Emotion Regulation Capabilities Research Articles

The Imperfect Yet Valuable Difficulties in Emotion Regulation Scale: Factor Structure, Dimensionality, and Possible Cutoff Score.

The Difficulties in Emotion Regulation Scale (DERS) is frequently used to assess emotion regulation (ER) capabilities. Originally a multidimensional scale, many utilize its total score, without clear recommendations. We aimed to explore the DERS's structure, dimensionality, and utility and provide clinicians and researchers with clear guidelines. Self-report data on ER, personality, psychopathology, and life satisfaction were collected from 502 adults. Seventy also participated in a lab study evaluating group interactions, which included additional self-report and physiological monitoring. Findings suggested favoring the correlated-traits and bifactor models, the latter excelling in direct comparisons. The total score was found reliable and valid, explaining 53.3% of the variance, with a distinct emotional awareness subfactor, suggesting a non-pure unidimensional solution. A cutoff score of 95 identified significant ER difficulties, linked to psychopathology. We thus recommend using the DERS's total score and 95 as its cutoff, while calling for further validation in diverse and clinical samples.

Demographic Characteristics, Stress and Emotion Regulation in the Caregivers of Elderly Hemodialysis Patients

Background: Caregiving for elderly hemodialysis patients is a complex, multifaceted experience that demands considerable emotional and physical resources. The role of caregivers, predominantly female, involves managing the stress and emotional turmoil associated with the patient's chronic illness, which significantly impacts their well-being. Understanding the dynamics of caregiving is essential for developing supportive interventions that enhance caregiver and patient outcomes. Objective: This study aimed to explore the relationship between demographic characteristics, stress, and emotion regulation in caregivers of elderly hemodialysis patients. It sought to identify key factors that contribute to caregiver stress and to evaluate how prolonged caregiving affects caregivers' ability to regulate emotions. Methods: Employing a correlational research design, the study analyzed data from 60 caregivers of elderly hemodialysis patients. Pearson Product Moment Correlation was used to examine the relationships among variables, while demographic characteristics were assessed through descriptive statistics. The Kingston Caregiver Stress Scale (KCSS) and the Emotion Regulation Questionnaire (ERQ) were administered to evaluate stress levels and emotion regulation capabilities, respectively. Results: The majority of caregivers were women (62%), with a significant proportion married (68%) and primarily in the age range of 35-50 years. A strong negative correlation was found between the duration of caregiving and KCSS total scores (r = -0.872, p < .001), indicating higher stress levels associated with longer caregiving durations. Conversely, a positive correlation was observed between the duration of caregiving and ERQ total scores (r = 0.380, p = .003), suggesting improved emotion regulation over time. The study also noted no significant relationship between family system types and stress levels. Conclusion: The study highlights the significant impact of caregiving on stress and emotion regulation among caregivers of elderly hemodialysis patients. It underscores the need for comprehensive support systems that address both the informational and emotional needs of caregivers, thereby enhancing their coping mechanisms and overall well-being.

Towards an Affective Intelligent Agent Model for Extrinsic Emotion Regulation

Emotion regulation is the human ability to modulate one’s or other emotions to maintain emotional well-being. Despite its importance, only a few computational models have been proposed for facilitating emotion regulation. None of them prepare a plan of all the actions necessary for emotion regulation customized to the needs of a specific individual. To address this gap, we propose a computational model for an intelligent agent which, grounded in a multidimensional emotion representation, facilitates emotion regulation in individuals. This computational model is based on J. Gross’s theoretical framework of emotion regulation. An intelligent agent selects the most appropriate regulation strategy to maintain an individual’s emotional equilibrium considering the individual’s personality traits. A dynamic planner prepares a plan of emotion regulation actions which is dynamically adapted according to the emotional changes observed in the individual after applying the previous emotion regulation actions. This refinement of the initial regulatory action plan allows the proposed emotion regulation agent to adapt the plan to the specific characteristics of the individual, facilitating the individual to improve their emotion regulation capabilities and improve their emotional health.

