Emotion Regulation Difficulties Research Articles

Using machine learning methods to identify trajectories of change and predict responders and non-responders to short-term dynamic therapy

Objectives Predicting therapy responders can significantly improve clinical outcomes. This study aims to identify predictors of response to short-term dynamic therapy. Methods Data from 95 patients who underwent 16-session therapy were analyzed using machine learning. Weekly progress was monitored with the Outcome Questionnaire (OQ45) and Target Complaints (TC). A machine learning model identified change trajectories for responders and non-responders, with a random forest algorithm and elastic net modeling predicting trajectory group membership using pre-treatment data. Results A weak positive relationship was found between the trajectories of the two outcome variables. The results of the different analysis methods were compared and discussed. Important predictors of OQ45 trajectories, based on random forest modeling, included initial symptom severity, difficulties in emotion regulation, coldness, avoidant attachment, conscientiousness, interpersonal problems, non-acceptance of negative emotion, neuroticism, emotional clarity, impulsivity, and emotion awareness (72.8% accuracy). Initial problem severity, self-scarifying extraversion, and non-assertiveness were the most dominant predictors for TC trajectories (62.8% accuracy). Conclusions These findings offer data-driven insights for selecting short-term dynamic therapy. Predicting response for the OQ45, a nomothetic measure, does not extend to the TC, an idiographic measure, and vice versa, highlighting the importance of multidimensional outcome evaluations for personalized treatment.

Examination of the relationship between conflict resolution styles and marital satisfaction: the mediating role of emotion regulation difficulties

ABSTRACT The aim of this study is to examine the mediating role of emotion regulation difficulties in the relationship between conflict resolution styles and marital satisfaction in married individuals. A total of 706 married individuals, 234 men and 472 women, constitute the study’s working group. The ages of the participants ranged from 21 to 60, with an average age of 38.45. As a result of the analysis conducted within the scope of the study It has been found that positive conflict resolution, retreat and subordination conflict resolution styles are positively related with marriage satisfaction, while negative conflict resolution styles are negatively related with marriage satisfaction. The results show that positive conflict resolution, negative conflict resolution, retreat and subordination conflict resolution styles have a direct effect on marital satisfaction, but this effect does not disappear when emotion regulation difficulties is controlled, so emotion regulation difficulties play a partial mediator role.

Autonomic response and attachment style in disruptive mood dysregulation disorder

Background: Disruptive mood dysregulation disorder (DMDD) is characterised by severe emotion regulation difficulties, particularly anger and irritability, in children. Despite the impact of attachment on emotional and behavioural regulation, the link between attachment style and DMDD is under-researched.Aim: This study investigated whether attachment style and parasympathetic regulation differentiate the response profiles to frustrating conditions between children diagnosed with DMDD and controls.Setting: Participants were assessed at schools in Johannesburg, Gauteng, South Africa.Methods: Thirty participants were divided into two matched groups (nDMDD = 15; nControl = 15) and assessed. Respiratory sinus arrhythmia (RSA) and heart period were measured during an Affective Posner Task, inducing frustration. Attachment style was assessed using the Attachment Style Classification Questionnaire for children. Parents of children with DMDD completed a social interaction problems questionnaire.Results: The DMDD group showed a higher prevalence of avoidant attachment style (p = 0.013) compared to controls. Both groups displayed adaptive vagal withdrawal and recovery during the task (p = 0.005; p = 0.021). Controls had significantly higher heart period throughout the assessment (game 1: p = 0.006; game 2: p = 0.013; game 3: p = 0.007). In the DMDD group, lower vagal tone during frustration correlated with more social interaction problems (p = 0.049).Conclusion: The study demonstrates a potential link between attachment style and altered physiological state in children with DMDD.Contribution: The findings provide insight into possible atypical vagal regulation of the heart and avoidant attachment styles in DMDD, highlighting potential therapeutic and intervention targets.

