Unprocessed Emotion Research Articles

Pain Severity During Hysteroscopy by GUBBINI System in Local Anesthesia: Covariance Analysis of Treatment and Effects, Including Patient Emotional State.

Pain accompanying medical procedures can be considered in the "mind-body" problem of accounting for and describing the relationship between mental and physical processes (psyche and soma). Background/Objectives: The purpose of this study is to evaluate the severity of pain among patients undergoing a minihysteroscopy procedure under local anesthesia using the "GUBBINI SYSTEM" (GUBBINI Mini Hystero-Resectoscope; Tontarra Medizintechnik, Tuttlingen, Germany) and to assess the association of various covariates with pain during the procedure, including patient emotional state. Methods: This study included 171 patients admitted to the Center for Hysteroscopy under Local Anesthesia at the Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital of the Karol Marcinkowski Medical University in Poznań, Poland, for hysteroscopic treatment under local anesthesia (paracervical, using lignocaine). The Center for Hysteroscopy is the first certified "CENTER OF EXCELLENCE" of The International Society for Gynecologic Endoscopy (ISGE) in Poland. Results: A positive relationship was observed between alexithymia and its trait of difficulty identifying emotions and pain, as well as between perceived pain and one of the deficits of emotional processing-signs of unprocessed emotion. Conclusions: In conclusion, before the hysteroscopy, adequate information and counseling related to the procedure can effectively reduce the pain and anxiety levels of the women, and nurses can navigate this stressful process. Providing education and counseling to all women undergoing hysteroscopy, and explaining the procedure in detail, should be the preferred approach.

(Un)muzzled: Dogs in Mid-Nineteenth-Century Fiction

ABSTRACT This article considers the relationship between dogs as fictional constructs and the shifting dynamics of the novel form in the mid-nineteenth century in order to account more fully for their particular importance to realist writing. In revisiting three canonical novels associated with the realist tradition, Charles Dickens’s Dombey and Son (1848), Charlotte Brontë’s Villette (1853), and George Eliot’s Adam Bede (1859), it demonstrates the ways in which writers regularly rely on dogs in depicting moments of deep personal and interpersonal conflict. Where most previous analyses of animals in Victorian fiction have tended to treat them as minor characters within their respective human narratives, this article is attuned to the affective functions of the domestic dog in contexts that exceed mere verisimilitude, exploring the significance of the connection between the dog’s textual body and the intense experience of grief, sexual desire, and anger respectively. I argue that the dog’s simultaneously narrative and extra-narrative position in the emergent realist novel reflects the genre’s larger formal tensions, generated by the representation of excess affects. These tensions are closely linked to the novel’s primary mode of representation: language. I conclude that it is the dog’s extralinguistic presence, predicated on its inability to encode affect in language, that marks it as the ideal, if increasingly unstable, nexus of powerful, unprocessed emotion in the mid-nineteenth-century novel.

A network analysis of ICD-11 Complex PTSD, emotional processing, and dissociative experiences in the context of psychological trauma at different developmental stages.

Traumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model. This study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure. Signs of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms. In this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.

Attenuated maladaptive emotion processing as a potential mediator of the relationship between dispositional mindfulness and mental health

The emotion processing and regulation mechanisms by which dispositional (personality trait) mindfulness exerts its positive effects on mental health remain unclear. Here, we tested, using structural equation modeling, whether the relationship between higher dispositional mindfulness and better mental health is mediated by reduced maladaptive processing of emotional information (e.g., expressive suppression, impoverished emotional experiences, unprocessed emotions, avoidance, externalizing strategies) and associated lower negative affect, enhanced adaptive processing of emotional information (e.g., cognitive reappraisal) and associated higher positive affect, or a combination of these two emotion processing styles. Dispositional mindfulness, mental health, diverse emotional constructs with adaptive and maladaptive dimensions (including range and differentiation of emotional experiences, use of specific emotion regulation strategies, emotion processing deficits, negative affect repair strategies, negative mood regulation expectancies), and positive and negative affect were assessed using self-report measures in a non-clinical sample of 256 adults. The relationship between higher dispositional mindfulness and better mental health was found to be best explained by reduced maladaptive emotion processing styles and associated lower negative affect, rather than by enhanced adaptive emotion processing and higher positive affect. Further research should investigate whether the same mechanisms explain psychological benefits of cultivated mindfulness in people with low dispositional mindfulness and/or with mental health disorders following mindfulness skills training.

