, compared to a standard, skills-based HIV prevention intervention and a general health promotion intervention (HP) for 377 youth, ages 13-19, in therapeutic schools in two cities. 1 month after the intervention, analyses that adjusted for the baseline scores found adolescents in AM were more likely to report condom use at last sex than those in HP (0.89 vs. 0.67, p = 0.02) and that their HIV knowledge was significantly greater. These data suggest that AM techniques might improve the impact of standard skills-based prevention programs for adolescents in therapeutic schools.
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