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Abstract Having people around, especially if they provide social support, often leads to positive outcomes both physically and mentally. Mere social presence is especially beneficial when it comes from a loved one or romantic partner. In these studies, we aim to expand the understanding of how the presence of one’s romantic partner affects emotion regulation in parental situations. Specifically, we examined how partner presence influences the parent’s emotional intensity, emotion regulation, and interpretation of their child’s emotion regulation. We examined these questions in parents of both non-autistic children (Study 1) as well as autistic children (Study 2), which we hypothesize leads to more intense emotional interactions. The parents of autistic children were better able to regulate their emotions when their partners were present compared to when they were absent. Furthermore, in both studies, parents’ ratings of their children’s ability to regulate their emotions were higher when their parent’s partner was present compared to when the partner was absent. However, in both studies, we found no significant difference in the parents’ emotional intensity when their partners were present compared to when their partners were absent during the emotionally charged interaction with their child. Our findings help highlight the impact of partner presence on parent and child emotion regulation.

Impairments in sleep and affect regulation are evident across a wide range of mental disorders. Understanding the sleep factors that relate to affect regulatory difficulties will inform mechanistic understanding and aid in treatment. Despite rising interest, some research challenges in this area include integrating across different clinical and non-clinical literatures investigating the role of sleep architecture (measured with polysomnography) and experimentally manipulated sleep, as well as integrating more explicit versus implicit affect regulation processes. In this comprehensive review, we use a unifying framework to examine sleep's relationship with implicit-automatic regulation and explicit-controlled regulation, both of which are relevant to mental health (e.g., PTSD and depression). Many studies of implicit-automatic regulation (e.g., fear extinction and safety learning) demonstrate the importance of sleep, and REM sleep specifically. Studies of explicit-controlled regulation (e.g., cognitive reappraisal and expressive suppression) are less consistent in their findings, with results differing depending on the type of affect regulation and/or way that sleep was measured or manipulated. There is a clear relationship between objective sleep and affect regulation processes. However, there is a need for 1) more studies focusing on sleep and explicit-controlled affect regulation; 2) replication with the same types of regulation strategies; 3) more studies experimentally manipulating sleep to examine its impact on affect regulation and vice versa in order to infer cause and effect; and 4) more studies looking at sleep's impact on next-day affect regulation (not just overnight change in affect reactivity).

Affective responses during stressful, high-stakes situations can play an important role in shaping performance. For example, feeling shaky and nervous at a job interview can undermine performance, whereas feeling excited during that same interview can optimize performance. Thus, affect regulation—the way people influence their affective responses—might play a key role in determining high-stakes outcomes. To test this idea, we adapted a synergistic mindsets intervention (SMI) (Yeager et al. 2022 Nature 607, 512–520 (doi:10.1038/s41586-022-04907-7)) to a high-stakes esports context. Our approach was motivated by the idea that (i) mindsets both about situations and one’s stress responses to situations can be shaped to help optimize stress responses, and (ii) challenge versus threat stress responses will be associated with improved outcomes. After a baseline performance task, we randomly assigned gamers (n = 300) either to SMI or a control condition in which they learned brain facts. After two weeks of daily gaming, gamers competed in a cash-prize tournament. We measured affective experiences before the matches and cardiovascular responses before and throughout the matches. Contrary to predictions, gamers did not experience negative affect (including feeling stressed), thus limiting the capacity for the intervention to regulate physiological responses and optimize performance. Compared with the control participants, synergistic mindsets participants did not show greater challenge responses or improved performance outcomes. Though our adaptation of Yeager et al.’s SMI did not optimize esports performance, our findings point to important considerations regarding the suitability of an intervention such as this to different performance contexts of varying degrees of stressfulness.

IntroductionEmotion regulation (ER) is a complex process that manifests gradually over time. This study investigated the temporal dynamics of ER in modifying positive emotions in terms of both negative affect (NA) and positive affect (PA) dimensions.MethodsAfter participants had been exposed to pleasant pictures for 8,000 ms, they received instructions to either continue viewing the picture (no regulation) or reappraise it with a neutral meaning (neutralize goal) or negative meaning (transform goal) for another 8,000 ms. We obtained corrugator supercilii and zygomaticus major electromyography (EMG) as objective measures of NA and PA.ResultsFor the no-regulation condition, upon instruction onset, we observed maintained low levels of corrugator and high levels of zygomaticus EMG reactivity, indicating sustained PA activation. Compared to the no-regulation condition, for the neutralize goal, we observed no change in corrugator reactivity, which remained at a low level, while zygomaticus reduction started at 1,000 ms after instruction onset, indicating decreased PA and generation of a neutral emotional state. For the transform goal, we observed corrugator increase and zygomaticus decrease both starting at 1,500 ms after instruction onset and co-existing throughout the regulation period. These results indicate increased NA and decreased PA, relating to generation of a negative emotional state. The transform goal differed from the neutralize goal in terms of corrugator increase starting at 2,500 ms after instruction onset. Albeit simultaneous onset of changes on corrugator and zygomaticus reactivity under the transform goal, model-fitting analyses indicated that the best-fitting trajectory was one that first emphasized PA reduction until, at 3,000 ms, it turned into primary NA increase.DiscussionThese distinct temporal patterns highlight the possibility of effecting one-dimensional PA change with the neutralize goal and sequential two-dimensional change (first decreasing PA, then increasing NA) with the transform goal. This research sheds light on the time course of emotional change brought about by different regulatory goals.

Background: There is evidence that beliefs about emotions are important for mental health. However, this field needs further research. Via the Emotion Beliefs Questionnaire, we aimed to explore the latent structure of emotion beliefs, their associations with numerous emotion constructs, and the role of emotion regulation in mediating emotion beliefs and emotional problems. Methods: This cross-sectional study involved 508 general community adults via an online survey, participants completed the EBQ, the Perth Emotion Regulation Competency Inventory, and the Depression Anxiety Stress Scale-21 for the central analyses, in addition to several related emotion measures. Our analytical strategy included: 1. Factor analyses to test the psychometric properties of the EBQ including its measurement invariance; 2. Correlational analyses to investigate the relationship between beliefs about emotions and several emotion constructs; and 3. Mediation analyses to explore the role of emotion regulation in the association between beliefs about emotions and depression and anxiety. Results: The findings supported a four-factor structure for the EBQ, with invariance across different demographic categories. Beliefs about the controllability of emotions were associated with most emotion constructs relative to beliefs about the usefulness of emotions. The links between beliefs about emotions with depression and anxiety were mediated by emotion regulation. Conclusions: Our findings underscore the importance of assessing the multidimensional emotion beliefs construct, as these beliefs are associated with impaired emotion regulation and many important emotional outcomes. Beliefs about emotion thus represent a useful area for future clinical research so that interventions tackle psychological difficulties in an effective way.

Abstract Background There has been steadily increasing use of bilateral mastectomy (BMX) in the treatment of primary breast cancer (BC). In this study, we utilized functional magnetic resonance imaging (fMRI) to examine the influence of emotion regulation on the decision of newly diagnosed BC patients to choose BMX rather than non‐BMX treatments. Methods We recruited 123 women with unilateral BC, 61 of whom received BMX and 62 of whom received non‐BMX treatments, and 39 healthy controls. While participants were in the fMRI scanner, we showed them BC‐related and non‐BC‐negative images. In one condition, they were instructed to watch the images naturally. In another, they were instructed to regulate their negative emotion. We compared the fMRI signal during these conditions throughout the brain. Results With non‐BC‐negative images as the baseline, BC patients showed greater self‐reported reactivity and neural reactivity to BC‐related images in brain regions associated with self‐reflection than did controls. Among the BC patients, the BMX group showed weaker activation in prefrontal emotion regulation brain regions during emotion regulation than did the non‐BMX group. Conclusions BC patients are understandably emotionally hyper‐reactive to BC‐related stimuli and those who ultimately received BMX experience more difficulty in regulating BC‐related negative emotion than non‐BMX BC patients. These findings offer neuropsychological evidence that difficulty in managing anxiety related to the possibility of cancer recurrence is a factor in surgical treatment decision‐making and may be an intervention target with the goal of strengthening the management of cancer‐related anxiety by nonsurgical means. Trial Registration NCT03050463.