Forensic Mental Health Evaluators' Unprocessed Emotions as an Often-Overlooked Form of Bias.

There has been robust interest in the influence of cognitive and implicit biases that can hamper a forensic mental health evaluator's ability to provide objective opinion evidence. By contrast, literature exploring the biasing effects of the examiner's unacknowledged and unprocessed emotions has been scanty. Borrowing from concepts originating from psychodynamic treatment literature, this article explores how a forensic mental health evaluator's emotional and transferential reactions can affect the assessment process and formulation of findings. We make the case that forensic mental health evaluators are not impervious to their own mental health concerns, including vicarious trauma. We ultimately argue for a cultural shift in forensic practice that acknowledges the unavoidable existence and influence of a forensic evaluator's human emotions, personal reactions, and conflicts, so that strategies can be developed for compassionate but careful management in training programs, supervision, and beyond. We suggest that self-reflection, sometimes with the aid of consultation and psychotherapeutic support, is not only important for clinical trainees but also could serve forensic practitioners throughout their careers, especially during challenging junctures in their personal and professional lives.

Starting University at the Time of COVID-19: Psychoemotional Adjustment of a Group of Italian Students.

The transition from school to university typically occurs during emerging adulthood; this coming together of multiple challenging development tasks at the same time may be stressful for some students. The coronavirus disease 2019 (COVID-19) pandemic, and above all the health measures implemented to deal with it, may have been an additional factor contributing to the difficult adaptation of first-year students to academic life. This study evaluated the role played by emotional processing and differentiation of self for psychological well-being in a sample of 218 Italian students (78.4% women) who began their 1st year of college during the pandemic. The results showed that higher levels of differentiation of self, combined with fewer signs of unprocessed emotions, predicted lower psychological distress. The data support the importance of these variables as protective factors in promoting psychological well-being along with the transition to adulthood and adaptation to new life challenges. These findings draw attention to the relevance of support services aimed at university students and of emerging adults in general in considering and promoting the role of self-differentiation and the style of emotional processing for addressing well-being and mental health during the transition to adult life.

Classification of Post-COVID-19 Emotions with Residual-Based Separable Convolution Networks and EEG Signals

The COVID-19 epidemic has created highly unprocessed emotions that trigger stress, anxiety, or panic attacks. These attacks exhibit physical symptoms that may easily lead to misdiagnosis. Deep-learning (DL)-based classification approaches for emotion detection based on electroencephalography (EEG) signals are computationally costly. Nowadays, limiting memory potency, considerable training, and hyperparameter optimization are always needed for DL models. As a result, they are inappropriate for real-time applications, which require large computational resources to detect anxiety and stress through EEG signals. However, a two-dimensional residual separable convolution network (RCN) architecture can considerably enhance the efficiency of parameter use and calculation time. The primary aim of this study was to detect emotions in undergraduate students who had recently experienced COVID-19 by analyzing EEG signals. A novel separable convolution model that combines residual connection (RCN-L) and light gradient boosting machine (LightGBM) techniques was developed. To evaluate the performance, this paper used different statistical metrics. The RCN-L achieved an accuracy (ACC) of 0.9263, a sensitivity (SE) of 0.9246, a specificity (SP) of 0.9282, an F1-score of 0.9264, and an area under the curve (AUC) of 0.9263 when compared to other approaches. In the proposed RCN-L system, the network avoids the tedious detection and classification process for post-COVID-19 emotions while still achieving impressive network training performance and a significant reduction in learnable parameters. This paper also concludes that the emotions of students are highly impacted by COVID-19 scenarios.

The pattern of self in women with borderline personality disorder in the context of their life narratives: A qualitative study

Introduction: Although self-disturbance is considered as an essential aspect of borderline personality disorder, there is little knowledge about its nature in affected individuals. Aim: The present study aimed to determine the patterns of self in women with borderline personality disorder. Method: This study was a basic research with a qualitative approach. The statistical population consisted of women with borderline personality disorder in Mashhad and psychologists and psychiatrists in Mashhad and Tehran, Iran, in 2021. Fifteen women with borderline personality disorder were selected by convenience sampling using Leichsenring's Borderline Questionnaire (1999) from Ibn Sina Hospital in Mashhad, and eight specialists were selected through purposive sampling. Data was collected through semi-structured interviews and coded through thematic analysis. Results: In the data analysis, five main themes, including self-knowledge, self-agency, loneliness, self and injury, and self and emotions, were identified. The self-knowledge theme has two sub-themes, namely, lack of self-awareness and instability. Self-agency included two external and internal themes. Loneliness was also divided into three themes of rejection, being misunderstood, and avoidance. Self and injury contained the themes of self pathology and self-harm, and finally, the main theme of self and emotions was divided into positive and negative emotions. Conclusion: In women with borderline personality disorder, under the influence of adverse and harmful experiences from early relationships and due to the accumulation of unprocessed emotions that cause impulsive behaviors, the self is incoherent, unstable with low self-awareness, and weak agency in facing life difficulties. Therefore; the extracted themes can provide a more comprehensive understanding of these individuals.

