Affect Regulation Research Articles

Association between personality traits and symptoms of depression and anxiety via emotional regulation and distress tolerance.

The Big Five personality traits have shown associations with symptoms of depression and anxiety among college students, but it is unclear which factors mediate these relationships. Past research suggests that psychological distress is closely related to difficulties in affect regulation (e.g., low distress tolerance). Therefore, the present study examined the associations between personality traits and depression and anxiety via emotion regulation and distress tolerance. Participants were 694 (81.4% females; Mean age = 23.12 [SD 2.75]) Argentinian college students who completed an online survey examining mental health and personality variables. A sizeable percentage of students endorsed moderate to severe symptoms of depression (45.1%) or anxiety (25.9%). Utilizing path analyses, we found that appraisal, a dimension of distress tolerance, atemporally mediated the association between emotional stability and symptoms of depression/anxiety (i.e., higher levels of emotional stability → higher appraisal distress tolerance → fewer symptoms of depression/anxiety). Further, expressive suppression (a dimension of emotion regulation) significantly mediated the associations between personality traits (i.e., agreeableness and extraversion) and symptoms of depression (higher levels of agreeableness/extraversion → lower use of expressive suppression → fewer symptoms of depression). Taken together, the results suggest that higher levels of emotional stability, extraversion and agreeableness could protect students from the development of symptoms of depression/anxiety via lower maladaptive emotion regulation strategies and higher distress tolerance (particularly appraisal). These findings highlight the relevance of intervention strategies specifically tailored to improve distress tolerance and emotion regulation for those students undergoing mental health problems.

Supplemental Material for Change Processes Associated With Functional Improvement in a Web-Based Version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for Trauma-Exposed Veterans

Supplemental Material for Change Processes Associated With Functional Improvement in a Web-Based Version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for Trauma-Exposed Veterans

Regulation of positive and negative affect: Associations with stress and resilience in health professions students

The study aimed to establish the relationship between affect regulation strategies, perceived stress, and resilience in health professions students. A total of 181 undergraduates participated in the survey. The instruments used were Brief Resilience Scale, Responses to Positive Affect Scale, Emotion Regulation Questionnaire, Cognitive Emotion Regulation Questionnaire, Perceived Stress Scale. The analyses indicated that reappraisal performed as a positive predictor of resilience, whereas rumination and dampening - as negative predictors with dampening effect being the strongest. Dampening, rumination, and self-blame predicted perceived stress positively and reappraisal predicted it negatively. Perceived stress fully mediated rumination-resilience relationship. The study show that regulation of negative affect via rumination, self-blame, reappraisal, and down-regulation of positive affect via dampening, but not its up-regulation, were associated with students' perceived stress and resilience. Tendencies to reappraise negatives experiences boosts resilience, but self-blaming, ruminating and suppressing positive ones make students vulnerable to negative appraisals and experience of stress with the latter presenting as the strongest risk factor for their adaptability. Implications of implementing emotion regulation skills in psycho-education to enhance students' resilience are discussed.

Towards Metacognitive Development through Simulation in Teacher Education

Several studies have collected the voices of prospective teachers regarding their lack of metacognitive knowledge about problem-solving strategies. Although the practicum has long been the official procedure for pre-service teachers to learn and practice classroom teaching, it has been demonstrated that it does not always guarantee success in terms of safe practice experiences, repetition possibilities, feedback and reflection necessary for them to gain adequate knowledge and assertiveness in decision-making. The identification of strengths and weaknesses of one’s own learning process should be a cornerstone of any educational context (Daniel et al, 2005). The virtues of simulation in education have been described at length. However, it still seems there is a long way to consider it a central part in pre-teacher practice. A qualitative study was conducted to examine three consecutive years of final reports by all pre-service teachers who have followed a teacher training module framed under simulation methodology. Results revealed three interrelated areas within the simulation context that led to the development of metacognition: the valley of despair, affective involvement and the more knowledgeable other. Pre-service teachers had high metacognitive awareness of their ability to tackle the problems posed in the scenario. Pre-service teachers’ realisation of what they could do and their limitations were the starting point for the metacognitive development based on the simulation. The learning gain extended far beyond the content. It also included affect regulation and the valley of uncertainty, re-oriented through the presence of the more knowledgeable other, with whom there was interaction and dialogue. This study adds value to the literature thanks to the collaborative nature of the pedagogical proposal. This proposal brought together academics, in-service teachers and pre- service teachers through interaction in a simulation.

