Emotional eating is considered a maladaptive coping strategy for negative affect. This study aimed to examine the daily relationship between negative affect and emotional eating, and further explore the role of emotion regulation in this process. Daily diary data was collected among 108 college students (Meanage = 19.8 ± 1.51, 83.3 % women) to assess the dynamic relationships between negative affect and emotional eating over 14 days. Difficulties in emotion regulation was assessed at pre- and post-test. Results of dynamic structural equation modeling revealed that emotional eating predicted next day's negative affect (β = .06, 95 % Credible Interval [.01, .15]), but not vice versa. Moreover, four subscales of difficulties in emotion regulation at baseline-nonacceptance of emotional responses, difficulties in engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies-significantly predicted the association between negative affect and emotional eating. This association, in turn, was associated with five subscales of difficulties in emotion regulation at posttest, including nonacceptance of emotional responses, difficulties in engaging in goal-directed behavior, impulse control difficulties, limited access to emotion regulation strategies, and lack of emotional clarity. Our findings suggest that emotional eating can reinforce negative affect the following day, especially in individuals with difficulties in emotion regulation. Further, when emotional eating and negative affect are strongly linked, this may be associated with the reinforcement of difficulties in emotion regulation. Whether negative affect can trigger emotional eating could not be determined by our study, and should be investigated with more intensive study designs.

Impairments in personality functioning often emerge during developmental processes in youth, a period in which the experience of psychological distress peaks. Both impairment in personality functioning and psychological distress are related to general psychopathology and insight in their developmental trajectories may contribute to early detection of severe mental health problems. This study is aimed at examining the temporal dynamics between personality functioning and psychological distress in an outpatient sample of youth (Mage = 20.33) across two timepoints spaced 6 months apart. Mean differences, correlations, and correlated change are examined using bivariate latent change score analysis. The findings revealed a significant negative association between self-reported personality functioning and levels of psychological distress. Both constructs demonstrated moderate improvement over time, and their changes were strongly correlated. Initial scores showed small correlations with change scores within and across domains, indicating that higher initial severity of both impairment in personality functioning and psychological distress is related to greater within-construct and across-construct changes over time. These results provide insight in how impairment in personality functioning and psychological distress seem fundamentally related and suggest that youth entering a treatment setting with higher severity may show greater improvement in both domains during the first 6 months. Limitations and future directions are discussed, as well as the benefit of these results for broadening our understanding of the onset and early intervention of psychopathology in youth.

Emotion regulation difficulties are widely thought to be a transdiagnostic risk factor for eating disorders. However, there is limited data on the precise patterns of emotion regulation strategy use that characterize eating-disorder symptoms. Our aim was to comprehensively examine the relationship between emotion-regulation strategy use and eating-disorder symptoms, identifying profiles of strategy use that might characterize these symptoms.

University students and general community members (N = 665, Mage = 23.72, 77.3 % female) completed psychometric measures assessing the use of 12 emotion regulation strategies as well as eating disorder symptoms.

Regression analyses revealed that emotion regulation patterns accounted for a significant 16.2 % of the variance in overall eating disorder symptoms (p < .001). Regarding specific eating disorder facets, emotion regulation accounted for 8.9 % of the variance in eating restraint, 16.8 % in weight concerns, 16.8 % in shape concerns, and 15.2 % in eating concerns. A latent profile analysis extracted eight profiles with different combinations of emotion regulation strategy use and eating disorder symptoms. Profiles associated with elevated eating-disorder symptoms were generally characterized by increased use of maladaptive, and decreased use of adaptive, strategies. Particularly important were patterns of behavioral avoidance and cognitive emotion-heightening.

Our study used cross-sectional data from a single Western country. Future longitudinal work in clinical samples would be beneficial.

Emotion regulation strategy use appears to be an important factor for understanding eating disorder symptoms. Targeting specific patterns of emotion regulation strategy use may be beneficial in the assessment and treatment of eating disorder symptoms.

Binge eating (BE), a transdiagnostic feature that occurs across eating disorders and in the general population, carries significant health risks even in the absence of a full-syndrome diagnosis. The limited efficacy of current treatments for binge-type eating disorders highlights the need to better understand the mechanistic heterogeneity underlying BE to optimize treatment allocation, advance personalized medicine, and ultimately improve outcomes. We hypothesized considerable heterogeneity within three neurofunctional domains prevalent across compulsive behaviors and implicated in BE: approach-related behavior, executive function, and negative emotionality. We analyzed data from 612 participants (ages 18-59, 66% female) from the enhanced Nathan Kline Institute-Rockland Sample, including 461 controls and 151 individuals with BE behaviors. Using data-driven statistical modeling of comprehensive, multimodal measures across the three hypothesized domains, we identified subtypes of BE. Subtypes were validated using assessments of eating pathology, substance use, clinical diagnostics, and resting-state functional magnetic resonance imaging. Three distinct and stable subtypes emerged: a 'Negative Emotionality' subtype characterized by greater negative affect, emotion dysregulation and psychiatric comorbidity, an 'Approach' subtype with higher approach-related and impulsive behaviors, and a 'Restrained' subtype that was overcontrolled and harm avoidant. The Approach and Restrained subtypes further demonstrated unique neurobiological profiles, as determined by graph theory analysis of resting-state functional connectivity. All subtypes showed similar proportions of BE episodes meeting clinical-level threshold (≥4 objective binge episodes/month), and no differences in BMI, indicating functionally distinct expressions of BE, beyond clinical severity and diagnostic classification. This study is the first to explore the mechanistic heterogeneity of BE through a comprehensive multi-modal assessment across three neurofunctional domains in a single sample. Findings highlight the need for updated models of BE etiology that integrate approach/reward-related behaviors, impulsivity and overcontrolled behaviors, and negative emotionality, and suggest the potential of these functionally-derived subtypes to inform the development of personalized, targeted interventions.

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.

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.

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.

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.

This study used network analysis to investigate the characteristics in the networks of first-onset depression and borderline personality traits (BPTs) among community residents, aiming to enhance community-based mental disorders prevention.

Depression and BPTs among 7474 samples were assessed using PHQ-9 and BPTs module of DSM-5. Centrality indices and bridge centrality indices were measured to identify the central and bridge symptoms in the networks. The stability and accuracy of the networks were estimated. Additionally, a Network Comparison Test was conducted to evaluate potential gender differences.

Females had a significantly higher prevalence of first-onset depression (12.25 % vs. 9.05 %, P < 0.01) and scores (P < 0.01) than males. Males had higher total BPT scores than females (P = 0.02), despite no gender differences in prevalence. Fatigue and sad mood emerged as central symptoms in the first-onset depression and BPTs network, while feeling of emptiness and impulsivity served as key symptoms connecting the two node communities. Especially impulsivity was identified as a risk factor for first-onset depression in males (OR = 1.87, 95%CI: 1.20-2.90, P = 0.01). Additionally, the network characteristics of first-onset depression and BPTs showed relative consistency across genders.

Self-reported data limits diagnostic accuracy, and the limited follow-up restricts capturing long-term dynamics between first-onset depression and BPTs.

The core and bridge symptoms identified in this study are key targets for alleviating first-onset depression and BPTs. While developing universal prevention strategies, specific gender-sensitive interventions for particular symptoms should also be considered.

