Negative Affect Reduction Research Articles

The role of the personal relevance of images in retrieving autobiographical memories for emotion regulation: A randomized controlled trial study

Little is known about what types of positive specific autobiographical memory-inducing images are most effective in regulating emotions. This study analyses the effectiveness of personal relevance of images associated with specific positive autobiographical memories as a method of emotional regulation. The sample comprised 263 participants (179 women), divided into a group of young adults (N = 139) aged 18–28 years and a group of older persons (N = 124) aged 65 years and over. In a randomized controlled trial study, participants were randomly assigned to three experimental conditions based on the type of image used (images of International Affective Picture System (IAPS), images of places and personal photographs). Negative mood was induced by viewing a film clip. Positive mood induction was subsequently conducted through the presentation of six images (according to the group) associated with specific positive autobiographical memories. Changes in mood state were measured using the Positive and Negative Affect Schedule (PANAS) before and after each induction. SPSS 28.0 (IBM) statistical software was used for the data analysis. The positive mood induction procedure repaired participants’ mood state, increasing positive affect and decreasing negative affect. The older adults showed a greater increase in positive affect while their younger counterparts recorded a greater decrease in negative affect. The three types of images were equally effective in augmenting positive affect. Regarding the reduction in negative affect, the personal photographs scored highest in the group of young adults, while, in the older group, the IAPS images were the most effective. The findings of this study show that using images associated with positive specific autobiographical memories is an effective mood induction method. Consequently, the use of such images might be effective in interventions designed to enhance emotion regulation and reduce depressive symptomatology.

The effectiveness of peer support from a person with lived experience of mental health challenges for young people with anxiety and depression: a systematic review

BackgroundPeer workers support individuals experiencing mental health challenges by drawing on their shared lived experience. Peer support has become increasingly popular for young people with anxiety and depression, but the evidence base is unclear. This systematic review aimed to understand the effectiveness of peer support for youth depression and anxiety (either primary or comorbid), and to understand in which contexts, for whom, and why peer support works.MethodsA systematic search was conducted with the Orygen Evidence Finder, Embase, MEDLINE, and PsycInfo from January 1980 to July 2022. Controlled trials of interventions to improve mental health in young people (mean age 14–24), delivered by a peer worker with lived experienced of mental health challenges were included. Outcomes related to depression or anxiety were extracted and descriptive synthesis was undertaken due to the heterogeneity of studies. Study quality was rated using the Critical Appraisal Skills Programme; reporting adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.ResultsNine randomised controlled trials with 2,003 participants were included, with seven undertaken in high income countries. One targeted depression and anxiety, two stigma-distress (any mental disorder), one first episode psychosis, four studies preventing eating disorders and one drug misuse. One study successfully reduced anxiety and depression, another reduced depression only, four reported reductions in negative affect, with the final three measuring, but not having a significant impact on depression. Study quality was rated as ‘good’ overall.DiscussionDespite the uptake of youth peer support globally, there is limited evidence from controlled trials of the effect of peer support-related interventions on anxiety and depression. There is some effect on negative affect, especially for university students. Further rigorously designed trials of peer delivered interventions for young people need to be conducted with a focus on understanding the mechanisms of action underpinning peer support.

Predictors of Pain Reduction Among Fibromyalgia Patients Using Medical Cannabis: A Long-Term Prospective Cohort Study.

Many patients with fibromyalgia (FM) report using cannabis as a strategy to improve pain. Given that pain often co-occurs with symptoms of anxiety and depression (i.e., negative affect) and sleep problems among patients with FM, improvements in these symptoms might indirectly contribute to reductions in pain intensity following cannabis use. The main objective of the study was to examine whether changes in pain intensity following initiation of medical cannabis among patients with FM could be attributed to concurrent changes (i.e., reductions) in negative affect and sleep problems. This was a 12-month prospective cohort study among patients with FM (n=323) initiating medical cannabis under the care of physicians. Patients were assessed at baseline, and follow-up assessment visits occurred every 3 months after initiation of medical cannabis. Patients' levels of pain intensity, negative affect, and sleep problems were assessed across all visits. Multilevel mediation analyses indicated that reductions in patients' levels of pain intensity were partly explained by concurrent reductions in sleep problems and negative affect (both P < 0.001). This remained significant even when accounting for patients' baseline characteristics or changes in medical cannabis directives over time (all P > 0.05). Our findings provide preliminary insight into the potential mechanisms of action underlying pain reductions among patients with FM who are using medical cannabis. Given the high attrition rate (i.e., 75%) observed in the present study at 12 months, our findings cannot be generalized to all patients with FM who are using medical cannabis.