Psycho-Socio-Demographic Risk Factors of Self-injurious Behaviors in Iranian Females Inmates: A Case-Control Study

Background: Self-injurious behavior or self-harm among inmates is a common phenomenon. However, no study has yet been conducted in Iran regarding self-harm in female inmates. Objectives: The present study aimed to investigate the psycho-socio-demographic risk factors associated with non-suicidal self-harm in Iranian female inmates. Patients and Methods: Participants in this case-control study were 306 female inmates in Tehran, who were randomly selected and divided into two groups: (1) 88 individuals who scored 5 or higher on the Sansone Self-harm Inventory (SHI), and (2) 88 individuals randomly selected from the 218 inmates who did not self-harm as the comparison group. The participants completed a researcher-designed questionnaire, SHI, and the Difficulties in Emotion Regulation Scale. The data were analyzed using logistic regression analysis in SPSS version 16. Results: Logistic regression analysis revealed that marital status (B = 1.438, P = 0.002), arrest history (B = 1.295, P = 0.005), substance abuse (B = 1.198, P = 0.011), psychiatric diagnoses (B = 1.126, P = 0.018), parental divorce (B = 1.280, P = 0.005), and difficulties in emotion regulation (B = 0.027, P = 0.022) were significant predictors of self-harm in inmates. Although there was a difference in the addiction rates of parents between those with self-harm and those without, this variable did not predict self-harm in female inmates (B = 0.488, P = 0.307). Conclusions: The results of this study underscore the importance of family-based preventive interventions to prevent self-harm behaviors among female inmates.

Examining the roles of reward sensitivity and difficulties in emotion regulation in relation to low-restraint binge eating.

Leading treatments for binge eating target dietary restraint, but up to 35% of the people with binge eating report low restraint. This study examined the roles of reward sensitivity and emotion dysregulation in relation to low-restraint binge eating. Women with binge eating (low-restraint: n = 22; high-restraint: n = 69) and controls (n = 49) completed self-report measures of generalized reward sensitivity and emotion dysregulation and a picture-viewing task assessing craving and pleasure for high-calorie food. As expected, food-related craving and emotion dysregulation were greater in the clinical than in the control group, but no differences emerged between high- and low-restraint binge eating groups. However, correlational analyses found that, within the clinical group, the number of restraint days related to greater anticipatory sensitivity for generalized rewards and lower pleasure ratings of food. Results suggest that emotion dysregulation characterizes both high- and low-restraint binge eating. As self-reported food liking was linked with lower restraint, greater enjoyment of palatable foods may uniquely contribute to low-restraint binge eating. Increasing emphasis on emotion regulation and food-related reward sensitivity may enhance treatment outcomes for individuals with low-restraint binge eating.

Inside the gamer's mind: How violent video games and emotional dysregulation affect EEG interbrain synchronization

BackgroundExposure to violent video games influences players’ cortical activations. In addition, intra-individual variables like emotional regulation play an important role in the consequences of such exposures. However, most research has studied these relationships at the intra-individual level. Therefore, the present study investigated the effects of violent video games on the interbrain synchronization (IBS) of dyads in which one member played video games, and evaluated IBS differences between high and low-emotionally dysregulated groups. MethodsEighteen participants (M = 24.1 ± 2.1) were enrolled in this study. Participants gazed into another person's eyes before playing (“First Direct Gaze”), after playing a violent video game (“Post-VV”), and after playing a nonviolent video game (“Post-NVV”) during an electroencephalographic hyperscanning acquisition. Afterward, each participant completed a socio-demographic questionnaire and the Difficulties in Emotion Regulation Scale. ResultsA cluster-based analysis revealed an increased theta IBS Post-VV compared to Post-NVV. A median split was used to define the high emotionally dysregulated (“HED”) and low emotionally dysregulated (“LED”) groups. Results showed a decreased alpha IBS in the First Direct Gaze, Post-VV, and Post-NVV in the HED group compared to the LED group. ConclusionsExposure to violent video games was associated with higher theta IBS, suggesting a greater social attunement, potentially due to a higher perceived dominance and control or due to an effort of managing the emotional activations elicited. In addition, difficulties in emotional regulation could elicit specific alpha activities regardless of exposure to a video game, leading to a lower tendency to attune with another person on this band.Results from this study should not be generalized to infer that playing any type of video game causes harm to people's brains.