Emotion regulation deficits are prevalent in most psychiatric conditions; in particular in affective and personality disorders. The insula cortex is an intersection of emotion regulation, (expressive suppression vs. cognitive reappraisal), affective disorders, and traits predisposing dysfunctional personality. In this study, we tested the interrelation of emotion regulation strategies, brain structure, and narcissistic personality traits in a sub-clinical cohort.

In a sample of 172 psychiatrically healthy individuals we obtained 3 T MRI to acquire high resolution T1 weighted images for analyses of voxel- and surface-based structural parameters (SPM12/CAT12) along with measures of dispositional use of emotion regulation (Emotion Regulation Questionnaire; ERQ) and narcissistic traits (Pathological Narcissism Inventory; PNI). We tested their interrelation using a GLM approach and mediation models.

ERQ mediated the negative association of right insula volume and PNI and the association of right insula gyrification and PNI. PNI mediated the association of bilateral insula volume and ERQ. Additionally, PNI sub-scales were positively associated with gyrification of bilateral anterior insulae, cortical thickness of left precuneus and negatively correlated with cortical thickness of the left inferior temporal gyrus.

In contradistinction to preceding studies, no associations have been identified in prefrontal brain regions.

This is the first study that primarily tested meditated correlations of emotion regulation, brain structure, and narcissistic traits supporting the idea of the insula as a convergence structure for affective and personality disorders. Moreover, additional analyses indicate involvement of further brain regions such as precuneus and inferior temporal gyrus that have also been discussed in self-attributional processes.

The diagnosis of personality disorders (PD) in adolescence still poses a challenge. Early diagnosis and targeted intervention are called for, since patients with PD present with severe consequences in terms of psychosocial functioning and personal suffering including higher suicide risk. New guidelines advise semi-structured interviews for the dimensional assessment of personality functioning.

We included 136 patients aged 13 to 17.9 years with a categorical PD diagnosis and 35 healthy control (HC) adolescents to assess the applicability of the Structured Interview for Personality Organization (STIPO) for adolescents and evaluate its validity by correlating the six outcome domains (identity, object relations, defenses, aggression, moral values, reality testing) and the overall severity level to several validated instruments. Furthermore, we assessed personality traits, internalizing and externalizing behavior and depressive symptoms.

All STIPO domains differed significantly between patients and HC (p <  0.001). Outcome measures correlated significantly with validated self-rating questionnaires. STIPO severity levels correlated significantly with psychopathology. Personality traits "dissocial behavior" and "emotional dysregulation" correlated positively with all STIPO domains and the overall level of personality organization (PO).

Results indicate that the STIPO is a reliable and valid instrument for the assessment of PD in adolescents. It comprises the core elements of personality functioning, as requested in Criterion A in the AMPD of the DSM-5 and ICD-11 and could be useful for treatment planning, evaluation of the course of treatment as well as for prognostic considerations.

Few studies explored emotion regulation (ER) repertoires (the tendency to utilize multiple ER strategies in different contexts) in patients with major depressive disorder (MDD). It remains unclear to what extent ER repertoires can assess the risk of MDD and other psychiatric disorders.

Three subsamples including 1397 non-clinical individuals, 135 MDD patients, and 127 healthy controls (HCs) were combined to explore ER repertoires. We further built classifiers of ER repertoires to distinguish MDD patients from HCs, and additionally examined its performance based on published studies (total N = 4918).

Adaptive, average, maladaptive, and intensely maladaptive repertoires were identified. The classifier based on ER repertoires effectively distinguished MDD patients from HCs, demonstrating an AUC of 0.803 (SD = 0.067). Additionally, the classifier exhibited discriminatory power for various psychopathologies in published studies, including depression, anxiety, eating disorders, PTSD, and personality disorders (AUC: 0.616-0.779).

Future studies should investigate the longitudinal influence of ER repertoires on the development of psychopathologies.

Our findings suggest that an individual's ER repertoire is a critical psychopathological risk that can serve as a valuable indicator for assessing risk and imply the potential utility of reforming ER repertoire.

There is a growing interest in clinical interventions targeting emotion regulation difficulties across mental health conditions. Experiential dynamic therapies (EDTs) are transdiagnostic, affect-focused, short-term psychodynamic therapy models that emphasize in-session emotional processing. This review provides a 10-year update on the efficacy of EDTs for mood, anxiety, personality and somatic symptom disorders in adults and children/adolescents. A comprehensive search identified 57 randomized controlled trials (n = 4330) conducted in Western (k = 38; n = 3178) and non-Western countries (k = 19; n = 1152) between 1978 and 2024. Random-effects meta-analyses on primary outcomes indicated large, significant effects for EDTs compared to inactive controls at post-treatment (Hedge's g = -0.96; k = 41) and follow-up (g = -1.11; k = 20). Compared to active controls, effects were small and non-significant post-treatment (g = -0.17; k = 27) but became significant at follow-up (g = -0.40; k = 19), suggesting a potential modest long-term advantage of EDTs. Despite substantial heterogeneity (I2 > 75%), results remained robust in sensitivity analyses. Moderator analyses revealed few significant findings, indicating relative consistency across diagnostic groups, treatment formats and active comparators. Non-Western and lower quality studies reported larger effects compared to inactive, but not active, controls. While cautious interpretation is warranted due to unexplained heterogeneity, findings support EDTs as efficacious transdiagnostic interventions for emotional disorders, with sustained benefits over time. Future research should prioritize large-scale, methodologically rigorous trials that explore mechanisms of change, optimize treatment delivery and identify moderators of long-term outcomes.

Mental health disorders are the most prevalent health complication experienced during pregnancy and the postpartum, with anxiety disorders being most common. Intolerance of uncertainty (IU) is a well-known feature of anxiety disorders and has recently been identified as a risk factor for the worsening of anxiety during the postpartum period. Cognitive Behavioural Therapy (CBT) is a first-line treatment for perinatal anxiety, and CBT specifically targeting IU in non-perinatal populations has demonstrated positive findings for reducing anxiety. As such, the objective of our study is to examine whether CBT targeting IU in pregnancy can reduce the risk of postpartum anxiety.

This protocol paper outlines a proof-of-concept randomised clinical trial assessing the effectiveness of a newly developed CBT for IU (CBT-IU) protocol to reduce the risk of postpartum anxiety. Pregnant individuals identified at increased risk for postpartum anxiety (defined as a baseline score of 64 or greater on the Intolerance of Uncertainty Scale) will be randomised to receive CBT-IU or care as usual (CAU) during pregnancy and will be followed through the postpartum period (6-12 weeks). The CBT-IU protocol is a weekly, six session treatment, which includes psychoeducation, behavioural experiments, imaginal exposure, and problem-solving to target IU.

To our knowledge, this will be the first study to investigate the efficacy of a CBT protocol aimed at reducing the risk of developing postpartum anxiety. Establishing this protocol as a potentially preventative strategy will offer a new option to improve the mental health and well-being of mothers and their infants.

Trial Number is NCT05691140 and accessible at https://clinicaltrials.gov/study/NCT05691140.

Taste and smell alterations (TSAs) in nasopharyngeal cancer patients negatively impact their quality of life. This study is aimed at assessing the prevalence of TSAs in patients with nasopharyngeal carcinoma undergoing radiotherapy and at exploring the correlation between TSAs and quality of life.