A Qualitative Study of a Couple Experiencing Reproductive Trauma: An Attachment Perspective through a Duoethnography

Within the academic literature, no ethnographies exist describing reproductive trauma and its effects on couples directly. The purpose of our study is to engage in a duoethnography and examine our own road to secure attachment amidst reproductive trauma. We analyzed 8,478 words of our personal journals, documented intentionally for this study. Thematic analysis revealed that our unprocessed emotions led to decreased empathy, thus enacting avoidant-insecure attachment. However, engaging in empathic communications and spiritual connection enabled more secure couple attachment for us. We propose emotion-focused couples therapy as a best-practice approach for therapists working with couples experiencing reproductive trauma. Clinical implications will be discussed.

Do difficulties in emotional processing predict procedure pain and shape the patient’s colonoscopy experience?

ObjectivesPain and fear of colonoscopy are inter-related; they make the colonoscopy experience unpleasant and impede adherence to colorectal cancer screening and prevention campaigns. According to previous research, fear and pain...

Emotion transformation: a grounded theory for uncovering painful triggers and repairing relational connection for parents of autistic children

PurposeIt is often voiced that parents of autistic children are the expert of their child, whereas parenting programmes target them as effective mediators for change. This paper aims to explore this unchallenged heuristic to develop an understanding of both emotional and relational needs of parents through trainers’ experiences of delivering emotion-focused and autism parent training.Design/methodology/approachThis qualitative study used a constructivist approach of grounded theory to gain an in-depth understanding of trainers’ experiences from their encounters when delivering parent training. Six expert trainers were interviewed, and a two-phased coding of ground theory and an adapted thematic analysis was used.FindingsAn overarching theme emerged: emotion transformation from painful triggers, to enhanced attunement and relational repair. Four main themes containing 13 subthemes were identified. The interaction of these themes and subthemes are presented in a three-phase process model. Phase 1: uncovering painful emotions from a shared journey contained one theme: parent painful triggers. Phase 2: uncovering interpersonal rupture cycle contained one theme: relational rupture cycle within non-synchrony of attunement. Phase 3: parent–child relational repair contained two themes: repairing attachment bonds and therapist’s prizing stance.Social implicationsThe authors challenge the parent as expert heuristic and propose that not all parents feel expert in neurotypical-neurodivergent intersubjectivity. The authors are curious to see whether trainers/therapists can guide parents through unprocessed emotions and non-synchrony of attunement to promote healing and relational repair, which requires further investigation.Originality/valueTo the best of the authors’ knowledge, this is the first emotion-transformation process model grounded in humanistic principles of relational acceptance and emotion theory. The authors propose that a focus on process rather than outcome is more likely to result in higher parenting self-efficacy.

EXPLORING ALEXITHYMIA IN SOMATIZATION USING RORSCHACH PSYCHODIAGNOSTICS

It has been classically postulated that alexithymia is related to a pervasive inability of emotional recognition and expression. This leaves some individuals little choice but to somatise unprocessed emotions commonly caused by internal conflicts. The present study thus aimed to explore the nature of conflicts, controls and stress tolerance, affect, self-perception, and interpersonal perception and behavior in somatization patients with alexithymia. 30 individuals of both sexes and of the age range 20-50 years, diagnosed with somatization disorder and alexithymia, were purposively undertaken for the study. Toronto Alexithymia Scale 20, Sack’s Sentence Completion Test and the Rorschach Test – Exner’s Comprehensive System were used to screen for alexithymia, to measure conflicts and the other aforementioned domains respectively. Results revealed that conflicts related to self-concept, sex, and family were primarily present in this sample. Characteristic patterns of underlying vulnerabilities seemed to account for poor stress tolerance, affective complications, negative self-perception, and maladaptive interpersonal functioning. It is suggested that alexithymia and a tendency to develop conflicts in somatization are based on the foundation of certain fundamental personality predispositions. Identifying said personality patterns could aid in appropriate and effective goal-setting in psychotherapy, specific to this otherwise treatment-resistant patient population.