Polytraumatization, defense mechanisms, PTSD and complex PTSD in Indian adolescents: a mediation model

BackgroundAdolescence is recognized as a particularly susceptible developmental period for experiencing multiple types of Adverse Childhood Experiences (ACE), increasing the vulnerability to higher levels of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD symptoms. Some studies found that defense mechanisms play an important role on the association between ACE and psychological symptoms.MethodsWe analyzed the associations between direct and indirect exposure to ACE and PTSD and Complex PTSD (affective dysregulation, negative self-concept and disturbances in relationships) through the mediation role of mature defense mechanisms: mature, neurotic, and immature defense mechanisms in Indian adolescents. A sample of 411 Indian adolescents (M = 14.2 years old; S.D. = 0.5) completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modelling employing Preacher and Hayes’ procedures (2008).ResultsImmature and neurotic defense mechanisms mediated the association between direct exposure to ACE with PTSD symptoms. Immature defense mechanisms were mediators of the relationship between direct exposure to ACE and Complex PTSD symptoms clusters.ConclusionsMaladaptive defense mechanisms can disturb the process of self-regulation and emotion regulation capabilities in coping with traumatic experiences, leading to higher PTSD and Complex PTSD symptoms severity.

Managers' emotion-regulation capabilities and family firm innovativeness: a dynamic managerial capability view

PurposeWhile previous studies have proved the significance of family firm innovativeness (FFI), the question of how the emotion-regulation capabilities of family business managers affect FFI still remains open. This paper aims to examine the impact of the emotion-regulation capabilities of family business managers on FFI moderated by the family involvement in business management.Design/methodology/approachThe present study is based on a quantitative research design. Data were collected with the help of a telephone survey. Overall, 192 family firms were surveyed, and the results were analysed using structural equation modelling (SEM).FindingsThe findings indicate that managers' emotion-regulation capabilities (independent variable) positively impact FFI (dependent variable). The research results also indicate that having more family members involved in the business (moderating variable) can lead to better innovation outcomes, assuming these family managers have sufficient emotion-regulating capabilities.Research limitations/implicationsThe research context could be broadened by differentiating between the industries in which family firms operate. This could aid a better understanding of the challenges, opportunities and market trends in different sectors. Future research might also include more diverse countries with deep family business traditions, strengthening the robustness of the findings across more varied contexts.Originality/valueUsing a multi-level perspective, this study contributes to the dynamic managerial capabilities and family business literature by showing that, in an environment where familial relationships can affect working relationships, the ability of managers to control their emotions and others' emotions can be a critical managerial resource that impacts FFI.

Examining Cadets’ Beliefs about Meditation Using the Reasoned Action Approach

Meditation has been shown to be a character and virtue formation tool due to its emotion regulation capabilities. Training academies can help their students better develop their character by enabling meditation behavior acquisition. This study examines United States Military cadets’ beliefs about meditation as a means of informing education and intervention programming to maximize the likelihood of cadets adopting the behavior. Implications and suggestions for character education programs are provided.

Emotion Regulation and Strategic Decision Making: A Depletion of Resources Perspective

A growing body of evidence shows that making strategic decisions is emotionally draining and requires managers to devote significant effort to regulating emotions. However, theoretical models of strategic decision have not kept pace with these developments and largely overlook the role of emotion regulation. In this paper, we adopt a resource depletion perspective to examine how executives’ emotion regulation capabilities influence strategic decision processes and outcomes in dynamic environments. We propose that executive emotion regulation resources are vital for developing and sustaining novel representations of strategic opportunities, searching for distant solutions, and utilizing social systems for evaluating and selecting alternatives. Hence, the depletion of regulatory resources inhibits these processes and reduces the effectiveness of strategic decision making. By identifying interdependencies among executive emotion regulation capacity and the cognitive and social resources required for strategic decision making, our analysis extends understanding of the requirements for making strategic decisions in dynamic environments. We discuss implications for research on strategic decision making, executive job demands and dynamic managerial capabilities.