Abstract Background Dissociation is a ubiquitous clinical phenomenon. Dissociative disorders (DD) are primarily characterized by dissociation, and dissociative states are also a criterion for borderline personality disorder (BPD) and the dissociative subtype of post-traumatic stress disorder (PTSD). Dissociative reactions (e.g., depersonalization/derealization or gaps in awareness/memory) across diagnostic categories are believed to be affect contingent and theorized to serve affect regulation functions. What is not clear, however, is how self-reported affect and physiological reactivity unfold within dissociative episodes. To address this issue, the present project aims to investigate the hypothesis (1) whether self-reported distress (as indicated by arousal, e.g., feeling tense/agitated, and/or valence, e.g., feeling discontent/unwell) and physiological reactivity increase before dissociative episodes and (2) whether self-reported distress and physiological reactivity decrease during and after dissociative episodes in a transdiagnostic sample of patients with DD, BPD, and/or PTSD. Methods We will use a smartphone application to assess affect and dissociation 12 times per day over the course of one week in everyday life. During this time, heart and respiratory rates will be remotely monitored. Afterwards, participants will report affect and dissociative states eight times in the laboratory before, during, and after the Trier Social Stress Test. During the laboratory task, we will continuously record heart rate, electrodermal activity, and respiratory rate, as well as measure blood pressure and take salivary samples to determine cortisol levels. Our hypotheses will be tested using multilevel structural equation models. Power analyses determined a sample size of 85. Discussion The project will test key predictions of a transdiagnostic model of dissociation based on the idea that dissociative reactions are affect contingent and serve affect regulation functions. This project will not include non-clinical control participants. In addition, the assessment of dissociation is limited to pathological phenomena.

Measurement(s) COVID-19 Protocols, Restrictions • Health Behaviors • Personality and Behavioral Change, CTCAE • Emotion • Message Framing • Self-Determination Technology Type(s) Survey • Experiment Design Type Factor Type(s) COVID-19 Protocols, Restrictions • Health Behaviors • Loss-Gain Framing • Cognitive Reappraisal • Self-Determination Messaging Sample Characteristic - Organism Homo Sample Characteristic - Environment Daily Life Sample Characteristic - Location North America • South America • Africa • Australia • Europe • United Kingdom • Asia

Background: Neuroscience research has generally studied emotions each taken in isolation. However, mixed emotional states (e.g., the co-occurrence of amusement and disgust, or sadness and pleasure) are common in everyday life. Psychophysiological and behavioral evidence suggests that mixed emotions may have response profiles that are distinguishable from their constituent emotions. Yet, the brain bases of mixed emotions remain unresolved. Methods: We recruited 38 healthy adults who viewed short, validated film clips, eliciting either positive (amusing), negative (disgusting), neutral, or mixed (a mix of amusement and disgust) emotional states, while brain activity was assessed by functional magnetic resonance imaging (fMRI). We assessed mixed emotions in two ways: first by comparing neural reactivity to ambiguous (mixed) with that to unambiguous (positive and negative) film clips and second by conducting parametric analyses to measure neural reactivity with respect to individual emotional states. We thus obtained self-reports of amusement and disgust after each clip and computed a minimum feeling score (shared minimum of amusement and disgust) to quantify mixed emotional feelings. Results: Both analyses revealed a network of the posterior cingulate (PCC), medial superior parietal lobe (SPL)/precuneus, and parieto-occipital sulcus to be involved in ambiguous contexts eliciting mixed emotions. Conclusion: Our results are the first to shed light on the dedicated neural processes involved in dynamic social ambiguity processing. They suggest both higher-order (SPL) and lower-order (PCC) processes may be needed to process emotionally complex social scenes.

Background: Stimulation of the ventromedial hypothalamic region in animals has been reported to cause attack behavior labeled as sham-rage without offering information about the internal affective state of the animal being stimulated. Objective: To examine the causal effect of electrical stimulation near the ventromedial region of the human hypothalamus on the human subjective experience and map the electrophysiological connectivity of the hypothalamus with other brain regions. Methods: We examined a patient (Subject S20_150) with intracranial electrodes implanted across 170 brain regions, including the hypothalamus. We combined direct electrical stimulation with tractography, cortico-cortical evoked potentials (CCEP), and functional connectivity using resting state intracranial electroencephalography (EEG). Results: Recordings in the hypothalamus did not reveal any epileptic abnormalities. Electrical stimulations near the ventromedial hypothalamus induced profound shame, sadness, and fear but not rage or anger. When repeated single-pulse stimulations were delivered to the hypothalamus, significant responses were evoked in the amygdala, hippocampus, ventromedial-prefrontal and orbitofrontal cortices, anterior cingulate, as well as ventral-anterior and dorsal-posterior insula. The time to first peak of these evoked responses varied and earliest propagations correlated best with the measures of resting-state EEG connectivity and structural connectivity. Conclusion: This patient's case offers details about the affective state induced by the stimulation of the human hypothalamus and provides causal evidence relevant to current theories of emotion. The complexity of affective state induced by the stimulation of the hypothalamus and the profile of hypothalamic electrophysiological connectivity suggest that the hypothalamus and its connected structures ought to be seen as causally important for human affective experience.

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) has received empirical support as a viable treatment alternative for treatment-resistant major depressive disorder. Nevertheless, patients and the public-at-large may be hesitant to adopt rTMS. In three studies, we sought to (1) assess and (2) improve public perceptions of rTMS as a treatment for depression. Methods In Study 1 (N = 107), we administered questionnaires on Amazon’s Mechanical Turk (MTurk) to individuals from the US and Canada in a cross-sectional design to assess perceptions of rTMS compared to psychopharmacology, electroconvulsive therapy (ECT), and talk therapy. In Study 2 (N = 106), we again used an MTurk sample and a cross-sectional design to assess perceptions of rTMS after providing participants with a relatively long description of rTMS. In Study 3 (N = 308), we conducted an experiment in undergraduate students. Participants were randomized to one of four experimental conditions manipulating participants’ understanding of the causal mechanisms of depression prior to assessing their perceptions of rTMS. Results Public perceptions of rTMS were more negative than pharmacotherapy and talk therapy but not ECT (Study 1). rTMS perceptions were notably better when participants were given thorough information about rTMS procedures, pain, and side-effects (Study 2), compared to the previous study when they were given a very brief description of rTMS. Finally, perceptions of rTMS were significantly better when participants were given a brain circuitry-based causal explanation of depression compared to when they were given a psychological explanation of the causes of depression (Study 3). Conclusions Public perceptions of rTMS are relatively poor. To improve rTMS acceptability, practitioners should carefully consider patients’ prior attitudes and beliefs when explaining rTMS as a treatment alternative. Given that beliefs can have powerful effects on treatment outcome (e.g., placebo, nocebo), future research should explore whether rTMS effects on depression can be improved by facilitating less negative perceptions of rTMS.

