Enhance Emotion Regulation Research Articles

Decreased Amygdala Reactivity to Parent Cues Protects Against Anxiety Following Early Adversity: An Examination Across 3 Years

BackgroundThe human brain remains highly plastic for a protracted developmental period. Thus, although early caregiving adversities that alter amygdala development can result in enduring emotion regulation difficulties, these trajectories should respond to subsequent enriched caregiving. Exposure to high-quality parenting can regulate (i.e., decrease) children’s amygdala reactivity, a process that, over the long term, is hypothesized to enhance emotion regulation. We tested the hypothesis that even following adversity, the parent–child relationship would be associated with decreases in amygdala reactivity to parent cues, which would in turn predict lower future anxiety. MethodsParticipants were 102 children (6–10 years of age) and adolescents (11–17 years of age), for whom data were collected at one or two time points and who either had experienced institutional care before adoption (n = 45) or had lived always with their biological parents (comparison; n = 57). We examined how amygdala reactivity to visual cues of the parent at time 1 predicted longitudinal change (from time 1 to time 2) in parent-reported child anxiety across 3 years. ResultsAt time 1, on average, amygdala reactivity decrements to parent cues were not seen in children who had received institutional care but were seen in children in the comparison group. However, some children who previously experienced institutional care did show decreased amygdala reactivity to parent cues (∼40%), which was associated with greater child-reported feelings of security with their parent. Amygdala decreases at time 1 were followed by steeper anxiety reductions from time 1 to time 2 (i.e., 3 years). ConclusionsThese data provide a neurobiological mechanism by which the parent–child relationship can increase resilience, even in children at significant risk for anxiety symptoms.

Age differences in everyday stressor-related negative affect: A coordinated analysis.

Advancing age is often characterized by preserved or even enhanced emotion regulation, which is thought to manifest in terms of age-related reductions in the within-person association between stressors and negative affect. Existing research from ecological momentary assessment and end-of-day daily diary studies examining such age-related benefits have yielded mixed results, potentially due to differences in samples, design, and measurement of everyday stressors and negative affect. We conducted a coordinated analysis of 5 ecological momentary assessments and 2 end-of-day daily diary studies to examine adult age differences in the within-person association between everyday stressors and negative affect. Reported stressor occurrences are robustly associated with higher negative affect, regardless of study design and sample characteristics. Across studies, interactions between age and everyday stressors predicting negative affect revealed a pattern of age-related decreases in the stressor-negative affect association, but this interaction was only significant for 2 studies. Further, examination of statistical power of the included studies suggests that, despite differences in the number of repeated assessments, power to detect within-person stressor-negative affect associations is quite good. In contrast, despite possessing wider age ranges, observed age differences were relatively small in magnitude, and studies are potentially underpowered to detect age differences in these within-person associations. We discuss the importance of study design, interval of repeated assessments and number of participants for examining age differences in everyday stressors and negative affect, as well as the virtue of coordinated analyses for detecting consistent direction of associations, but inconsistent patterns of statistical significance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Transcranial magnetic stimulation in borderline personality disorder – case series

We present the results of a case series study of individual ly navigated repetitive transcranial magnetic stimulation (rTMS) in four patients with borderline personality disorder (BPD). Patients and methods: Four patients with BPD performed a Go/NoGo task dur ing functional MRI (fMRI) designed for observ ing behavioural inhibition neural cor relates. The site within the right dorsolateral prefrontal cortex with the largest diff erence in BOLD signal between the NoGo and Go conditions was as signed as a target for rTMS in each patient. Four patients underwent 15 ses sions of individual ly navigated 10-Hz rTMS treatment at 110% of their individual rest ing motor threshold for 3 weeks (one ses sion per work ing day). One ses sion contained 1,500 pulses delivered in 15 trains by 10 s, lead ing to a total of 22,500 pulses dur ing the treatment. Results: The treatment was very well tolerated without any serious side eff ects. After the treatment, the patients reported that they felt better self-control of their emotions, especial ly anger; that their urges for self-harm and suicidal thoughts decreased or disappeared; and that their derealisation/depersonalisation episodes disappeared. Patients also showed less depres sion symp toms after the treatment. Conclusion: rTMS with neuronavigation individualised by a fMRI Go/NoGo task is a promis ing tool for reduc ing impulsive behaviour and enhanc ing emotion regulation in BPD patients. Double-blind placebo-control led studies in larger samples are neces sary to draw further conclusions about rTMS eff ectiveness in BPD.