Progressive modulation of resting-state brain activity during neurofeedback of positive-social emotion regulation networks

Neurofeedback allows for the self-regulation of brain circuits implicated in specific maladaptive behaviors, leading to persistent changes in brain activity and connectivity. Positive-social emotion regulation neurofeedback enhances emotion regulation capabilities, which is critical for reducing the severity of various psychiatric disorders. Training dorsomedial prefrontal cortex (dmPFC) to exert a top-down influence on bilateral amygdala during positive-social emotion regulation progressively (linearly) modulates connectivity within the trained network and induces positive mood. However, the processes during rest that interleave the neurofeedback training remain poorly understood. We hypothesized that short resting periods at the end of training sessions of positive-social emotion regulation neurofeedback would show alterations within emotion regulation and neurofeedback learning networks. We used complementary model-based and data-driven approaches to assess how resting-state connectivity relates to neurofeedback changes at the end of training sessions. In the experimental group, we found lower progressive dmPFC self-inhibition and an increase of connectivity in networks engaged in emotion regulation, neurofeedback learning, visuospatial processing, and memory. Our findings highlight a large-scale synergy between neurofeedback and resting-state brain activity and connectivity changes within the target network and beyond. This work contributes to our understanding of concomitant learning mechanisms post training and facilitates development of efficient neurofeedback training.

Risk factors for binge eating severity among adolescent girls and boys. A structural equation modeling approach

ObjectiveParental bonding, low self-esteem, emotion dysregulation, and eating style are correlated with each other and are associated with binge eating among adolescents. However, no studies have yet examined all these variables simultaneously. In the current study, the independent and combined influences of such constructs on binge eating were tested with structural equation modeling. MethodA sample of 973 students aged between 12 and 16 (M = 14.17, SD = 1.25) years was screened by means of self-report measures assessing parental bonding, self-esteem, emotion dysregulation, eating styles and binge eating severity. ResultsSelf-esteem (β = −0.205) and eating styles (emotional β = 0.313, external β = 0.133, and restrained β = 0.178) had a direct effect on binge eating severity. The model (χ2(22) = 57.679; RMSEA = 0.041; CFI = 0.987; TLI = 0.949; SRMR = 0.024) revealed that the paths from both maternal and paternal care and maternal overprotection to binge eating were mediated through low self-esteem, emotion dysregulation and each eating style, explaining 35% of the variance. DiscussionFindings provide support for a comprehensive theoretical-based model of risk factors for binge eating and suggest the possible mechanisms through which the quality of early parental relationships contribute to developing dysfunctional eating patterns. Treatment and prevention efforts should improve self-esteem and emphasize emotion regulation capabilities.

To Regulate or Not to Regulate: Emotion Regulation in Participants With Low and High Impulsivity.

Successful emotion regulation plays a key role in psychological health and well-being. This study examines (1) whether cognitive control and corresponding neural connectivity are associated with emotion regulation and (2) to what extent external instructions can improve emotion regulation in individuals with low vs. high cognitive control capacity. For this, emotion regulation capabilities and the impact of emotion regulation on a subsequent emotional Stroop task was tested in participants with low (N = 25) vs. high impulsivity (N = 32). The classification according to impulsivity is based upon the stable correlation between high impulsivity and reduced cognitive control capacity. A negative emotion inducing movie scene was presented with the instruction to either suppress or allow all emotions that arose. This was followed by an emotional Stroop task. Electromyography (EMG) over the corrugator supercilii was used to assess the effects of emotion regulation. Neurophysiological mechanisms were measured using functional near-infrared spectroscopy over frontal brain areas. While EMG activation was low in the low-impulsive group independent of instruction, high-impulsive participants showed increased EMG activity when they were not explicitly instructed to suppress arising emotions. Given the same extent of functional connectivity within frontal lobe networks, the low-impulsive participants controlled their emotions better (less EMG activation) than the high-impulsive participants. In the Stroop task, the low-impulsive subjects performed significantly better. The emotion regulation condition had no significant effect on the results. We conclude that the cognitive control network is closely associated with emotion regulation capabilities. Individuals with high cognitive control show implicit capabilities for emotion regulation. Individuals with low cognitive control require external instructions (= explicit emotion regulation) to achieve similarly low expressions of emotionality. Implications for clinical applications aiming to improve emotion regulation are discussed.