The relationship between emotion regulation difficulties and eating disorder outcomes: a longitudinal examination in a residential eating disorder treatment facility

ABSTRACT Eating disorders (EDs) are associated with numerous comorbidities and deleterious outcomes (e.g. medical complications, high rates of death by suicide). The complexities of EDs are further compounded by treatment dropout, poor treatment outcomes, and relapse. One way to better understand these complexities is to investigate broad, transdiagnostic risk factors that contribute to the etiology and maintenance of EDs, such as emotion regulation (ER) difficulties. We longitudinally tested the relationship between ER difficulties and ED outcomes in a sample of 101 female ED patients in a southeastern U.S. residential ED treatment facility. Consistent with hypothesis, there were significant improvements in both ER difficulties and eating pathology from admission to discharge. Further, improvement in ER difficulties was associated with improvements in eating pathology. These findings further substantiate the role of ER difficulties in eating disorders and provide further evidence for the relationship between ER difficulties and eating pathology among residential eating disorder patients.

Eating Problems in Young Adults: The Role of Unbalanced Family Cohesion and Difficulties in Emotion Regulation

Strong emotional bonds with the family often result in many positive consequences for human functioning, including emotional regulation and eating patterns. The study aimed to determine the relationship between unbalanced family cohesion, emotion regulation, and eating problems in young adults. A correlation research design was used with a non-probability purposive sampling technique to recruit a sample consisting of 300 university students, 50% men and 50% women, with an age range from 18 to 25 years ( M = 21.60, SD = 1.95) from the four universities of Lahore. Demographic performa, Family Cohesion Scale (FCS), Difficulties in Emotion Regulation Scale (DERS), and Eating Problem Scale (EPS) were used to explore the study variables. Data was analyzed using SPSS 21. Pearson product-moment correlation indicated a significant positive relationship between unbalanced family cohesion, difficulties in emotion regulation, and eating problems. It also revealed that a positive relationship was found among unbalanced family cohesion, difficulties in emotion regulation, and eating problems in young adults. Mediation analysis shows that emotion regulation fully mediates the relationship between unbalanced family cohesion and eating problems in young adults. The findings will help students and family counselors identify risk factors of eating problems and its impact on their transition into marriage life. They will contribute to a deeper understanding of unbalanced family dynamics, difficulties in emotion regulation, and eating problems.

Treating Trauma and PTSD in Children with Autism Spectrum Disorder (ASD): Unique Challenges Call for an Active Role in Psychotherapeutic Interventions— Case Report

ABSTRACT Contemporary research shows that patients with autism spectrum disorder (ASD) suffer more traumatic experiences and more post-traumatic symptoms than neurotypical patients. Autistic children are more vulnerable to trauma due to their increased sensitivity to the environment and are more at risk of suffering mistreatment from caretakers and strangers. The unique symptoms of ASD of repetitiveness, memory biases, and increased emotion regulation difficulties may increase the risk of traumatic events, creating traumatic symptoms and making the psychotherapeutic intervention more challenging. The term “autistic traumatic memory object” is offered to describe the unique sensational, emotional, repetitive qualities of rumination. A case report will demonstrate the difficulties in a therapeutic change in a child with ASD. It will demonstrate adjustments and active role participant techniques during play therapy. These interventions relate and expand ideas from the active role of the therapist working with traumatized children with autism. Neither empathy nor interpretation appeared to affect the child’s repetitive, emotionally dissociative reenactments of trauma. Active resistance and empathic refusal to collaborate with the aggressor on the part of the therapist during play helped reconstruct and process the traumatic memory and achieve therapeutic change.