The modulating role of gender and aggression in emotional reactions of nursing students: A cross-sectional study.

To examine whether and to what extent emotion reactions of nursing students are affected by emotional features inherent in nursing care situations, focusing on gender and aggression. How individual characteristics of nurse students interact with emotional demands inherent in nursing practice and modulate the way they are perceived and acted upon may have an impact on quality of patient care. Cross-sectional study, conducted from May to September 2013. Nursing students (N=157) of the Nursing Degree Course of School of Medicine, Bologna University, completed self-report questionnaires assessing individual differences (i.e. aggression, personality traits, empathy) and evaluated emotion-inducing pictures of pleasant, unpleasant and neutral content. Gender and verbal aggression level modulate emotional responses of nursing students: females rated negative picture categories as significantly less pleasant than male students; those with high compared to low verbal aggression levels rated negative stimuli as less arousing and more pleasant. Verbal aggression level is positively related to physical aggression and anger and negatively related to emotional stability and empathy in both males and females. High verbal aggression scores seem to be associated with attenuated arousal in response to emotional stimuli and decreased aversive reaction towards negative content pictures, indicating a potential facilitation of approach and management of adverse events strictly connected to nursing practice. Nonetheless, aggression can represent a risk factor in nursing practice. Negative implications of verbal aggression are highlighted together with the need for tailoring education programs aimed at enhancing emotion regulation and aggression management skills in nursing context.

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

AbstractPolicy makers and researchers have worked to explain the perplexing rise in U.S. military suicides since 2001, with little progress in explaining this widespread phenomenon. This article synthesizes several literatures to highlight the role of emotion dysregulation in military suicidality. After considering advances in suicidal ideation‐to‐action frameworks and the factors that contribute to the prevalence of emotion dysregulation in the modern U.S. military, it explores how military service provides for two distinct circumstances in which such emotion dysregulation may facilitate the transition from suicidal ideation to behavior. The first circumstance is high distress tolerance, wherein the effects of disproportionately high rates of adverse childhood experiences (ACEs) among service‐members may increase vulnerability to suicidal behavior. The second circumstance is preexisting acquired capability with lethal means paired with executive functioning degradation. Empirically associated with military environments, such degradation may undermine the effectiveness of top‐down emotion regulation strategies—thereby allowing acquired familiarity with lethal means to assist the transition from suicidal ideation to action. Thus, emotion dysregulation’s unique relationship with the U.S. military may help to explain the powerful correlation between service and suicide since 2001—suggesting that enhancing emotion regulation skills may present a key leverage point for effectively addressing the issue.

Trait Mindfulness: A Multifaceted Evaluation

Scant studies have addressed the relations of an array of variables related to trait mindfulness in the context of a single investigation. We tested 800 (67.9% females, 31.3% males, .6% other, and .3% missing) undergraduate participants to evaluate three hypotheses: (a) increased positive affect, extraversion, openness, agreeableness, conscientiousness, acceptance, mysticism, transliminality, emotion regulation, and resilience would be related to increased trait mindfulness; (b) decreased negative affect, neuroticism, trait anxiety, behavioral avoidance, depression, and psychopathy would be associated with increased trait mindfulness; and (c) emotion regulation and resilience would demonstrate the strongest relations with trait mindfulness. All variables correlated significantly with trait mindfulness in the hypothesized directions, except for mysticism. Regression analyses revealed that emotion regulation, resilience, neuroticism, openness, conscientiousness, and behavioral avoidance all uniquely related to trait mindfulness. Enhanced emotion regulation and resilience alone accounted for more than 50% of variance in trait mindfulness.

