Poor Emotional Awareness Research Articles

What is the relationship between alexithymia and experiential avoidance? A latent analysis using three alexithymia questionnaires

Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns. Individuals with high alexithymia tend to engage in experiential avoidance and this may mediate psychological distress. However, little is known about what specific processes of experiential avoidance are involved, and the nature of the relation between alexithymia, experiential avoidance, and psychological distress remains unclear at a latent construct level. To examine this relationship at the latent construct level, a representative sample of 693 U.S. adults completed alexithymia (TAS-20, BVAQ, PAQ), general distress (DASS-21), multi-dimensional experiential avoidance (MEAQ), and general health (PROMIS-G-10) questionnaires. Structural equation modeling revealed that alexithymia significantly predicted experiential avoidance (β = 0.966, t = 82.383, p < .01), experiential avoidance significantly predicted general distress (β = 0.810, t = 2.017, p < .05), and experiential avoidance fully mediated the relationship between alexithymia and general distress (βindirect = −0.159, t = −0.398, p > .05). Correlations between alexithymia and experiential avoidance subfactors revealed a strong relationship to the repression and denial subfactor. Experiential avoidance is a promising target for clinical interventions, though longitudinal research is necessary to elucidate how the relationship between alexithymia and experiential avoidance unfolds over time.

Developmental trajectories of anger and sadness dysregulation in childhood differentially predict later borderline symptoms.

Difficulties with emotion regulation are integral to borderline personality disorder (BPD) and its hypothesized developmental pathway. Here, we prospectively assess trajectories of emotion processing across childhood, how BPD symptoms impact these trajectories, and whether developmental changes are transdiagnostic or specific to BPD, as major depressive (MDD) and conduct disorders (CD) are also characterized by emotion regulation difficulties. This study included 187 children enriched for those with early symptoms of depression and disruptive behaviors from a longitudinal study. We created multilevel models of multiple components of emotional processing from mean ages 9.05 to 18.55 years, and assessed the effect of late adolescent BPD, MDD, and CD symptoms on these trajectories. Linear trajectories of coping with sadness and anger, and quadratic trajectories of dysregulated expressions of sadness and anger were transdiagnostic, but also exhibited independent relationships with BPD symptoms. Only inhibition of sadness was related to BPD symptoms. The quadratic trajectories of poor emotional awareness and emotional reluctance were also independently related to BPD. Findings support examining separable components of emotion processing across development as potential precursors to BPD, underscoring the importance of understanding these trajectories as not only a marker of potential risk but also potential targets for prevention and intervention.

THE MODERATOR ROLE OF DIFFICULTIES OF EMOTIONAL REGULATION IN THE RELATIONSHIP BETWEEN AGE AND THE INTENSITY OF POSITIVE EMOTIONS

Objectives. Identifying aspects of the difficulties of emotional regulation (awareness and understanding of emotions, acceptance of emotions, the ability to control impulsive behavior and be in line with the desired goals in terms of negative experiences and the ability to flexibly use emotional regulation strategies in similar situations to correctly modulate emotional responses) and the force with which positive emotional experiences are lived in adolescence. Material and methods. The sample of this study was made up of 427 students aged between 15 and 18 years (Mage = 16.35, SD = .93), 136 male (Mage = 16.38, SD = .95), from which data have been collected by applying questionnaires aimed at self-reporting to different emotional situations using Difficulties in Emotion Regulation Scale (DERS) and Revised Emotional Intensity Scale (EIS-R). Results. The results shows the effect of the predictor (age) on the dependent variable (the intensity of positive emotions) at different levels of the moderator (average, low and high). Five of the six dimensions of emotional disorder have a moderator effect between age and the intensity of positive emotions (respectively: non-acceptance of emotional responses, difficulty in achieving objectiveoriented behaviors, limited access to emotional regulation strategies, lack of emotional clarity and difficulty in controlling impulse). Poor emotional awareness is the difficulty of emotional regulation that does not moderate the relationship. Conclusions. The results of the study emphasize those strategies of emotional regulation that specialists interested in developing in any programs or psychotherapeutic intervention techniques to consider with regard to adolescents. Keywords: adolescence, emotion regulation, intensity of positive emotions, age.

