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This study aimed to examine the therapeutic mechanism of the benefit-finding therapeutic (BFT) intervention that used cognitive reappraisal and alternative thinking to construct positive aspects of caregiving (PAC), in a cluster-randomized controlled trial for Alzheimer caregivers. Forty two caregivers received BFT, whereas 87 received psychoeducation as control. Depressive symptoms and global burden were outcomes measured at baseline, postintervention, and 4- and 10-month follow-up. Mediators considered included PAC (measured by benefit word count to a qualitative measure) and three self-efficacies-controlling upsetting thoughts (SE-CUT), responding to disruptive behaviors, and obtaining respite. Using mixed-effects regression, we demonstrated that benefit-finding increased caregivers' PAC and SE-CUT, but that only SE-CUT uniquely predicted depressive symptoms and global burden longitudinally. Path analyses with bootstrapped confidence intervals, using full information maximum likelihood estimation to retain the whole sample with partial missing data, showed that SE-CUT change from baseline to postintervention mediated intervention effects on depressive symptoms, but not global burden, at both follow-ups. No mediation effects were found for PAC and the other self-efficacies. The BFT effect on depressive symptoms was partly accounted for by improvement in SE-CUT. The therapeutic mechanism for the effect on burden remained unknown. The study sheds light on the importance of actively promoting positive caregiver functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objectives The benefit-finding therapeutic (BFT) intervention, training cognitive reappraisal, and alternative thinking to construct positive aspects of caregiving have been found to reduce caregiver depression. This study examines BFT effects on care-recipient outcomes via reduced caregiver depression. Design Cluster-randomized double-blind controlled trial. Setting Social centers and clinics. Participants A total of 129 caregivers. Inclusion criteria were 1) primary caregiver aged 18+, 2) without cognitive impairment, 3) providing ≥14 care hours weekly to a relative with mild-to-moderate Alzheimer's disease, and 4) scoring ≥3 on the Hamilton Depression Rating Scale. Exclusion criterion was care-recipient having Parkinsonism or other forms of dementia. Interventions BFT was evaluated against two forms of psychoeducation—standard and simplified (lectures only) psychoeducation. Measurements Care-recipient outcomes included neuropsychiatric symptoms (NPS), functional impairment, and global dementia severity (Clinical Dementia Rating sum-of-box), measured at baseline, postintervention, and 4- and 10-month follow up. Results Mixed-effects regressions showed a significant effect on NPS when compared with simplified psychoeducation only, with BFT participants reporting fewer NPS (especially mood symptoms) at 4-month follow-up (d = -0.52). Furthermore, longitudinal path analysis (using changes in caregiver depression scores at postintervention to predict changes in care-recipient NPS at follow-up) found that this effect was mediated by improved caregiver depression. No other intervention or mediation effects were found or were consistent across analyses. Conclusions Less depressed caregivers may be able to provide better care and more positive interactions, leading to reduced NPS in care-recipients. However, this benefit of BFT was limited to the comparison with simplified psychoeducation only.