Remembering to Breathe: The Challenges and Rewards of Teaching Mindfulness Practices to Pre-Service Teachers

This paper reports on a pilot study conducted to investigate the effectiveness of mindfulness-based program in reducing stress and enhancing emotion regulation skills for a cohort of undergraduate students completing their pre-service teaching experience. The intent of the present paper is to highlight the advantages of incorporating a mindfulness component into pre-service teacher training programs for university faculty who train and prepare these students for their culminating student teaching field experience. The purpose of incorporating mindfulness into the weekly seminar time was to provide students with the training to learn to let go of the worry, let go of the doubt, and just be for a short time.

141. Enhancing Emotion Regulation in Borderline Personality Disorder Patients Through Longitudinal Reappraisal Training: Evidence From Self-Reported Negative Affect and fMRI

Borderline personality disorder (BPD) is the prototypical disorder of emotion dysregulation. We have shown previously that when BPD patients attempt the highly adaptive emotion regulatory strategy of cognitive reappraisal, they do not engage brain regions known to participate in healthy individuals. In this study, we assessed whether BPD patients could be trained to improve cognitive reappraisal and normalize neural activity.

175. Cognitive Behavioral Therapy for Depression and the Neural Correlates of Emotion Regulation: Prediction of Treatment Outcome and Longitudinal Effects

Cognitive behavioral therapy (CBT) is effective for a substantial minority of patients with major depressive disorder (MDD), but its mechanism of action is unknown, and predictors of treatment outcome are lacking. As core techniques of CBT seek to enhance emotion regulation, we examined the neural correlates of emotion regulation using functional Magnetic Resonance Imaging (fMRI) before and after a course of CBT for MDD.

Longitudinal effects of cognitive behavioral therapy for depression on the neural correlates of emotion regulation

Cognitive behavioral therapy (CBT) is effective for a substantial minority of patients suffering from major depressive disorder (MDD), but its mechanism of action at the neural level is not known. As core techniques of CBT seek to enhance emotion regulation, we scanned 31 MDD participants prior to 14 sessions of CBT using functional magnetic resonance imaging (fMRI) and a task in which participants engaged in a voluntary emotion regulation strategy while recalling negative autobiographical memories. Eighteen healthy controls were also scanned. Twenty-three MDD participants completed post-treatment fMRI scanning, and 12 healthy volunteers completed repeat scanning without intervention. Better treatment outcome was associated with longitudinal enhancement of the emotion regulation-dependent BOLD contrast within subgenual anterior cingulate, medial prefrontal cortex, and lingual gyrus. Baseline emotion regulation-dependent BOLD contrast did not predict treatment outcome or differ between MDD and control groups. CBT response may be mediated by enhanced downregulation of neural activity during emotion regulation; brain regions identified overlap with those found using a similar task in a normative sample, and include regions related to self-referential and emotion processing. Future studies should seek to determine specificity of this downregulation to CBT, and evaluate it as a treatment target in MDD.

Anxiety Sensitivity and Nicotine Replacement Therapy Side Effects: Examining the Role of Emotion Dysregulation Among Treatment-Seeking Smokers.

Nicotine replacement therapy (NRT) significantly increases the likelihood of quit success at least over the short term, yet some smokers prematurely discontinue use. NRT side effects are often cited as the primary reason for medication discontinuation. The current study examined a theoretical pathway by which two smoking-related emotional vulnerabilities (anxiety sensitivity and emotion dysregulation) were related to the number of NRT (nicotine patch) side effects reported 1 week following a scheduled quit attempt. It was hypothesized that anxiety sensitivity would have an indirect effect on NRT side effects through emotion dysregulation. A total of 179 treatment-seeking, adult daily smokers with elevated anxiety sensitivity (47.5% male; M age = 39.73 years, SD = 13.87) were enrolled in a smoking cessation trial. Covariate-adjusted analyses provided support for the hypothesized pathway, such that emotion dysregulation explained the association between anxiety sensitivity and NRT side effects (b = 0.02, SE = 0.01, 95% CI [0.002, 0.03]; completely standardized estimate = .15). The findings underscore the importance of developing cessation treatments that incorporate techniques to enhance emotion regulation, particularly among smokers higher in anxiety sensitivity, to decrease the risk of NRT side effects.

Choir singing and creative writing enhance emotion regulation in adults with chronic mental health conditions.