Emotional Processing and Its Association to Somatic Symptom Change in Emotional Awareness and Expression Therapy for Somatic Symptom Disorder: A Preliminary Mediation Investigation.

Objective: The aim of this study was to investigate emotional processing as a potential mediator in therapist-guided, internet-based Emotional Awareness and Expression Therapy (I-EAET) for somatic symptom disorder, using data from a previously published pilot study.Methods: Participants (N = 52) engaged in a 9-week I-EAET treatment. Before treatment and each week during treatment (i.e., 10 weekly measurements), emotional processing was assessed with the Emotional Processing Scale-25 (EPS-25), which contains five subscales, and somatic symptoms were assessed with the Patient Health Questionnaire-15 (PHQ-15).Results: Mediation analyses using linear mixed models showed that two EPS-25 subscales—Signs of Unprocessed Emotions and Impoverished Emotional Experience—were uniquely associated with somatic symptom reduction. The proportion of the mediated effect was 0.49, indicating that about half of the total association of the PHQ-15 with symptoms was accounted for by the two EPS-25 subscales.Conclusion: This preliminary mediation analysis suggests that improved emotional processing is associated with change in somatic symptoms in I-EAET. However, randomized controlled and comparison trials are needed to establish that I-EAET creates the change in emotional processing and that such changes are specific to I-EAET.

Psychometric Properties of Iranian Version of Emotional Processing Scale

BACKGROUND: Emotional processing scale (EPS) is a fundamental test for measurement of the abnormal processing of emotion and psychosomatic disorders in psychotherapy sessions. Despite its importance, EPS has not been yet translated and validated in the Iranian population. AIM: To fill this gap, this study aims to adapt and examined the psychometric properties of five EPS in the Iranian population. Using cluster sampling, we selected 1283 university students. METHODS: The structural equation modeling and confirmatory factor analysis used to analyze the assessment of validity. RESULTS: The result showed the Cronbach’s alpha, split half, and test re-test reliability in acceptable ranges; 0.91, 0.90, and 0.91, respectively, for total scores scale. Root Mean Square Error of Approximation, Standardized Root Mean Square Residual, goodness of fit, and comparative fit index were at an acceptable range, 0.07, 0.05, 0.90, 0.90, 0.89, and 0.85, respectively. The total scores of EPS also showed a positive correlation (0.63, p < 0.001) with GHQ 28. CONCLUSION: The result suggested that five factors model of EPS which includes: The suppression, sign of unprocessed emotion, unregulated emotion, avoidance, and impoverished emotional experience model fit the data well be most appropriated for Iranian population.

The Structure of the Emotional Processing Scale (EPS-25)

Abstract. The Emotional Processing Scale (EPS) assesses emotional processing in terms of suppression, signs of unprocessed emotion, controllability of emotions, avoidance of emotional triggers, and impoverished emotional experience. Previous confirmatory factor analyses (CFA) yielded insufficient fit and questioned the EPS factors’ discriminant validity. The present study aimed to test unidimensional, five-factor, and bifactor models using exploratory structural equation modeling (ESEM) and CFA. We administered the scale to 350 Italian participants in good health and 346 gastrointestinal patients referred for endoscopy because of mild-to-severe gastrointestinal symptoms. ESEM models outperformed corresponding CFA models. The bifactor ESEM model was a good fit in single group analyses and achieved metric and scalar invariance in multigroup analyses. The inspection of latent mean differences revealed a consistent trend for patients to avoid emotional triggers and have less general emotional processing difficulties. The study clarified the EPS factor structure and supported its use to assess the emotional processing of medical patients and community participants.

Comparison Quality of Life and Emotional Processing among Patients with Major Thalassemia, Type 2 Diabetes Mellitus, and Healthy People

Objectives: This study aimed at comparing emotional processing and quality of life among patients with major thalassemia, type 2 diabetes mellitus, and healthy individuals. Methods: The present causal-comparative study was conducted on patients with thalassemia, type 2 diabetes mellitus, and healthy people in Saravan City in 2017. In this study, the available sampling method was conducted and 153 individuals (major thalassemia = 53, type 2 diabetes mellitus = 50, and healthy people = 50) were selected. Later, emotional processing and quality of life questionnaires were distributed among the participants. The data were analyzed using multivariate analysis of variance and Tukey post hoc test by running SPSS version 23. Results: In the thalassemia group, the mean score of emotional processing was higher than the other two groups; whereas, the mean score of the quality of life was lower compared with the other study groups. The three groups were significantly different in terms of emotional processing and the quality of life. The paired comparison between the groups showed that the signs of unprocessed emotion components of emotional processing were lower in the healthy group compared with the two patients’ groups. However, among the components of the quality of life, the mean scores of personal benefit, relationships, and environmental factors were higher among the healthy group. Conclusions: Chronic diseases affect emotional processing and the individuals’ quality of life. Therefore, we recommend to health centers to conduct comprehensive and preventive programs to improve participants’ mental health.