RECENT ADVANCES IN ASSESSING AGE DIFFERENCES IN AFFECT DYNAMICS

Abstract Affective experiences are inherently dynamic and short-term changes in affect offer important insights into well-being. Changes in the processes underlying affect dynamics, namely, affect reactivity and regulation, are often invoked as explanations for age-related stability or enhancement of well-being. However, previous evidence for age differences in affect dynamics is inconsistent. In this symposium, we leverage theory-based approaches and cutting-edge statistical tools to gain a deeper understanding of how individuals manage daily affect. Wirth and colleagues investigated age differences in affect reactivity and regulation, using a formalized theoretical approach to affect dynamics. Their results indicated complex, multi-directional age differences in reactivity and regulation. Neupert and Graham focused on the idea that perception of time remaining in life plays a key role in age differences in affect dynamics. Feeling closer to death was related to lower positive and higher negative affect. These relations were particularly pronounced in older adults. Wolfe and colleagues investigated age-differential associations between cognitive capacities and affect regulation preferences. Their results indicated that cognitive capacities affected regulation preferences mostly in middle-aged rather than older adults. Mikkelsen and colleagues related affect regulation patterns to well-being in an age-diverse sample. Their findings indicated that older adults exhibit less variation in regulation strategy use and that regulation effectiveness was less important for well-being in older adults. The discussion will center on the value of considering age-related similarities and differences in affect dynamics, age-relevant factors for successful emotion regulation, and the contexts that might influence affect dynamic processes.

A prognostic index to predict symptom and functional outcomes of a coached, web-based intervention for trauma-exposed veterans.

Researchers at the Department of Veterans Affairs (VA) have studied interventions for posttraumatic stress disorder and co-occurring conditions in both traditional and digital formats. One such empirically supported intervention is web skills training in affective and interpersonal regulation (webSTAIR), a coached, 10-module web program based on STAIR. To understand which patient characteristics were predictive of webSTAIR outcomes in a sample of trauma-exposed veterans (N = 189), we used machine learning (ML) to develop a prognostic index from among 18 baseline characteristics (i.e., demographic, military, trauma history, and clinical) to predict posttreatment posttraumatic stress disorder severity, depression severity, and psychosocial functioning impairment. We compared the ML models to a benchmark of linear regression models in which the only predictor was the baseline severity score of the outcome measure. The ML and "severity-only" models performed similarly, explaining 39%-45% of the variance in outcomes. This suggests that baseline symptom severity and functioning are strong indicators for webSTAIR outcomes in veterans, with higher severity indicating worse prognosis, and that the other variables examined did not contribute significant added predictive signal. Findings also highlight the importance of comparing ML models to an appropriate benchmark. Future research with larger samples could potentially detect smaller patient-level effects as well as effects driven by other types of variables (e.g., therapeutic process variables). As a transdiagnostic, digital intervention, webSTAIR can potentially serve a diverse veteran population with varying trauma histories and may be best conceptualized as a beneficial first step of a stepped care model for those with heightened symptoms or impairment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient experiences of a 10-weeks weight-neutral treatment program for clinical binge eating disorder in a higher weight population

BackgroundWeight based stigma might drive the development of both higher weight and binge eating disorder (BED). To improve treatment and outcomes, a deeper understanding of how stigma and shame are correlated in clinical encounters is needed. The current study was designed to gain insight into how participating in a 10-weeks weight-neutral treatment program for patients with binge eating disorder and higher weight was experienced.MethodsSemi-structured interviews were conducted with 10 patients who had completed the BED treatment. The intervention was group based, addressing stigma and shame, using models of attachment and affect regulation in the presentation of BED. Interviews were analyzed guided by van Manen’s hermeneutic-phenomenological approach.ResultsA profound feeling of inferiority due to weight stigma and adverse childhood experiences appeared to have kept the participants stuck in a shame driven carousel of dieting, weight loss, bingeing, and weight regain. Participants and health care professionals’ mutual acknowledgement of driving elements of binge eating appeared to support participants feeling more equal. Feeling equal was described as facilitating increased awareness and tolerance of bodily sensations and emotions, and a deeper understanding and self-caring attitude towards themselves. Feeling less shame was described as important for self-disclosure in family relationships, leading to increased understanding and support from others. Simultaneously, unchanged stigmatizing surroundings were described to relate to challenges with eating patterns and weight after end of treatment.ConclusionOur findings indicate that relational symmetry, by patients experienced as being met with recognition, compassionate acceptance, and mutual investigation of subjective experience, can contribute to reduction of weight stigma and shame, and the burdensome notion of inferiority experienced by the participants in everyday life, hence improving treatment outcomes.Trail registration The study was approved and registered by the Data Access Committee at Nord-Trøndelag Hospital Trust August 8th, 2019, registration number 2019_2335.