Postpartum Stress and Neural Regulation of Emotion among First-Time Mothers.

Early parenting relies on emotion regulation capabilities, as mothers are responsible for regulating both their own emotional state and that of their infant during a time of new parenting-related neural plasticity and potentially increased stress. Previous research highlights the importance of frontal cortical regions in facilitating effective emotion regulation, but few studies have investigated the neural regulation of emotion among postpartum women. The current study employed a functional neuroimaging (fMRI) approach to explore the association between perceived stress, depressive symptoms, and the neural regulation of emotion in first-time mothers. Among 59 postpartum mothers, higher perceived stress during the postpartum period was associated with less self-reported use of cognitive reappraisal in everyday life, and greater use of emotion suppression. While viewing standardized aversive images during the Emotion Regulation Task (ERT), mothers were instructed to experience their natural emotional state (Maintain) or to decrease the intensity of their negative emotion by using cognitive reappraisal (Reappraise). Whole-brain analysis revealed a two-way interaction of perceived stress x condition in the right dorsolateral prefrontal cortex (DLPFC) at p < .05 cluster-wise corrected, controlling for postpartum months and scanner type. Higher levels of perceived stress were associated with heightened right DLPFC activity while engaging in cognitive reappraisal versus naturally responding to negative stimuli. Higher right DLPFC activity during Reappraise versus Maintain was further associated with elevated parenting stress. Findings suggest that stress and everyday reappraisal use is reflected in mothers' neural regulation of emotion and may have important implications for their adaptation to parenthood.

Decreased emotional reactivity after 3-month socio-affective but not attention- or meta-cognitive-based mental training: A randomized, controlled, longitudinal fMRI study

Meditation-based mental training interventions show physical and mental health benefits. However, it remains unclear how different types of mental practice affect emotion processing at both the neuronal and the behavioural level. In the context of the ReSource project, 332 participants underwent an fMRI scan while performing an emotion anticipation task before and after three 3-month training modules cultivating 1) attention and interoceptive awareness (Presence); 2) socio-affective skills, such as compassion (Affect); 3) socio-cognitive skills, such as theory of mind (Perspective). Only the Affect module led to a significant reduction of experienced negative affect when processing images depicting human suffering. In addition, after the Affect module, participants showed significant increased activation in the right supramarginal gyrus when confronted with negative stimuli. We conclude that socio-affective, but not attention- or meta-cognitive based mental training is specifically effective to improve emotion regulation capabilities when facing adversity.

The hidden role of owners' spouses in family firm innovativeness: a dynamic managerial capabilities perspective

PurposeThe purpose of this paper is to investigate the effect of the dynamic managerial capabilities (DMC) of the spouse (either working or non-working) of a family firm owner on firm innovativeness. This paper assesses the role of three elements of the DMC of owners' spouses (emotion regulation, conflict resolution and networking capabilities) that are bridged by familiness on family firm innovativeness.Design/methodology/approachThis paper presents the results of a multiple case study. Twelve cases were selected: six innovative and six non-innovative family firms in Lithuania. The study design enabled a comparison not only of innovative and non-innovative family firms but also of non-working and working spouses of family firm owners.FindingsThe findings show that family firm owners' spouses contribute to firm innovativeness through their DMC in terms of emotion regulation, conflict resolution and networking capabilities.Research limitations/implicationsThis research focused on a sample of firms in Lithuania. Future studies should broaden the research to other countries.Originality/valueThis research provides empirical evidence of the hidden role of the DMC of family firm owners' spouses and their contribution to firm innovativeness. This paper extends the application of DMC to family business research.