Pathological Narcissism and Symptoms of Major Depressive Disorder Among Psychiatric Outpatients: The Mediating Role of Impaired Emotional Processing.

Research is scarce regarding the mechanisms by which pathological narcissism--consisting of narcissistic grandiosity and vulnerability--is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.

Emotional Processing In Patients with Ischemic Heart Diseases.

BACKGROUND:Cardiovascular disease is the most prevalent public health problem on a worldwide scale, and ischemic heart disease accounts for approximately one-half of these events in high-income countries. One of the most important risk factors for this disease is mental and psychological especially stressful experiences.AIM:This research was established to compare emotional processing, as a key factor in stress appraisal, between IHD patients and people with no cardiovascular disease.METHODS:Using simple sampling, fifty patients were selected from people who diagnosed as IHD in the hospital and referred for treatment after discharging care and treatment. Control group participants were selected as control group peoples, using neighbourhood controls selection. The Emotional Processing Scale was filled by all members of the two groups.RESULTS:There were significant differences between the two groups on the EPS-25 total scores, as well as on emotional processing dimensions of signs of unprocessed emotion, unregulated emotion; avoidance and impoverished. Also, there was no significant difference between the two groups in the dimension of Suppression. The final step of regression revealed a β of 10.15 and 1.05 for AVO and IEE subscales respectively.CONCLUSION:The result showed that patients with IHD are using more negative emotional processing styles.

Does alexithymia moderate the relation between stress and general sleep experiences?

A tendency for experiencing unusual dream and sleep-wake transition phenomena (e.g., recurrent dreams, hypnagogic hallucinations, and confusion upon awakening), labeled general sleep experiences (GSEs), is linked with stress as well as psychological distress, explicit as well as covert. We hypothesized that alexithymia may moderate the relationship between stress and GSEs. Undergraduate students (N=187) completed online questionnaires; Three months later, n=78 of them reported perceived stress and dreaming each day for 14days. Regression analyses for trait data and multilevel modeling for daily diary data both revealed a pattern of two competing alexithymic mechanisms: difficulty in identifying feelings was related to increased GSEs, whereas externally-oriented thinking was related to decreased GSEs. As hypothesized, a cross-level interaction was found: daily stress predicted daily GSEs of the following night, only among those who reported difficulty identifying their emotions. It seems that those who experience GSEs following stress, tend to be internally-oriented (i.e., notice their inner experiences), yet find it difficult to understand and identify those experiences. GSEs seem to represent a nocturnal manifestation of unprocessed emotion.

A Study of Emotional Processing and Patterns of Adjustment among Patients with Dissociative Disorder

The objective of this study was to explore the emotional processing and adjustment patterns in patients with dissociative disorders. The Study was conducted at Institute of Medical Sciences and Neurosciences (IMHANS), Srinagar, India. Methods: The patients were chosen with the help of purposive sampling. A total of 30 participants (both male and female) were taken for the study. The Cross-sectional Research Design was used to collect the data. The tools used were Personal Information Schedule, Emotional Processing Scale (EPS 25) (Roger Baker 2000) and Bell’s Adjustment Inventory. Scoring of Emotional Processing Scale and Bell’s Adjustment inventory were done using the manual. Mean and Correlation was calculated by using SPSS. Results: It was found that dissociative disorder patients were plagued by intrusive and persistent emotions. In order to avoid those negative emotions, the patients tried to avoid experiencing them. Unprocessed emotional style was found to be most frequently used by the patients. Dissociative disorder patients were found to have poor adjustment in home, social, health as well as emotional areas of adjustment; with the maximum adjustment on emotional front. Further, it was found that there was no significant correlation between emotional processing and adjustment. However there was positive correlation between health and unregulated and unprocessed emotions. Conclusion: The findings of this exploratory study shed some light on the emotional processing and patterns of adjustment. This would help in the understanding and formulation of therapeutic cases and its implications on therapeutic interventions.