Effects of Acute Exercise on Affect, Anxiety, and Self-Esteem in Poly-Substance Dependent Inpatients

Introduction: Negative affect and anxiety frequently precede the onset of drug use in those with substance use disorder (SUD). Low self-esteem may increase the risk of relapse. We examined the short-term effects of exercise on affect, anxiety, and self-esteem in inpatients with poly-SUD. Methods: This is a multicenter randomized control trial (RCT) with a crossover design. Thirty-eight inpatients (37.3 ± 6.4 years; 84% male) from three clinics participated in 45 min of soccer, circuit training, and control condition (psychoeducation) in a random order. Positive and negative affect (PANAS), state anxiety (single item), and self-esteem (Rosenberg SE-scale) were measured immediately before, immediately after, 1-h, 2-h, and 4-h post-exercise. Heart rate and ratings of perceived exertion were taken. Effects were assessed using linear mixed effects models. Results: Compared to the control condition, there were significant post-exercise improvements in positive affect (β = 2.99, CI = 0.39: 5.58), self-esteem (β = 1.84, CI = 0.49: 3.20), and anxiety (β = −0.69, CI = −1.34: −0.04) after circuit training (shown) and soccer. Effects persisted 4-h post-exercise. Reductions in negative affect were observed 2-h (circuit training: β = −3.39, CI = −6.35: −1.51) and 4-h (soccer: β = −3.71, CI = −6.03: −1.39) post-exercise, respectively. Conclusion: Moderately strenuous exercise undertaken in naturalistic settings may improve mental health symptoms in poly-SUD inpatients for up to 4-h post-exercise.

Anxiety sensitivity and reasons for smoking among Black smokers

Black smokers demonstrate higher nicotine dependence and experience higher rates of smoking-related diseases and mortality relative to European American/White smokers. A potential factor relevant to race-specific smoking health disparities may be smoking motives (i.e., motivational basis of smoking). Yet, little research has been conducted to understand psychological factors that may be associated with specific smoking motives among Black smokers. To address this gap in the literature, the current study explored the association between anxiety sensitivity and smoking motives within a subset sample of Black smokers who were interested in participating in a smoking cessation trial (N = 105; 70.5 % male; Mage = 44.8 years, SD = 11.6 years). Hierarchical regression analyses indicated anxiety sensitivity was associated with smoking motives related to habit (β = 0.39, p <.001), negative affect reduction (β = 0.32, p <.001), stimulation (β = 0.31, p <.001), and sensorimotor manipulation (β = 0.26, p =.008). Limited support was found for the effect of motives on past quit attempt engagement. These results may broaden understanding of the psychological mechanisms related to smoking motivation among Black smokers and may inform future intervention efforts to reduce smoking motivation among this health disparities population.

Vindicating pollyanna? An experimental test of cognitive restructuring and positive thinking interventions

Objective Despite its considerable potential, psychotherapy research has made limited use of small-scale experimental study designs to test intervention components. This study employs such a design to test the immediate effects on emotional experience of two approaches to changing negative thoughts, cognitive restructuring and fostering positive thinking. Cognitive restructuring draws on the strategies core to cognitive behavioral therapies. Fostering positive thinking has also received attention, though less so as a psychological intervention. Method We tested the benefits of these strategies over a brief interval by randomizing 230 participants to complete a worksheet introducing one of the two strategies. Participants reported their skills prior to exposure to these worksheets and affect was assessed immediately prior to and following use of worksheets. Results Participants’ negative affect reduced following both strategies. Conditions did not differ significantly in affect change. Analysis of potential moderators showed that, among those with higher levels of cognitive behavioral therapy skills, the positive thinking condition produced greater gains in positive affect than the cognitive restructuring condition. Conclusions These results indicate that both forms of brief interventions promote reductions in negative affect. Positive thinking interventions, which are not focused on the accuracy of one's thinking, appear to be particularly effective in promoting positive affect.

The role of eating expectancies and eating motives in the association between mood and loss-of-control eating: A national sample daily diary study

Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions.