The research was a cross-sectional survey conducted from June 2023 to March 2024 in which the Taste and Smell Survey (TSS) questionnaires were administered to 135 patients receiving radiotherapy for nasopharyngeal cancer.

The mean total score on the TSS scale was 9.37 ± 4.595. A higher TSS score indicates more alterations. We enrolled 135 patients, 91.1% of whom reported alterations in taste and smell. The severity of alterations was classified as mild (6.7%), moderate (33.3%), and severe (51.1%). The occurrence of changes in taste sensitivity to salty, sweet, sour, and bitter flavors were 66.7%, 52.6%, 52.6%, and 53.3%, respectively, while olfactory sensitivity changes were found in 48.9% of the patients. Notably, a statistically significant correlation was found between cumulative dose of radiotherapy and the TSS score (p < 0.05). TSAs were significantly correlated with anxiety and overall quality of life (p < 0.05).

TSAs are prevalent among patients undergoing radiotherapy for nasopharyngeal carcinoma, with the majority experiencing moderate to severe alterations. The findings underscore the importance of implementing targeted interventions to address the sensory alterations and improve the patients' psychological well-being and life quality.

Different aspects of emotion dysregulation (ED) have been found to be broadly associated with various anxiety-related disorders (ADs), but the mechanism underlying these transdiagnostic associations is largely unknown. There are at least two possible hypotheses. The generality hypothesis suggests that the associations are better explained by the link between a general ED factor and the general vulnerability factor derived from various ADs. The specificity hypothesis posits that specific ED facets make a unique contribution beyond the general ED factor.

In a treatment-seeking sample of 351 patients with a primary diagnosis of an AD, we simultaneously examined both the general and facet-specific effects of ED, as assessed by the Difficulties in Emotion Regulation Scale (DERS), on the general vulnerability factor underlying ADs over the course of treatment using a bifactor latent change modelling approach.

Supporting the generality hypothesis, we found decreases in the general DERS factor were associated with symptoms reduction and improvement in life functioning. Except for emotional clarity, specific DERS factors had limited effects beyond the general factor.

Our findings suggested that the well-documented broad associations between ED and various ADs are best explained by the relationship between the general ED factor, rather than specific facets, and the general vulnerability factor to ADs. Thus, assessing overall ED, rather than focusing on specific facets, may be more effective for screening individuals at risk for ADs and monitoring therapeutic progress in the treatment of ADs.

To diagnose and manage adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), or their co-occurrence (ADHD + ASD), clinicians must identify specific features that differentiate these diagnostic categories. Self-report questionnaires targeting specific features are widely used and, together with clinical assessments, provide reliable diagnoses. Although affective lability is present in various psychiatric disorders, it lacks specificity when screening for ADHD in the general population, and its discriminant value for ADHD, ASD, and ADHD + ASD has not been studied.

This study involved 300 adults without intellectual developmental disorder (188 male) who received an ADHD (n = 174), ASD (n = 68), or ADHD + ASD (n = 58) diagnosis after a multidisciplinary consensus decision according to DSM-5 criteria. Before clinical assessment, all patients requesting evaluation for one of these diagnoses completed questionnaires on an online platform. The assessment instruments included a modified version of the Barkley Adult ADHD Rating Scale (BAARS IV) for ADHD, the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ) for ASD features, and the Affective Lability Scale (ALS) for affective lability. Total scores and sub-scores of the instruments were compared among the three groups. Additionally, stepwise logistic regression analyses were conducted to identify specific measures that contribute to group discrimination.

Results revealed distinct patterns in symptomatology as expected. The ADHD and the ADHD + ASD groups presented significantly higher ALS total score compared to ASD. Stepwise logistic regression analyses identified specific measures contributing to group differentiation. ASD vs. ADHD + ASD discrimination included BAARS IV current total score and EQ total score. The subscale anger from ALS in addition with BAARS IV past total score and AQ total score were the factors that discriminated ADHD diagnosis from the co-occurrence of ADHD and ASD. Finally, BAARS IV past total score, BAARS IV current inattention, AQ total score, and EQ total score were found to differentiate ADHD from ASD.

The study highlights the significance of incorporating emotional dimensions in diagnostic frameworks and may contribute valuable insights for clinicians differentiating neurodevelopmental conditions.

Emotional disorders (ED) are highly prevalent worldwide. The PsicAP trial, conducted in Spain, demonstrated the benefits of adding transdiagnostic cognitive behavioural therapy (TD-CBT) to treatment as usual (TAU) for the attention of these disorders in primary care (PC). Here we describe the design of a stepped wedge randomized controlled trial (RCT), inspired by the PsicAP project. This RCT has two main aims: 1) to test the implementation of the PsicAP protocol in a real clinical setting, further evaluating possible mechanisms of change underlying the efficacy of TD-CBT (emotional regulation, alliance, and therapist experience and training), and 2) to assess the impact of psychotropic medication use on neuropsychological function and treatment outcomes.

A single-blind multicentre RCT with a stepped wedge design will be conducted. Participants (N=320) will be randomly assigned to an experimental group (EG1) or to a waiting list group (WG). The EG1 will receive immediate treatment and the WG will remain on the waiting list for 3 months. After this time, the WG will become a second experimental group (EG2) that will receive the same treatment as EG1 (PsicAP protocol). Patients will be assessed at post-treatment, at 3 and 9 months. Before starting treatment, a random subsample of patients (n=90) will undergo a neuropsychological assessment. These patients will be assigned to three groups based on their use of psychotropic medication at the time of randomization: no psychotropic medication, short-term use (< 3 months) and long-term use (≥ 3 months). All 90 participants will undergo the same neuropsychological assessment at one year. The RCT is expected to run from 01/05/23 to 01/10/25.

The results of this trial are expected to provide further support for the efficacy of the PsicAP TD-CBT protocol, as well as insight into the mechanisms of change that lead to the positive therapeutic outcomes of this protocol. In addition, this study will help determine the effects of short- and long-term psychotropic use on neuropsychological function and therapeutic outcomes. In short, it is hoped that this RCT will help to better understand how to implement evidence-based psychological treatment in the PC setting.

EURADICT 2013-001955-11/ ISRCTN58437086.

Systematic reviews have confirmed that home treatment (HT) is an appropriate alternative to conventional inpatient treatment. So far, research on predictors for treatment outcomes of HT has been rather inconsistent, and potential predictors have not been systematically investigated yet. This exploratory study has a prospective naturalistic design with repeated measurements of symptoms, well-being, and self-efficacy at baseline, at post-assessment (discharge from HT) and at follow-up. Repeated measures analysis of variance (ANOVA) was carried out to measure changes between assessment points. Changes in emotion regulation were analysed between baseline and post-assessment using t-tests. Potential predictor variables were assessed at baseline. Linear regression models were estimated with post scores of symptoms, well-being, self-efficacy and emotion regulation as dependent variables and potential predictors as independent variables. 58 patients participated in the study. Significant differences between baseline and post-assessment were found for psychiatric symptoms, well-being, self-efficacy and emotion regulation. No significant changes were found at follow-up. Of the investigated potential predictors, three significantly predicted outcome of HT: Patients with former treatments in a psychiatric institution had significantly higher post-assessment in symptoms (β = .26, p = .04) and lower well-being (β = -.28, p = .02) compared to patients without former treatment in a psychiatric institution. Furthermore, hope for change and symptoms of anxiety were found to be predictors of outcome. General improvement in symptoms and well-being indicate that HT was effective. Previous psychiatric history, hope of improvement and anxiety were identified as predictors of treatment outcome.

