A longitudinal model of emotion pathways to growth, depreciation, and health outcomes after life stress

Emotion regulation (ER) refers to the processes by which individuals influence the onset, intensity, and duration of emotions. Previous studies have examined the effects of adaptive ER and maladaptive ER in isolation, but growing evidence suggests that they should be studied in conjunction. This study examined the interactions between habitual adaptive and maladaptive ER strategies with eating disorder (ED) symptoms and ED-related clinical impairment. Students (N = 1377) from a Midwestern American university reported ED symptoms, ED-related impairment, habitual adaptive ER (i.e., cognitive reappraisal), and habitual maladaptive ER (i.e., distraction and suppression). Multiple linear regressions were conducted using the PROCESS v3 macro. The study found that adaptive ER was negatively associated with ED symptoms and ED-related impairment, whereas maladaptive ER was positively associated with both outcome variables. Adaptive ER moderated the association between maladaptive ER and ED symptoms, but not clinical impairment. When habitual adaptive ER was low (< 33.4th percentile), there was no association between maladaptive ER and ED symptoms; however, when habitual adaptive ER was moderate to high (> 33.4th percentile), there was a positive association between frequency of maladaptive ER use and ED symptoms. There was no significant three-way interaction among adaptive ER, maladaptive ER, and probable ED diagnosis, for ED-related impairment or symptoms. Results suggest that irrespective of frequency of maladaptive ER, people with low adaptive ER reported elevated psychopathology. Findings point to the utility of interventions to reduce maladaptive ER and increase adaptive ER in ED populations. Level V, cross-sectional descriptive study.

Trait-level emotion regulation (ER) difficulties are associated with eating disorders (EDs) transdiagnostically. However, little research has examined whether within-person fluctuations in ER longitudinally predict ED behaviors in daily life or the mechanisms of ER effects. Investigating daily ER could help us better understand why people experience ED behaviors at a given time. We examined whether day-to-day changes in adaptive (e.g., cognitive reappraisal) and maladaptive (e.g., rumination) ER longitudinally predicted core ED behaviors (binge eating, purging, dieting) and whether changes in affect mediated effects. Female participants (N = 688) ages 15-30 from the Michigan State University Twin Registry reported their adaptive and maladaptive ER use, negative affect (NA), positive affect (PA), binge eating, purging, and dieting on 49 consecutive days. Using structural equation modeling, we examined whether within-person fluctuations in ER predicted same- and next-day ED behaviors and whether changes in affect mediated longitudinal ER effects. Greater maladaptive ER predicted increased likelihood of same-day binge eating and next-day binge eating and purging. The association between maladaptive ER and next-day binge eating and purging was mediated by increased next-day NA. In contrast, dieting was more closely related to changes in PA. Adaptive ER did not predict reduced likelihood of any ED behavior. Maladaptive ER may longitudinally increase risk for binge eating and purging by amplifying NA. Interventions focused on decreasing maladaptive ER and subsequent NA might help disrupt binge eating-purging cycles. Conversely, results add to evidence that PA fluctuations may play a unique role in maintaining restrictive behaviors. Little is known about how daily changes in emotion regulation may impact disordered eating. We found that maladaptive emotion regulation (e.g., rumination) was associated with a higher likelihood of binge eating and purging on the next day because it predicted increased next-day negative affect. In contrast, dieting was more closely tied to fluctuations in positive affect. Targeting daily emotion regulation and affective processes may help disrupt cycles of disordered eating.

ABSTRACTPast research results suggest that executive functioning (EF) impairment represents an important vulnerability factor in depression. Little research, however, has examined mechanisms underlying this association. The current study investigates the associations between EF impairment, emotion regulation (ER) strategies, and depressive symptoms in a sample of 579 adolescents (320 females, mean age = 12.06 years). Parents reported on adolescents’ EF and general psychopathology, and adolescents self-reported ER strategies and depressive symptoms. The results indicate that greater EF impairment is associated with more depressive symptoms. Youth with greater EF impairment reported more maladaptive ER and less adaptive ER, and maladaptive and adaptive ER strategies jointly mediated the association between EF impairment and depressive symptoms. The results highlight an important role of both maladaptive and adaptive ER in explaining the relationship between EF and depressive symptoms and suggest that clinical interventions targeting ER skills may provide one strategy for the prevention and treatment of depression. Further longitudinal research is needed to replicate these results and evaluate the causality of the relations.