Testing the interaction of thinness/restriction and negative affect reduction expectancies on disordered eating behavior

ObjectiveThinness/restriction expectancies (i.e., perceived rewards from thinness/dietary restriction) and negative affect reduction expectancies (i.e., beliefs that eating will reduce negative emotions) are associated with disordered eating, but have largely been studied in isolation despite evidence that individuals can endorse these expectancies simultaneously. Guided by the goal conflict model, we hypothesized that for individuals reporting high levels of one type of expectancy, stronger endorsement of the second expectancy category would be associated with more dietary restriction, binge eating, and compensatory behaviors. A secondary aim included testing an adapted goal conflict model. DesignInteraction effects were tested using multiple linear and negative binomial regressions. Exploratory indirect effect models tested the adapted goal conflict model. Given gender differences, hypotheses were tested separately by gender. MeasuresParticipants (N = 406, 54.2% female, non-Hispanic White = 68.8%, Mage = 20.99, MBMI = 25.05) completed measures of thinness/restriction expectancies, negative affect expectancies, dietary restriction, binge eating, and compensatory behaviors (e.g., purging, laxative/diuretic use, compensatory exercise). ResultsNo statistically significant interaction of thinness/restriction and negative affect expectancies on disordered eating was observed for either the male or female sample. Main effects models revealed consistent findings across subsamples. Greater thinness/restriction expectancies were associated with more dietary restriction, binge eating, and compensatory behaviors. Greater negative affect reduction expectancies were associated with more binge eating. Exploratory indirect effect models yielded significant effects of each expectancy category on disordered eating. ConclusionExpectancies may be independent risk factors for disordered eating. Disordered eating prevention and intervention efforts may benefit from explicitly targeting thinness/restriction and negative affect expectancies.

The Effects of Zentangle® on Affective Well-Being Among Adults: A Pilot Randomized Controlled Trial.

Zentangle® is a self-help art modality purported to have repetitive, mindful, and meditative qualities. It can be a cost-effective intervention, but its effect on affective well-being has been underresearched. To evaluate the immediate and 2-wk postintervention effects of Zentangle delivered by a certified Zentangle teacher on affective well-being in the general population. Two-armed parallel-groups pilot randomized controlled trial. Thirty-eight participants from a nonclinical population. Participants were randomized into the Zentangle group, which participated in a 2-hr Zentangle class and were encouraged to practice for 2 wk, or the waitlist control group. Participants learned basic Zentangle principles and drew two Zentangles under the teacher's instructions. The Positive and Negative Affect Schedule, 21-item Depression Anxiety Stress Scale, and Self-Compassion Scale-Short Form were used to assess positive and negative affect; depression, anxiety, and stress symptoms; and self-compassion. Significant reductions in negative affect were found in the Zentangle group compared with the waitlist control group at both immediate and 2-wk postintervention assessments (ds = 1.04 and 0.79, respectively, p < .001). Participants who practiced Zentangle for >80 min per week had a significant reduction in anxiety symptoms and an improvement in self-compassion (ds = 0.84 and 0.24, ps < .05 and .005, respectively). No significant between-groups difference was found for other measures. Our results shed light on the effects of Zentangle on improving affective well-being in the general population. With sufficient practice, Zentangle can also help improve self-compassion and reduce anxiety. What This Article Adds: The results of this study could provide information to determine whether Zentangle can be used as a tool in occupational therapy intervention to improve affective well-being.

A brief nap during an acute stressor improves negative affect.

Overnight sleep can reduce perceived stress, and improve associated cognitive disruptions and negative affect after an acute stressor. Whether a brief nap can also bestow these benefits in a non-sleep-restricted population is currently unknown. In this study that used a between-subjects design, stress was triggered by administering a modified Trier Social Stress Test to two groups of participants (nap [n=29], wake [n=41]). All participants were instructed they would give a speech during the study but the topic would be withheld until later, and then completed a math task. After a 40-min break in which participants watched a neutral video or took a nap monitored with electroencephalography, stress was reinforced by presenting the speech topics and giving participants a 10-min preparation period. Next, instead of giving a speech, the study ended and participants were debriefed. Negative affect, perceived stress and working memory were measured at multiple time points before and after the break. Both groups showed lower perceived stress and improved working memory after the break than before, but a nap did not confer additional benefits for perceived stress or working memory beyond taking a break. However, the nap group exhibited lower negative affect after the break than the wake group, and only the nap group showed a reduction in negative affect compared with initial negative affect levels. These results indicate a nap can improve negative emotions accompanying a stressor to a greater extent than taking a break, and suggest that brief naps may be a useful way to improve mood while experiencing an acute stressor.