IntroductionThe ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure.MethodsInternational experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance.ResultsSixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control—Performance Monitoring; (3) Arousal and Regulatory Systems—Arousal; (4) Cognitive Control—Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control—Response Selection and Inhibition/Suppression; (6) Working memory—Flexible Updating; (7) Working memory—Active Maintenance; (8) Perception and Understanding of Self—Self-knowledge; (9) Working memory—Interference Control, and (10) Expert-suggested—Shifting.DiscussionOur results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.

Emotion regulation (ER) strategies are thought to contribute to mental as well as physical health outcomes. Two common ER strategies include expressive suppression, or inhibition of emotional expression, and cognitive reappraisal, which involves changing how to think about an emotion-eliciting event in order to change its emotional impact. Recent reports have hypothesized that one potential way in which ER may be linked to health outcomes is via the immune system. However, information on this putative link is scarce. The present study aims to explore whether peripheral inflammatory biomarkers are associated with individual differences in ER-strategy use. Participants (n = 117) from the Midlife in the United States II (MIDUS II) study completed the Emotion Regulation Questionnaire (ERQ), and provided a blood sample for immune biomarker extraction including interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), E-selectin, Intercellular Adhesion Molecule-1 (ICAM-1), and fibrinogen. Results showed higher levels of expressive suppression were associated with decreased IL-10, TNF-α, and ICAM-1 levels (controlling for age, sex, BMI, total prescribed medications, and depressive symptoms). Consistent with these findings, hierarchical regression results identified TNF-α as a significant predictor of expressive suppression use. In contrast, no inflammatory markers were associated with predicted use of cognitive reappraisal. Our findings suggest a link between inflammation and specific ER-strategy use. Future research should consider the effects of pro-vs. anti-inflammatory cytokines on adaptive ER and subsequent mental and physical health.

There is increasing evidence that sleep plays an important role in affective processing. However, it is unclear whether dreaming—the subjective experiences we have during sleep—also serves an affect regulation function. Here, we investigated the within-person relationship between negative affect experienced in dreams and next-day waking affect level, affect reactivity, and affect regulation. For 5 days, 40 participants reported their dreams and rated their dream affect and post-sleep waking affect level upon morning awakening. Thereafter, they performed an affect reactivity and regulation task which involved viewing neutral and negative pictures with the instruction either to simply view the pictures or to down-regulate the affect evoked by these pictures. Multilevel regression analyses showed that the more negative affect people experienced in their dreams at night, the more negative affect and the less positive affect they reported the next morning. However, negative dream affect was associated neither with affect reactivity to the pictures nor with the ability to down-regulate negative affect in response to these pictures. In fact, Bayesian analyses favored the null hypotheses. These findings fail to provide support for the affect regulation function of dreaming and, instead, speak for affective continuity between dreaming and post-sleep wakefulness.

Parents of children with autism spectrum disorder (ASD) experience higher stress levels than those of typically developing children. The goal of the current study was to examine whether a mentalization-based intervention would enhance parental cognitive reappraisal, an adaptive form of emotion regulation associated with lower levels of stress. Findings from 27 parents who completed a short training indicated an improvement in cognitive reappraisal. In exploratory analyses, two different types of reappraisal were examined. The intervention-related improvement was found mainly with one type of reappraisal, namely reflective reappraisal that consist of cognitive reappraisal with mentalization characteristics. In light of the evidence indicating that high cognitive reappraisal and high reflective functioning are associated with quality caregiving, findings from the current study suggesting that a brief mentalization-based intervention supports ASD parents' cognitive reappraisal with mentalization characteristics are promising and warrant further investigation.

The many stressors associated with teaching can take a toll, resulting in high levels of burnout among teachers and reduced motivation and academic performance among students. This is especially true in the context of science, technology, engineering, and mathematics (STEM) subjects. Despite the efficacy of emotion regulation interventions in pedagogical settings in general and in STEM teaching in particular, there is a lack of suitable interventions. We applied the process model of emotion regulation to STEM teaching and proposed a framework, STEM-Model of EmotioN regulation: Teachers’ Opportunities and Responsibilities (STEM-MENTOR), to elucidate how the high demands of STEM teaching and contextual factors (e.g., culture, reforms, teacher-student interactions) may lead to intensified negative emotions and deficits in executive functioning and emotion regulation implementation. Teacher emotions, in turn, shape students’ STEM-related achievements and epistemic emotions. Thus, teachers’ emotion regulation skills have pervasive effects on teaching outcomes for both teachers and students. We illustrate how at each level of our framework, steps could be taken to improve teachers’ emotional trajectory. Our proposed STEM-MENTOR framework has implications for theoretical understanding and may help to shape future interventions that focus on cognitive-emotional processes in STEM education.

Abstract Predictive brain markers promise a number of important scientific, clinical, and societal applications. Over 600 predictive brain markers have been described in published reports, but very few have been tested in independent replication attempts. Here, we conducted an independent replication of a previously published marker predicting treatment response to cognitive-behavioral therapy for social anxiety disorder from patterns of resting-state fMRI amygdala connectivity1. The replication attempt was conducted in an existing dataset similar to the dataset used in the original report, by a team of independent investigators in consultation with the original authors. The precise model described in the original report positively predicted treatment outcomes in the replication dataset, but with marginal statistical significance, permutation test p = 0.1. The effect size was substantially smaller in the replication dataset, with the model explaining 2% of the variance in treatment outcomes, as compared to 21% in the original report. Several lines of evidence, including the current replication attempt, suggest that features of amygdala function or structure may be able to predict treatment response in anxiety disorders. However, predictive models that explain a substantial amount of variance in independent datasets will be needed for scientific and clinical applications.

BackgroundLoneliness, especially when chronic, can substantially reduce one's quality of life. However, positive social experiences might help to break cycles of loneliness by promoting more prosocial cognitions and behaviors. Internet-mediated live video communication platforms (eg Zoom and Twitch) may offer an engaging and accessible medium to deliver such social experiences to people at scale. Despite these platforms' widespread use, there is a lack of research into how their socially interactive elements affect users' feelings of loneliness and connection.ObjectiveWe aimed to experimentally evaluate whether socially interactivity in live video experience improves loneliness-related outcomes.Materials and MethodsWe recruited participants from an online survey recruitment platform and assigned half to participate in a socially interactive live video experience with 6–12 strangers and the other half to a non-interactive control experience that was designed to be identical in every way but not socially interactive. Participants completed several baseline self-report measures of psychosocial wellbeing, participated in the hour-long video experience (an entertaining astronomy lesson), and then completed some baseline measures again. Four weeks later, we followed up with participants to evaluate their change in trait loneliness since baseline. We Pre-registered our hypotheses and analysis plan and provide our data, analysis code, and study materials online.ResultsTwo hundred and forty-nine participants completed the initial study and met inclusion criteria, 199 of whom also completed the 4-week follow-up. Consistent with our predictions, we found that directly after the more socially interactive experience, participants' feelings of connectedness increased more (p < 0.001), positive affect increased more (p = 0.002), feelings of loneliness decreased more (p < 0.001), social threat decreased more (p = 0.006), and negative affect decreased more (p = 0.003) than they did after the less interactive experience. However, change in trait loneliness between baseline and 4 weeks later did not differ between conditions (p = 0.953).ConclusionsIncluding socially interactive components in live video experiences can improve loneliness-related psychosocial outcomes for a short time. Future work should explore leveraging these benefits toward longer-term prosociality. Future work can also identify if the effects we observed generalize across different populations and kinds of online experiences.