Adolescents with anorexia (AN) and bulimia nervosa (BN) often struggle with emotion regulation (ER). These difficulties have predominantly been assessed across emotions, without considering adaptive and maladaptive ER separately. We compared adolescents with AN or BN to healthy adolescents (HCs) regarding the adaptive and maladaptive ER of three emotions. A treatment-seeking sample of 197 adolescents (atypical/full-threshold AN: N=118, atypical/full-threshold BN: N=32; HC: N=47) reported emotion-specific ER with the FEEL-KJ questionnaire. Mixed models were calculated for adaptive and maladaptive ER to assess differences between emotions (anxiety, anger, and sadness) and groups (AN, BN, and HC). Main effects of emotion (p < .001) and group (p < .001) were found, but no interaction effects were found (p > .05). Post hoc tests showed lower maladaptive and higher adaptive ER for anxiety than anger or sadness (p < .001). AN and BN reported lower adaptive (p < .001) and higher maladaptive ER than HCs (p < .001). BN showed the highest levels of maladaptive ER (p=.009). The differences between AN and BN in adaptive and maladaptive ER should be considered. Furthermore, investigating differences in ER of other emotions in eating disorders might be promising.

Music listening, an inherently emotional activity, is commonly used as a form of emotion regulation (ER). Although research suggests that some strategies of listening to music to regulate emotion are linked with psychological well-being and symptoms of affective disorders, the mechanisms underlying these relationships have not been thoroughly explored. The present study examined whether associations between music as ER and symptoms of depression and anxiety were mediated by individuals’ use of other adaptive and maladaptive ER strategies. A nationwide online sample of US adults ( n = 146) completed measures assessing their use of music as ER, other adaptive and maladaptive ER strategies, and symptoms of depression and anxiety. The results indicated that the overall use of music as ER was not directly associated with symptoms of depression and anxiety, whereas using music as discharge (venting negative emotions by listening to mood-congruent music) was positively associated with such symptoms. Mediational analyses revealed that adaptive ER mediated the relationship between overall use of music as ER and symptoms of depression and anxiety, whereas maladaptive ER mediated the relationships between discharge and symptoms. These findings suggest that people use music as ER alongside their other ER efforts, which in turn are linked with symptoms of depression and anxiety. Furthermore, although the overall use of music to regulate emotion may be beneficial for well-being via its association with adaptive ER, a more maladaptive pattern when using music for emotional discharge suggests that music plays a more nuanced role in ER and mental health.

BackgroundSocial anxiety disorder (SAD) in adolescents may be associated with the use of maladaptive emotion regulation (ER) strategies. The present study examined the use of maladaptive and adaptive ER strategies in adolescents with SAD.Methods30 adolescents with SAD (CLIN) and 36 healthy adolescents for the control group (CON) aged between 11 and 16 years were assessed with the standardized questionnaires PHOKI (Phobiefragebogen für Kinder und Jugendliche) for self-reported fears as well as FEEL-KJ (Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen) for different emotion regulation strategies.ResultsCompared to controls, adolescents with SAD used adaptive ER strategies significantly less often, but made use of maladaptive ER strategies significantly more often. There was a significant positive correlation between maladaptive ER and social anxiety in adolescents. Examining group differences of single ER strategy use, the CLIN and CON differed significantly in the use of the adaptive ER strategy reappraisal with CLIN reporting less use of reappraisal than CON. Group differences regarding the maladaptive ER strategies withdrawal and rumination, as well as the adaptive ER strategy problem-solving were found present, with CLIN reporting more use of withdrawal and rumination and less use of problem-solving than CON.ConclusionsPromoting adaptive emotion regulation should be a central component of psychotherapy (cognitive behavioral therapy-CBT) for social anxiety in adolescents from the beginning of the therapy process. These findings provide rationale for special therapy programs concentrating on the establishment of different adaptive ER strategies (including reappraisal). As an increased use of maladaptive ER may be associated with SAD in adolescents, it may be paramount to focus on reduction of maladaptive ER (for example withdrawal and rumination) from the beginning of the psychotherapy process. Incorporating more ER components into psychotherapy (CBT) could increase the treatment efficacy. Further investigations of the patterns of emotion regulation in specific anxiety groups like SAD in adolescents is needed to continue to optimize the psychotherapy (CBT) concept.