Neuropathic pain is a global health concern due to its severity and its detrimental impact on patients' quality of life. It is primarily characterized by sensory alterations, most commonly hyperalgesia and allodynia. As the disease progresses, patients with neuropathic pain develop co-occurring emotional disorders, such as anxiety and depression, which further complicate therapeutic management. While pharmacotherapy remains the first-line treatment, limitations in its efficacy and the prevalence of side effects often leave patients with insufficient pain relief. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, has recently emerged as a promising alternative for chronic pain management. This review provides an overview of preclinical studies examining the effects of tDCS in rodent models of neuropathic pain. It specifically highlights the potential of tDCS to modulate the emotional-affective component of pain, with a focus on identifying optimal cortical targets for stimulation to enhance the translational application of tDCS in managing pain-related emotional disorders.

Obsessive-compulsive personality disorder is a chronic condition characterized by a maladaptive pattern of excessive perfectionism, preoccupation with rules and details, and the urge to control the environment, which results in significant distress or impairment, especially in interpersonal functioning. Individuals diagnosed with the mentioned disorder are often seen as rigid, inflexible, and highly controlling. Therefore, the present study aims to investigate the effectiveness of unified transdiagnostic interventions based on common mechanisms of obsessive personality patterns.

This quantitative research is a semi-experimental single-case and multiple-base design with asynchronous participants. Five participants were selected using purposive sampling through semi-structured interviews based on DSM-5 among patients who visited the clinics during 2022-2023. The research included the Millon Clinical Multiaxial Inventory. Moreover, the treatment intervention was administered individually throughout 12 sessions with one session a week. Data analysis involved visual inspection or graphical representation of each case's improvement percentage and change index.

The results from visual representation indicated that the transdiagnostic intervention based on common mechanisms significantly influenced the obsessive personality patterns at baseline, during treatment, and at follow-up. There was a significant change in the reliable change index compared to the baseline for all five participants. During the treatment phase, participants showed a mean score of 30.28 for the obsessive personality pattern, indicating a significant level of effectiveness. However, the mean score increased to 57.50 at the follow-up stage.

According to Blanchard and Schwartz's classification, the unified transdiagnostic interventions based on common mechanisms and their effectiveness on obsessive personality patterns fell into the improvement category during treatment and into the success category at the follow-up stage of the study. Overall, the findings suggest a bright future for the treatment of individuals with obsessive personality patterns, as unified diagnostic interventions show great potential for significant impact.

Emotion dysregulation (ED) is a key transdiagnostic symptom in several psychiatric disorders such as borderline personality disorder (BPD), bipolar disorder (BD), and attention-deficit/hyperactivity disorder (ADHD). These disorders, here defined as ED disorders (EDD), share similarities in symptoms, comorbidity, and heritability, emphasizing the importance of a transdiagnostic approach to identify markers of vulnerability to EDD in high-risk populations, such as EDD patients' offspring (EDDoff). The hippocampus, central to ED, exhibits alterations across EDD.

We employed a state-of-the-art approach (micro-co-activation patterns, μCAPs) to study the transdiagnostic dynamic functional connectivity (dFC) of hippocampal subregions from resting-state functional MRI of 201 participants (74 EDD patients, 57 EDDoff, 70 controls). μCAPs provide a data-driven differentiation within the seed region.

DFC between the sensorimotor network (SMN) and the hippocampal body was lower in EDD patients (pFDR=0.0002) and EDDoff (pFDR=0.01) compared to controls, with EDDoff displaying an intermediate pattern between EDD patients and controls. dFC between the limbic network (LN) and the hippocampal head was higher in EDD patients than in controls (pFDR=0.01) and in EDDoff (pFDR=0.01). A negative correlation was found between ED and SMN (pFDR=0.01), suggesting increasing ED with decreasing SMN dFC with the hippocampus.

Increased dFC between the hippocampal head and the LN, at the expense of the SMN, may represent a marker of disease in EDD patients. Lower dFC between the SMN and the hippocampal body may represent a marker of vulnerability to EDD in EDDoff, correlating with ED. Such a transdiagnostic construct represents a clinically relevant target for early interventions aimed at reducing vulnerability to EDD in high-risk populations.

Rumination is an essential trans-diagnostic process associated with substance use disorders (SUDs) in psychopathology. In China, methamphetamine and heroin have become major illegal drugs, but the role of rumination in their use remains unclear. The objective of this study was to investigate the relationship between rumination subtypes and drug craving in patients with methamphetamine use disorder (MAUD) and 81 patients with heroin use disorder (HUD).

A total of 489 participants, including 408 patients with MAUD and 81 patients with HUD, were recruited from a rehabilitation center. Participants were screened for inclusion criteria, and the Obsessive Compulsive Drug Use Scale (OCDUS) was used to assess drug craving. Rumination was assessed using the Ruminative Responses Scale (RRS), categorized into three dimensions: symptom rumination, brooding, and reflective pondering. Correlational and multiple regression analyses were conducted to examine associations between rumination and craving.

Compared to patients with MAUD, patients with HUD had significantly higher RRS and OCDUS total score (42.51 vs 39.71 and 25.99 vs 20.95, both p < 0.01). In patients with MAUD, the OCDUS total score was positively correlated with the total score (r = 0.298, p < 0.01) and all subscale scores of the RRS (for reflective pondering, r = 0.180; for brooding, r = 0.230; for symptom rumination, r = 0.325; all p < 0.01). However, in patients with HUD, only symptom rumination was positively associated with the OCDUS total score (r = 0.247, p < 0.05). Multiple regression showed symptom rumination was independently associated with OCDUS total score in both groups (for patients with MAUD, β = 0.324, p < 0.001; for patients with HUD, β = 0.252, p < 0.05).

Our findings suggest that rumination shows different effects on craving in male patients with MAUD and HUD. Moreover, symptom rumination may have a significant influence on the connection between rumination and craving in individuals with MAUD and HUD.

Negative posttraumatic cognitions (NPCs) and cognitive emotion regulation (CER) strategies have both been proposed as predictors of change in evidence-based cognitive behavioral therapies for posttraumatic stress disorder (PTSD). However, they are rarely studied simultaneously, with only one study examining these predictors in a randomized clinical trial of prolonged exposure therapy. It remains to be tested how these variables predict improvements in PTSD severity in real world clinical settings or different delivery formats. Data from 487 military service members and veterans that participated in a 2-week nonrandomized, uncontrolled cognitive processing therapy-based intensive treatment program (ITP) for PTSD were used to evaluate NPCs and CER strategies as predictors of improvements in PTSD severity. Results showed that, in a model with both predictors, decreases in self-focused NPCs, world-focused NPCs, and catastrophizing (CER strategy) were associated with reductions in PTSD severity during treatment and at follow-up. However, these effects were small (R2 ranging from .005 to.04) relative to reductions in depression severity (R2 = .40). Although NPCs and CER strategies significantly predicted reductions in PTSD severity, their overall impact was relatively small in this nonrandomized, uncontrolled ITP. Future research should continue to investigate these and other predictors in a variety of treatment settings.