Perfectionistic concerns are associated with various forms of distress, and research has shown that maladaptive emotion regulation mediates this relation. To our knowledge, this mediation process has not been studied in the lab when an individual experiences distress in the moment. This study was designed to determine (a) whether spontaneous emotion regulation mediates the relation between an experimentally induced experience of failure and distress and (b) whether perfectionistic concerns moderate this indirect effect. College students (N = 165) completed self-reports of perfectionistic concerns and past-week affect. They then completed one of the two anagram tasks that induced either a high degree of failure or a low degree of failure. Finally, spontaneous emotion regulation during the anagram task and post-task affect was measured. Spontaneous use of cognitive reappraisal mediated a positive indirect effect in the association between manipulated degree of failure and post-task negative affect at high levels of perfectionistic concerns but not at low levels. Moreover, spontaneous use of rumination mediated (a) a positive indirect effect for post-task negative affect and (b) a negative indirect effect for post-task positive affect at low levels of perfectionistic concerns but not at high levels. These findings suggest there is value in perfectionism research addressing the process of regulating emotions as it unfolds in the moment a person experiences failure. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This study focused on experiences of mental health providers in independent practice in the initial months of the COVID-19 pandemic. We aimed to understand transition to telehealth, stress, and if self-care and emotion regulation were related to stress level. Participants (N = 207) were mental health providers in independent practice. Participants completed the Perceived Stress Scale (Cohen et al., 1983);Emotion Regulation Questionnaire (Gross & John, 2003);and Self-Care Assessment for Psychologists (Dorociak, Rupert, Bryant, et al., 2017) in alternating order, and answered questions about personal and professional demographics, type of independent practice, and stressors and supports during COVID-19 (closed-ended and open-ended questions). Results indicated that participants rarely used telehealth prior to COVID 19 (with 46.80% stating they never used it and 42.36% stating they used it less than a quarter of their time) and had a rapid shift to telehealth provision (with 72.91% exclusively using telehealth shortly before or after the declaration of the pandemic). Most participants reported only moderate stress during the early months of COVID-19. For emotion regulation, increased use of cognitive reappraisal was associated with less stress, but increased use of expressive suppression was associated with increased stress. All facets of self-care were associated with less stress-having professional support, engaging in professional development, having life balance, utilizing cognitive strategies, and aiming for daily balance. Participants indicated a wide variety of stressors, some related to practice and some to the pandemic, as well as sources of support, including colleagues and professional organizations. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Mental health providers in independent practice made a rapid shift to telehealth in the initial months of the COVID-19 pandemic. Higher utilization of adaptive emotion regulation and regular self-care strategies were associated with lower provider stress, emphasizing the importance of regular use of these strategies. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Inhibitory control (IC) enables goal-directed behaviour by reducing the interference of irrelevant information. Studies have shown that IC can downregulate performance-based behavioural and physiological measures of emotional reactivity. This study examined whether transient recruitment of IC can modulate self-reported negative feelings after exposure to negative or neutral content. Furthermore, it was tested if triggering IC can improve the ability to reduce the negativity of unpleasant content by reinterpreting its meaning (cognitive reappraisal). For this purpose, a combined flanker and cognitive reappraisal task was performed by 49 participants. The flanker task was used to prime IC before participants reappraised or observed negative and neutral content. Priming IC before negative images reduced self-reported negative feelings compared to when IC was not primed. In contrast, priming IC before neutral images increased negative feelings. Priming IC had no influence on the ability to reappraise negative emotional content. Finally, trait rumination was associated with higher emotional reactivity only when IC was not primed. These results illustrate the importance of IC in decreasing emotional reactivity after being exposed to negative content. IC is revealed as a mechanism that can dynamically modulate subjective emotional reactivity as a function of emotional context.

Neural bases of cognitive reappraisal may depend on the direction of regulation (up- or downregulation) and stimulus valence (positive or negative). This study aimed to examine this using a cognitive reappraisal task and conjunction analysis on a relatively large sample of 83 individuals. We identified regions in which activations were common for all these types of emotion regulation. We also investigated differences in brain activation between the ‘decrease’ and ‘increase’ emotional response conditions, and between the regulation of negative and positive emotions. The common activation across conditions involved mainly the prefrontal and temporal regions. Decreasing emotions was associated with stronger involvement of the dorsolateral prefrontal cortex, while increasing with activation of the amygdala and hippocampus. Regulation of negative emotions involved stronger activation of the lateral occipital cortex, while regulation of positive emotions involved stronger activation of the anterior cingulate cortex extending to the medial prefrontal cortex. This study adds to previous findings, not only by doing a conjunction analysis on both emotional valences and regulation goals, but also doing this in a bigger sample size. Results suggest that reappraisal is not a uniform process and may have different neural bases depending on regulation goals and stimulus valence.