Self-control is often thought to be synonymous with willpower, defined as the direct modulation of impulses in order to do what is best in the long-run. However, research has also identified more strategic approaches to self-control that require less effort than willpower. To date, field research is lacking that compares the efficacy of willpower to strategic self-control for consequential and objectively measured real-world outcomes. In collaboration with the College Board, we surveyed two national samples of high school students about how they motivated themselves to study for the SAT college admission exam. In Study 1 (N = 5,563), compared to willpower, strategic self-control predicted more hours of SAT practice and higher SAT scores, even when controlling for prior PSAT scores. Additionally, the more self-control strategies students deployed, the higher their SAT scores. Consistent with dose-response curves in other domains, there were positive albeit diminishing marginal returns to additional strategies. Mediation analyses suggest that the benefits of self-control strategies to SAT scores was fully explained by increased practice time. These results were confirmed in Study 2, a preregistered replication with N = 14,259 high school students. Compared to willpower, strategic self-control may be especially beneficial in facilitating the pursuit of goals in high-stakes, real-world situations.

Abstract. Introduction:. Temporal summation (TS) and conditioned pain modulation (CPM) represent different aspects of central pain processing. Their relationship and differential performance within distinct body locations are not well understood. Objectives:. To examine the association between TS and CPM in chronic low back pain and the influence of testing location on this relationship. Methods:. We analyzed baseline data from 2 clinical trials on participants with chronic low back pain (n = 264; 47.3% female; mean age = 41 years, SD = 12; mean pain = 5.3/10, SD = 1.4). Measures used included questionnaires assessing pain and negative affect, phasic thermal TS at the hand (thenar) and the lower back (lumbar), followed by CPM that included a thermal testing stimulus (Heat-6, the temperature where pain rating is 6/10) and a cold-pressor conditioning stimulus. Nonparametric, proportional odds logistic regression was used to model thenar, and separately, lumbar TS, using CPM, Heat-6, negative affect, and demographics. Results:. Our models revealed a small association (βs = 0.17, P = 0.01) between reduced CPM and heightened TS at both testing sites, regardless of demographics or negative affect. Conclusion:. Results suggest a modest association between TS and CPM, irrespective of anatomical testing location, demographics, and negative affect. These findings will help improve the methodology and interpretation of TS and CPM measurement in clinical pain populations.

Abstract Background Chronic low back pain (CLBP) is the most common chronic pain condition and is often resistant to conventional treatments. Acupuncture is a popular alternative for treating CLBP but its mechanisms of action remain poorly understood. Evidence suggests that pain regulatory mechanisms (particularly the ascending and secondarily the descending pain modulatory pathways) and psychological mechanisms (e.g., expectations, pain catastrophizing and self-efficacy) may be involved in the pathogenesis of CLBP and its response to treatments. We will examine these mechanisms in the treatment of CLBP by electroacupuncture (EA). Methods We present the aims and methods of a placebo-controlled, participant-blinded and assessor-blinded mechanistic study. Adult patients with CLBP will be randomized to receiving 16 sessions of real (active) or sham (placebo) EA over the course of 8 weeks. The primary pain regulatory measure for which the study was powered is temporal summation (TS), which approximates ascending pain facilitation. Conditioned pain modulation (CPM), representing a descending pain modulatory pathway, will be our secondary pain regulatory measure. The primary psychological measure is expectations of benefit, and the secondary psychological measures are pain catastrophizing and self-efficacy in managing pain. Main clinical outcomes are back pain bothersomeness on a 0–100 visual analog scale (primary), Roland Morris Disability Questionnaire (secondary), and relevant items from the National Institutes of Health (NIH) Patient-Reported Outcome Measures Information System (secondary). We hypothesize that compared to sham, real EA will lead to greater reduction in TS after 8 treatment sessions (4 weeks); and that reduction in TS (and secondarily, increase in CPM) after 8 treatment sessions will mediate reduction in back pain bothersomeness from baseline to week 10 (clinical response) to EA. We also hypothesize that the three psychological factors are moderators of clinical response. With 100 treatment completers, the study is designed to have 80% power to detect a medium-sized between-group effect (d = 0.5) on temporal summation. Discussion To the best of our knowledge, this is the first appropriately powered, placebo-controlled clinical trial evaluating mechanisms of EA in the treatment of CLBP. Trial registration ClinicalTrials.gov, NCT02503475. Registered on 15 July 15 2015. Retrospectively registered.

Mounting evidence shows that nature contact is associated with affective benefits. However, the psychological mechanisms responsible for these effects are not well understood. In this study, we examined whether more time spent in nature was associated with higher levels of positive affect in general, and lower levels of negative affect and rumination in general. We also conducted a cross-sectional mediation analysis to examine whether rumination mediated the association of nature contact with affect. Participants (N = 617) reported their average time spent in nature each week, as well as their general levels of positive and negative affect, and the degree to which they typically engaged in rumination in daily life. We then used structural equation modeling to test our hypotheses. Our results support the hypothesis that nature contact is associated with general levels of affect, and that rumination mediates this association for negative affect, and marginally mediates this association for positive affect.

Skin conductance responses (SCRs) reliably occur in the absence of external stimulation. However, the neural correlates of these non-specific SCRs have been less explored than brain activity associated with stimulus-elicited SCRs. This study modeled spontaneous skin conductance responses observed during an unstructured resting state fMRI scan in 58 adolescents. A Finite Impulse Response (FIR) fMRI model was used to detect any type of hemodynamic response shape time-locked to non-specific SCRs; the shape of these responses was then carefully characterized. The strongest evidence for signal change was found in several sub-regions of sensorimotor cortex. There also was evidence for engagement of discrete areas within the lateral surfaces of the parietal lobe, cingulate cortex, fronto-insular operculum, and both visual and auditory primary processing areas. The hemodynamic profile measured by FIR modeling clearly resembled an event-related response. However, it was a complex response, best explained by two quickly successive, but opposing neuronal impulses across all brain regions – a brief positive response that begins several seconds prior to the SCR with a much longer negative neuronal impulse beginning shortly after the SCR onset. Post hoc exploratory analyses linked these two hemodynamic response phases to different emotion-related individual differences. In conclusion, this study shows the neural correlates of non-specific SCRs are a widespread, cortical network of brain regions engaged in a complex, seemingly biphasic fashion. This bimodal response profile should be considered in replication studies that attempt to directly link brain activity to possible homeostatic mechanisms or seek evidence for alternative mechanisms.

Psychological well-being is a core feature of mental health, and may be defined as including hedonic (enjoyment, pleasure) and eudaimonic (meaning, fulfillment) happiness, as well as resilience (coping, emotion regulation, healthy problem solving). To promote psychological well-being, it is helpful to understand the underlying mechanisms associated with this construct and then develop targeted and effective training programs. In this perspective article, we discuss key components and potential brain-body mechanisms related to psychological well-being and propose mindfulness training as a promising way to improve it. Based on a series of randomized controlled trial (RCT) studies of one form of mindfulness training in adolescents and adults, the integrative body-mind training (IBMT), we use IBMT as an exemplar to provide research evidence of the positive effects of mindfulness training on psychological well-being. We focus on one of the mechanisms by which IBMT enhances psychological well-being—the interaction between mind (mindfulness) and body (bodifulness)—which involves both the central nervous system (CNS) and the autonomic nervous system (ANS). We also highlight the role of brain self-control networks, including the anterior cingulate cortex/prefrontal cortex (ACC/PFC), in improving psychological well-being. We suggest that mindfulness training may be a promising program that promotes the synergistic engagement of mind and body to achieve the goals of enhancing psychological well-being.