Alexithymia and aggressiveness in old age: Mediation by impulsivity and emotion dysregulation

Aggressiveness is prevalent in old age, and to adapt treatments and diminish the accompanying damage to the self and others, it is important to understand aggressiveness predictors. Poor emotional awareness, impulsivity, and emotion dysregulation are potential mechanisms influencing aggressiveness. The present study examines whether alexithymia, emotion dysregulation, and impulsivity influence aggressiveness in older adults; and whether the effect of alexithymia is conditioned by emotional dysregulation and impulsivity after controlling for probable confounders. The sample consisted of 326 Portuguese older adults (63.2% female) aged 60-96 years from residential care homes and the community. Participants completed report instruments measuring alexithymia, emotional dysregulation, impulsivity, and aggressiveness. Results of the mediation analysis showed that older adults who had more alexithymia tended to report higher levels of emotional dysregulation and impulsivity, which in turn accounted for higher reported aggressiveness. All these effects were independent of cognitive functioning and depressive symptoms. This study suggests the relevance of evaluating and intervening on alexithymia, impulsivity, and emotion dysregulation to reducing aggressiveness in older people.

The Bifactor Structure of the Emotion Expression Scale for Children in a Sample of School-Aged Portuguese Children.

The Emotion Expression Scale for Children (EESC) is a 16-item self-report questionnaire assessing children's difficulties in emotion expression (i.e., poor emotion awareness and reluctance to express emotions). Considering the inconsistent findings regarding its factorial structure and dimensionality, this study aims to explore the factor structure and psychometric properties of the EESC in a sample of 286 Portuguese children (8-12 years). Three competing models were analyzed through confirmatory factor analysis (correlated two-factor model, one-factor model, and bifactor model). The bifactor model provided a better fit than the competing models, and the results suggested a strong general factor of "difficulties in emotion expression." The validity of the EESC was also indicated by its positive correlations with variables assessing child anxiety, depression, and behavioral avoidance and its negative correlation with mindfulness skills. The EESC is a valid measure of children's difficulties in emotion expression and the use of its total score is recommended.

Emotion regulation abilities as a predictor of anxiety, positive emotions, heart rate, and alpha asymmetry during an impromptu speech task

ABSTRACT Background and Objectives Recent approaches suggest that emotion regulation (ER) abilities represent potential predictors of emotional response among youths navigating stressful situations. To test this, we investigated whether ER abilities predicted the subjective and physiological emotional response experienced by youths during a stressful situation. Design A cross-sectional design was employed. Method One hundred and thirty-four youths completed measures of ER abilities (emotional awareness, anxiety sensitivity, emotional control) and were asked to deliver a speech while their anxiety, positive emotions, heart rate, and alpha asymmetry were collected at four time points: baseline, anticipation, speech, and post-recovery. Results Pearson r correlations showed that poor emotional control and awareness, as well as high anxiety sensitivity were related to greater anxiety and lower positive emotions experienced during the speech. Hierarchical multiple regressions also revealed that emotional control and emotional awareness predicted greater speech anxiety and lower positive emotions. Moreover, anxiety sensitivity was related to and predicted an increased heart rate experienced during speech. Conclusions Findings suggest that difficulties in emotional awareness, anxiety sensitivity, and emotional control predict the emotional response experienced by youths during a stressful situation. Interventions delivered by clinicians/teachers that target ER difficulties may be effective in improving emotional functioning when navigating stressful situations.

Co-Rumination Moderates the Relation between Emotional Competencies and Depressive Symptoms in Adolescents: a Longitudinal Examination.