This study thus aims to test differences between patients with inflammatory bowel disease (IBD) regarding IBD symptomatology, cognitive fusion, and psychological and physical health, as well as to explore whether the maladaptive emotion regulation process of cognitive fusion longitudinally impacts on the baseline and evolution of these outcomes over a period of 18months. Participants include 116 IBD patients with a mean age of 36.76 (SD=11.39) of both genders (69.83% females) that completed the self-report measures of interest in three different times, equally spaced 9months apart, over a period of 18months. Latent growth curve models were conducted using structural equationmodelling to estimate the growth trajectory of the variables in study. Inflammatory bowel disease symptomatology and cognitive fusion's levels were negatively associated with psychological health and physical health's baseline levels. Furthermore, IBD symptomatology did not influence the growth of psychological health, while cognitive fusion did (β=.30, p=.007). The same result was found for physical health (β=.26, p=.024). These findings indicate that individuals with higher levels of cognitive fusion present lower levels of psychological health and physical health that tend to further decrease over the time through the effects of this maladaptive emotion regulation process. This study implies that it is of crucial importance to include psychotherapeutic interventions in the health care of patients with IBD. If successful, these interventions could represent decreases in the cost of IBD treatment and in the use of drugs with adverse side effects, in addition to improving patients' mental health and quality of life. Further implications for clinical and research work are discussed. Statement of contribution What is already known on this subject? Research has demonstrated the impact of emotion regulation on both physical and mental health. Nevertheless, the longitudinal effects of the specific emotion regulation process of cognitive fusion on physical and psychological health have never been explored. Additionally, no study has yet examined the causal role of emotion regulation in evolution of physical health in inflammatory bowel disease (IBD). What does this study add? Cognitive fusion longitudinally impacted on IBD patients' physical and mental health. These variables were measured over a period of 18months. Treatment for IBD should include interventions aiming to diminish maladaptive emotion regulation.

Race, Ethnicity and Experienced Racism Are Associated with Adverse Physical and Mental Health Outcomes Among Cancer Survivors

Emotion generation and emotion regulation: The role of emotion beliefs

The aim of this study was to confirm and extend the authors' previous work indicating that symptoms of traumatic grief are predictors of future physical and mental health outcomes. The study group consisted of 150 future widows and widowers interviewed at the time of their spouse's hospital admission and at 6-week and 6-, 13-, and 25- month follow-ups. Traumatic grief was measured with a modified version of the Grief Measurement Scale. Mental and physical health outcomes were assessed by self-report and interviewer evaluation. Survival analysis and linear and logistic regressions were used to determine the risk for adverse mental and physical health outcomes posed by traumatic grief. Survival and regression analyses indicated that the presence of traumatic grief symptoms approximately 6 months after the death of the spouse predicted such negative health outcomes as cancer, heart trouble, high blood pressure, suicidal ideation, and changes in eating habits at 13- or 25-month follow-up. The results suggest that it may not be the stress of bereavement, per se, that puts individuals at risk for long-term mental and physical health impairments and adverse health behaviors. Rather, it appears that psychiatric sequelae such as traumatic grief are of critical importance in determining which bereaved individuals will be at risk for long-term dysfunction.

Introduction: In old age, diseases and frailty can be minimized through proper care and understanding, paving the way for healthy and normative aging. The present study aimed to investigate the mediating role of emotion regulation in the relationship between loneliness and empathy with death anxiety in the elderly. Methods: This study utilized structural equation modeling. The statistical population included all elderly residents of Ahvaz, Iran, in 2023. Convenient sampling was employed to select 108 elderly individuals. The research instruments included the Death Anxiety Scale, UCLA Loneliness Scale, Interpersonal Reactivity Index, and Cognitive Emotion Regulation Questionnaire. Pearson correlation coefficient and structural equation modeling were adopted for data analysis. Results: There was a direct relationship between loneliness and adaptive emotion regulation and maladaptive emotion regulation in the elderly. Additionally, there was a direct relationship between empathy and death anxiety, adaptive emotion regulation, and maladaptive emotion regulation. Moreover, a positive relationship was observed between maladaptive emotion regulation and death anxiety, while a negative relationship existed between adaptive emotion regulation and death anxiety in the elderly (p &lt; 0.001). The results revealed an indirect relationship between loneliness and death anxiety mediated by emotion regulation. There was also an indirect relationship between empathy and death anxiety mediated by emotion regulation (p &lt; 0.001). Conclusion: The proposed model exhibited a good fit. Therefore, raising awareness and implementing measures to empower the elderly in emotion regulation concerning the relationship between loneliness and empathy can play a key role in reducing their death anxiety.