Objective The current study aimed at investigating the perceived impact of the COVID-19 pandemic on Italian individuals with a preexisting medical condition. Specifically, the study analyzed: (a) if different conditions were associated with different levels of distress, different levels of worry, and different emotion regulation strategies (i.e., cognitive reappraisal, expressive suppression); and (b) if distress levels were associated with levels of worry about COVID-19, emotion regulation strategies, and changes to medical treatment due to the pandemic. Method This cross-sectional study involved 124 individuals (79.8% female; mean age = 48.88 years; SD = 14.95) with a diagnosis of chronic disease. The questionnaires, administered during the peak of the first wave of the COVID-19 pandemic in Italy (April-May 2020), comprised the Perceived Stress Scale, the Emotion Regulation Questionnaire, a COVID-19 worry questionnaire, and a questionnaire designed to collect anamnestic and sociodemographic data. Results Higher levels of expressive suppression and worries related to COVID-19, and changes to medical treatment due to the pandemic, were associated with higher perceived stress in patients with a preexisting chronic disease. No differences emerged in the study variables according to the type of chronic disease. Conclusions The results highlight the importance of considering expressive suppression, levels of worry about COVID-19, and changes to scheduled medical treatment. Screening procedures based on these factors may be useful for identifying individuals with a preexisting medical condition at higher risk of distress, in order to offer them specific and remotely delivered psychological support. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Previous work has generally conceptualized emotion regulation as contributing to mental health outcomes, and not vice versa. The present study challenges this assumption by using a prospective design to investigate the directionality of underlying relationships between emotion regulation and mental health in the context of a major population-level stressor. We surveyed a large nationally representative sample of adults (18-91 years, N = 704) at three 1-month intervals across the acute lockdown phase of the COVID-19 pandemic in Australia, using standardized measures of depression and anxiety symptoms. At each time point, we also measured the use of two emotion regulation strategies-cognitive reappraisal and emotional suppression-previously associated with adaptive and maladaptive mental health outcomes, respectively. We found cognitive reappraisal was unrelated to mental health symptoms. In contrast, greater emotional suppression was robustly associated with higher symptom levels for both depression and anxiety. Longitudinal analyses revealed this association reflected bidirectional relationships. Higher symptoms of depression and anxiety each predicted greater subsequent use of emotional suppression, and greater use of emotional suppression predicted higher subsequent symptoms. This bidirectionality suggests emotional suppression is both symptomatic and predictive of psychological distress. The lack of a relationship for cognitive reappraisal is discussed with respect to the pandemic context and evidence that high stress might reduce people's ability to use this strategy effectively. Given the strong emphasis on reappraisal in clinical practice, there is a critical need to understand for whom, what and when this strategy is helpful. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Affective valence during exercise is thought to switch from positive to negative at the ventilatory threshold (VT). The emotion regulation strategy cognitive reappraisal (CR) can be used to reevalu...

Romantic conflict is known to have escalated during the lockdown period of the COVID-19 pandemic. This research investigates whether a single-session online writing intervention results in changes in romantic conflict among American adults cohabitating during COVID-19 quarantine (May 2020). Participants (N = 716, 50% female;mean age = 51.8 years) completed a baseline assessment which was followed by a brief (5–8 min) writing task in Qualtrics. Participants were randomized to one of five conditions, where they were asked to write about (a) a conflict with their romantic partner using cognitive reappraisal;(b) a conflict with their romantic partner expressing their deepest thoughts and feelings;(c) a conflict with someone other than their partner using cognitive reappraisal;(d) a conflict with someone other than their partner and a conflict with their partner expressing their deepest thoughts and feelings;or (e) mundane tasks like laundry, house cleaning, or lawn care. In the reappraisal conditions, participants were asked to use this perspective with the target person in the upcoming weeks. Two weeks later, participants were invited to complete a follow-up survey identical to baseline, where they were asked about conflict with their partner during the follow-up period. Results indicated that participants in the romantic partner cognitive reappraisal condition reported fewer disagreements, fewer relationship aggression events, and lower levels of conflict relentlessness with their partner relative to at least one of the control conditions. Results demonstrate preliminary support for a brief, cost-effective, and accessible tool that can help couples mitigate downstream effects of negative interactions during this stressful time. (PsycInfo Database Record (c) 2021 APA, all rights reserved) © 2021 American Psychological Association

Effectiveness of various emotion regulation (ER) strategies have received much attention in recent research. Among the most studied ER strategies are cognitive reappraisal and expressive suppression. However, the evidence of their effectiveness is controversial and depends on the measures used. The aim of the present study was to compare the effectiveness of cognitive reappraisal and expressive suppression strategies of ER via different measures such as self-report, facial expressions (zygomaticus major and corrugator supercilii electromyography), and physiological assessment (skin conductance response and heart rate deceleration). Participants were presented with intensely unpleasant or neutral pictures and performed ER tasks. We expected that the implementation of ER strategies would reduce negative emotions, and cognitive reappraisal would produce greater reduction in negative emotions compared to expressive suppression. Self-report data showed that reappraisal had a greater effect on the reduction of negative emotions compared to suppression. There was no difference between reappraisal and suppression assessed with skin conductance response and electromyography. Curiously, heart rate deceleration increased while participants tried to suppress their emotional expressions, which could reflect efforts exerted in the attempt to suppress. The ER strategies reduced negative emotions during the presentation of unpleasant pictures partially in skin conductance response and heart rate deceleration. Overall, reappraisal is more effective in changing subjective experience, whereas the physiological reactions do not differ substantially between the two ER strategies explored. We therefore recommend that the assessment of ER strategies in the laboratory should accommodate more than one type of measures to come to more reliable conclusions.