Research suggests co-rumination during adolescence has developmental tradeoffs that result in elevated self-disclosure and intimacy between friends but also can be associated with increases in depression (Rose et al. 2007; Rose 2002). The current study further examined this paradox by assessing the role of emotional competencies in co-rumination as they predict depressive symptoms over a 2-year period. We tested whether co-rumination moderated the relation between emotional awareness and emotion regulation and depressive symptoms in reciprocated best friend dyads. At Time 1, 202 adolescents (101 same-sex best friend dyads; Mage = 12.68, 52.5% girls, 76.6% White, middle-class) reported on their emotional competencies (i.e., emotional awareness and perceptions of their friend's anger and sadness regulation), and depressive symptoms as well as engaged in a discussion task where co-rumination was observed. Multilevel modeling (Actor-Partner Interdependence Modeling) was used to account for similarity within friend dyads. The results indicated that when girls engaged in high levels of co-rumination, poor emotional awareness was related to greater depressive symptoms in their friend. Regarding the analyses of emotion regulation, at high levels of co-rumination, Friend A's perceptions of stronger anger regulation by Friend B predicted fewer depressive symptoms in Friend A. Stronger sadness regulation in Friend B at high levels of co-rumination predicted fewer depressive symptoms in Friend B. Our findings highlight the potentially adaptive nature of emotional competencies that may ameliorate the negative sequelae of co-rumination as adolescents are afforded the opportunity to discuss problems, better understand their emotions, skills that are then associated with fewer depressive symptoms over time.

Emotionality and temperament in attention deficit disorder with or without hyperactivity

Those who suffer from attention deficit disorder with or without hyperactivity (ADHD) find it difficult to direct their emotions in order to solve challenges or problems. This alteration in emotional self-regulation implies greater disability than that attributed to the traditional dimensions -attention deficit and hyperactivity- with an evident impact on the development of personality. To review how the confluence of poor self-regulatory skills, emotion awareness and autonomy, and a particular temperament profile increase the risk of children diagnosed with ADHD for the development of a range of adjustment problems in childhood and adolescence. The typical temperamental profile of children with ADHD is characterised by high emotional reactivity and poor self-regulatory skills. The effects of the interaction of emotionality and temperament in ADHD can be either direct on the child himself or indirect on the environment, interactional by fitting or mismatch with environmental expectations, and transactional due to their dynamic relation with other characteristics in the child's environment. The confluence of poor self-regulation skills, emotion awareness and autonomy, and a temperament profile with a higher novelty seeking and lower persistence increase the risk of children diagnosed with ADHD for the development of a series of adjustment and adaptation problems in childhood and adolescence.

Relationship between Pain, Somatisation, and Emotional Awareness in Primary School Children.

Poor emotional awareness (EA) seems to play an important role in the aetiology of functional somatic complaints featuring pain as a form of somatisation. The aim of this study was to shed more light on this relationship by investigating the links between pain, somatisation, and emotional awareness in a nonclinical population of 445 children aged 6–10. Assessing pain through the Children's Somatisation Inventory (CSI), a very high percentage of the entire sample complained of experiencing pain at least one site (84.07%) over the preceding 2 weeks. Although no difference in the prevalence of pain (whole) was found when the sample was subdivided by Levels of Emotional Awareness Scale-Children (LEAS-C), a relationship between low level of LEAS-Self and prevalence of headache (H) was detected (χ2=7.69, p=0.02). LEAS (Self) was correlated with the intensity of back pain (BP) (r=-0.12; p< 0.05), H (r=-0.12; p< 0.05) but not with abdominal pain (AP). Pain worsened QoL, and the greatest negative correlation with total KidScreen-10 was found for abdominal pain (r=-0.14; p< 0.01). Our results suggest that low EA is a predictor of somatisation, BP severity, H, and severity of pain in general, but not AP.

Metacognition, emotional functioning and binge eating in adolescence: the moderation role of need to control thoughts.

Binge eating is predicted by emotion dysregulation and poor emotional awareness. Dysfunctional metacognition is also implied in several eating disorders, but research has not yet investigated the interactions among emotional and metacognitive processes involved in binge eating. The present study investigated the relation between metacognition and binge eating in a sample of adolescents, testing the interaction effect between the need to control thoughts and thelack of emotional awareness on binge eating. Participants were 804 adolescents (age range 15-20; 49.7% female), who completed self-report instruments assessing binge eating, emotion regulation, and metacognition. Binge eating was predicted by gender, BMI, emotion dysregulation, lack of emotional awareness, and dysfunctional metacognition dimensions (cognitive confidence and need to control thoughts). An important moderating effect was found, whereby the relationship between binge eating and lack of emotional awareness was only significant for individuals with a high need to control thoughts. Results described emotional and metacognitive functioning in binge eating adolescents, suggesting that the need to control thoughts is a risk factor, whereas good metacognitive competencies are protective from binge eating, even in presence of poor emotional awareness. Level V, cross-sectional descriptive study.