Mindfulness-Based Interventions (MBIs) have shown promising results in improving mental health in the general population. However, traditional MBIs require substantial time and effort due to the high dose of mindfulness practice, which makes them inaccessible to many individuals. This study aimed to (1) test the effectiveness of a novel low-dose MBI-Mindfulness-Based Integrative Programme (MBIP)-delivered synchronously online, on mental health symptom severity, emotion regulation, and trait mindfulness in the general population; (2) test the acceptability of this intervention; and (3) identify baseline characteristics that may predict changes in emotion regulation. A non-randomised controlled trial design was used to compare pre- to post-intervention change scores in trait mindfulness (FFMQ), mental health symptom severity (SCL-90-R GSI), and emotion dysregulation (DERS) between a self-selected and self-paid experimental group (n = 116) and a passive control group (n = 115). The experimental group showed significant increases in trait mindfulness and reductions in mental health symptom severity and emotion dysregulation, with effect sizes ranging from small to large, which is comparable to traditional in-person MBIs. Baseline trait mindfulness and mental health symptom severity significantly predicted intervention outcomes, with greater improvements in emotion regulation among participants with lower baseline scores. Participants demonstrated high levels of engagement and reported high satisfaction with the intervention. These findings support the acceptability and effectiveness of a novel low-dose, synchronous online MBI for the general population.

Numerous studies have explored the relationship between sleep quality and internalizing symptoms (i.e., depression and anxiety), but there is uncertainty about their directional pathways. Here, we investigated the longitudinal associations between sleep quality and internalizing symptoms and tested the potential mediation effect of perceived stress.

A longitudinal survey of Chinese healthcare students (N = 343) was conducted at three time points: Time 1 (baseline), Time 2 (1 week later), and Time 3 (3 weeks after Time 2). Participants completed the Sleep Quality Questionnaire (SQQ), Perceived Stress Questionnaire-30 (PSQ-30), and the Patient Health Questionnaire-4 (PHQ-4) at each time point, where each asked about participants' experiences over the past week. A higher SQQ score indicated poorer sleep quality, while higher scores on the PHQ-4 and PSQ-30 indicated more severe internalizing symptoms and perceived stress. Using autoregressive cross-lagged panel modeling (CLPM), we examined the bidirectional relationships among sleep quality, internalizing symptoms, and perceived stress.

CLPM revealed that baseline sleep quality negatively predicted subsequent changes in internalizing symptoms, and vice versa. While perceived stress mediated the relationship between sleep quality and internalizing symptoms at the 3-week follow-up (β = 0.017, p = .038), it did not mediate the reverse relationship between internalizing symptoms and sleep quality.

There was a negative bidirectional relationship between sleep quality and internalizing symptoms. Furthermore, perceived stress mediated the effect of poor sleep quality on internalizing symptoms, suggesting that good-quality sleep may enhance stress resilience and alleviate symptoms of depression and anxiety, thereby improving overall wellbeing.

Using multiple emotion regulation strategies in response to a single stressor-known as polyregulation-is an understudied but common event. The role of polyregulation in psychological disorders characterized by repetitive negative thinking (RNT) is unexplored, despite well-documented difficulties in emotion regulation and strong urges to avoid and escape one's intrusive thoughts in RNT.

Participants (N = 60) either had clinical levels of RNT (n = 15 with worries, n = 14 with ruminations, n = 16 with obsessions) or non-clinical levels of RNT (n = 15) and were exposed to their most personally distressing intrusive thought during an in-lab task. Proportional odds logistic regressions were used to test if RNT group and situation-level factors predicted greater polyregulation following the thought exposure. Multilevel regressions were used to test the short-term effectiveness of polyregulation on subjective distress and psychophysiological responding (heart rate, skin conductance).

Ninety percent of participants reported using two or more strategies following intrusive thought exposure. Extent of polyregulation was not significantly predicted by RNT group, most situation-level factors, or short-term regulatory effectiveness. Endorsing a greater need to control one's intrusive thought did, however, predict use of more strategies.

This is a secondary analysis in a small sample.

Given treatments for psychological disorders characterized by RNT attempt to disrupt the connection between a person's urge to control their distressing thoughts and efforts to escape or avoid those thoughts, continued investigation into the role of polyregulation in intrusive thinking may guide clinical intervention.

Sexual minority young adults report higher rates of anxiety and depression, and affective vulnerability factors (i.e. anxiety sensitivity, distress tolerance, emotion dysregulation) may help explain these mental health disparities.

The current cross-sectional study examined differences between sexual minority and heterosexual college students (n = 465; Mage = 19.84, SD = 3.51; 76.3% female) in anxiety, depression and affective vulnerability and whether affective vulnerability served as an explanatory mechanism in these associations.

Participants completed self-report measures for course credit.

Sexual minority young adults reported greater anxiety, depression, anxiety sensitivity, emotion regulation difficulties and lower distress tolerance. There were also significant indirect effects for all three affective vulnerability variables for anxiety symptoms and for emotion regulation difficulties for depression symptoms.

Affective vulnerability, particularly emotion regulation difficulties, appears to serve as a mechanism through which sexual minority status is associated with anxiety and depression. Improving emotion regulation skills may help to reduce mental health disparities in this population.

Existing research suggests that emotion plays an important role in airway inflammation and asthma symptom control. The objective of this study was to determine whether difficulties regulating emotion were associated with overuse of short-acting inhaled medications and acute medical care usage in adults with asthma.

The sample included 401 adults with asthma recruited from an online panel of adults with chronic respiratory disease. Sequential binary logistic regression models were used to examine the associations of emotion regulation with short-acting inhaled medication use and acute medical care use, controlling for patient characteristics and comorbid mental health conditions.

Greater difficulties with emotion regulation were significantly associated with greater odds of short-acting inhaler medication overuse (p < 0.001), emergency department visits (p < 0.001), and hospitalizations (p = 0.001).

Emotion dysregulation may play an important role in asthma management. Evidence-based interventions to reduce difficulties in emotion regulation may help improve problematic patterns of short-acting medication overuse and acute service use. The current findings should be interpreted in the context of several limitations, including the use of self-report measures. Future research should use electronic medical records or metered dose inhalers to objectively assess short-acting inhaler overuse and acute medical care use.

Emotion regulation is a crucial function implicated in multiple mental health disorders; understanding the mechanisms by which emotion regulation has such impact is essential. Mentalizing has been posited as a prerequisite for effective emotion regulation. The current study aims to examine the roles of epistemic trust and interpersonal problems in driving the association between mentalizing and emotion regulation, contrasting clinical and non-clinical populations.

A total of 652 individuals (296 clinical and 356 community control) were employed. Sequential mediation analysis was used to examine the role of epistemic stances and interpersonal problems in the mentalizing-emotion regulation link, and moderated mediation analysis was conducted to identify group differences in these pathways.

Ineffective mentalizing was associated with emotion dysregulation and interpersonal problems. Higher levels of epistemic credulity and mistrust were associated with ineffective mentalizing, interpersonal problems, and emotion dysregulation. Sequential mediation analysis indicated that disruptions in epistemic trust (epistemic mistrust and credulity) and interpersonal problems partially mediated the relationship between inadequate mentalizing and emotion dysregulation, with these pathways being consistent across both clinical and control groups. The pathways including epistemic trust were not significant.