Self-compassionate reflective writing for affect regulation in Australian perinatal women.

The current study investigated the effect of a brief online self-compassionate reflective writing task on affect regulation in a sample of Australian perinatal women. Participants were 55 women (Mage = 35.47, SD = 3.79) who were pregnant (16.4%) and/or had an infant <24 months old (76.4%). State self-compassion, positive and negative affect, and future help-seeking behavior intentions were compared at pre- and post-intervention while controlling for trait self-compassion. Inductive thematic analysis was used to extract themes regarding why participants deemed the intervention helpful or unhelpful. As hypothesized, global state self-compassion and intention to engage in self-care behavior were higher, and negative affect was lower, immediately post-intervention relative to pre-intervention scores. Follow-up subscale analyses revealed that the mechanisms of the shift in state self-compassion scores were via reduced self-judgment and overidentification and increased common humanity. There was no significant change in positive affect or intention to engage in help-seeking behavior. Most participants (75%) indicated that the task was helpful with themes identified as written format, changed perspective, dedicating time to reflect, improved mood, and practicing self-kindness. Self-compassionate reflective writing may be a brief and accessible psychosocial approach with the potential to foster healthy emotion regulation and coping among perinatal women.

The critical role of affect regulation accounting for increased general distress, risk to self, and lower quality of life in females with EUPD and CPTSD, compared to EUPD alone

BackgroundComplex Post-Traumatic Stress Disorder (CPTSD) and Emotionally Unstable Personality Disorder (EUPD) have shared aetiology and symptomatology, and are associated with multiple comorbidities and poor clinical outcomes. Evidence from studies with clinical populations indicates high levels of morbidity between the two diagnoses. Yet, the cumulative impact of coexisting CPTSD and EUPD diagnoses on levels of general distress, risk, quality of life and resulting treatment needs have not been explored. Accordingly, our understanding of the impact of experiencing both disorders and the relationship between coexisting trauma responses, and associated treatment needs remains limited. MethodologyUsing a convenience sample of 47 women admitted to a specialised DBT inpatient service, associations between general distress, risk, quality of life and diagnostic status were explored. ResultsWomen with comorbid EUPD and CPTSD reported significantly higher levels of general distress and risk to self, and significantly lower quality of life compared to women with EUPD alone. Hierarchical regression analyses revealed that, when exploring the isolated effect of each symptom cluster, only affective dysregulation remained a significant predictor of distress, risk to self, and quality of life (all p < .05). ConclusionsAlthough our results require further replication, the current study indicates that the experience of comorbid EUPD and CPTSD is impactful. Affect regulation may play a critical role in explaining comorbidity between EUPD and CPTSD. Accordingly, the current findings offer novel insights into the relationship between the two diagnoses, with clinical and theoretical consequences explored.

Clients’ experiences of Music and Imagery (MI)sessions: An integrative literature review

Music and Imagery (MI), which forms part of the Continuum Model of Guided Imagery and Music (CMGIM), is a receptive music therapy method developed by Lisa Summer (1999) as an adaptation of the Bonny Method of Guided Imagery and Music (BMGIM). Training in MI started around 2005, and it is therefore a relatively new phenomenon in music therapy practice and research. MI includes and favours the use of clients’ preferred music during therapy. An integrative literature review was conducted to investigate how clients experienced MI sessions. Initially, 108 studies were identified through a comprehensive electronic search, including dissertations and presentations as well as personal correspondence with the developer of MI. Nineteen studies met the inclusion criteria with a total of 189 participants, ranging from one to 76 participants per study. Participants’ own descriptions of their experiences and researchers’ interpretations of participants’ feedback were examined in the six-phase thematic analysis process as described by Braun and Clarke (2021). Six themes were identified: Music as a catalyst for transformational experiences; Emotional experiences; Strengths, acceptance and self awareness; Affect regulation; Trust and feeling protected; and Connectedness. Upon reflection, the researchers found that these themes could all be connected. Music generated emotional experiences, which could assist with affect regulation as well as the recognition of personal strengths, acceptance and self-awareness, and feelings of trust and protection ultimately formed part of a sense of connectedness.