Culture Specific Influences on Anxiety in Latino Youth

Accumulating evidence indicates that Latino children and adolescents are at risk for higher anxiety relative to youth of other ethnicities. However, to date, very little research has been conducted to examine culture specific mechanisms of anxiety in Latino youth. This study explored whether strict adherence to Latino cultural values emphasizing maintenance of group harmony, familismo and simpatia, in combination with poor awareness and identification of negative emotions predicts increased anxiety among Latino youth. Familismo, simpatia, poor emotion awareness, and anxiety were measured in a mixed clinically anxious (n = 27) and non-clinical (n = 20) sample of 7–13 year-old Latino children. Anxiety was measured through self-report and mother report. Two way interactions between familismo and simpatia, and between poor emotion awareness and simpatia predicted anxiety level. Graphs of the interactions indicated that the combination of high levels of each variable was associated with the highest levels of child-reported anxiety, while high familismo in the context of low simpatia was associated with low anxiety levels per child and parent report. In contrast, low simpatia in the context of poor emotion awareness was associated with low mother-reported child anxiety. Strict adherence to cultural values emphasizing family cohesion and positive interdependent social experiences in combination with poor emotion awareness are linked to anxiety in Latino youth.

Emotion dysregulation and eating disorders-Associations with diagnostic presentation and key symptoms.

Emotion dysregulation seems involved in the development, maintenance, and outcome of eating disorders (EDs). The present study aimed to differentiate patients with EDs from a comparison group on emotion dysregulation, and to examine emotion dysregulation in relation to ED diagnostic presentation and ED symptoms. Participants, patients with EDs (N = 999) and a student comparison group (N = 252), completed the Difficulties in Emotion Regulation Scale and the Eating Disorder Examination Questionnaire. Patients were compared to the comparison group and compared by diagnosis regarding emotion dysregulation, and unique associations between emotion dysregulation aspects and ED symptoms were examined. Patients reported greater general emotion dysregulation than the comparison group, especially poorer emotional awareness and clarity. There were very few diagnostic differences. In both patients and the comparison group, limited access to emotion regulation strategies was associated with cognitive ED symptoms, and presence of binge eating in the comparison group. In patients, poor emotional awareness and emotional non-acceptance were additionally associated with cognitive symptoms, and difficulties in impulse control and emotional non-acceptance were associated with binge eating. Emotion dysregulation is an important transdiagnostic characteristic of ED. Results suggest interventions that enhance emotional awareness and acceptance, as well as emotion regulation skills training, in both ED treatment and prevention.

Emotion awareness and somatic complaints in preadolescence: The mediating role of coping strategies

AbstractSomatic complaints are frequent among preadolescents with impaired emotion awareness and maladaptive coping strategies. In addition, coping strategies in response to stressful events have been suggested to affect the association between emotion awareness and somatic complaints. However, empirical support for this assumption is missing. In this study, we examined the extent to which emotion awareness and coping contributed uniquely to somatic complaints and the indirect effect of emotion awareness on somatic complaints through coping strategies, among preadolescent boys and girls. Self‐reports were administered to 265 preadolescents (137 boys; Mage = 12.04) to investigate somatic complaints, emotion awareness, and coping strategies to deal with peer victimization. A subsample (N = 97) was assessed after a 12‐month time‐span. Cross‐sectional results indicated that more somatic complaints were associated with less emotion awareness and problem‐solving and with more internalizing and externalizing coping. Poor emotion awareness was indirectly associated with somatic complaints through internalizing for boys and through distraction, externalizing, and internalizing for girls. Emotion awareness was longitudinally associated with somatic complaints through distraction for boys. Overall, findings suggested that less emotion awareness was associated with more maladaptive coping strategies, which in turn contributed to more somatic complaints. Implications for research and intervention are discussed.Highlights The present study investigated the associations between somatic complaints, emotion awareness, and coping strategies among preadolescent boys and girls. Self‐report data were collected. Results showed that poor emotion awareness was indirectly associated with somatic complaints through internalizing for boys and through distraction, externalizing, and internalizing for girls. Improving emotion awareness and effective coping strategies may reduce somatic complaints among preadolescents and offer them a better social and psychological adjustment.