Affective Control Training (AffeCT) reduces negative affect in depressed individuals

Depression is the leading cause of disability worldwide, with prevalence rates rising. Despite the scale of the problem, available pharmacological and psychological interventions only have limited efficacy. The National Institute of Health's Science of Behaviour Change framework proposes to address this issue by capitalising on insights from basic science to identify mechanisms that can be targeted by novel interventions. The current study evaluated the potential of a computerized programme aimed at improving affective control, a mechanistic target involved in both risk and maintenance of depression. In a first phase the cognitive profiles of 48 depressed individuals (mean age: 39 years, 75 % female) were compared to cognitive functioning in 16 never-depressed individuals (mean age: 31 years, 56 % female). The sole index of functioning that differed between diagnostic groups was reaction time across negative and positively valanced trials on an affective Stroop task (d = 0.58). This index was then used to evaluate an affective control training (AffeCT) against a placebo training. Results showed no significant changes on tasks that showed no differences with never-depressed individuals in Phase I. However, compared to placebo training, AffeCT led to significantly greater improvement in the target index, affective Stroop performance (d = 1.17). Importantly, AffeCT led to greater reductions in negative affect as measured by the Positive Affect and Negative Affect Schedule compared to the placebo training (d = 0.98). This proof-of-concept study shows promising benefits of AffeCT on depressed individuals' affect, but not depressive symptoms. It further supports the utility of the Science of Behaviour Change framework, highlighting the need for determining meaningful assays of target mechanisms when evaluating novel interventions.

Greater negative affect reduction expectancies moderate the interactive relationship between emotion regulation difficulties and distress tolerance in predicting loss-of-control eating.

Loss-of-control eating (LOCE) is often conceptualized as a negative reinforcement mechanism. However, LOCE does not consistently reduce negative affect (NA). One explanation for continued LOCE, despite a lack of NA reduction, may be expectations of NA reduction. Emotion regulation difficulties and low distress tolerance often predict LOCE, but have not been examined in the context of NA reduction expectancies. This study examined the main and interactive relationships between emotion regulation difficulties, distress tolerance and NA reduction expectancies on LOCE in US adults (n=3331). This study consisted of a battery of surveys administered to a national sample of US adults. Results indicate NA reduction expectancies are robust, eclipsing the predictive effects of other emotion regulation variables. Distress tolerance was only able to attenuate the relationship between emotion regulation difficulties and LOCE when NA reduction expectancies were low. These findings identify NA reduction expectancies as having a strong relationship with LOCE, such that the protective factor of distress tolerance is only relevant when such expectancies are low. Clinical implications suggest that targeting NA reduction expectancies in eating interventions that bolster emotion regulation difficulties and distress tolerance may improve the effectiveness of said interventions. Additionally, stand-alone expectancy interventions should be assessed for the purpose of LOCE reduction. Directions for future research are discussed.

Acute Effect of Physical Exercise on Negative Affect in Borderline Personality Disorder: A Pilot Study.

Physical exercise is an evidence-based treatment to reduce symptoms and negative affect in several psychiatric disorders, including depressive, anxiety, and psychotic disorders. However, the effect of physical exercise on negative affect in patients with borderline personality disorder (BPD) has not yet been investigated. In this pilot study, we tested the safety, acceptability, and potential acute effects on negative affect of a single session of aerobic physical exercise in adults with BPD. After completing a negative mood induction procedure, 28 adults with BPD were randomly assigned to a 20-minute single session of stationary bicycle or a control condition (emotionally neutral video). No adverse effects attributed to the physical exercise were reported and it was considered acceptable to patients. Following the negative mood induction, both conditions decreased the level of negative affect with a medium effect size but there was no significant difference between them. The results suggest that a single 20-minute session of physical exercise does not produce a reduction of negative affect in BPD. Future research should consider the duration and intensities of physical exercise with the greatest potential to reduce negative affect both acutely and in a more prolonged manner in this patient group.

The Effectiveness of a Brief Telehealth and Smartphone Intervention for College Students Receiving Traditional Therapy: Longitudinal Study Using Ecological Momentary Assessment Data.