The management of unhelpful negative emotions has been addressed by two literatures, one focused on coping via humor, and the other focused on emotion regulation. In the present study, we directly compared humorous coping with conventional (serious) reappraisal. We expected humorous coping to be more effective than serious reappraisal in the short and longer term. Fifty-seven participants used either humorous coping, serious reappraisal, or attended naturally while viewing negative pictures and then rated their positive and negative emotional responses. One week later, participants viewed and rated the pictures again. In the short-term, while humorous coping was more difficult than serious reappraisal, it was more effective in down-regulating negative and up-regulating positive emotions. In the longer-term, both strategies had beneficial effects on positive emotions while humorous coping was more beneficial than serious reappraisal in down-regulating negative emotions. This is the first study that empirically shows short and longer-term beneficial effects of humorous coping versus serious reappraisal in the context of emotions elicited by negative stimuli.

Two relatively independent research traditions have developed that address emotion management. The first is the emotion regulation (ER) tradition, which focuses on the processes which permit individuals to influence which emotions they have, when they have them, and how they experience and express these emotions. The second is the emotional intelligence (EI) tradition, which focuses—among other things—on individual differences in ER. To integrate these two traditions, we employed the process model of ER (Gross, 1998b) to review the literature on EI. Two key findings emerged. First, high EI individuals shape their emotions from the earliest possible point in the emotion trajectory and have many strategies at their disposal. Second, high EI individuals regulate their emotions successfully when necessary but they do so flexibly, thereby leaving room for emotions to emerge. We argue that ER and EI traditions stand to benefit substantially from greater integration.

The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER) framework suggests that (1) emotion regulation (ER) strategies require resources and that (2) higher levels of relevant resources may increase ER success. In the current experiment, we tested the specific hypothesis that individual differences in one internal class of resources, namely cognitive ability, would contribute to greater success using cognitive reappraisal (CR), a form of ER in which one reinterprets the meaning of emotion-eliciting situations. To test this hypothesis, 60 participants (30 younger and 30 older adults) completed standardized neuropsychological tests that assess fluid and crystallized cognitive ability, as well as a CR task in which participants reinterpreted the meaning of sad pictures in order to alter (increase or decrease) their emotions. In a control condition, they viewed the pictures without trying to change how they felt. Throughout the task, we indexed subjective emotional experience (self-reported ratings of emotional intensity), expressive behavior (corrugator muscle activity), and autonomic physiology (heart rate and electrodermal activity) as measures of emotional responding. Multilevel models were constructed to explain within-subjects variation in emotional responding as a function of ER contrasts comparing increase or decrease conditions with the view control condition and between-subjects variation as a function of cognitive ability and/or age group (older, younger). As predicted, higher fluid cognitive ability – indexed by perceptual reasoning, processing speed, and working memory – was associated with greater success using reappraisal to alter emotional responding. Reappraisal success did not vary as a function of crystallized cognitive ability or age group. Collectively, our results provide support for a key tenet of the SOC-ER framework that higher levels of relevant resources may confer greater success at emotion regulation.

People frequently have to control their emotions to function in life. However, mounting evidence suggests that deliberate emotion regulation often is costly. This presents a dilemma: Is it better to let emotions go or to pay the price of exerting costly control? In two studies, the authors explore whether emotion regulatory processes associated with implicit positive evaluation of emotion regulation might provide the benefits of successful emotion regulation without the costs. In Study 1, the authors introduce a measure of implicit evaluation of emotion regulation (ER-IAT). Study 2 examined whether this measure is associated with actual emotional responses to an anger provocation. It was found that greater ER-IAT scores were associated with lesser anger experience, fewer negative thoughts, lessened self-reported effortful emotion regulation, and an adaptive pattern of cardiovascular responding. These findings suggest that implicit positive evaluation of emotion regulation is associated with successful, automatic, and physiologically adaptive down-regulation of anger. [ABSTRACT FROM AUTHOR]

Cognitive reappraisal can alter emotional responses by changing one's interpretation of a situation's meaning. Functional neuroimaging has revealed that using cognitive reappraisal to increase or decrease affective responses involves left prefrontal activation and goal-appropriate increases or decreases in amygdala activation (Ochsner, Bunge, Gross, & Gabrieli, 2002; Ochsner, Ray, et al., 2004). The present study was designed to examine whether patterns of brain activation during reappraisal vary in relation to individual differences in trait rumination, which is the tendency to focus on negative aspects of one's self or negative interpretations of one's life. Individual differences in rumination correlated with increases in amygdala response when participants were increasing negative affect and with greater decreases in prefrontal regions implicated in self-focused thought when participants were decreasing negative affect. Thus, the propensity to ruminate may reflect altered recruitment of mechanisms that potentiate negative affect. These findings clarify relations between rumination and emotion regulation processes and may have important implications for mood and anxiety disorders. [ABSTRACT FROM AUTHOR]

BackgroundSleep bruxism (SB) is an oral behavior characterized by high levels of repetitive jaw muscle activity during sleep, leading to teeth grinding and clenching, and may develop into a disorder. Despite its prevalence and negative outcomes on oral health and quality of life, there is currently no cure for SB. The etiology of SB remains poorly understood, but recent research suggests a potential role of negative emotions and maladaptive emotion regulation (ER). ObjectiveThis study’s primary aim investigates whether ER is impaired in individuals with SB, while controlling for affective and sleep disturbances. The secondary aim tests for the presence of cross-sectional and longitudinal mediation pathways in the bidirectional relationships among SB, ER, affect, and sleep. MethodsThe study used a nonrandomized repeated-measures observational design and was conducted remotely. Participants aged 18-49 years underwent a 14-day ambulatory assessment. Data collection was carried out using electronic platforms. We assessed trait and state SB and ER alongside affect and sleep variables. We measured SB using self-reported trait questionnaires, ecological momentary assessment (EMA) for real-time reports of SB behavior, and portable electromyography for multinight assessment of rhythmic masticatory muscle activity. We assessed ER through self-reported trait questionnaires, EMA for real-time reports of ER strategies, and heart rate variability derived from an electrocardiography wireless physiological sensor as an objective physiological measure. Participants’ trait affect and real-time emotional experiences were obtained using self-reported trait questionnaires and EMA. Sleep patterns and quality were evaluated using self-reported trait questionnaires and sleep diaries, as well as actigraphy as a physiological measure. For the primary objective, analyses will test for maladaptive ER in terms of strategy use frequency and effectiveness as a function of SB using targeted contrasts in the general linear model. Control analyses will be conducted to examine the persistence of the SB-ER relationship after adjusting for affective and sleep measures, as well as demographic variables. For the secondary objective, cross-sectional and longitudinal mediation analyses will test various competing models of directional effects among self-reported and physiological measures of SB, ER, affect, and sleep. ResultsThis research received funding in April 2017. Data collection took place from August 2020 to March 2022. In all, 237 participants were eligible and completed the study. Data analysis has not yet started. ConclusionsWe hope that the effort to thoroughly measure SB and ER using gold standard methods and cutting-edge technology will advance the knowledge of SB. The findings of this study may contribute to a better understanding of the relationship among SB, ER, affect, and sleep disturbances. By identifying the role of ER in SB, the results may pave the way for the development of targeted interventions for SB management to alleviate the pain and distress of those affected. International Registered Report Identifier (IRRID)DERR1-10.2196/41719

PurposeNegotiation is a consequential activity that can exacerbate power differentials, especially for women. While traditional contexts can prime stereotypical gender roles and promote conditions that lead to performance differences, these can be mitigated by context shifts. This proof-of-concept study explores whether an easy-to-apply context shift, moving from seated indoors to walking outside, can help improve the quality of negotiated interactions. Here we examine walking's effects on negotiation and relational outcomes as well as experienced emotions, moderated by gender.DesignSame-gender pairs were randomly assigned to either sitting or walking as either candidate or recruiter negotiating a job offer.ParticipantsEighty-one pairs of graduate students or community members participated: sitting pairs: 27 women, 14 men; walking pairs: 23 women, 17 men.InterventionParticipants negotiated either while seated (across from each other) or walking (side by side along a path).MeasuresWe measured: negotiation performance (total points) and outcome equity (difference between negotiating party points); subjective outcomes of positive emotions, negative emotions, mutual liking, and mutual trust. With mixed effects models, we tested main effects of condition, gender, and interaction of condition x gender.ResultsRelative to sitting, walking was associated with: increased outcome equality for women, but decreased for men (B = 3799.1, SE = 1679.9, p = .027); decreased negative emotions, more for women than men (IRR = .83, 95% CI:[.69,1.00], p = .046); and greater mutual liking for both genders (W = 591.5, p-value = 0.027). No significant effects were found for negotiation point totals, positive emotions, or mutual trust.ConclusionThis study provides a foundation for investigating easy-to-implement changes that can mitigate stereotyped performance differences in negotiation.