The purpose of this study was to evaluate the effects of various emotion regulation (ER) strategies on emotional distress and the urge to self-harm in response to mood induction in individuals who engaged in nonsuicidal self-injury (NSSI). Sixty-one individuals who engaged in NSSI participated in this study were assigned to an experimental ER strategy group (Distraction = 20, Cognitive Reappraisal = 21, Acceptance = 20). Participants completed the Self-Injury Urge Scale (SIUS), State-Trait Anxiety Inventory-State (STAI X-1), and Positive and Negative Affect Scales (PANAS) at several time points: T1) baseline; T2) after watching a film to induce negative mood; and a final time T3) after watching the film again but while using the group-specific ER strategy in response to the induced negative mood. We found that distraction effectively reduced the urge for NSSI after a negative mood induction, as measured using the SIUS. Additionally, cognitive reappraisal and distraction significantly reduced the STAI X-1 and negative affect scale (NAS) scores of the PANAS in individuals with NSSI who underwent negative mood induction. However, acceptance was significantly less effective in relieving unpleasant and undesirable inner experiences in the short term. Our findings suggest that both distraction and cognitive reappraisal are helpful in alleviating negative emotional experiences, and distraction may be useful in dealing with the urge to engage in NSSI. More evidence-based research to test the current findings is required.

Non-suicidal self-injury (NSSI) is a serious health concern in prison populations. Most previous research in prisons has examined lifetime engagement in NSSI, but less is known about correlates and risk factors during imprisonment. Using Nock’s integrated theoretical model as a conceptual framework, the present study tested the mediation effect of psychopathy and the moderation effect of cognitive reappraisal skills in the association between childhood maltreatment and NSSI in prisoners. A total of 1042 Chinese male prisoners anonymously completed measures of childhood maltreatment, psychopathy and cognitive reappraisal, and their NSSI was assessed through structured interviews. Regression based tests of the conceptual model showed that childhood maltreatment was significantly associated with NSSI in prisoners, and this association was mediated by psychopathy. Cognitive reappraisal moderated the relationship between psychopathy and NSSI. Specifically, the relationship between psychopathy and NSSI was significant for prisoners with low levels of cognitive reappraisal but non-significant for those with high levels of cognitive reappraisal. These findings highlight the need to consider environmental and intrapersonal factors simultaneously when evaluating risks associated with NSSI in prison populations, and can inform prevention and intervention programs in prison settings.

OBJECTIVES: Observational studies suggest emotion regulation (ER) as a potential treatment target for problematic college drinking. The primary aim of this laboratory study was to determine whether trait ER strategies would moderate the impact of negative affect induction on alcohol craving in college drinkers. METHODS: Participants were randomly assigned to a neutral (n = 74) or a negative affect induction (n = 76) and reported their craving after the affect inductions. RESULTS: Greater use of drinking to cope and less use of cognitive reappraisal predicted greater alcohol craving after the negative affect induction, but not after the neutral condition. In contrast, emotion suppression did not predict alcohol craving in either condition. CONCLUSION: Our results highlight the role of ER tendencies — particularly the benefits of cognitive reappraisal — on alcohol craving when experiencing emotional distress. Therefore, ER strategies may be an important target for college drinkers to prevent and reduce problematic drinking.