BackgroundBrief interventions such as mental health apps and single-session interventions are increasingly popular, efficacious, and accessible delivery formats that may be beneficial for college students whose mental health needs may not be adequately met by college counseling centers. However, no studies so far have examined the effectiveness of these modes of treatment for college students who are already receiving traditional therapy, despite it being common among this population.ObjectiveThe aim of this study was to compare the differences in self-reported momentary negative affect between college students in therapy and not in therapy who received a brief single-session intervention delivered by counseling center staff and a supplemental mobile app.MethodsData for this study were drawn from E-Manage, a brief mobile health intervention geared toward college students. Participants in the study were 173 college students who indicated whether they had received therapy. We conducted a multilevel model to determine whether there were differences between those in therapy versus not in therapy in negative affect reported throughout the study. Following this, we conducted multilevel models with therapy status as the predictor and negative affect as the outcome.ResultsResults of the multilevel model testing showed that the cross-level interaction between the time point (ie, pre- vs postexercise) and therapy status was significant (P=.008), with the reduction in negative affect from pre- to postexercise greater for those in therapy (b=–0.65, 95% CI –0.91 to –0.40; P<.001) than it was for those not in therapy (b=–0.31, 95% CI –0.43 to –0.19; P<.001). Therapy status was unassociated with both the pre-exercise (b=–1.69, 95% CI –3.51 to 0.13; P=.07) and postexercise (b=–1.37, 95% CI –3.17 to 0.43; P=.14) ratings of negative affect.ConclusionsThese findings suggest that app-based and single-session interventions are also appropriate to use among college students who are receiving traditional therapy. A randomized controlled trial comparing students receiving therapy to students receiving therapy and E-Manage will be necessary to determine to what extent E-Manage contributed to the reductions in negative affect that therapy-attending college students experienced.

Cross-sectional online survey of the impact of new tobacco health warnings in Colombia

ObjectivesThis study aimed to explore the impact of a new set of six pictorial warnings introduced in 2018.Design and settingUsing a cross-sectional design, we examined awareness of the new warnings...

Cannabis use and subjective response to alcohol in the human laboratory

BackgroundCannabis is often used in combination with alcohol; yet, whether cannabis use impacts risk factors for alcohol use disorder (AUD) remains unknown. Subjective response (SR) to alcohol represents a biobehavioral risk factor for subsequent heavy drinking and for developing AUD. Given the high prevalence of alcohol and cannabis co-use, it is plausible to hypothesize that cannabis users differ in SR to alcohol compared to non-cannabis users. The purpose of this study is to examine the influence of past-month cannabis use on subjective response to alcohol in the human laboratory. MethodsThis study culled data from multiple alcohol administration trials to test whether cannabis users, compared to non-cannabis users, differed in subjective response to alcohol, comprised of four domains: stimulation, sedation, negative affect, and craving. Non-treatment-seeking heavy drinkers (N = 168) completed a battery of self-report scales of mood and alcohol/cigarette/cannabis use and problems. All participants completed an intravenous alcohol administration session wherein SR domains were measured at the following breath alcohol concentrations (BrAC): baseline (i.e., 0), 20, 40, and 60 mg%. ResultsMultilevel statistical analyses revealed that cannabis users had a greater reduction in negative affect during alcohol administration, compared to non-cannabis users. No significant differences were found for the other SR domains. ConclusionsUsing a large sample and advanced data analytic methods, this study extends the literature by suggesting that cannabis users are more sensitive to alcohol-induced reductions in negative affect compared to non-cannabis users. This work extends research on how cannabis use may influence risk factors for AUD, such as subjective response to alcohol.

A Pilot Implementation-Effectiveness Trial of a Single-Session Telehealth Workshop and Smartphone-Based Cognitive Behavioral Intervention for Managing Emotions Among College Students

The number of college students who need mental health treatment outpaces the resources available to counseling centers to provide these needed services, presenting a need for low-cost, scalable interventions for college populations. We conducted a pilot implementation-effectiveness trial of a scalable treatment package that consisted of a single (telehealth) workshop plus a companion app that provided ecological momentary intervention. Participants (n = 177) received a workshop provided by counseling center staff and trainees. We were interested in (1) engagement with the app, (2) acceptability of the treatment package, and (3) initial effectiveness of the treatment package. Regarding engagement with the app, we found that participants preferred two reminder prompts per day and identified two key breakpoints when engagement declined significantly: at day 15, when just over half of the sample practiced a skill on the app at least once during the day and at day 41, when just over one third of people practiced a skill on the app each day. Regarding acceptability of the treatment package, students generally reported positive attitudes about the single-session workshop and app, but also noted that the content and assessments in the app needed to be more dynamic to improve how engaging it is. Regarding effectiveness, we found that about 75% of the sample experienced a significant reduction in negative affect from pre- to post-ecological momentary intervention. Moreover, there were significant pre- to post-study decreases in experiential avoidance and symptoms of anxiety and depression and increases in self-efficacy for managing negative emotions. The results of this study are promising in terms of providing initial support for this novel treatment package and provide useful information for researchers planning to develop and test similar interventions.