Inattention, emotion dysregulation and impairment among urban, diverse adults seeking psychological treatment

Emotion dysregulation is commonly reported among adults with Attention-Deficit/Hyperactivity Disorder. This study examined whether inattention and/or hyperactivity/impulsivity directly affect functional impairment, or whether they do so indirectly by decreasing emotion regulation capabilities. An ethnically, racially and socioeconomically diverse sample of clients seeking treatment at a low-fee outpatient mental health clinic were recruited [N = 177, male n = 59, 33.3%, mean (SD) age = 28.54 (8.41) years]. Participants completed measures of inattention, hyperactivity/impulsivity, emotion regulation and impairment at intake. Inattention was more strongly related to emotion regulation and impairment than hyperactivity/impulsivity. Hayes’ PROCESS was used to test for significant indirect effects. More severe inattention was associated with less emotional clarity, which in turn was associated with worse Interpersonal Relationship difficulties; more severe inattention was associated with less access to emotion regulation strategies and poorer emotional clarity, which in turn were associated with greater Symptom Distress; and inattention was directly associated with impairment at school and work. In addition to treating inattention, clinicians should focus on emotion regulation deficits. Specifically, working with individuals to improve identification and labeling of emotions, develop strategies to reduce the intensity of their negative emotions, and feel more confident that they have these tools at their disposable may help to reduce impairment.

Attention control and its emotion-specific association with cognitive emotion regulation in depression.

Individuals with major depression show impaired control of attention and emotions. Both processes are conceptually similar and might share common mechanisms. The current study aims to examine attention control and its association with cognitive emotion regulation in depression. 26 patients with a history of major depression (14 females) and 26 healthy controls (14 females) performed an emotional face-word Stroop task and a cognitive emotion regulation task while undergoing fMRI. Patients and controls showed a similar behavioral performance in both tasks. Across groups, participants who were less distracted from happy faces by the incongruent word "sadness" (Stroop task) were better at regulating their happiness (emotion regulation task). Notably, both the Stroop and emotion regulation task recruited the left supramarginal gyrus. Additionally, only patients showed a relative attentional disengagement from positive compared to negative stimuli in the Stroop task. Attention control and cognitive emotion regulation capabilities appear to be linked at both the behavioral and neural level. Shared mechanisms suggest that emotional disturbances in depression may be improved by interventions that target attention control, particularly regarding the processing of positive stimuli.

Acculturative stress and alcohol use among Latinx recruited from a primary care clinic: Moderations by emotion dysregulation.

Among Latinx in the United States, alcohol is the most widely abused substance and is associated with a range of negative consequences. Acculturative stress is one factor that is relevant regarding Latinx substance use although more work is needed in this area. In theory, those with more adaptive emotion regulation capabilities may be better able to buffer against the adverse effects of acculturative stress on alcohol use because the person has more and better strategies to deal with life stress. Thus, the current study sought to examine the moderating role of dysregulation in the association of acculturative stress and alcohol use among Latinx in primary care. Latinx adults (N = 94; Mage = 38.5 years, SD = 10.8; 86.6% female) recruited from a Federally Qualified Health Center provided self-reported ratings of acculturative stress, emotion dysregulation, and alcohol use. All measures were in Spanish. Covariates included sex, marital status, age, years in the United States, negative affectivity, and clinic visit reason (patient vs. person accompanying patient). There was a statistically significant interaction of acculturative stress and emotion dysregulation (β = 1.65, t = 2.29, p = .025) on alcohol use, which accounted for 4.8% of additional variance over and above covariates and the nonsignificant main effects. Simple slope analyses revealed that acculturative stress was associated with alcohol use among those with high (β = 0.28, t = 2.04, p = .045), but not low (β = -0.28, t = -1.26, p = .210) levels of emotion dysregulation. The current results indicate that emotion dysregulation moderates the association between acculturative stress and alcohol use among Latinx in primary care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Preterm-infant emotion regulation during the still-face interaction