Background Panic disorder (PD) is thought to be related with deficits in emotion regulation, especially in cognitive reappraisal. According to the cognitive model, PD patients’ intrinsic and unconscious misappraisal strategies are the cause of panic attacks. However, no studies have yet been performed to explore the underlying neuromechanism of cognitive reappraisal that occur on an unconscious level in PD patients. Methods Twenty-six patients with PD and 25 healthy controls (HC) performed a fully-verified event-block design emotional regulation task aimed at investigating responses of implicit cognitive reappraisal during an fMRI scan. Participants passively viewed negatively valanced pictures that were beforehand neutrally, positively, or adversely portrayed in the task. Results Whole-brain analysis of fMRI data showed that PD patients exhibited less activation in the right dorsolateral prefrontal cortex (dlPFC) and right dorsomedial prefrontal cortex (dmPFC) compared to HC, but presented greater activation in parietal cortex when negative pictures were preceded by positive/neutral vs negative descriptions. Simultaneously, interactive effects of Group × Condition were observed in the right amygdala across both groups. Furthermore, activation in dlPFC and dmPFC was is negatively correlated to severity of anxiety and panic in PD when negative images were preceded by non-negative vs negative descriptions. Conclusions Emotional dysregulation in PD is likely the result of deficient activation in dlPFC and dmPFC during implicit cognitive reappraisal, in line with impaired automatic top-down regulation. Correlations between severity of anxiety and panic attack and activation of right dlPFC and dmPFC suggest that the failure to engage prefrontal region during implicit cognitive reappraisal might be associated wtih the severity of anxiety and panic; such functional patterns might be the target of possible treatments.

Parental burnout is a state that parents experience overwhelming exhaustion in their parental role. Given the detrimental impacts of parents’ stress on adolescent development, youth may suffer from undesirable emotional adjustment due to parental burnout. Therefore, it is key to understand the underlying mechanisms through which parental burnout may play a role in youth’s mental health and identify protective factors that may reduce the potential negative impacts. Using a sample of 442 Chinese parent-adolescent dyads (Mean age of youth = 13.35 years; 50% girls), this two-wave longitudinal study examined how parental burnout contributes to youth’s mental health over the span of two months. Moreover, the current research investigated the potential mediating role of autonomy support and the potential moderating role of emotion regulation in the links between parental burnout and youth’s mental health. The results showed that greater parental burnout was predictive of youth’s greater depressive and anxiety symptoms two months later, and such effects were partially mediated by less autonomy-supportive parenting. Notably, the negative effects of parental burnout on autonomy-supportive parenting and youth’s mental health were not significant when parents used more cognitive reappraisal to regulate their emotions. These findings demonstrate the underlying mechanisms of how parental burnout affects youth’s mental health over time and highlight the protective role of healthy emotion regulation against parental burnout.

Emotional dysregulation is a key symptom in participants with personality disorders. The Emotional Regulation Questionnaire (ERQ) has been studied with nonclinical samples; however, it is necessary to confirm the factorial structure of the ERQ in participants with personality disorders. The aims of the present study were to confirm the factorial structure of the Spanish version of the ERQ and analyse its psychometric properties as well as the association between the ERQ and the Borderline Symptoms List (BSL-23) and the Difficulties in Emotion Regulation Scale (DERS). The overall sample was composed of 250 patients with personality disorders, of whom 195 met the criteria for borderline personality disorder. Confirmatory factor analysis was conducted. The two-factor model showed an acceptable fit, similar to the original structure, in the participants with personality disorders and with borderline personality disorder. Cognitive reappraisal was negatively correlated with the DERS and BSL-23, and expressive suppression was positively correlated with the BSL-23. The ERQ is a reliable and valid instrument to evaluate emotional dysregulation in participants with personality disorders and participants with borderline personality disorder.

Cognitive reappraisal is associated with reduced emotional distress; however, little is known about the nature of this relationship in autism. This study tested whether autistic traits moderate reappraisal success (i.e., the negative correlation between reappraisal use and emotional symptom severity). Emotional symptoms were assessed using measures of depression, anxiety, and stress. It was hypothesized that more severe autistic traits would be associated with weaker reappraisal success across all scales. Data were collected from 377 adults using an on-line survey. Structural equation models found moderation effects for depression and anxiety, but not stress. Contrary to hypotheses, more severe autistic traits were associated with stronger reappraisal success. These preliminary results support including reappraisal in emotion regulation treatments for individuals with autistic traits.