Emotion Regulation, Eating Psychopathology, and Putative Transdiagnostic Psychological Processes: Findings from an Exploratory Network Analysis in a College Sample

Objective: Considering the prevalence of ED-related prodromal symptoms among higher education students (making them a population at risk for developing EDs), the main goals of this study were to conduct a network analysis in a college sample and to explore multivariate dependencies between a selection of empirically informed variables of interest to eating psychopathology, namely difficulties in emotion regulation and psychological processes (e.g., interoceptive awareness, self-compassion, self-criticism, mindfulness, and experiential avoidance). Methods: The sample included 294 college students (Mage = 21.4, SD = 5.0; MBMI = 22.4, SD = 3.7). A Gaussian graphical network model was estimated to visualize interactions among the studied variables and to assess their centrality in terms of betweenness, closeness, strength, and expected influence. Results: A network system with 21 nodes was estimated (sparsity = 0.52). Nodes assessing disordered eating symptoms displayed the strongest correlation coefficients with nodes assessing dimensions of interoceptive awareness: eating concerns and not-distracting (r = −0.11), shape concerns and trusting (r = −0.16), and weight concerns and trusting (r = −0.10). Self-compassion was the node with the highest betweenness (SELFCS = 2.27) and closeness centrality (SELFCS = 1.70). The nodes with the highest strength centrality were strategies (DERS = 1.91) and shape concerns (EDE-Q = 1.51). Discussion: In this network model conducted in a college sample, eating-related symptoms were mainly associated with dimensions of interoceptive awareness. Also, the lack of effective strategies to regulate emotions, shape concerns, and self-compassion stood out as central nodes in the network model. The results suggest that addressing these variables may be promising in disrupting network systems marked by the presence of prodromal eating psychopathology symptoms in at-risk populations (e.g., college students).

Intensity of Physical Activity in Young People: Focus on Emotional, Cognitive, and Healthy Lifestyle-Related Variables.

The college years represent a crucial developmental period in which unhealthy behaviors, including smoking, alcohol consumption, inadequate physical activity (PA), poor sleep quality, and unhealthy nutrition habits are often acquired, influencing the onset or exacerbation of pre-existing mental disturbances such as anxiety, depression, or difficulties in emotion regulation. Our aim was to analyze the effect of the intensity of physical activity (PA) on the emotional, behavioral, and cognitive variables in a sample of young people. We recruited 103 participants (19.85 ± 0.25) who completed several online questionnaires (IPAQ-SF, STAI-t, DERS, UPPS-P, ISP-20, and Mini-IPIP). Subsequently, face-to-face sessions were conducted to assess the cognitive variables and to collect more details about their lifestyle habits, including drug use, sleep quality, and leisure activities. Based on the IPAQ-SF results, we categorized the sample into three groups: light PA (n = 47), moderate PA (n = 29), and vigorous PA (n = 27). Vigorous PA group showed better emotional regulation, lower impulsivity, fewer prefrontal symptoms and unhealthy behaviors, better sleep quality, and more leisure activities. No significant cognitive differences were found. It seems that young people are a vulnerable group with emotional and impulsivity traits and engaging in intense PA appears to be a promising avenue for managing these symptoms. In conclusion, our study suggests that young people are a vulnerable group with emotional and impulsivity traits that may precipitate in future mental disorders. Nevertheless, engaging in PA, particularly at high intensity, appears to be a promising avenue for reducing and managing these symptoms during this critical period of life.

The Impact of Insecure Attachment on Emotional Dependence on a Partner: The Mediating Role of Negative Emotional Rejection.