Very-preterm (VPT), moderately-preterm (MPT), and full-term (FT) infants’ emotion-regulation behaviors were assessed via the Still-Face procedure at a corrected age of four months. As a developmental task during the first year of life, emotion regulation is important for social and cognitive development. Although substantial evidence indicates that VPT infants exhibit emotion-regulation difficulties, little is known about MPT infants' emotion regulation capabilities, this group also possibly being at risk. The participants included 135 parent-infant dyads: 46 VPT (gestational age 24–32 weeks), 51 MPT (gestational age 32–34 weeks), and 38 FT (gestational age 37–41 weeks). The infants’ affect, gaze-aversion, and self-comforting behaviors were coded. Preterm infants responded to parental still face in similar fashion to FT infants, displaying robust still-face and recovery effects. The preterm infants exhibited less developed emotion-regulation behaviors, however, manifested in less positive affect and more gaze aversion in the face-to-face and reunion episodes compared to FT infants. With respect to self-comforting behaviors, each group displayed a significantly different pattern of behaviors throughout the procedure, suggesting better emotion regulation skills among MPT infants compared to the VPT infants. The findings on gaze aversion and self-comforting behaviors could have implications for strategies to incorporate into intervention programs supporting development of emotion regulation skills.

Real-Time-Monitoring in der Behandlung komplexer posttraumatischer Belastungsstörung: Ein Fallbericht

Hintergrund: Anhand eines Fallbeispiels soll gezeigt werden, wie Real-Time-Monitoring die Therapie von PatientInnen mit komplexer posttraumatischer Belastungsstörung (PTBS) wirksamer gestalten hilft. Patient und Methoden: Die Fallkonzeption und Behandlung fußten auf einem störungsspezifischen stationären Behandlungsprogramm für komplex traumatisierte Erwachsene und orientierten sich an Empfehlungen bezüglich der traumafokussierten Behandlung von Patienten mit pathologischem Narzissmus. Der Veränderungsprozess des Patienten wurde mit einem webgestützten Tool für Real-Time-Monitoring (Synergetic Navigation System) erfasst und im Therapieverlauf wiederholt gemeinsam mit dem Patienten reflektiert. Ergebnisse: Der Patient remittierte hinsichtlich PTBS, Depression, somatoformer Beschwerden, interaktioneller Schwierigkeiten, Selbstwirksamkeit und Beeinträchtigungen des psychischen Wohlbefindens. Insbesondere konnten im Rahmen von Feedback-Gesprächen die persönlichkeitsspezifischen affektiven Dynamiken von Scham, Schuld und Wut des Patienten sowie deren kritische Instabilitäten und Phasenübergänge im Rahmen der Traumakonfrontation reflektiert werden. Der Patient entwickelte neue Selbstfürsorgemuster und lernte, eigene Gefühle wahrzunehmen, zu verantworten und zu regulieren. Schlussfolgerungen: Die auf Traumakonfrontation ausgerichtete multimodale Therapie erwies sich im vorliegenden Fall als geeignet, neben den Kernsymptomen der PTBS auch bedeutsame komorbide Symptome wirksam zu reduzieren. Das Real-Time-Monitoring unterstützt die Identifizierung und Bearbeitung zentraler affektiver Dynamiken eines Patienten und erlaubt so, die Therapie von Patienten mit komplexen Traumafolgestörungen und persönlichkeitsprägender Symptomatik effektiver zu gestalten.

REL@X: SENSORY AND VIRTUAL IMMERSION TO REDUCE THE ANXIETY OF PATIENTS CONSULTING FOR THE FIRST TIME IN NICE MEMORY CENTER