Adults with mental health conditions commonly experience difficulties with emotion regulation which affect their social functioning. Arts-based groups provide opportunities for shared emotional experiences and emotion regulation. This study explores emotion regulation strategies and the emotional effects of arts-based group participation in adults with mental health problems and in controls. The 62 participants included 39 adults with chronic mental health problems who were members of arts-based groups (ABG) and 23 comparison choir (CC) members who were not specifically experiencing mental health problems. The repeated measures design included self-reports of emotion upon waking (T1), the hour before group (T2), end of the group (T3), and evening (T4), as well as participant notes to explain their emotion ratings at each time. They also completed measures of individual and interpersonal emotion regulation. The ABG participants engaged marginally more in affect worsening strategies than CC (p=.057 and .08), but there were no other group differences. All participants reported a significant increase in positive emotions, F (3, 180)=28.044, p<.001, np2=.319; and a decrease in negative emotions during the arts-based activity: F (2.637, 155.597)=21.09, p<.001, np2=.263. The influence on positive emotions was short-lived, while the effect on negative emotions lasted until evening. Findings show that participation in arts-based groups benefits the emotions of both healthy adults and those experiencing mental health conditions through individual and interpersonal processes. Individuals with chronic mental health conditions often experience difficulties in emotion processing Participation in arts-based groups was associated with significant increases in positive emotions although these were short-lived Negative emotion was significantly decreased during arts-based group activities, and sustained to the evening assessment Adults with chronic mental health conditions were equally able to derive emotional benefits as healthy adults.

A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.

Individual and group‐based psychotherapeutic interventions increasingly incorporate mindfulness‐based principles and practices. These practices include a versatile set of skills such as labeling and attending to present‐moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy. This paper describes the benefits of mindfulness‐based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family‐based mindfulness intervention might be evaluated.

Increased Support for Political Compromise in the Israeli-Palestinian Conflict Following an 8-Week Mindfulness Workshop

Mindfulness training has been shown to have a beneficial impact on emotions and perceptions. We examined whether it would reduce negative emotions and perceptions and lead to increased support for compromise in the context of prolonged intergroup conflict. We also examined the effect of an intervention that combines mindfulness with cognitive reappraisal, a method that enhances emotion regulation. Israeli students participated in a mindfulness course that either began in the winter semester (mindfulness group) or in the spring semester (control group). After the termination of the mindfulness course, all participants were invited to a laboratory session in which they were randomly assigned to either receive or not a short cognitive reappraisal training. The results showed that after being presented with anger-inducing information related to the Israeli-Palestinian conflict, participants in the mindfulness condition only, the reappraisal condition only or the combined group (mindfulness and reappraisal), were more supportive of conciliatory policies compared to participants that received no mindfulness nor reappraisal training. The increased support for conciliatory policies was mediated by a decrease in negative emotions in all groups, while in the mindfulness group, it was also mediated by reduction in negative perceptions. The combined impact of mindfulness and reappraisal did not reveal any additional effect.

A pilot study evaluation of psychosocial competency training for junior physicians working in oncology and hematology.

This pilot and feasibility study evaluated a work-related self-care competency training in oncology and hematology medicine for junior physicians working in oncology and hematology medicine. A pilot study was conducted with 80 physicians working in oncology and hematology hospital departments in Germany. Physicians were distributed to either the intervention group receiving competency training or a comparison group. The intervention took place in groups over a period of 12weeks. Training content included work-related self-care strategies, problem-solving techniques solution-focused counselling. The outcomes studied were changes in work-related stress, emotional exhaustion, emotion regulation, and job satisfaction. Follow-up assessments were arranged after 12weeks (T1), after 24weeks (T2), and after 36weeks (T3). Intervention group reached a decrease in perceived job stress and emotional exhaustion. Self-perceived improvements were also obvious regarding enhanced emotion regulation skills. Future oncologists valued the intervention with high scores for training design, content, received outcome, and overall training satisfaction. This study provided first indications that an innovative self-care competency training might be a supportive approach for junior physicians starting work in oncology and hematology. However, replication studies are needed to verify the results in the medical working context.

Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges.