Previous evidence has demonstrated a relationship between insecure attachment and the development of emotional dependence towards an individual's partner. However, the possibility that this relationship may be indirect and mediated by individual factors such as difficulties in emotional regulation has not previously been explored. Consequently, the objectives of the present study were to analyze the (i) differences in emotional dependence on an individual's partner and difficulties in emotional regulation capacity according to secure, preoccupied or dismissing attachment style and (ii) mediating role of difficulties in emotional regulation in the relationship between both insecure attachment styles and emotional dependence on an individual's partner. The sample comprised 741 participants ranging in age from 18 to 30 years (M = 21.32, SD = 2.93). The mediations were tested with linear regressions with the macro PROCESS v4.0. The results showed that emotional dependence on a partner and difficulties in emotional regulation were greater among individuals who had developed a dismissing attachment compared those with secure or preoccupied attachment. Likewise, the mediation model confirmed the mediating role of difficulties in the capacity for emotional regulation in the relationship between dismissing attachment and emotional dependence, with rejection of negative or discomfort-generating emotions predominating. The findings provide preliminary evidence that rejection of negative emotional experiences may play an important role in the relationship between insecure dismissing attachment style and emotional dependence on an individual's partner. Consequently, it is recommended that emotional dependence intervention programs include of the management of intolerance to negative emotions.

Fears of positive and negative evaluation and their within-person associations with emotion regulation in adolescence: A longitudinal analysis.

Fear of positive evaluation (FPE) has recently emerged as an important aspect of social anxiety, alongside fear of negative evaluation. These evaluation fears peak during adolescence, a developmental stage that is also often accompanied by difficulties in emotion regulation, thereby increasing young individuals' vulnerability to mental disorders, such as social anxiety. We aimed to examine the longitudinal within-person associations between fears of evaluation, social anxiety, and three emotion regulation strategies (i.e., acceptance, suppression, rumination) in adolescents. Data were collected from a sample of 684 adolescents through an online survey three times over the course of 6 months and were analyzed using random intercept cross-lagged panel models. At the between-person level, FPE was linked to all three emotion regulation strategies, whereas fear of negative evaluation and social anxiety were associated with acceptance and rumination. At the within-person level, difficulties in accepting emotions predicted FPE, suppression predicted social anxiety, and social anxiety predicted rumination over time. These findings reveal complex interdependencies between emotion regulation, social anxiety, and evaluation fears, both reflecting individual differences and predicting changes within individuals, and further elucidate the developmental trajectory of social anxiety in adolescence.

Strategies and goals in Emotion Regulation models: a systematic review.

Studies examining the role of Emotion Regulation (ER) do not consistently explain the underlying model or theory they are employing, resulting in a conflation of different strategies and goals within the ER scientific literature. This study aims to conduct a systematic review and conceptual analysis of the primary strategies and goals advocated in the ER models, theories, and frameworks. Furthermore, we explored the distinctions between the prevailing contemporary ER models and classical conceptions of emotional dynamics, such as those proposed by Aristotle, Descartes, and Darwin. An electronic search was conducted in the Web of Science, Medline, and Scopus databases in November 2023. The key search terms used were grouped into two different topics: Emotion Regulation and Models/Theories/Frameworks. Articles were included if they reported one or more ER model in healthy individuals or emotionally disordered individuals and if they were published in a peer-reviewed journal in English in the last 5 years (from 2019 to 2023). A total of two reviewers independently assessed the titles, abstracts, and full texts. Models identified were summarized and classified based on the different ER strategies and goals. Of the 1,012 titles for initial consideration, 139 articles met the full eligibility criteria and were included for data extraction and synthesis. The review identified 10 ER models, and the most commonly used were the Process Model of Emotion Regulation and the Difficulties in Emotion Regulation. There was a great deal of homogeneity among the proposed ER strategies and goals: the cognitive dimension is the core of ER strategy, and the ER goals are primarily hedonic or instrumental in nature. Both Descartes and Darwin views were present in the ER models; however, some of the most significant contributions in Aristotelian proposal seem to be forgotten, such as the integration of the physical, operational, and growth dimensions (eudaimonic goals). This systematic review was conducted in accordance with the PRISMA guidelines and was preregistered at Prospero platform (CRD42023491948).