Clinical Factors Influencing Quality of Life in Anorexia Nervosa Patients

Objective: The purpose of this study was to elucidate clinical factors influencing quality of life (QOL) in anorexia nervosa (AN) patients. Methods: Twenty female patients with AN (median age = 30.0 years, quartile deviation = 6.8) and forty female healthy controls (HC) (median age = 30.0 years, quartile deviation = 8.6) participated in the study. QOL was assessed with the 36-Item Short Form Health Survey (SF-36) and social support was evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS). Clinical symptoms were evaluated with the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) and the Eating Disorder Inventory-2 (EDI-2). Results: Scores of the SF-36 Mental Component Summary (MCS) (U = 124.0, P U = 223.0, P = 0.006) and scores of total (U = 108.0, P U = 46.0, P ρ = −0.565, P ρ = −0.556, P ρ = −0.581, P ρ = −0.617, P ρ = −0.672, P Conclusion: These results suggest that among a variety of clinical symptoms and psychopathologies, depressive symptoms, poor emotional awareness and impaired sense of control are the most important influencing factors on AN patients’ QOL.

Association Between Early Life Adversity and Risk for Poor Emotional and Physical Health in Adolescence

Adverse childhood experiences (ACEs) have been associated with poor mental and physical health outcomes. However, the mechanism of this effect, critical to enhancing public health, remains poorly understood. To investigate the neurodevelopmental trajectory of the association between early ACEs and adolescent general and emotional health outcomes. A prospective longitudinal study that began when patients were aged 3 to 6 years who underwent neuroimaging later at ages 7 to 12 years and whose mental and physical health outcomes were observed at ages 9 to 15 years. Sequential mediation models were used to investigate associations between early ACEs and brain structure, emotion development, and health outcomes longitudinally. Children were recruited from an academic medical center research unit. Early life adversity. Early ACEs in children aged 3 to 7 years; volume of a subregion of the prefrontal cortex, the inferior frontal gyrus, in children aged 6 to 12 years; and emotional awareness, depression severity, and general health outcomes in children and adolescents aged 9 to 15 years. The mean (SD) age of 119 patients was 9.65 (1.31) years at the time of scan. The mean (SD) ACE score was 5.44 (3.46). The mean (SD) depression severity scores were 2.61 (1.78) at preschool, 1.77 (1.58) at time 2, and 2.16 (1.64) at time 3. The mean (SD) global physical health scores at time 2 and time 3 were 0.30 (0.38) and 0.33 (0.42), respectively. Sequential mediation in the association between high early ACEs and emotional and physical health outcomes were found. Smaller inferior frontal gyrus volumes and poor emotional awareness sequentially mediated the association between early ACEs and poor general health (model parameter estimate = 0.002; 95% CI, 0.0002-0.056) and higher depression severity (model parameter estimate = 0.007; 95% CI, 0.001-0.021) in adolescence. An increase from 0 to 3 early ACEs was associated with 15% and 25% increases in depression severity and physical health problems, respectively. Study findings highlight 1 putative neurodevelopmental mechanism by which the association between early ACEs and later poor mental and physical health outcomes may operate. This identified risk trajectory may be useful to target preventive interventions.

Profiles of Emotion Deficits and Adolescent Nonsuicidal Self-Injury in an Inpatient Sample.

This study examined profiles of specific emotion deficits, including poor emotion awareness, reluctance to express emotion, sadness inhibition and dysregulation, and anger inhibition and dysregulation. Self-report questionnaires assessed adolescents' emotion skills and nonsuicidal self-injury (NSSI) engagement, frequency, severity, methods, and age of onset. Latent profile analysis yielded a three-profile solution: Low Deficit (LD; n=49), Unaware/Anger Dysregulated (UAD; n=24), and Anger Inhibited (AI; n=20) profiles. Adolescents in the UAD profile were more likely to engage in NSSI, displayed a higher NSSI frequency, and reported a higher number of NSSI methods when compared to adolescents in the LD profile. No links emerged for NSSI severity or age of onset.