The main purpose of this review was to critically evaluate the literature on psychotherapies for borderline personality disorder (BPD) published over the past 5years to identify the progress with remaining challenges and to determine priority areas for future research. A systematic review of the literature over the last 5years was undertaken. The review yielded 184 relevant abstracts, and after applying inclusion criteria, 16 articles were fully reviewed based on the articles' implications for future research and/or clinical practice. Our review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes.

A Qualitative Exploration of an Eight-Week Mindful Parenting Program for Parents

Mindful parenting is a relatively new extension of mindfulness and is beneficial for the well-being of both parents and their children. In this study, an eight-week mindful parenting program was conducted in a Hong Kong community. The qualitative method was adopted to explore how the program could benefit parents with stress and parenting problems. Six participants were included in the interviews. Analysis of the qualitative data suggested four themes: enhanced emotion regulation, more compassion, positive changes in the parent-child relationship, and home practice consistency and obstacles. The practical implications of the mindful parenting program to improve parents’ emotion regulation and parent-child relationships are addressed. The limitations of this study and future research directions are also discussed.

‘I can’t accept that feeling’: Relationships between interoceptive awareness, mindfulness and eating disorder symptoms in females with, and at-risk of an eating disorder

Mindfulness based therapies (MBTs) for eating disorders show potential benefit for outcomes yet evidence is scarce regarding the mechanisms by which they influence remission from symptoms. One way that mindfulness approaches create positive outcomes is through enhancement of emotion regulation skills. Maladaptive emotion regulation is a key psychological feature of all eating disorders. The aim of the current study was to identify facets of emotion regulation involved in the relationship between mindfulness and maladaptive eating behaviours. In three cross-sectional studies, clinical (n=39) and non-clinical (n=137 and 119) female participants completed: 1) the Eating Disorder Inventory (EDI) eating specific scales (drive-for-thinness and bulimia) and the EDI psychological symptom scales (emotion dysregulation and interoceptive deficits); and 2) mindfulness, impulsivity, and emotion regulation questionnaires. In all samples mindfulness was significantly and inversely associated with EDI eating and psychological symptom scales, and impulsivity. In non-clinical samples interoceptive deficits mediated the relationship between mindfulness and EDI eating specific scales. Non-acceptance of emotional experience, a facet of interoceptive awareness, mediated the relationship between mindfulness and eating specific EDI scores. Further investigations could verify relationships identified so that mindfulness based approaches can be optimised to enhance emotion regulation skills in sufferers, and those at-risk, of eating disorders.

Overcome procrastination: Enhancing emotion regulation skills reduce procrastination

Procrastination is a widespread phenomenon that affects performance in various life domains including academic performance. Recently, it has been argued that procrastination can be conceptualized as a dysfunctional response to undesired affective states. Thus, we aimed to test the hypothesis that the availability of adaptive emotion regulation (ER) skills prevents procrastination.In a first study, cross-sectional analyses indicated that ER skills and procrastination were associated and that these connections were mediated by the ability to tolerate aversive emotions. In a second study, cross lagged panel analyses showed that (1) the ability to modify aversive emotions reduced subsequent procrastination and that (2) procrastination affected the subsequent ability to tolerate aversive emotions. Finally, in a third study, a two-arm randomized control trial (RCT) was conducted. Results indicated that systematic training of the ER skills tolerate and modify aversive emotions reduced procrastination. Thus, in order to overcome procrastination, emotion-focused strategies should be considered.

Pilot Study.

A significant proportion of youth engage in health risk behaviors, which are of concern, as they are associated with adverse health consequences across development. Two factors associated with engagement in such behaviors are emotion dysregulation and impulsivity. Dialectical behavioral therapy (DBT) is an effective intervention that enhances emotion regulation skills to reduce problem behaviors among adolescent populations; however, limited research has been conducted implementing the program within school settings. The current study was a 9-week DBT skills group conducted among 80 middle school youth, with pre-posttest data among 53 students. Findings indicated feasibility to implement the program in schools and preliminary evidence of efficacy in decreasing youth's likelihood to engage in risky, particularly among youth high on an emotion-based impulsivity trait. Brief DBT skills group may be an effective program to be utilized by school nurses and health-care teams to reduce health risk behaviors among school-aged youth.