Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety?

STEVEN TAYLOR and GORDON J. G. ASMUNDSON Treating Health Anxiety: A Cognitive-Behavioral Approach New York: Guilford Press, 2004, 307 pages (ISBN 1-57230-998-9, US$35.00 Hardcover) Health anxiety had been somewhat neglected for years as it by nature evades clear diagnostic boundaries, wavering between a somatoform disorder, an anxiety disorder, and in some cases, a delusional disorder. Recently, the topic of health anxiety has received increasing attention, primarily from leaders in the anxiety disorders field, as reflected in the growing literature on the topic. Treating Health Anxiety: A Cognitive-Behavioral Approach is a timely and much needed addition to this area that will appeal to both clinicians and researchers alike. Taylor and Asmundson, both well published in this area, have done a fine job producing a comprehensive book on health anxiety that is well written, interesting, and provides broad coverage of the nature, assessment, and treatment of health anxiety. The use of case examples throughout and the relatively short chapters certainly make this an interesting and quick read. Although there are several theoretical perspectives on health anxiety in the literature, Taylor and Asmundson have grounded their approach in empirical research. This book will be especially useful for clinicians treating the full range of health anxiety, including hypochondriasis, disease phobia, somatic delusion, or any disorder characterized by excessive anxiety about one's health. The book is very well organized and the chapters follow a logical order. The first part of the book presents a thorough review of the literature on health anxiety in terms of descriptive features, assessment issues, and a conceptual model for the development and maintenance of health anxiety. Chapter 1 presents an interesting discussion of the nature of health anxiety. Given that health anxiety exists on a continuum, useful guidelines for distinguishing adaptive and maladaptive presentations are provided. Clinical features for the various forms of health anxiety are well described and there is attention to the issues pertinent to diagnostic assessment and conceptualization. Useful descriptive information on health anxiety is also provided, including the personal and economic costs, prevalence, onset, course, and cultural considerations. In Chapter 2, Taylor and Asmundson present a comprehensive model for understanding the various components (biological, environmental, cognitive, and behavioural) that play a role in the perpetuation and maintenance of excessive health anxiety. They review the empirical research for each of these factors. The schematic diagram of the model is very useful for the clinician although it may be somewhat busy and confusing to present directly to patients. Chapter 3 nicely brings together the research on behavioural factors and their consequences in the maintenance of health anxiety. Specific focus is placed on four common maladaptive coping strategies: reassurance seeking, checking, reliance on safety cues, and avoidance, as well as how these maladaptive strategies persist and perpetuate health anxiety. Of particular importance is the role the physician may play in iatrogenic worsening of health anxiety. Interesting and relevant phenomenon associated with health anxiety such as cyberchondria (internet checking) and the nocebo effect (expectation-induced negative side effects in response to medication) are highlighted. Chapter 4 reviews evidence for the role of environmental and biological factors in the etiology and maintenance of health anxiety. The second part of the book is focused on assessment and treatment. Chapter 5 presents a review of the treatment outcome literature, including psychological and pharmacological treatments. Taylor and Asmundson supplement their review with presentation of their own preliminary metaanalysis of treatments for health anxiety. Chapter 6 focuses on clinical strategies for thorough assessment and case formulation. …

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.

BackgroundAmong adolescent girls, anorexia nervosa (AN) and major depression (MD) are common and often comorbid mental health problems. Both disorders are characterised by difficulties in recognising and verbalising (alexithymia) as well as regulating one’s emotions, but research in adolescent patients is scarce and little is known about the relation between alexithymia and difficulties in emotion regulation. The aims of this study were to investigate alexithymia and emotion regulation skills in adolescents with AN, adolescents with MD, and healthy adolescents, and to determine whether alexithymia functions as a predictor for emotion regulation skills.MethodsEmotion regulation strategies, alexithymia, and depressive symptoms were assessed by questionnaire measures in 12–18 year old girls with AN (n = 26), girls with MD (n = 25), and healthy girls (n = 35). Groups were compared with respect to the these variables and multiple regression analyses were calculated separately for adaptive and maladaptive emotion regulation strategies in order to examine if alexithymia predicted emotion regulation over and above age and depressive symptoms.ResultsGirls with AN or MD both reported using adaptive emotion regulation strategies less frequently and maladaptive emotion regulation skills more frequently as well as higher levels of alexithymia compared to healthy girls. Alexithymia positively predicted maladaptive emotion regulation strategies, while depressive symptoms negatively predicted adaptive emotion regulation strategies.ConclusionsThe results suggest that different mechanisms may underlie the lack of adaptive and the surplus of maladaptive emotion regulation strategies in adolescent psychiatric patients.