The study's limitations include a simplified theoretical model, a cross-sectional design preventing causal inference, and sample recruitment methods possibly limiting generalizability.

These findings suggest a potential mechanism connecting mentalizing, disruptions in epistemic trust, interpersonal problems, and emotion regulation, to illuminate a crucial aspect of psychological functioning. These results emphasize the significance of social-communicative aspect in clinical outcomes.

Adolescents with a history of suicide exposure, defined as experiencing the suicide death of a family member, friend, or other acquaintances, are more likely to experience mental health issues such as depression or anxiety.

This study aimed to explore prevalence rates and the network of adolescents' suicide exposure, depression, and anxiety symptoms, and to clarify the correlations between suicide exposure and symptoms of depression and anxiety.

A total of 8,957 adolescents were included in this cross-sectional study. Data regarding general information, symptoms of depression and anxiety, and suicide exposure were collected from mid-September to early October 2021. Network analysis was employed to assess relationships between suicide exposure and individual symptoms of both depression and anxiety. Central symptoms were identified by strength; the flow network was visualized to identify symptoms directly related to suicide exposure.

The prevalence rates of suicide exposure, depression, and anxiety were 5.28%, 12.87%, and 10.48%. Results indicated that suicide exposure was associated with both depression and anxiety, and had the strongest positive association with suicidal ideation. Central symptoms of the network were sad mood, nervousness, fatigue, irritability, and uncontrollable worry. Bridge symptoms were suicidal ideation and irritability. Appetite changes, suicidal ideation, uncontrollable worry, sleep difficulties, and irritability were symptoms directly related to suicide exposure.

There were significant inter-symptom associations between suicide exposure, depression, and anxiety in adolescents. It is recommended that future studies explore whether targeted interventions and long-term monitoring concerning these inter-symptom associations can protect adolescents with suicide exposure.

Emerging research shows that distancing one's language by reducing the use of "I" and present-tense verbs is associated with more successful emotion regulation. However, construal level theory posits that increasing psychological distance should also shift mental representations to be more abstract. Here, we test whether successful emotion regulation is related to linguistic measures of both abstractness and psychological distance in two emotion regulation experiments reported previously (N 1 = 217, N 2 = 464). As hypothesized, we found that (i) linguistic measures of psychological distancing and abstractness were highly correlated, (ii) linguistic abstractness increased when people used cognitive reappraisal strategies to regulate their responses to negative images, (iii) instructing participants to distance their language by not using the word "I" increased linguistic abstractness, and (iv) the extent to which people made their language more abstract while regulating correlated with regulation success. These results extend theoretical arguments that psychological distance and abstract construals are strongly connected in the mind. Furthermore, they provide novel evidence that successful cognitive reappraisal is associated with more abstract representations of stimuli and that this cognitive shift can be achieved merely by shifting one's language.

The online version contains supplementary material available at 10.1007/s42761-024-00269-7.

The study aimed to explore the relationship between intrinsic spirituality, emotion dysregulation, resilience, and PTSD in Turkish university students who were earthquake survivors. In addition, the validity and reliability of the Brief Emotion Dysregulation Scale (BEDS) were evaluated among Turkish university students who were earthquake survivors.

A sample of 651 Turkish university students who were earthquake survivors participated in an online survey distributed via WhatsApp, completing the Intrinsic Spirituality Scale (ISS), the Brief Emotion Dysregulation Scale (BEDS), the Brief Resilience Scale (BRS), and the Post-Traumatic Stress Disorder Checklist for DSM-5. Structural equation modeling and mediation analysis were employed to explore the predictive relationships between these psychological variables and PTSD symptoms.

The findings confirmed that the BEDS is a valid and reliable scale for assessing emotion dysregulation levels in Turkish university students who were earthquake survivors. Intrinsic spirituality had a negative correlation between emotion dysregulation and PTSD, indicating that higher levels of PTSD are associated with lower intrinsic spirituality. A positive correlation was found between intrinsic spirituality and resilience, suggesting that increased intrinsic spirituality is linked to higher levels of resilience. Furthermore, emotion dysregulation and resilience were found to mediate the relationship between intrinsic spirituality and PTSD. Moreover, emotion dysregulation has a mediating effect in the relationship between resilience and PTSD.

The study highlights the determinant effects of intrinsic spirituality on emotional dysregulation, resilience and PTSD in Turkish university students who survived the earthquake. Interventions and support programs designed to reduce PTSD symptoms should benefit from the results of this research, and future research should include longitudinal studies to assess the long-term effects of intrinsic spirituality on PTSD. It is also crucial to examine the effects on various demographic groups, including differences in age, education level, and socio-economic status.

Posttraumatic stress disorder (PTSD) frequently co-occurs with myriad mood and anxiety disorders including generalized anxiety disorder (GAD). Despite this comorbidity's prevalence, mechanisms underlying the co-occurrence of PTSD and GAD remains understudied. An emotion dysregulation framework routinely is used to understand both PTSD and GAD but has not been applied to the PTSD-GAD comorbidity. Using MANOVA, the present study tested domains of emotion dysregulation (DERS) and of positive emotion regulation (AEQ) as differentiators of PTSD alone versus PTSD with GAD using pre-intervention data from a randomized controlled trial including 292 women with PTSD secondary to interpersonal violence. Five of six emotion dysregulation domains differentiated the two groups: fewer regulation strategies, nonacceptance of emotional responses, impulse control difficulties, lack of emotional awareness, and lack of emotional clarity were associated with comorbidity. Of three positive emotion regulation domains, participants with PTSD alone reported more positive emotionality than those with PTSD and GAD, and those with comorbid PTSD and GAD reported more negative affective interference than those with PTSD only. Rather than specific domains underlying unique presentations, findings indicate a general dysregulation factor, where PTSD-GAD comorbidity is supported by an overall higher level of emotion dysregulation as compared to PTSD alone.

The purpose of this study was to investigate the examining the transdiagnostic model related to emotion regulation of adolescents with high-risk behaviors and the effectiveness of transdiagnostic treatment on reducing anxiety, depression, and emotion dysregulation in students with high-risk behaviors.

The statistical population included all teenage students between the ages of 12-17 years studying in the academic year 2021-2022 in Tehran. For this purpose, 60 students who met the inclusion criteria were selected using a multistage cluster method and then randomly assigned to two experimental and control groups. Barlow's transdiagnostic treatment package (special for adolescents) was performed on the experimental group by a clinical specialist during 12 one-hour weekly sessions. The participants answered Beck's depression, Beck's anxiety, and emotion regulation questionnaires in three stages: pretest, posttest, and follow-up. Data were analyzed using multivariate covariance analysis.

The results showed that the transdiagnostic protocol can be effective in reducing emotional problems such as reducing anxiety, depression, and emotional dysregulation in the experimental group compared to the control group.

According to the results obtained from the present study, similar transdiagnostic protocols can be used as effective methods to improve the emotional regulation of adolescents with high-risk behaviors.