BackgroundEmotion regulation is a key transdiagnostic risk factor for a range of psychopathologies, making it a prime target for both prevention and treatment interventions in childhood. Existing interventions predominantly rely on workshops or in-person therapy-based approaches, limiting the ability to promote emotion regulation competence for children in everyday settings and at scale. Purrble is a newly developed, inexpensive, socially assistive robot—in the form of an interactive plush toy—that uses haptic feedback to support in-the-moment emotion regulation. It is accessible to children as needed in their daily lives, without the need for a priori training. Although qualitative data from previous studies show high engagement in situ and anecdotal evidence of the robot being incorporated into children’s emotion regulation routines, there is no quantitative evidence of the intervention’s impact on child outcomes. ObjectiveThe aim of this study is to examine the efficacy of a new intervention model for child-led emotion regulation—Purrble—that can be deployed across prevention and treatment contexts. MethodsOverall, 134 children aged 8 to 10 years will be selected from an enriched nonclinical North American population; for inclusion, the cutoff for the parents’ rating of child dysregulation will be ≥10 points in the total difficulties score on the Strengths and Difficulties Questionnaire. This cutoff was selected to obtain a measurable, but not necessarily clinical, level of the child’s emotion regulatory difficulties. The selected families will be randomly assigned with .5 probability to receive either a Purrble or an active control (noninteractive plush toy). The primary outcome will be a daily ecological momentary assessment measure of child emotion regulation capability (as reported by parents) over a period of 4 weeks. Exploratory analyses will investigate the intervention impact on secondary outcomes of child emotion regulation, collected weekly over the same 4-week period, with follow-ups at 1 month and 6 months postdeployment. Quantitative data will be analyzed on an intent-to-treat basis. A proportion of families (approximately 30% of the sample) will be interviewed after deployment as part of the process analysis. ResultsThe study is funded by the UKRI Future Leaders Fellowship (MR/T041897/1) and an in-kind contribution from the Committee for Children. This study received ethical approval from the Pearl institutional review board (#18-CFC-101). Participant recruitment started in February 2021, with the 1-month deployment in April-May 2021. The results of this analysis will be published in 2022. ConclusionsThis study will be the first quantitative evaluation of the efficacy of an innovative, proof-of-concept intervention model for an in situ, child-led emotion regulation intervention. Insights into the trajectory of daily changes, complemented with weekly questionnaire batteries and postdeployment interviews, will result in an in-depth understanding of whether and how the hypothesized intervention logic model works, leading to further intervention optimization. Trial RegistrationClinicalTrials.gov NCT04810455; http://clinicaltrials.gov/ct2/show/NCT04810455 International Registered Report Identifier (IRRID)PRR1-10.2196/28914

People's beliefs about emotions may be grouped into two main categories: beliefs about the controllability of emotions and beliefs about the usefulness of emotions. These beliefs influence emotion regulation efforts and mental health, so the assessment of these beliefs is important. However, few psychometric measures are available, particularly for assessing the usefulness dimension. In this study (N = 161), we address this issue by developing and conducting an initial validation of a 16-item self-report measure called the Emotion Beliefs Questionnaire (EBQ). Confirmatory factor analyses found its structure to consist of three first-order factors: a controllability factor spanning both negatively and positively valenced emotions (General-Controllability), and two valence-specific usefulness factors (Negative-Usefulness, Positive-Usefulness). All first-order factors also loaded together on a higher-order factor, representing an overall maladaptive beliefs about emotions construct. All subscale and composite scores had good levels of internal consistency. Correlational and regression analyses found that EBQ scores related in expected ways with other measures, and were significant predictors of emotion regulation abilities and psychopathology. We conclude that the beliefs about emotions construct is multidimensional, and the EBQ appears to be a promising new tool to assess it.

It has long been thought that emotional intelligence (EI) involves skillful emotion regulation, but surprisingly little is known about the precise links between EI and emotion regulation. To address this gap in the literature, we examined the relation between EI-operationalised as an ability-and the use of two common emotion regulation strategies-cognitive reappraisal and expressive suppression. Seven hundred and twelve participants from a community sample in Spain were assessed on ability EI (using the MSCEIT) and emotion regulation (using the ERQ). Findings revealed that EI ability was positively associated with cognitive reappraisal and negatively associated with expressive suppression. These relationships were moderated by gender and age. The strength of the association between EI and cognitive reappraisal increased with age for men, while this strength decreased with age for women. Conversely, the strength of the association between EI and suppression decreased with age for men, but increased with age for women. These findings confirm the expectation that EI is associated with greater use of generally adaptive forms of emotion regulation (reappraisal), and lesser use of generally maladaptive forms of emotion regulation (suppression), although effect sizes were quite modest. Observed differences in the strength of associations between EI and emotion regulation may be the result of gender differences in the development of emotional skills along with cultural changes in emotional education and social norms.

The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation.We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis.Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p

In the last decade there has been a growing literature exploring the neuroanatomical and neuropsychological basis of reappraisal. This data suggests that reappraisal tasks activate a set of areas in the left hemisphere, which are commonly associated to language abilities and verbally mediated cognitive control. The main goal of this study was to investigate such hypothesis, by exploring whether subjects with focal damage to the left hemisphere [LH, n=8] were more markedly impaired on a reappraisal generation task than individuals with right hemisphere lesions [RH, n=8], and healthy controls [HC, n=14]. The reappraisal generation task consisted of a set of ten pictures from the IAPS, depicting negative events of different sort. Participants were asked to quickly generate as many positive reinterpretations as possible for each picture. Two scores were derived from this task; reappraisal difficulty and productivity. A second goal was to explore which cognitive control processes were associated to performance on the reappraisal task. For this purpose, participants were assessed on several measures of cognitive control. The results showed that the average amount of seconds used to generate a first reappraisal did not differ between LH and RH groups. However, significant differences were found between patients with brain injury [LH+RH] and HC, thus suggesting that having a brain damage, with disregard of the laterality of the lesion, does have an impact on reappraisal difficulty. In relation to reappraisal productivity, no differences were found across the three groups, suggesting that neurological groups and HC are equally productive when time constraints is not considered. Finally, only two cognitive control processes –inhibition and verbal fluency- were inversely associated to reappraisal difficulty. The results of this study are discussed in relation to the neuroanatomical and neuropsychological basis of reappraisal, and its implications for neuro-rehabilitation.