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.

This study aimed to investigate whether cognitive emotion regulation in children varies with parenting style, family type and gender. Toward this end, cognitive emotion regulation and perceived parenting style of 206 school children were measured. Standard regression analyses of data revealed that the models were significant and explained 17.3% of the variance in adaptive emotion regulation (Adjusted R²=0.173; F=9.579, p&lt;.001), and 7.1% of the variance in less adaptive emotion regulation (Adjusted R²=.071, F=4.135, p=.001). Results showed that children’s cognitive emotion regulation is functionally associated with parenting style, but not with family type and their gender. Amongst the three types of parenting, authoritative parenting was the strongest predictor of overall adaptive emotion regulation while authoritarian parenting was the strongest predictor of overall less adaptive emotion regulation. Permissive parenting has impact on neither adaptive nor less adaptive emotion regulation. The findings have implications for parents, caregivers, child psychologists and other professionals working with children/ adolescents. DOI: http://dx.doi.org/10.3329/jasbs.v39i2.17860 J. Asiat. Soc. Bangladesh, Sci. 39(2): 211-220, December 2013

Well-being consists of several different dimensions, such as hedonic and eudaimonic well-being. However, peace of mind (PoM)—an aspect of well-being characterized by internal peace and harmony—has only recently begun to receive attention. It has been shown that PoM predicts important outcomes, such as depression and anxiety. An open question is what underlies individual differences in PoM. One important factor may be emotion regulation. However, to date, no studies have been conducted on PoM and emotion regulation. Here, we investigated the relationship between individual differences in PoM and trait emotion regulation. In two studies, participants from Finland (Study 1, N = 417) and the US (Study 2, N = 303) completed measures of PoM, trait emotion regulation, and other aspects of well-being and ill-being. Results showed that people with higher levels of PoM displayed a greater tendency to use cognitive reappraisal and a lesser tendency to use expressive suppression. Our findings suggest that adaptive emotion regulation may play an important role in explaining PoM and may serve as a promising target for interventions designed to enhance PoM.

Burnout is a state of chronic exhaustion caused by excessive stress. Medical trainees are highly vulnerable to burnout, which can negatively affect their well-being. Empirical evidence from Bethell et al. demonstrates that positive childhood experiences reduce adult depression and anxiety, while Gross’s process model suggests that adaptive emotion regulation strategies buffer against stress-related outcomes. Building upon these frameworks, positive childhood experiences (PCE) and adaptive (positive) emotion regulation (ER) are thought to be protective against burnout, but the mechanisms which mediate these effects are poorly understood. This study aimed to explore whether adaptive ER mediates the relationship between PCE and burnout among medical students. Participants completed well-established and validated measurements of PCEs (Benevolent Childhood Experiences scale), adaptive ER (Cognitive Emotion Regulation Questionnaire short version), and burnout (Maslach Burnout Inventory). Our results indicate that adaptive ER mediates the relationship between PCEs and burnout, with a moderate indirect effect of PCEs on burnout (β = −0.31, accounting for approximately 67% of the total effect). These findings suggest that targeted intervention programs aiming to strengthen adaptive ER could help protect medical students against burnout. However, limitations include the cross-sectional design precluding casual inference, reliance on self-reported data, and recruitment from a single institution with predominantly female participants, which may limit generalizability to other medical schools.

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

Health anxiety is associated with fearful imagery of contracting COVID-19: An experimental study

This study examined the effects of maternal parenting, children`s self-esteem and emotion regulation strategy on emotion regulation. Data were collected from 493 5th and 6th graders. The results were as follows: Firstly, maternal authoritarian and permissive parenting directly affected children`s maladaptive emotion regulation, while maternal affectionate and permissive parenting directly affected children`s adaptive emotion regulation. Secondly, children`s self-esteem directly affected both their maladaptive and adaptive emotion regulation, while also acting as a mediator between maternal parenting and children`s maladaptive and adaptive emotion regulation. Children`s cognitive reappraiser strategy positively affected adaptive emotion regulation, but emotion suppressive strategy negatively affected adaptive emotion regulation. These emotion regulation strategies played a mediating role between maternal parenting or children`s self-esteem and adaptive emotion regulation.