Adiposity and Insulin Resistance Moderate Brain Electrophysiology and Affect Regulation in Young Adults

AbstractBackgroundObesity and insulin resistance (IR) may negatively influence affect regulation in young adulthood. The paucity of studies that have investigated such associations have predominantly used functional magnetic resonance imaging. However, electroencephalography (EEG) can evaluate neural signatures in real‐time that may be complementary. Thus, this study investigated how adiposity and IR moderated brain activity and underlying affect regulation using EEG.MethodReal‐time EEG was recorded in 28 lean and obese young adults with and without IR (18‐39 years, 46.4% female). Two event‐related potential (ERP) components of affect regulation, early posterior negativity (EPN) and late positive potential (LPP), were quantified from EEG data. Participants completed the Interactional Picture Affective System task to measure affect regulation, from which mean valence ratings and stimulus‐to‐response‐onset reaction times were calculated. ERP components and affect regulation parameters were then contrasted in three conditions, as follows: 1) Negative – Neutral; 2) Positive – Neutral; and 3) Negative – Positive. Height, weight, body fat percentage (%BF), and serum proteomics were collected. Fasting glucose and insulin readings were obtained to quantify Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR). Hierarchical moderated regression analysis was utilized to test the interrelationships between adiposity, IR, neural activity, and affect regulation.ResultAcross all contrasted conditions, HOMA‐IR and %BF were found to moderate the relationships between frontal and parietal LPP amplitudes during the late latency window and affect regulation. Specifically, higher late frontal LPP amplitudes were associated with less negative and more positive valence ratings to unpleasant and pleasant stimuli, respectively, among participants with low, but not high, IR and %BF levels. In the Negative – Neutral and Negative – Positive conditions, lower late parietal LPP amplitudes were also associated with less negative overall valence ratings in response to unpleasant stimuli, but only in lean, insulin sensitive participants. These results overall suggest that modulation of negative and positive affectivity only occurs in lean young adults without IR.ConclusionYoung adults with greater adiposity and IR showed worse affect regulation than those without obesity and IR. Furthermore, AD‐associated characteristics may start early in life, and EEG signatures may be a useful neuroimaging approach for tracking such events.

Utility of Cortical Atrophy in Functional Networks as a Predictor of Progression in bvFTD

AbstractBackgroundBehavioral variant frontotemporal dementia (bvFTD) is a clinically heterogeneous neurodegenerative disorder with variable rates of disease progression. Predictors of disease progression in bvFTD are significantly lacking, limiting the ability of clinical care planning. We recently showed that cortical atrophy in the frontoparietal control network (FPN) at baseline predicts the conversion to dementia in patients with Primary Progressive Aphasia (PPA). Leveraging this methodology, we hypothesized that FPN atrophy would predict progression of dementia in patients diagnosed with bvFTD.MethodWe analyzed data from 48 bvFTD patients (mean age 59.9 years, 20 Female) with very mild or mild dementia from our Frontotemporal Disorders Unit cohort and the Frontotemporal Lobar Degeneration Neuroimaging Initiative. Our primary outcome measure was change in the Clinical Dementia Rating‐FTLD Sum‐of‐Boxes (SoB) at baseline and at least one year later. Each participant underwent baseline MRI scanning for cortical thickness estimates. We ran a Pearson correlation analysis between the annualized change of CDR‐FTLD SoB from baseline to last observation, and baseline cortical network atrophy (quantified as network‐wise W scores). Vertex‐wise GLM analyses and network‐wise bivariate correlation analyses were also used to assess the relationship between network cortical atrophy and annualized CDR changes.ResultOf the 7 networks investigated, only FPN atrophy predicted annualized change in CDR‐FTLD SoB scores (r = ‐0.31, p = 0.03). That is, in bvFTD patients at the very mild/mild dementia stage, the greater the baseline FPN atrophy, the more rapid the clinical decline. Vertex‐wise GLM maps did not show that atrophy across the entire FPN predicted clinical decline. Rather, baseline atrophy in the dorsal precuneus and supramarginal gyrus nodes of the FPN was most predictive of clinical disease progression.ConclusionCortical atrophy in the FPN, and particularly in posterior regions of this network, is predictive of the rate of clinical decline in bvFTD patients, possibly due to the critical roles this network serves in executive function and affective regulation. This work could promote the use of structural imaging biomarkers to guide prognostication for bvFTD patients and their families, and to inform the design of clinical trials.