Contemporary cognitive models of depression propose that cognitive biases for negative information at the level of attention (attention biases; AB) and interpretation (interpretation biases; IB) increase depression risk by promoting maladaptive emotion regulation (ER). So far, empirical support testing interactions between these variables is restricted to non-clinical and clinical adult samples. The aim of the current study was to extend these findings to a sample of children and adolescents. This cross-sectional study included 109 children aged 9–14 years who completed behavioural measures of AB (passive-viewing task) and IB (scrambled sentences task) as well as self-report measures of ER and depressive symptoms. In order to maximize the variance in these outcomes we included participants with a clinical diagnosis of depression as well as non-depressed youth with an elevated familial risk of depression and non-depressed youth with a low familial risk of depression. Path model analysis indicated that all variables (AB, IB, adaptive and maladaptive ER) had a direct effect on depressive symptoms. IB and AB also had significant indirect effects on depressive symptoms via maladaptive and adaptive ER. These findings provide initial support for the role of ER as a mediator between cognitive biases and depressive symptoms and provide the foundations for future experimental and longitudinal studies. In contrast to studies in adult samples, both adaptive as well as maladaptive ER mediated the effect of cognitive biases on depressive symptoms. This suggests potentially developmental differences in the role of ER across the lifespan.

Findings on the relationship of posttraumatic growth (PTG) with adjustment to potentially traumatic events are inconsistent, whereupon posttraumatic depreciation (PTD) has been suggested as a possible moderator. The objective of this study is to investigate the associations between PTG and PTD on one side and life satisfaction and indicators of mental and physical health on the other side in individuals with spinal cord injury (SCI). The primary study aim is to test whether PTD moderates the relationships of PTG and different adjustment indicators. A total of 141 patients administered to one of the four Swiss SCI rehabilitation centers completed questionnaires assessing PTG and PTD and different indicators of mental and physical health as well as life satisfaction at discharge from first rehabilitation. Correlational and regression methods were used to examine the research question. PTG and PTD were significantly positively correlated (rs = .47). PTD was significantly associated with lower mental and physical health and lower life satisfaction, with small to large effect sizes. PTD moderated the associations of PTG with symptoms of depression and life satisfaction (β of interaction term = -.18 and .24, respectively). PTG was significantly related to lower levels of symptoms of depression and higher life satisfaction in individuals experiencing moderate to high levels of PTD. In contrast, PTG was not significantly related to these outcomes in individuals with low PTD levels. The neglect of PTD in research partially explains mixed findings on the relationship of PTG and adjustment to potentially traumatic events. (PsycINFO Database Record

Cognitive control plays a key role in both adaptive emotion regulation, such as positive reappraisal, and maladaptive emotion regulation, such as rumination, with both strategies playing a major role in resilience and well-being. As a result, cognitive control training (CCT) targeting working memory functioning may have the potential to reduce maladaptive emotion regulation and increase adaptive emotion regulation. The current study explored the effects of CCT on positive reappraisal ability in a lab context, and deployment and efficacy of positive appraisal and rumination in daily life. A sample of undergraduates (n = 83) was allocated to CCT or an active control condition, performing 10 online training sessions over a period of 14 days. Effects on regulation of affective states in daily life were assessed using experience sampling over a 7-day posttraining period. Results revealed a positive association between baseline cognitive control and self-reported use of adaptive emotion regulation strategies, whereas maladaptive emotion regulation strategies showed a negative association. CCT showed transfer to working memory functioning on the dual n-back task. Overall, effects of CCT on emotion regulation were limited to reducing deployment of rumination in low positive affective states. However, we did not find beneficial effects on indicators of adaptive emotion regulation. These findings are in line with previous studies targeting maladaptive emotion regulation but suggest limited use in enhancing adaptive emotion regulation in a healthy sample. (PsycINFO Database Record

Emotionality and Emotion Regulation as Risk Markers for Social Anxiety: Considering Development, Multiple Dimensions, and Social Threat