Temptations besiege us, and we must resist their appeal if we are to achieve our long-term goals. In two studies, we tested the hypothesis that cognitive reappraisal could be used to successfully maintain performance in a task embedded in temptation. In Study 1, 62 participants had to search for information on the Internet while resisting attractive task-irrelevant content on preselected sites. In Study 2, 58 participants had to count target words in a funny TV sequence. Compared to the no-reappraisal condition, participants who understood the situation as a test of willpower (the reappraisal condition) (1) performed better at the task (Studies 1 and 2), and (2) were less tempted by the attractive content of the TV sequence (Study 2). These findings suggest that, by making the temptation less attractive and the task more appealing, cognitive reappraisal can help us resist temptation.

Does expecting positive outcomes—especially in important life domains such as relationships—make these positive outcomes more likely? In a longitudinal study of dating couples, the authors tested whether optimists (who have a cognitive disposition to expect positive outcomes) and their romantic partners are more satisfied in their relationships, and if so, whether this is due to optimists perceiving greater support from their partners. In cross-sectional analyses, both optimists and their partners indicated greater relationship satisfaction, an effect that was mediated by optimists' greater perceived support. When the couples engaged in a conflict conversation, optimists and their partners saw each other as engaging more constructively during the conflict, which in turn led both partners to feel that the conflict was better resolved 1 week later. In a 1-year follow-up, men's optimism predicted relationship status. Effects of optimism were mediated by the optimists' perceived support, which appears to promote a variety of beneficial processes in romantic relationships. [ABSTRACT FROM AUTHOR]

Introduction: Purrble, a socially assistive robot, was codesigned with children to support in situ emotion regulation. Preliminary evidence has found that LGBTQ+ youth are receptive to Purrble and find it to be an acceptable intervention to assist with emotion dysregulation and their experiences of self-harm. The present study is designed to evaluate the impact of access to Purrble among LGBTQ+ youth who have self-harmful thoughts, when compared with waitlist controls., Methods and Analysis: The study is a single-blind, randomised control trial comparing access to the Purrble robot with waitlist control. A total of 168 LGBTQ+ youth aged 16-25 years with current self-harmful ideation will be recruited, all based within the UK. The primary outcome is emotion dysregulation (Difficulties with Emotion Regulation Scale-8) measured weekly across a 13-week period, including three pre-deployment timepoints. Secondary outcomes include self-harm (Self-Harm Questionnaire), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). We will conduct analyses using linear mixed models to assess primary and secondary hypotheses. Intervention participants will have unlimited access to Purrble over the deployment period, which can be used as much or as little as they like. After all assessments, control participants will receive their Purrble, with all participants keeping the robot after the end of the study. After the study has ended, a subset of participants will be invited to participate in semistructured interviews to explore engagement and appropriation of Purrble, considering the young people's own views of Purrble as an intervention device., Ethics and Dissemination: Ethical approval was received from King's College London (RESCM-22/23-34570). Findings will be disseminated in peer review open access journals and at academic conferences., Trial Registration Number: NCT06025942., Competing Interests: Competing interests: PS has been involved in the development of what is now Purrble as part of his postdoctoral fellowship and serves as a paid research adviser to the Committee for Children (CfC) but has no financial stake in either CfC (Purrble brand owners) or Sproutel (company manufacturing Purrbles). Neither Committee for Children nor Sproutel had access to the data or had been part of the data collection in any way nor did they approve or see the publication before it was submitted. There were no conflicting interests among the remaining research team., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Background: Mental health difficulties among university students have been rising rapidly over the last decade, and the demand for university mental health services commonly far exceeds available resources. Digital interventions are seen as one potential solution to these challenges. However, as in other mental health contexts, digital programs often face low engagement and uptake, and the field lacks usable, engaging, evidence-supported mental health interventions that may be used flexibly when students need them most., Objective: The aim of this study is to investigate the feasibility and acceptability of a new, in situ intervention tool (Purrble) among university students experiencing anxiety. As an intervention, Purrble was designed to provide in situ support for emotion regulation (ER)-a well-known transdiagnostic construct-directly in the moments when individuals are facing emotionally challenging situations. A secondary aim is to consider the perceived impact of Purrble on youth mental health, as reported by students over a 7-week deployment., Methods: A mixed methods open trial was conducted with 78 under- and postgraduate students at Oxford University. Participants were recruited based on moderate to high levels of anxiety measured by Generalized Anxiety Disorder-7 at baseline (mean 16.09, SD 3.03). All participants had access to Purrble for 7 weeks during the spring term with data on their perceived anxiety, emotion dysregulation, ER self-efficacy, and engagement with the intervention collected at baseline (pre), week 4 (mid), and week 8 (postintervention). Qualitative responses were also collected at the mid- and postintervention points., Results: The findings demonstrated a sustained engagement with Purrble over the 7-week period, with the acceptability further supported by the qualitative data indicating that students accepted Purrble and that Purrble was well-integrated into their daily routines. Exploratory quantitative data analysis indicated that Purrble was associated with reductions in student anxiety (dz=0.96, 95% CI 0.62-1.29) and emotion dysregulation (dz=0.69, 95% CI 0.38-0.99), and with an increase in ER self-efficacy (dz=-0.56, 95% CI -0.86 to -0.26)., Conclusions: This is the first trial of a simple physical intervention that aims to provide ongoing ER support to university students. Both quantitative and qualitative data suggest that Purrble is an acceptable and feasible intervention among students, the engagement with which can be sustained at a stable level across a 7-week period while retaining a perceived benefit for those who use it (n=32, 61% of our sample). The consistency of use is particularly promising given that there was no clinician engagement or further support provided beyond Purrble being delivered to the students. These results show promise for an innovative intervention model, which could be complementary to the existing interventions., (©A Jess Williams, Maureen Freed, Nikki Theofanopoulou, Claudia Daudén Roquet, Predrag Klasnja, James Gross, Jessica Schleider, Petr Slovak. Originally published in JMIR Mental Health (https://mental.jmir.org), 31.10.2023.)

Pre-sleep affect is thought to influence sleep, but associations with both sleep architecture and the electroencephalographic (EEG) power spectrum are mixed. In this pre-registered study, we assessed negative valence and arousal 1 h pre-sleep in 52 adults drawn from the community, then recorded one night of polysomnography (PSG) in participants' own homes. Pre-sleep affect was not associated with nonrapid eye movement (NREM) or rapid eye movement (REM) sleep architecture parameters, but we did observe inverted U-shaped relationships between both negative valence and arousal and REM frontal theta power, such that theta power was highest at moderate negative valence and arousal, and lowest at either affective extreme. When entered into a model together, both valence and arousal accounted for independent variance. Secondary analyses revealed a similar quadratic association with pre-sleep positive valence, suggesting a nonspecific effect of pre-sleep valence on REM frontal theta. Robustness checks confirmed that effects were not explained by homeostatic sleep pressure or sleep timing. Our results suggest that mixed findings in the literature may reflect different ends of a quadratic function, underscoring the importance of assessing how different components of pre-sleep affect relate to sleep., (© 2022. The Psychonomic Society, Inc.)

Abstract: The students at Mayo Clinic Alix School of Medicine (MCASOM) wrote a call to action to medical school leadership in June 2020. The students requested help in navigating socio-political barriers that affected one another and contributed to healthcare inequities and mistrust. Using the Association of American Medical Colleges (AAMC) tool to assess cultural competence training, our team evaluated the baseline 2017-2018 MCASOM curriculum. There were 254 learning objectives, of which 43 (17%) were related to inclusion, diversity, antiracism, and equity (I-DARE). Mirroring the concerns of the students, the findings identified minimal content about antiracism and inclusion. By applying DMAIC principles for quality and process improvement, we aimed to increase the number of taught learning objectives about I-DARE content for the first-year and second-year medical students by 100%, from 43 to 86 objectives, without adversely affecting student satisfaction and true attendance. To address the underlying causes, we launched a virtual, multisite I-DARE medical school course and doubled the number of I-DARE-taught learning objectives from 43 to 107 (149%), compared with the baseline. The program evaluation review revealed that the students were self-reflective and provided a spectrum of experiences regarding the I-DARE course., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 National Association for Healthcare Quality.)