Interoception, emotion regulation strategies and skin-picking behaviors – Results of an intensive longitudinal study

Compulsive skin-picking is associated with emotion regulation difficulties, whose origins remain unclear. Interoception, plays an important role in effective emotion regulation. This study examined the relationship between interoception, emotion regulation strategies, and skin-picking in 136 individuals (85% women, aged 18–41), including 71 engaging in skin-picking and 65 psychologically healthy controls. We were interested in between-group differences in maladaptive and adaptive emotion regulation and aspects of interoception as well as associations of the latter with skin-picking symptoms and use of emotion regulation strategies. At baseline, we assessed habitual emotion regulation strategies (rumination, suppression, distraction, engagement, arousal control, reappraisal) and Interoceptive Sensibility (e.g., emotional awareness, body listening, self-regulation, noticing) through self-report questionnaires. Moreover, Interoceptive Accuracy (IAc) was measured via a Heartbeat Counting Task. Additionally, Ecological Momentary Assessment (EMA) over seven days was used to register use of emotion regulation strategies and the occurrence and severity of skin-picking episodes during that period. At baseline, the skin-picking group exhibited lower IAc, emotional awareness, and higher habitual use of rumination than control group. Lower IAc was associated with higher odds of reporting skin-picking episodes assessed during EMA. Body listening correlated with a reduced sense of control over skin-picking during EMA. In total sample, self-regulation was related to lower odds of using rumination during EMA and noticing with less use of cognitive reappraisal. The study highlights the complex relationship between interoception, emotion regulation, and skin-picking, offering new insights into the mechanisms underlying skin picking disorder.

Is visual information use during facial emotion recognition related to eating disorder symptoms in college-aged men and women? An experimental study

BackgroundPrevious studies of emotion recognition abilities of people with eating disorders used accuracy to identify performance deficits for these individuals. The current study examined eating disorder symptom severity as a function of emotion categorization abilities, using a visual cognition paradigm that offers insights into how emotional faces may be categorized, as opposed to just how well these faces are categorized.MethodsUndergraduate students (N = 87, 50 women, 34 men, 3 non-binary) completed the Bubbles task and a standard emotion categorization task, as well as a set of questionnaires assessing their eating disorder symptomology and comorbid disorders. We examined the relationship between visual information use (assessed via Bubbles) and eating disorder symptomology (EDDS) while controlling for anxiety (STAI), depression (BDI-II), alexithymia (TAS), and emotion regulation difficulties (DERS-sf).ResultsOverall visual information use (i.e. how well participants used facial features important for accurate emotion categorization) was not significantly related to eating disorder symptoms, despite producing interpretable patterns for each emotion category. Emotion categorization accuracy was also not related to eating disorder symptoms.ConclusionsResults from this study must be interpreted with caution, given the non-clinical sample. Future research may benefit from comparing visual information use in patients with an eating disorder and healthy controls, as well as employing designs focused on specific emotion categories, such as anger.

Psychological mechanisms and neural correlates of trait mindfulness in emotion regulation: Testing a novel approach to the monitor and acceptance theory