Borderline Personality Disorder (BPD) is associated with emotion dysregulation. The emotion regulation strategies people adopt may depend on one’s belief about emotion as either fixed or changeable (termed “implicit theory”). We test this experimentally by modifying beliefs about emotions using virtual reality (VR). A sample of 29 adolescents (ages 14–17 years) were recruited from two adolescent inpatient units for an uncontrolled pilot trial of a new brief intervention. We measured BPD traits, beliefs about emotion, treatment preference, cognitive reappraisal and rumination, before the VR game and 14–31 days later. Adolescents with higher levels of BPD traits endorsed fixed beliefs of emotion and reported higher levels of rumination and lower levels of cognitive reappraisal. After a one-time message delivered via VR, adolescents evidenced an increase in belief that their emotions were changeable. These findings suggest beliefs about emotions may have an important role in interventions for adolescents with BPD traits.

The COVID‐19 outbreak negatively impacted the mental health and emotions of many individuals. The study presented here explores the mental health and emotion regulation experienced by undergraduate nursing students in China during the pandemic. Potential risk factors related to negative mental health symptoms were identified in this study. An online cross‐sectional study including 342 respondents was performed from March 6, 2020, to April 1, 2020, at a University in China. A Generalized Anxiety Disorder‐7 (GAD‐7), Patient Health Questionnaire‐9 (PHQ‐9), and Emotion Regulation Questionnaire (ERQ) were used to evaluate mental health and emotions. The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 22. The prevalence of anxiety, depression, or comorbid anxiety and depression were 55.0%, 56.4%, and 31.6%, respectively. The mean score of cognitive reappraisal and expressive suppression was 29.36 ± 8.00 and 15.55 ± 5.14. Lower scores for cognitive reappraisal and higher scores for expressive suppression were susceptible to symptoms of anxiety, depression, or comorbid anxiety and depression. Issues with mental health occurred in nursing students during the COVID‐19 pandemic. Findings from this study provide a better understanding of the association between mental health and emotion regulation, which will help direct psychological intervention that relieves these issues during the pandemic.

Background: Youth with anxiety disorders struggle with managing emotions relative to peers, but the neural basis of this difference has not been examined. Methods: Youth (Mage=13.6; range=8-17) with (n=37) and without (n=24) anxiety disorders completed a cognitive reappraisal task while undergoing fMRI. Emotional reactivity and regulation, functional activation, and beta-series connectivity were compared across groups. Results: Groups did not differ on emotional reactivity or regulation. However, affect ratings and fronto-limbic activation after viewing aversive imagery (with and without regulation) were higher for anxious youth. Anxious youth did not demonstrate age-dependent changes in regulation, whereas regulation in control youth increased linearly. Stronger amygdala-vmPFC connectivity related to greater anxiety in control youth, but less anxiety in anxious youth. Stronger amygdala-frontal pole connectivity related to worse emotion regulation in control youth, but better emotion regulation in anxious youth. Conclusions: Anxious youth regulate when instructed, but this does not relate to age. Viewing aversive imagery related to heightened negative affect even after reappraisal, accompanied by higher fronto-limbic activation. Emotion dysregulation in youth anxiety disorders may stem from heightened emotionality and potent bottom-up neurobiological responses to aversive stimuli. Findings suggest the importance of treatments focused on both reducing initial emotional reactivity and bolstering regulatory capacity.

According to emotion socialization theory, parent characteristics interact with child and contextual factors to influence parent responding to youth emotions, which impacts youth emotional reactivity and regulation. However, little is known about how treatments for youth emotional disorders, particularly those with significant parent intervention components, may impact parents’ own emotional reactivity and their responses to youth emotion. We investigated whether parents (N = 91) participating in a transdiagnostic treatment for youth emotional disorders experienced change in their own emotional reactivity (i.e., symptoms, distress tolerance [DT], emotion regulation), supportive responses to youth emotion (e.g., expressive encouragement), and unsupportive responses to youth emotion (e.g., punitive, minimizing). We also examined the relationship of these changes to treatment-related change in youth symptoms. Parent anxiety, depression, stress, DT, and cognitive reappraisal significantly improved from pre- to post-treatment. Unsupportive responses to youth emotions also decreased. Change in parent DT and baseline youth symptoms were the only significant predictors of parent-rated post-treatment youth anxiety and depressive symptoms when all variables were included in regression models. This is the first known investigation of changes in parent emotional reactivity and responses to youth emotions in response to a transdiagnostic treatment of emotional disorders for youth. Results support the beneficial impact of treatment involvement on parents’ own emotional reactivity and behaviors, as well as the potential importance of targeting parent DT to improve youth symptoms.