A taxonomy of threat and soothing influences in rheumatic and musculoskeletal diseases and central sensitivity syndromes

BackgroundAn imbalance in affect regulation, reflected by a hyperactive threat system and hypoactive soothing system, may impact physical symptoms in people with rheumatic and musculoskeletal diseases (RMD) and central sensitivity syndromes (CSS), including chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome. This study aimed to identify and structure comprehensive overviews of threat and soothing influences that may worsen or alleviate physical symptoms in people with RMD or CSS. MethodA concept mapping procedure was used. An online open-question survey (N = 686, 641 [93.4%] women) yielded comprehensive sets of 40 threats and 40 soothers that were individually sorted by people with RMD or CSS (N = 115, 112 [97.4%] women). ResultsHierarchical cluster analyses generated eight threat clusters: environmental stimuli, physical symptoms, food and drugs, inactivity, demands, effort, invalidation, and emotional stress. Ten soother clusters were identified: social emotional support, rest and balance, pleasant surroundings, illness understanding, positive mindset and autonomy, spirituality, leisure activity, wellness, treatment and care, and nutrition and treats. ConclusionsOur study provided a comprehensive taxonomy of threats and soothers in people with RMD or CSS. The results can be used in experimental research to label threat and soothing stimuli and in clinical practice to screen and monitor relevant treatment targets.

A Comprehensive Literature Review of Borderline Personality Disorder: Unraveling Complexity From Diagnosis to Treatment.

Borderline personality disorder (BPD) is a severe mental illness marked by unpredictable feelings, behaviors, and relationships. Symptoms like emotional instability, impulsivity, and poor social connections are the basis for diagnostic criteria. A noteworthy discovery highlights the clinical overlap between BPD and several psychotic disorders by arguing that BPD and psychotic symptoms raise the risk of psychopathology. According to neuroimaging evidence, structural and functional brain changes, notably in regions controlling affective regulation and impulse control, are seen in BPD patients. Adolf Stern, a psychoanalyst, used the word "borderline" in 1938 to describe patients who exhibited increased symptoms during therapy and displayed masochistic tendencies. Modern BPD research has highlighted the complexity of symptoms like boredom, a former diagnostic criterion associated with feelings of emptiness. Though there are still unanswered problems regarding its precise, practical components, the treatment technique known as Schema therapy (ST) has shown promise in treating BPD. It's interesting to note that BPD displays complex relationships with other illnesses; for instance, some neurochemical pathways coincide with those in bulimia nervosa, pointing to a deeper level of interconnection. Concerning diagnosis, BPD's defining symptoms include, among others, the fear of abandonment, identity disruption, and recurrent suicidal conduct. The range of treatment options includes pharmacological interventions and psychotherapies like dialectical behavior therapy (DBT). Even though antidepressants like selective serotonin reuptake inhibitors (SSRIs) are routinely prescribed, research on their efficacy is ongoing, underlining the significance of thorough treatment planning. In conclusion, BPD continues to be a complex condition that calls for early detection, especially considering that it usually manifests in adolescence. While many patients report symptom relief, lingering problems still exist, emphasizing the value of comprehensive and personalized treatment strategies.

Effects of an Online Meditation Course on Quality of Life and Positive Emotions: A Prospective Observational Study (EXPANSION Study).