Alexithymia, emotion dysregulation, impulsivity and aggression: A multiple mediation model

There is a need to better understand the antecedent of aggressive behaviors in order to tailor treatments and reduce the associated damage to the others and the self. Possible mechanisms underlying aggression are poor emotional awareness and emotion dysregulation, as well as impulsivity. Here, we examined the relationships among alexithymia, emotion dysregulation, impulsivity and aggression, comparing a mixed psychiatric sample (N=257) and a community sample (N=617). The clinical sample reported greater levels of alexithymia, emotion dysregulation, trait impulsivity and aggression, than the community sample. Furthermore, in the community sample, emotion dysregulation and impulsivity mediated the relationship (i.e., accounted for the shared variance) between alexithymia and aggression. In the clinical sample, only emotion dysregulation explained the alexithymia-aggression link. In particular, specific dimensions of the emotion dysregulation (i.e., Negative Urgency) and impulsivity constructs (i.e., cognitive and motor impulsivity) played a unique role in explaining these associations. Finally, controlling for depressive symptoms reduced some of the findings involving impulsivity to nonsignificant results. Overall, our findings add to the extant literature attesting to the relevance of alexithymia and emotion dysregulation for understanding aggression, and providing concrete recommendation for the treatment and prevention of aggressive tendencies.

Borderline personality disorders: the central role of emotional dysregulation

Emotional dysregulation is considered as a core feature of borderline personality disorders. Emotional dysregulation can express itself both as emotional instability (i.e. an inability to modulate affects than can become uncontrolled) or in terms of poor emotional awareness (i.e. emotional numbing, alexithymic features). Whereas the first dimension is closely related to symptoms, such as impulsivity, suicidal behaviours or inappropriate anger, the latter can be associated with dissociative experiences and chronic feeling of emptiness. Although both dimensions have been related to negative experiences during childhood, however, little is known about the specific developmental pathways leading to emotional instability or emotional awareness in borderline adolescents. In this presentation, we will show some data concerning the specific traumatic pathways observed in a sample of borderline adolescents issued from the European Network on borderline personality disorders.

The Relation of Poor Emotional Awareness and Externalizing Behavior Among Children With ADHD

Objective: Children with ADHD often demonstrate poor emotional self-awareness and higher levels of externalizing behavior problems relative to unaffected children. This study examined the relation of deficient emotional self-awareness to externalizing behavior problems in children with ADHD, and the role of emotional reactivity in this relationship. Method: Fifty-one 8- to 12-year-old children with ADHD and their parents completed measures of the children’s emotional and behavioral functioning, as well as a diagnostic structured interview. Results: Logistic regression suggested that more impaired emotional self-awareness was strongly associated with the diagnosis of a comorbid externalizing disorder. Hierarchical regression analyses strongly supported the relation of poor emotional awareness to reactivity-driven externalizing behavior, but not to proactive externalizing behavior. These effects were evident across reporters. Conclusion: This study suggested that poor emotional self-awareness is significantly linked to externalizing problems in children with ADHD, and that dysregulated emotional reactivity plays an important role in this relationship.

Mother–child attachment, emotion regulation, and anxiety symptoms in middle childhood

This study examined whether the relation of mother–child attachment with anxiety symptoms is mediated by emotion regulation (ER) processes (poor emotional awareness, biased interpretations of emotionally charged events, and coping strategies). Attachment patterns were assessed in a sample of eighty‐seven 10‐ to 12‐year‐olds using story‐stem interviews. Children who were less secure and more disorganized reported more anxiety. Attachment was also related to ER; security was associated with less difficulty identifying emotions, and disorganization was associated with more catastrophizing interpretations and less active coping. Anxiety symptoms were related to all three ER processes. Finally, relations of security or disorganization with anxiety symptoms were partially mediated by ER processes.