Dysphagia and symptoms of depression, anxiety and stress are common in persons with multiple sclerosis (MS). We posited a relationship between dysphagia and increased frequency of psychological symptoms. Therefore, the aim of the present study was to examine associations between symptoms of psychological difficulties, use of emotional suppression and cognitive reappraisal strategies, and dysphagia status in persons with MS. One hundred persons with MS were prospectively assessed in multiple domains of functioning: cognitive, psychological, and dysphagia-related. Participants underwent cognitive screening with the Mini Mental State Examination and completed two psychological inventories: The depression, anxiety and stress scale (DASS)-21 and the Emotion Regulation Questionnaire. Further, they completed the dysphagia in Multiple Sclerosis questionnaire. A speech-language pathologist evaluated persons suspected of having dysphagia with the Mann Assessment of Swallowing Ability. Dysphagia was present in 29 persons with MS, and the sample was split accordingly. The two groups differed at baseline with respect to Expanded Disability Status Scale scores. There were significant between-group differences for mental health symptoms and for use of emotional regulation strategies. Accordingly, multivariate logistic regressions showed that increased symptoms of psychological stress, decreased use of cognitive reappraisal strategies, and increased indicators of emotional suppression independently predicted the presence of dysphagia. There was a clear pattern towards poorer psychological well-being in persons with dysphagia compared to those without. Psychological difficulties may contribute to the manifestation or worsening of dysphagia and should be addressed in treatment planning and future investigations. Therapeutic interventions that promote improvement in mental state alongside swallowing function may be highly beneficial.

OBJECTIVE: The primary objective of this study was to test perceived controllability of stressors as a moderator of the association between coping and depressive symptoms in children and adolescents with sickle cell anemia (SCA). METHOD: Twenty-eight children and adolescents (M(age) = 11.71, SD = 4.31; 60.7% female) with SCA were enrolled. Caregivers provided reports of child and adolescent coping using the Response to Stress Questionnaire (RSQ), perceived control of stressors on the RSQ, and depressive symptoms using the Child Behavior Checklist. Children and adolescents also completed Wechsler assessments of working memory and verbal comprehension. RESULTS: Secondary control coping (i.e., cognitive reappraisal, acceptance, distraction) was a significant predictor of depressive symptoms such that greater use of secondary control coping was related to fewer reported depressive symptoms when accounting for use of primary control (problem-solving, emotion expression and regulation) and disengagement coping and neurocognitive variables. Further, perceived control of peer-related stress was a significant moderator of the association between secondary control coping and depressive symptoms, such that there was a significant negative association of secondary control coping with depressive symptoms only for low perceived control. CONCLUSION: Secondary control coping may be particularly helpful for reducing depressive symptoms when adolescents’ peer-related stressors are perceived as uncontrollable. Interventions to reduce internalizing problems in this population should consider teaching children and adolescents secondary control coping skills in addition to skills in identifying uncontrollable sources of stress.

This study examined whether expressive suppression (ES), a maladaptive regulation strategy, was more strongly associated with PTSD diagnosis and symptom clusters in veterans than cognitive reappraisal (CR), an adaptive regulation strategy.In a cohort study, 746 participants recruited from VHA facilities completed Clinician Administered PTSD Scale-IV, Emotion Regulation Questionnaire, and Patient Health Questionnaire. Participants were categorized into groups: Current, Remitted/Lifetime, and Never PTSD.One-way ANOVA revealed significant differences between Current PTSD and both Remitted and Never PTSD for ES, but not CR. The Remitted and Never PTSD groups did not vary significantly from each other and were collapsed into one group for regressions. Adjusting for sex, race, employment, and comorbid depression, binary logistic regression showed ES, but not CR, was associated with increased likelihood of Current PTSD (p.001, OR: 1.43). ES was also significantly associated with increased odds of meeting criteria for all symptom clusters (ps0.001). CR was not significantly associated with meeting criteria for Current PTSD or any symptom cluster.Cross-sectional design and use of self-report limit causality inferences that can be drawn.ES is associated with increased odds of Current PTSD diagnosis and symptom clusters. Veterans in the Remitted and Never PTSD groups did not differ significantly. Greater suppression of emotional expression is more strongly linked with PTSD criteria in veterans than decreased cognitive reappraisal.