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.

Background: Divorce represents a profound psychosocial crisis, eliciting intense negative emotions that impede forgiveness and emotional recovery. Theoretical frameworks posit that mindfulness and emotion regulation skills may promote post-crisis adjustment by fostering emotional healing. Objectives: This study aimed to examine the predictive roles of mindfulness and emotion regulation in forgiveness among divorced women in the context of marital dissolution. Methods: Employing a correlational descriptive design, this investigation targeted the population of divorced women in Qom County, Iran, during 2024. A convenience sample of 209 participants was recruited. Instruments included the Forgiveness in the Context of Divorce Questionnaire (FCDQ), the Mindfulness Attention Awareness Scale (MAAS), and the Cognitive Emotion Regulation Questionnaire (CERQ). Data were analyzed via Pearson correlation coefficients and simultaneous multiple regression. Results: Pearson correlations revealed significant positive associations between mindfulness and forgiveness (R = 0.37, P &lt; 0.01), as well as adaptive emotion regulation and forgiveness (R = 0.51, P &lt; 0.01). Maladaptive emotion regulation exhibited a significant negative correlation with forgiveness (R = -0.56, P &lt; 0.01). Multiple regression indicated that the predictors explained 42.3% of the variance in forgiveness (R = 0.65, F = 50.06, P &lt; 0.001). All predictors emerged as significant: Mindfulness (β = 0.22, P &lt; 0.01), adaptive emotion regulation (β = 0.24, P &lt; 0.01), and maladaptive emotion regulation (β = -0.39, P &lt; 0.01). Conclusions: The present findings suggest that higher levels of mindfulness and adaptive emotion regulation are associated with greater forgiveness in the context of divorce, whereas maladaptive emotion regulation is associated with lower forgiveness. Such insights highlight the value of incorporating mindfulness and emotion regulation interventions into therapeutic protocols to enhance forgiveness, mitigate distress, and support psychological resilience in divorced women.

Emotion understanding and emotion regulation play important roles in children’s development, but we have only a limited understanding of how these constructs are socialized. Constructionist theories suggest that as children engage in interactions with caregivers, they learn to associate words naming emotion categories with conceptual representations of specific emotions, leading to greater emotion understanding. In this preregistered study, we posit emotion word knowledge as a key feature of emotion understanding. Using path analysis with a cross-sectional sample of 252 mainly low socioeconomic status children (aged 4–8 years) and their caregivers collected between 2018 and 2024, we examined indirect effects of implicit parental emotion socialization (difficulties with emotion regulation and emotional expressivity) on children’s emotion regulation through children’s emotion word knowledge. While parental difficulties with emotion regulation and expressivity were unrelated to children’s emotion word knowledge, child emotion word knowledge predicted parent reports of children’s adaptive emotion regulation. In addition, we observed an indirect effect of children’s verbal intelligence on adaptive emotion regulation through children’s emotion word knowledge. In contrast, we observed a direct effect of parental difficulties with emotion regulation on children’s dysregulation. These findings align with constructionist theories underscoring the importance of emotion word knowledge for the development of emotion regulation skills and begin to shine light on how family contexts might support children’s development of emotion word knowledge.

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.

The present study aims to address how dyadic and triadic family interactions across the transition to parenthood contribute to the later development of toddlers' adaptive emotion regulation using structural equation modeling methods. Specifically, we examined the interrelations of observed marital negative affect before childbirth, parents' emotional withdrawal during parent-infant interactions at 8 months, and coparenting conflict at 24 months as predictors of toddlers' adaptive emotion regulation at 24 months. Data for the present study were drawn from a longitudinal dataset in which 125 families were observed across the transition to parenthood. Results suggested that prenatal marital negativity predicted mothers' and fathers' emotional withdrawal toward their infants at 8 months postbirth as well as coparenting conflict at 24 months postbirth. Coparenting conflict and father-infant emotional withdrawal were negatively associated with toddlers' adaptive emotion regulation; however, mother-infant emotional withdrawal was not related. The implications of our study extend family systems research to demonstrate how multiple levels of detrimental family functioning over the first 2 years of parenthood influence toddlers' emotion regulation and highlight the importance of fathers' emotional involvement with their infants. (PsycINFO Database Record