Background: Several meditation interventions showed positive effects on physical and mental health. The aim of this study is a first evaluation of the (within-group) effects of a 21-day online meditation course of the "expansion method." Methods: For this exploratory observational study, parameters were assessed at baseline, at 1 month, and at a 3-month follow-up. Exploratory endpoints were health-related quality of life (PROMIS Preference Score), global health (PROMIS) with the subscales physical and mental health, stress perception (Perceived Stress Scale), positive and negative affect regulation (Positive and Negative Affect Schedule), flourishing (Flourishing Scale), self-efficacy (Short Scale for Measuring General Self-Efficacy Beliefs), gratitude and awe (Gratitude and Awe Questionnaire), resilience (Connor-Davidson Resilience Scale), spirituality (Aspects of Spirituality), and mysticism (Mysticism Scale) on validated inventories. In addition, self-constructed questions (NRS) assessed health status, lifestyle, and concept evaluation. Results: Data from 359 participants were included in this study (response rate: 68% at 1 month, 46% at 3 months). The main analysis was based on the complete cases at 1 month (n = 244 participants; 84% female; 51 ± 11 years; 89% German). Medium effect sizes were found for mental health (p < 0.0001; d = 0.6), flourishing (p < 0.0001; d = 0.63), and negative affect (p < 0.0001; d = 0.68) at 1 month. Small effect sizes were obtained for physical health, stress, positive affect, self-efficacy, spirituality, and mysticism at 3 months. In a sensitivity analysis, the strongest effects at 1 month were found in the subgroup that completed per-protocol (n = 140), followed by those with complete data at all time points (n = 159). Effects were lowest in the intention-to-treat analysis (n = 359). The content of the course was positively evaluated by the participants. Conclusions: The online meditation course based on the expansion method had potentially beneficial effects, especially on mental health parameters. Based on the feasibility results, further research using randomized controlled designs is warranted. Clinical Trial Registration: NCT04950543.

Building resilience through daily smartphone app use: results of a pilot study of the JoyPop app with social work students.

The JoyPop™ smartphone app is a digital intervention designed to enhance day-to-day resilience in youth, particularly those exposed to traumatogenic events [adverse childhood experiences (ACEs)]. Processes of adaptation that foster resilience in response to high stress include affect, cognitive, and behavioral regulation, and social interaction. Digital interventions have application for youth and those who provide them support, including social work trainees navigating the stressors of university studies concurrent with practice internships. Research on resilience-enhancing apps is needed to understand the underlying mechanisms by which change occurs and who is most likely to benefit from these interventions. Social work student participants (N = 91) were invited to use the JoyPop app two times daily for 28 days. Baseline ACE exposure and change-over-time in affect regulation, stress responsivity, and social support were evaluated after 2 and 4 weeks of app use with t-tests and generalized estimating equation (GEE) modeling. Participants identified predominantly as cisgender women of European descent, mean age 26 years (SD = 6.78), 70% undergraduates, and reported consistent daily app use (Mean days = 26.9, SD = 1.90). Self-reported baseline ACE exposure was high (30% ≥ 5+). We tested change-over-time with generalized estimating equation and saw improvement in affect regulation in the Abbreviated Dysregulation Inventory scale (β = -3.38, p = <.001), and subscales of behavioral (β = -1.63, p = <.001), affect (β = -3.24, p = <.001), and cognitive regulation (β = 1.50, p = .009). Perceived stress decreased with app use (β = -2.65, p = <.001) and even more so for participants with reported exposure to more than 4 ACEs (β = -3.786, p = .030). The exploratory findings from our pilot study suggest that consistent use of the app may enhance multidimensional resilience amongst university students who self-report higher than average levels of baseline traumatogenic exposures. Our findings support an approach modeling resilience as a complex, dynamic, multicomponent process supported by resources within and between individuals. Further testing of the mechanisms of adaptation in response to high stress that enhance resilience and identification of the JoyPop™ app features that influence this change is needed to validate that daily app use could help youth with experiences of past and current high stress to better regulate their affect, reduce stress reactivity, and increase resilience.

The psychological impact of sarcoma on affected patients

AbstractObjectiveSarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level.MethodsThe systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results.ResultsOur findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision‐making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population.ConclusionOur review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.