BackgroundThe ongoing mental health crisis warrants investigations to understand why trait mindfulness is associated with beneficial mental health outcomes. This study examined attention monitoring and acceptance as psychological mechanisms underlying the relationship between trait mindfulness and emotion regulation and connectivity between the dorsolateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC) as a potential neural mechanism. MethodsA cross-sectional study was conducted with 501 adult participants (age range: 17–79, M = 31, SD = 11.3) representing the general population. To assess emotion regulation and trait mindfulness, participants completed the Difficulties in Emotion Regulation Scale (DERS) and Five Facets Mindfulness Questionnaire (FFMQ). Resting-state functional MRI was acquired in a subsample of 20 participants to explore the role of dlPFC-PCC functional connectivity. ResultsHigher levels of acceptance, as measured using the Non-judging and Non-reactivity subscales of the FFMQ, were significantly associated with fewer overall emotion regulation difficulties and predicted all emotion regulation subscales. In contrast, higher levels of attention monitoring, measured using the Observe subscale, predicted only three DERS subscales and with mixed effects: higher emotional awareness and clarity, but greater difficulties in goal-directed behaviour. The interaction between monitoring and acceptance was not significant, and no correlation was found between these variables and dlPFC-PCC functional connectivity. ConclusionsThese findings challenge previous theories that argue that attention monitoring is crucial for effective emotion regulation. Instead, we conclude that acceptance is the key psychological mechanism, indicating that the traditional focus on attention monitoring in mindfulness training may be less effective than a primary emphasis on acceptance. This study provides a critical review of past research, highlighting issues with operationalising acceptance, and offers recommendations for future studies and practical implications for developing mindfulness interventions.

The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder

Objective: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). Method: This study included 842 children aged 8–12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. Results: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. Conclusion: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.

Network Analyses Applied to the Dimensions of Cancer-Related Fatigue in Women With Breast Cancer.

Understanding cancer symptom cluster through network analyses is a new approach in oncology, revealing interconnected and influential relationships among reported symptoms. We aimed to assess these relationships using network analysis in posttreatment breast cancer patients, focusing on the five dimensions of cancer-related fatigue (CRF), and on other common difficulties encountered by oncological patients (i.e., pain, anxiety, depression, sleep difficulties, cognitive impairments, and emotion regulation and mental adaptation difficulties). This study involved a complementary analysis of data from two interventional studies. Participants completed questionnaires before and after the intervention, with baseline scores being used in this article. Partial correlation network analysis modeled the relationships between symptoms in five distinct networks, each of them including one specific dimension of CRF. The core symptom in each network was identified based on the highest centrality indices. Depression emerged as the core symptom in all networks, strongly associated with all fatigue dimensions (partial correlations ranging from 0.183 to 0.269) except mental fatigue. These findings indicate robust connections between symptoms, as variations in depression scores directly or indirectly influence fatigue and other symptoms within the cluster. Our results support the multidimensional aspect of CRF, and its links with other common symptoms. To effectively reduce patient CRF, interventions should address not only fatigue but also the closely related symptoms from the cluster, such as depression, given its centrality in the cluster. ClinicalTrials.gov (NCT03144154 and NCT04873661). Retrospectively registered on May 1, 2017 and April 29, 2021, respectively.

Verbal Weight-Related Abuse and Binge Eating Behavior: The Mediating Role of Attentional Bias to Threat Cues and Difficulties in Emotion Regulation.

Previous studies investigated the impact of weight-related abuse (WRA) on eating pathology. However, the circumstances of such an effect are still unclear. Our study aimed to examine the relationship between verbal WRA and binge eating (BE) behavior via attentional bias (AB) to threat cues and difficulties in emotion regulation. We conducted a parallel mediation model. On the basis of the purposive sampling method, 183 individuals with obesity and overweight (70.5% female and 28.4% male; Meanage=32.78), from February to June 2019, were recruited from a nutrition clinic in Tehran. The participants completed the BE scale (BES), the weight-related abuse questionnaire (WRAQ), the difficulties in emotion regulation scale (DERS), and the dot probe task (DPT). AB to threat cues had a significantly negative association with verbal WRA and BE. Difficulties in emotion regulation showed a significant positive association with verbal WRA and BE. The parallel mediation model showed a direct effect of verbal WRA on BE. Moreover, the bootstrap analysis revealed that difficulties in emotion regulation could mediate the association between verbal WRA and BE. Our findings suggest that experiences of verbal WRA can contribute to cognitive bias to negative emotion, maladaptive emotion regulation strategies, and behavioral problems like BE.