Emotion regulation difficulties affect many adolescents with attention-deficit/hyperactivity disorder (ADHD), and previous research has highlighted a need for accessible interventions to support them in this domain, especially in real-life contexts. Digital health interventions (DHIs) can be embedded in adolescents' daily lives and thus offer considerable promise for meeting this need. However, there is a lack of information to guide the development of suitable emotion regulation DHIs for this population. The goal of this study is, therefore, to identify recommendations to guide the development of emotion regulation DHIs for adolescents with ADHD. This narrative review synthesizes diverse relevant evidence to inform their development, including promising therapeutic approaches and components and relevant design and development considerations. We find that there is very little direct evidence of "what works" for emotion regulation DHIs and emotion regulation interventions more generally for adolescents with ADHD; however, we identify promising therapeutic approaches for new DHIs. We also recommend following a co-design or coproduction approach with adolescents with ADHD, including exploring elements designed to motivate and engage young people to support sustained adherence. We conclude that DHIs are a promising approach for emotion regulation interventions for adolescents with ADHD, could draw on a range of existing therapeutic approaches, and should be co-designed with users themselves.

Inhibitory deficits are common in psychopathology. Emotion-related impulsivity (ERI) and rumination are general risk factors for psychiatric distress that are similarly associated with dysfunctional inhibition-particularly in affective contexts. A number of cognitive remediation procedures have been developed to improve inhibitory control; however, most remediation programs focus on "cold" cognition independent of affective processing. This pilot trial will gather preliminary evidence for a new cognitive training intervention targeting "hot" affective control (ie, inhibitory functions during elevated emotional arousal) in a transdiagnostic sample of adults who report heightened emotion dysregulation.

This manuscript describes a protocol for a pilot randomized waitlist-controlled trial to assess changes in ERI and rumination after neurobehavioral affective control training (N-ACT), an 8-week cognitive training intervention designed to improve emotional response inhibition and emotional working memory. Our primary aim is to evaluate the efficacy, feasibility, and acceptability of N-ACT in reducing rumination and ERI, which we respectively conceptualize as complementary cognitive and behavioral consequences of emotion dysregulation. Secondarily, we will examine whether N-ACT leads to improvements in inhibitory control and, more distally, psychopathology symptoms.

The final sample will comprise 80 adults who report high ERI or rumination. Participants will be randomized to (1) begin the N-ACT program without delay or (2) join a waitlist condition and then complete N-ACT. Exclusion criteria include active alcohol or substance use disorders, psychosis, and suicide risk. At the baseline and postintervention time points, participants will complete measures of emotion dysregulation and psychiatric symptoms, as well as a neuropsychological assessment of inhibitory control. Individuals assigned to the control group will undergo an identical assessment before joining the waitlist, followed by parallel assessments before and after N-ACT.

This trial is funded by support from the University of California Board of Regents and the Peder Sather Foundation (funding period: October 2022-September 2025). Recruitment is scheduled to begin in spring 2025. We will begin data analysis once data collection is complete, which is planned to occur in fall 2025.

This pilot randomized waitlist-controlled trial is designed to assess the initial efficacy, feasibility, and acceptability of N-ACT, a novel cognitive remediation approach developed to address 2 key contributors to psychopathology: ERI and rumination. The N-ACT program uses computerized adaptive behavioral tasks to strengthen the affective control processes theoretically and empirically linked to ERI and rumination. We hope this work will help inform future studies with sufficient statistical power to ascertain whether enhancing affective control through cognitive training (N-ACT) produces downstream reductions in psychiatric symptoms via improved emotion regulation.

ClinicalTrials.gov NCT06226467; https://www.clinicaltrials.gov/study/NCT06226467; Open Science Framework Registry rak5z; https://osf.io/rak5z.

PRR1-10.2196/54221.

Background/Objectives: Difficulties in emotion regulation (DER) serve as a transdiagnostic risk factor for a wide range of emotion-based psychopathologies, including anxiety and depression disorders. This study presents a report on the psychometrics of the eight-item Difficulties in Emotion Regulation Scale-8 (DERS-8) and the development of its Polish norms. Methods: The sample comprised 1329 Polish adults aged 18-73, with 907 females, 384 males, 36 non-binary, and 2 people with an unidentifiable gender. The participants filled out a series of self-report questionnaires on DER, anxiety and depression symptoms, and well-being. Factor structure and measurement invariance, as well as discriminant validity of the DERS-8, were tested with confirmatory factor analysis. Convergent and divergent validity was assessed via relationships with negative and positive mental health outcomes. Internal consistency reliability was evaluated with alpha and omega coefficients. Demographic differences were also examined. Results: Our empirical evidence supported the strong psychometrics of the Polish DERS-8, including its good level of internal consistency reliability (i.e., 0.89) and strong validity. The one-factor DERS-8 model had a good fit, with its supported scalar invariance between a set of demographic variables and levels of mental health outcomes. DERS-8 scores were strong positive predictors of anxiety and depression symptoms and negative predictors of well-being, emphasizing the potential detrimental effects of DER on the dual continuum of mental health and mental illness. Conclusions: The Polish DERS-8 has strong psychometric properties. Given the development of its percentile rank norms, the scale can be used as a good screening measure of DER in the Polish adult sample.

Anxiety, a prevalent and detrimental mental disorder, usually emerges in late adolescence and emerging adulthood. Emotion regulation strategies, namely expressive suppression and cognitive reappraisal, share a close relation with the onset and maintenance of anxiety. Yet the relation between anxiety and emotion regulation strategies remains controversial and warrants further clarification.

The generalized anxiety disorder-7 (GAD-7) was used to measure the anxiety disorders and the emotion regulation questionnaire (ERQ) was utilized to assess the use of two emotion regulation strategies. In study 1, a total of 2201 college students completed two measurement waves (females = 1358, 61.70%, Mage = 18.37). The cross-lagged model was conducted to identify the directional relation between two emotion regulation strategies and anxiety. In study 2, 3150 college students (females = 1562, 49.59%, Mage = 19.73) completed the measurements. The moderated network model was utilized to clarify the influence of emotion regulation strategy on anxiety from the symptomatic perspective.

In study 1, the results of the cross-lagged model suggested that the level of anxiety in wave 2 could be negatively predicted by the cognitive reappraisal (b = -0.552, p < .01) but not by expressive suppression (b = 0.035, p = .174) in wave 1. In study 2, the results of the moderated network indicated that cognitive reappraisal could moderate the interaction between "Excessive worry"-"Irritability", "Nervousness" -"Uncontrollable worry", "Trouble relaxing"-"Nervousness" (GAD1) ,and "Restlessness" -"Irritability".

The current study confirmed cognitive reappraisal could serve as a protective factor for anxiety by diminishing the positive relation between "Excessive worry"-"Irritability" and "Nervousness" -"Uncontrollable worry". This finding may guide clinical workers to develop more targeted interventions using cognitive reappraisal to alleviate anxiety symptoms.

The goal of just-in-time adaptive interventions (JITAIs) is to use mobile, digital tools to provide individuals with personalized interventions at the optimal time and in the optimal context. Accordingly, JITAIs are promising for advancing accessible, equitable, and evidence-based treatment for behavioral health. To guide future inquiry in this space, a review of the literature is needed to describe the state of research on JITAIs for behavioral health.

This study aims to systematically review the literature to describe the landscape of existing JITAIs for behavioral health at any stage of intervention development. In addition, conditional upon a sufficiently homogeneous literature, we will conduct meta-analyses to investigate the effectiveness of JITAIs for promoting distal outcomes (here, aspects of behavioral health) and proximal outcomes (eg, emotion regulation).