Perceived stress moderates emotion regulation success in real-world contexts: an ecologically-valid multilevel investigation

ABSTRACT Background Emotion regulation plays a crucial role in well-being in everyday life. Effective emotion regulation depends upon adaptively matching a given strategy to a given situation. Recent research has begun to explore these interactions in the context of daily reports of perceived stress, affect, and emotion regulation strategy usage. To further understand these differences in strategy efficacy in an ecologically valid context, we examined responses to real world stressors in a young adult sample. Methods We surveyed a range of emotion regulation strategies, including two forms of cognitive reappraisal (i.e., reinterpretation, which involves cognitively reframing one’s emotional responses, and psychological distancing, which involves adopting an objective, impartial perspective). Participants reported strategy usage, momentary perceived stress, and affect in response to multiple ecological momentary assessments over a period of 7 days. Results Analyses of links between strategy usage and affect revealed that rumination was significantly negatively associated with more positive affect ratings. Further, a significant interaction between momentary perceived stress and reinterpretation usage was observed on affect, such that reinterpretation was more adaptive during situations perceived as less stressful. Conclusion These results provide further insight into the importance of situational context in determining the effectiveness of particular emotion regulation strategies.

Mindfulness-oriented recovery enhancement in opioid use disorder: Extended emotional regulation and neural effects and immediate effects of guided meditation in a pilot sample

ObjectiveMindfulness-Oriented Recovery Enhancement (MORE) is an efficacious intervention to aid recovery from substance use disorder. This study in a pilot sample of individuals in treatment for opioid use disorder (OUD) characterizes longer-term changes after the MORE intervention and immediate effects of a brief MORE guided meditation session. DesignTwelve female participants in residential treatment for OUD completed an 8-week MORE intervention. Participants completed two sessions: one before and one after the 8-week MORE intervention. Each session included an emotional regulation questionnaire outside an MRI scanner first and then a 10-minute guided MORE meditation inside the scanner during which functional magnetic resonance imaging (fMRI) data were collected. Emotional regulation was measured after 8-weeks of MORE intervention. In addition, functional connectivity (i.e. correlated fMRI signal) between regions in a hypothesized affect regulation network was measured during the meditation state to assess change in brain network function due to 8-weeks of MORE. For each 10-min guided meditation, we also assessed their mood and opioid craving. ResultsNine participants completed all measurements. Participants’ emotional regulation difficulty significantly decreased after 8-weeks of MORE intervention. Furthermore, after 8-weeks of MORE, there was significantly increased connectivity between left ventromedial prefrontal cortex and left amygdala and between left ventrolateral prefrontal cortex and left nucleus accumbens captured during a meditation state. In both sessions, positive mood significantly increased after 10-min of guided mediation, however opioid craving was not significantly influenced. ConclusionsThis pilot study characterizes potential benefits of 8-week MORE intervention in improving emotional regulation difficulty and brain function. A 10-min guided MORE meditation may immediately improve mood, with potential to reduce acute stress- or cue-provoked craving. These results warrant future studies with larger sample size.

Factors associated with susceptibility to e-cigarette use among Australian adolescents

BackgroundPreventing uptake of e-cigarette use among adolescents is critical to minimizing vaping-related harms. To inform the development of effective prevention programs and policies, this study explored potential determinants of susceptibility to e-cigarette use among young Australians. MethodsA cross-sectional online survey was administered to 12- to 17-year-old Australians who had never smoked nor vaped (N = 973; 53 % women). The survey assessed susceptibility to e-cigarette use (curiosity about use, willingness to use, and intentions to use) and a comprehensive range of potential correlates that included individual, social, and environmental factors. Regression analyses were conducted to identify factors significantly correlated with each of the dependent variables. ResultsSusceptibility to e-cigarette use was observed in 45 % of respondents. Individual factors associated with susceptibility included respondents’ (i) overall opinion of e-cigarettes, (ii) attitudes toward e-cigarettes, (iii) affect regulation expectancies, and (iv) quitting perceptions. Significant social factors included both descriptive and injunctive norms, specifically: perceiving that use is ok for people of one's age, approval from important others to use, and having at least one family member or close friend who vapes. ConclusionSusceptibility to vaping was observed in a substantial proportion of adolescents who have never smoked. Shifting attitudes and social norms around e-cigarette use appears critical to reducing susceptibility. Recommended prevention efforts include the development of communications addressing misperceptions about the benefits of vaping on affect regulation and stricter regulations on e-cigarette advertising to reduce young Australians’ exposure to claims that may result in favourable attitudes to e-cigarette use.