Background: Neuropsychiatric symptoms (NS) such as agitation, physical aggression, shadowing and vocalizations are common in individuals with dementia compromising their quality of life and safety. NS have been associated with more time spent care-giving, high level of distress among caregivers and greater mortality among people with dementia. Although pharmacological interventions are frequently used to manage such symptoms, they can lead to adverse effects or even add to mortality. Some non-pharmacological approaches have been shown to be safe and to reduce NS. In the present investigation we describe a ran-domized clinical trial, using the Tailored Activity Program Outpatient version (TAP-O) in a Brazilian sample, to test the efficacy of an activity program to reduce NS in patients with dementia and their caregivers burden. TAP-O version was adapted from original TAP (home intervention). Methods: Patients with dementia and their caregivers were randomized to intervention (TAP-O method) or control group (psychoeducative method). TAP-O is a method involving eight sessions in an outpatient service conducted by occupational therapists who train caregivers in using meaningful activities at home, as part of their daily care routines. Outcome measures were obtained by Neuropsychiatric Inventory – Clinician Rating Scale (NPI-C) and Zarit Scale to measure NS in patients and caregiver burden, respectively. Results:A total of 21 dyads (individuals with dementia and their caregivers) were included. Most of patients were female (76.2%) with mean age of 78.7 (SD ¼ 5.8), and most of caregivers were family members (71.4%). Eleven patients were randomized to experimental intervention (TAP-O) and ten to control group. Patients from experimental group presented significant decrease in symptoms of hallucination (p¼0.008), anxiety (p¼0.03), and sleep disorder (p¼0.04) compared to the control group. Regarding the caregiver burden, measured by Zarit, it was possible to detect a statistically significant decrease in the experimental group (p¼0.003). Conclusions: These preliminary findings suggest that TAP-O may be clinically relevant, such as original TAP (home version) for the NS in patients with demen-tia and burden of their caregivers. Background: Elevated plasma total homocysteine (tHcy) is associated with increased risk of cardiovascular disease, stroke and de-mentia. Results of clinical trials using B-vitamins to reduce the cognitive risks attributed to tHcy have been inconsistent. A high prevalence of hyperhomocysteinemia and of cognitive impairment in kidney transplant recipients makes them a convenient population in which to evaluate this question. Methods: We evaluated whether B-vitamin therapy to lower tHcy would prevent cognitive-decline in a cohort of stable kidney transplant recipients. The study was a longitudinal ancillary of the FAVORIT trial-a randomized, placebo controlled trial of high-dose B vitamins to reduce cardio-and cerebrovascular events in clinically stable kidney transplant recipients with elevated tHcy. 584 subjects from 18 sites across North America were assessed annually for up to 5 years (mean 3.3 years) using a standardized neuropsychological test battery. Efficacy was analyzed on an intention-to-treat basis using end-of-trial data. Subgroup analyses included stratification for baseline plasma B-vitamin and tHcy concentrations. Results: At baseline, cognitive impairment was prevalent with 61% of participants falling more than one standard deviation below published norms for at least one cognitive test. Fewer than 1% of participants had insufficient plasma folate < 5 ng/ml or vitamin B12 < 148 pmol/L. However, 44.6% had plasma B6 concentrations < 30 nmol/L. At follow-up, psychomotor speed and memory scores were modestly but significantly better in the B-vitamin supplement group than in controls (p0.05). There was no interaction between baseline tHcy, B-vitamin status and treatment on the cognitive outcomes. Conclusions: High-dose B-vitamin supplementation provided modest benefit for cognitive function in our cohort of kidney transplant recipients with elevated baseline tHcy. Since nearly all participants were folate and vitamin B12 sufficient at baseline, the potential cognitive benefits of folate and B12 supplementation in individuals with poor B-vitamin status remains to be determined. Background: Rel@x project aims at reducing the level of anxiety and to improve positive emotions in patients coming for the first time in consultation at Nice Memory Center. This is supposed to reduce errors due to stress in neuropsychological tests, and also allows to study emotion regulation capabilities of patients with and without cognitive impairment. To these aims, Rel@x project developed a multisensorial relaxing environment including virtual reality, music and odors. Methods: In the present study, we included 50 participants with (N¼25) and without (N¼25) mild cognitive impairment. Patients were immersed in a realistic universe then in a fantasy world on an island, and during this

Future Directions in “Food Addiction”: Next Steps and Treatment Implications

The purposes of this study were to examine future directions regarding food addiction and to discuss potential treatment implications. Foods likely differ in their ability to trigger addictive-like eating, with highly processed foods being the most closely associated with addictive processes. Harm reduction approaches may be relevant to the treatment of addictive-like eating. Food addiction is more closely associated with wanting for food, rather than liking the taste of food. Exposure to food cues increases wanting for food and increasing strategies to cope with cravings may be an important treatment approach. Negative affect likely increases vulnerability to overeating. Increasing emotion regulation capabilities may be important in reducing signs of food addiction. The role of addictive mechanisms in problematic eating requires additional research, but an addiction perspective may also have important treatment implications.