Background: Nonpharmacologic mind-body therapies have demonstrated efficacy in low back pain. However, the mechanisms underlying these therapies remain to be fully elucidated., Objective: In response to these knowledge gaps, the Stanford Center for Low Back Pain-a collaborative, National Institutes of Health P01-funded, multidisciplinary research center-was established to investigate the common and distinct biobehavioral mechanisms of three mind-body therapies for chronic low back pain: cognitive behavioral therapy (CBT) that is used to treat pain, mindfulness-based stress reduction (MBSR), and electroacupuncture. Here, we describe the design and implementation of the center structure and the associated randomized controlled trials for characterizing the mechanisms of chronic low back pain treatments., Methods: The multidisciplinary center is running two randomized controlled trials that share common resources for recruitment, enrollment, study execution, and data acquisition. We expect to recruit over 300 chronic low back pain participants across two projects and across different treatment arms within each project. The first project will examine pain-CBT compared with MBSR and a wait-list control group. The second project will examine real versus sham electroacupuncture. We will use behavioral, psychophysical, physical measure, and neuroimaging techniques to characterize the central pain modulatory and emotion regulatory systems in chronic low back pain at baseline and longitudinally. We will characterize how these interventions impact these systems, characterize the longitudinal treatment effects, and identify predictors of treatment efficacy., Results: Participant recruitment began on March 17, 2015, and will end in March 2023. Recruitment was halted in March 2020 due to COVID-19 and resumed in December 2021., Conclusions: This center uses a comprehensive approach to study chronic low back pain. Findings are expected to significantly advance our understanding in (1) the baseline and longitudinal mechanisms of chronic low back pain, (2) the common and distinctive mechanisms of three mind-body therapies, and (3) predictors of treatment response, thereby informing future delivery of nonpharmacologic chronic low back pain treatments., Trial Registration: ClinicalTrials.gov NCT02503475; https://clinicaltrials.gov/ct2/show/NCT02503475., International Registered Report Identifier (irrid): PRR1-10.2196/37823., (©Sean Mackey, Gadi Gilam, Beth Darnall, Philippe Goldin, Jiang-Ti Kong, Christine Law, Marissa Heirich, Nicholas Karayannis, Ming-Chih Kao, Lu Tian, Rachel Manber, James Gross. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 27.09.2022.)

Prevention of premalignant lesion progression is a promising approach to reducing lung cancer burden in high-risk populations. Substantial preclinical and clinical evidence has demonstrated efficacy of the prostacyclin analogue iloprost for lung cancer chemoprevention. Iloprost activates peroxisome proliferator-activated receptor gamma (PPARG) to initiate chemopreventive signaling and in vitro , which requires the transmembrane receptor Frizzled 9 (FZD 9 ). We hypothesized a Fzd 9 -/- mouse would not be protected by iloprost in a lung cancer model. Fzd 9 -/- mice were treated with inhaled iloprost in a urethane model of lung adenoma. We found that Fzd 9 -/- mice treated with iloprost were not protected from adenoma development compared to wild-type mice nor did they demonstrate increased activation of iloprost signaling pathways. Our results established that iloprost requires FZD 9 in vivo for lung cancer chemoprevention. This work represents a critical advancement in defining iloprost's chemopreventive mechanisms and identifies a potential response marker for future clinical trials., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

Counter-intuitively, sociodemographic characteristics account for a small proportion of explained variance in parental burnout. The present study conducted during the Covid-19 pandemic asks whether (i) sociodemographic characteristics are more predictive of parental burnout than usual in a situation of lockdown, (ii) situational factors, that is, the specific restrictive living conditions inherent in the context of lockdown, predict parental burnout better than sociodemographic characteristics do, and (iii) the impact of both sociodemographic and situational factors is moderated or mediated by the parents' subjective perception of the impact that the health crisis has had on their parenting circumstances. Results show that, within the context of lockdown, both sociodemographic and situational factors explain a negligible proportion of variance in parental burnout. By contrast, parents' cognitive appraisals of their parenthood within the context of the health crisis were found to play both a crucial mediating and moderating role in the prediction of parental burnout., Competing Interests: Conflicts of interestM.M. and I.R. founded the Training Institute for Parental Burnout (TIPB) which trains professionals on parental burnout. The TIPB did not participate in the funding of this study, nor did it influence the process or the results in any way., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

Objective: To compare the clinical presentation of UCPPS from a large clinical practice grouped by their presenting age to improve the evaluation of this condition., Methods: A total of 223 male and female patients seeking care for their UCPPS were recruited to study their urologic and non-urologic presentation. Their evaluation included cystoscopy and multiple questionnaires to assess their pelvic pain, non-urologic pain, urinary symptoms, somatic symptoms, and psychosocial health. Patients were then grouped by age into the following groups: less than 30 years of age, between the ages of 30 and 60, and older than 60. These groups were then compared on multiple domains., Results: Patients between the ages of 60 and 30 were most likely to have concomitant COPC (such as fibromyalgia or migraine headaches), more widespread distribution of non-urologic pain, higher somatic symptom burden, and depression. Patients 30 years old or younger were more likely to have more severe urologic and non-urologic pain, and urinary pain symptoms that are less typical of IC/BPS (eg, pain worsened during or after urination). Patients older than 60 were more likely to have Hunner lesion (55.6% vs 23.8% vs 8.6% among those who had cystoscopy, in decreasing age, P < .001)., Conclusion: Our findings support the evaluation of non-urologic pain, COPC and psychosocial health in middle-aged patients; Hunner lesion in older patients; and a higher clinical suspicion of other confusable diagnoses when younger patients present with atypical symptoms., (Copyright © 2021. Published by Elsevier Inc.)

Rationale: Having low subjective social status is associated with an array of negative health outcomes. However, the mechanisms linking subjective social status to health are not yet clear. One candidate mechanism is negative affect. Researchers have proposed that having low subjective social status may be associated with higher levels of negative affect, and these higher levels of negative affect may be associated with poor health. However, research demonstrating that status-related negative affect is prospectively associated with health in humans is limited., Objective: We examined whether negative affect prospectively mediates the relationship between subjective social status and physical health. In addition, we tested whether reappraisal - an affect regulation strategy used to downregulate negative affect - moderates the links among subjective social status, negative affect, and physical health., Method: We used two-wave longitudinal data from the Midlife in the United States (MIDUS) project to conduct a series of regression, mediation, and moderated mediation analyses to examine the relationships among subjective social status, negative affect, reappraisal, and health (i.e., four outcomes, chronic conditions, somatic symptoms, self-reported health and mortality)., Results: Negative affect mediates the relationship between status and change in morbidity (n = 3289; i.e., change in number of chronic conditions, somatic symptoms, self-reported health) and mortality (n = 4953), such that subjective social status is inversely associated with negative affect, and negative affect is positively associated with poor health. Reappraisal moderates each of these relationships, such that individuals who are low on subjective social status and have high scores on a novel measure of reappraisal experience lower levels of negative affect and better health than individuals who are low on subjective social status but who have low scores on this measure., Conclusion: These results have important implications for our understanding of subjective social status and how it relates to physical health., (Copyright © 2021 Elsevier Ltd. All rights reserved.)