Virtual Canine Comfort: A Randomized Controlled Trial of the Effects of a Canine-Assisted Intervention Supporting Undergraduate Wellbeing

ABSTRACT Being a university student is known to be a stressful experience, and researchers across studies have reported elevated stress and compromised mental health for university students when compared with findings from the general population. The unexpected disruption to their studies arising from COVID-19 and its corresponding social isolation added to the stress experienced by students. This study assessed the effects of a virtual canine-assisted intervention to support student stress reduction and wellbeing. Participants (n = 467) were recruited from undergraduate psychology classes at a mid-size Western Canadian university and were randomly assigned to either synchronous (i.e., live Zoom) or asynchronous (i.e., pre-recorded YouTube videos) sessions with or without a dog present. An abbreviated, small group dose intervention of five minutes was used and handlers across conditions followed a script that mirrored as closely as possible the dialogue shared during a typical live, in-person visit (i.e., shared information about their dog, asked participants to reflect on their wellbeing, etc.). Measures of wellbeing included 1-item measures of connectedness to campus, loneliness, and stress, the PANAS, State-Trait Anxiety Inventory, Circumplex Model of Affect, and self-ratings of engagement during the intervention. Results of paired samples t-tests revealed that participants, regardless of condition, reported significant reductions in anxiety, stress, loneliness, and negative affect and more positive emotional states and stronger feelings of connectedness to their campus. Regarding the impact of platform delivery, participants reported greater campus connectedness following their participation in the synchronous conditions; however, type of platform was not associated with other aspects of wellbeing as noted above. As hypothesized, undergraduate students in this study did report feeling less stressed at the end of the intervention when a dog was present. The implications of the findings are discussed within the context of university student wellbeing.

Changes in positive and negative affect following prolonged exposure for PTSD comorbid with alcohol use disorder: Secondary analysis of a randomized clinical trial

Many individuals with posttraumatic stress disorder (PTSD) report increased negative affect (NA) and decreased positive affect (PA). Little is known about whether treatments for PTSD improve PA. We conducted a secondary analysis of a randomized clinical trial comparing integrated exposure therapy (I-PE) to integrated coping skills therapy (I-CS) for comorbid PTSD and alcohol use disorder (AUD). Veterans (N = 119) were randomized to 12–16 weeks of I-PE (n = 63) or I-CS (n = 56) and completed PA and NA measures at baseline, post-treatment, and 3- and 6-month follow-up. The analysis sample included 80 (67%) participants with the required data. A significantly greater proportion of the full sample met “clinical” levels (i.e., ±0.5 SD away from a general population mean) for NA than PA at baseline, but not at post-treatment. At post-treatment, the I-PE group demonstrated significantly greater change in NA than PA. Change in NA compared to PA did not significantly differ in the I-CS group. In the full sample, NA reduction was significantly larger than PA elevation post-treatment; change in NA, but not PA, was independently associated with symptom changes. Results provide an initial evaluation of treatment efficacy in concurrently repairing PA and NA and suggest room to improve both in individuals with PTSD and AUD.

Exploring the use of virtual reality to manage distress in adolescent patients in emergency departments: A feasibility study.

The present study aimed to explore the feasibility and potential benefits of deploying virtual reality (VR) for adolescents in the ED. This multi-centre study was undertaken in paediatric and adult EDs in two university teaching hospitals. Twenty-six participants who had voluntarily attended the ED received the VR intervention. Pre- and post-measures assessing changes in state anxiety, stress and affect, and physical biomarkers were obtained. The use of VR intervention was associated with significant reductions in distress (Short State Stress Questionnaire - Distress Subscale; t=4.55, P < 0.001) and negative affect (the International Positive and Negative Affect Scale - Short Form version; t=4.99, P < 0.001). Most participants chose 'Netflix' as their content of choice. The technology was well received by the participants with subjective reports indicating that receiving VR intervention was 'insanely cool', 'takes you away from what's actually happening' and some participants felt 'privileged to get this experience in a hospital'. VR technology can effectively be used in EDs to assist adolescents and young adults better manage their distress and take steps towards activating more self-control mechanisms that will in turn allow for more meaningful engagements to be established with health clinicians. This technology has broad implications for reducing distress in adolescents in a variety of clinical contexts.