This systematic review is being conducted in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols). We developed our search strategy and executed the literature search in collaboration with biomedical librarians; 5 databases (PubMed, Embase, Cochrane Library, Web of Science: Core Collection, and APA PsycINFO) were searched, and results were managed using EndNote 20 (Clarivate). We are screening (title, abstract, and full text) all records in duplicate in Covidence according to eligibility criteria. Data items will be extracted, and risk of bias will be assessed in duplicate from the included articles in Covidence. We will summarize JITAI characteristics in tables and text. We will conduct meta-analyses for the distal and proximal outcomes conditional upon sufficient homogeneity in subgroups. Moderation (conditional upon sufficient heterogeneity of outcomes) and mediation (ie, whether changes in proximal outcomes mediate the relation between JITAIs and distal outcomes) will be conducted as appropriate. We will investigate publication bias and use the Grading of Recommendations Assessment, Development and Evaluation to characterize the quality of evidence of our estimates.

The search strategy was developed between July 2023 and November 2023. The literature search was executed between November 2023 and December 2023. Title and abstract screening began in December 2023, and full-text screening began in May 2024. Data extraction and analyses have not begun.

Here, we propose a systematic review to assess the state of the literature on JITAIs for behavioral health. The insights derived from this study will describe the literature on JITAIs in promoting behavioral health, reinforce JITAI definitions, clarify JITAI elements, and inform the next steps in JITAI research.

PRR1-10.2196/58917.

Emotion regulation (ER) and distress tolerance (DT) are considered transdiagnostic risk factors for a range of anxiety disorders. This study investigated the relationship between anxiety sensitivity (AS) and health anxiety (HA) in the general population, focusing on the mediating roles of DT and ER.

The study was conducted as a cross-sectional survey from October to December 2023 in Tehran Province, Iran. A total of 971 individuals participated in this study (52.8% female; mean age 39.04 years, SD=10.64). Participants completed self-report questionnaires to assess HA (The Short Health Anxiety Inventory), AS (The Anxiety Sensitivity Index-3), DT (The 15-item Distress Tolerance Scale) and ER (The 10-item Emotion Regulation Questionnaire). We used structural equation modeling (SEM) to examine the hypothesis that DT and ER would mediate the relationship between AS and the HA.

AS was modestly related to all measures (r from -0.40 to 0.55). According to the SEM analysis, AS (β = 0.45, 95%CI [0.34, 0.56]) had a significant direct effect on HA. However, the analysis of the indirect effects revealed that both DT (β = 0.10, 95% CI [0.06, 0.16]) and emotion regulation strategies-cognitive reappraisal (β = 0.06, 95% CI [0.01, 0.11]) and expressive suppression (β = 0.11, 95% CI [0.06, 0.18])-act as partial mediators in the relationship between AS and HA.

AS plays a crucial role in predisposing individuals to HA. The mediating roles of DT and ER provide insight into the link between AS and HA. Nevertheless, the study's cross-sectional design and reliance on a non-clinical sample limit the applicability of the results. Further research involving different samples and intervention studies is needed to validate and expand upon these findings.

Research on improving psychotherapy for youths with obsessive-compulsive disorder (OCD), including cognitive behavioral therapy (CBT), should explore what works for whom and how by examining baseline moderators and potential mechanisms of change. Emotion dysregulation is proposed as an intermediate therapy factor in a transdiagnostic framework. This study investigates emotion dysregulation as an outcome, mechanism, and moderator of psychotherapy in youths aged 8-17 years with OCD.

Data are from a randomized clinical trial and a parallel prospective study of healthy controls. Participants with OCD (n = 130; 121 in this study) were randomized to 14 sessions of either family-based CBT with exposure and response prevention versus family-based psychoeducation and relaxation training. We will; 1) assess if emotion dysregulation, measured by the Difficulties in Emotion Regulation Scale (DERS), decreases from baseline to end-of-treatment; 2) compare the proportion of participants with normative emotion regulation to a 90% reference interval from healthy controls (n = 90); 3) use linear regression to examine if baseline emotion dysregulation moderates treatment effects measured by the Children's Yale-Brown Obsessive-Compulsive Scale; 4) investigate if changes in emotion dysregulation mediate treatment effects; and 5) investigate the stability of emotion regulation over time in the healthy controls. Analyses 1-4 will be conducted for all OCD participants and separately for the two treatment groups. Two independent investigators will perform the analyses.

This protocol and statistical analysis plan are presented to enhance analytical transparency and limit bias.

Anxiety commonly occurs after experiencing negative life events. However, the role of emotion regulation strategies in moderating the relationship between negative life events and anxiety remains unclear. The current study 1) examines the associations between emotion regulation strategies and trait anxiety, and 2) explores whether the relationship between negative life events and trait anxiety is moderated by emotion regulation strategies, in particular, adaptative strategies such as cognitive reappraisal.

We used data from 1384 adolescents and young adults (ages 12-27) who completed measures of negative life events, emotion regulation strategies, and trait anxiety. Emotion regulation was measured using the Emotion Regulation Questionnaire and the Difficulties in Emotion Regulation Scale - Short Form.

Multiple regression analyses showed that limited access to emotion regulation strategies, difficulty engaging in goal-directed behavior, lack of emotional awareness, lack of emotional clarity, nonacceptance of emotional responses, and use of cognitive reappraisal were associated with trait anxiety. Additionally, the positive association between negative life events and trait anxiety was moderated by difficulty engaging in goal-directed behavior and use of cognitive reappraisal. Sex differences were apparent for difficulty engaging in goal-directed behavior. Age-based analyses revealed that these interactions were specific to young adults.

Limitations include a cross-sectional design and reliance on self-report measures.

Less use of adaptive emotion regulation strategies was associated with greater trait anxiety. Further, the relationship between negative life events and trait anxiety in young adults may depend on one's ability to engage in goal-directed behavior and use cognitive reappraisal.

Background/Objectives: The Emotion Regulation Questionnaire (ERQ) is a 10-item self-report measure of two emotion regulation strategies, cognitive reappraisal (CR) and expressive suppression (ES). This study aimed to (1) examine the latent structure of the Polish version of the ERQ, and (2) use it to explore different profiles of emotion regulation strategy use and their links with mental health outcomes. Methods: Our sample was 1197 Polish-speaking adults from the general community in Poland. Results: A factor analysis showed that the ERQ had strong factorial validity, with an intended two-factor structure (CR and ES factors) that was invariant across gender, age, and education categories, as well as across different levels of psychopathology symptoms and alexithymia. Our latent profile analysis extracted four emotion regulation profiles (subtypes): a Mainly Reappraisal profile (high CR, low ES), a Mainly Suppression profile (low CR with high ES), a Generally Low Regulation profile (low CR, low ES), and a Generally High Regulation profile (high CR, high ES). People with the Mainly Reappraisal profile had the best mental health outcomes, whereas people with the Mainly Suppression profile had the poorest mental health outcomes. Conclusions: Conceptually, these findings support the process model of emotion regulation, illustrating the differential affective outcomes of various emotion regulation strategies. Our results highlight the importance of considering individual differences in strategy use patterns, including combinations of strategies within an emotion regulation profile. The Polish version of the ERQ appears to be a robust measure of these key emotion regulation processes across a variety of demographic groups. To facilitate its use, including score interpretations in clinical practice, we present Polish percentile rank norms for the ERQ.