Even though dysfunctional emotion regulation is prominent in depression and a link between depression and inflammation is well established, there is little knowledge about how inflammation affects the regulation of emotions. The aim of this pilot study was to explore the effect of experimentally induced inflammation on the cognitive reappraisal of emotions, and to assess domain specificity by comparing success in regulation of emotions towards two unpleasant stimuli classes (general negative stimuli as well as disgust stimuli). In a between-subject design, ten healthy participants were injected with an intravenous injection of lipopolysaccharide (2 ng/kg body weight) and eleven were injected with saline. Participants performed a cognitive reappraisal task, in which they had to down-regulate or up-regulate their emotions towards general negative stimuli and disgust stimuli, 5-6 hours post-injection. Contrary to our hypotheses, participants injected with lipopolysaccharide reported greater success in down-regulating emotional responses towards unpleasant stimuli as compared to the saline group. In addition, both groups were poorer at down-regulating emotions towards disgust stimuli as compared to general negative stimuli. The current pilot study indicates that cognitive reappraisal of emotions is affected during experimental endotoxemia, and suggests that disgust stimuli might be difficult to reappraise.

Stressful life events are a common antecedent of suicidal thoughts. However, not all stressful events lead to increased suicidal thinking, even among those who frequently have suicidal thoughts. In this study, we examined whether the ways that individuals regulate their emotions moderates the association between stressful events and suicidal thinking. Building on prior research we hypothesized that cognitive reappraisal is associated with a weaker relationship between stress and same-day suicidal thoughts, and that expressive suppression is associated with a stronger relationship between stress and suicidal thoughts. We used a daily diary method to collect self-reports of stressful events and suicidal thoughts over a 28-day period. At baseline, we assessed participants’ tendency to use cognitive reappraisal and expressive suppression. Consistent with our first hypothesis, we found that at higher levels of reappraisal, there was a weaker relationship between stress and suicidal thoughts. Contrary to our second hypothesis, we found that at higher levels of expressive suppression there was also a weaker relationship between stress and suicidal thoughts. In contrast to laboratory-based findings suggesting that expressive suppression has negative psychological effects, these preliminary daily diary results suggest that expressive suppression could be an effective short-term emotion regulation strategy among individuals considering suicide.

Background: Poor sleep quality is associated with a broad range of psychopathology and is a common problem among college students. This study aimed to investigate the mediating role of metacognitive beliefs related to sleep, emotion regulation and a negative cognitive style related to anxiety (looming cognitive style) in the relation between neuroticism and reported sleep quality.Participants: Participants were 343 undergraduates from three universities in Tehran (56.3% females, Mean age = 22.01 ± 2.74 years).Method: Data were gathered with a questionnaire packet that included the Pittsburgh Sleep Quality Index (PSQI), Metacognitions Questionnaire-Insomnia (MCQ-I), Emotion Regulation Questionnaire (ERQ), Looming Maladaptive Style Questionnaire (LMSQ) and Neuroticism subscale of NEO-PI-R.Results: Structural equation modeling analyses supported a proposed model (R2 = 37%) which proposed that neuroticism both directly and indirectly linked to reported sleep quality through metacognitions related to sleep, cognitive reappraisal and looming cognitive style (χ2 = 1194.87, p < .001; CFI = 0.93, NFI = 0.90, RMSEA = 0.065, GFI = 0.92, SRMR = 0.069, IFI = 0.93).Conclusions: The results provide evidence for the impact of neuroticism on reported sleep quality through metacognitive, cognitive and emotional factors. The result suggest that special attention should be paid to these factors in the treatment and psychopathology of sleep quality.

Catastrophizing thoughts may contribute to the development of anxiety, but functional emotion regulation may help to improve treatment. No study so far directly compared up- and down-regulation of fear by cognitive reappraisal. Here, healthy individuals took part in a cued fear experiment, in which multiple pictures of faces were paired twice with an unpleasant scream or presented as safety stimuli. Participants (N = 47) were asked (within-subjects) to down-regulate, to up-regulate and to maintain their natural emotional response. Valence and arousal ratings indicated successful up- and down-regulation of the emotional experience, while heart rate and pupil dilation increased during up-regulation, but showed no reduction in down-regulation. State and trait anxiety correlated with evaluations of safety but not threat stimuli, which supports the role of deficient safety learning in anxiety. Reappraisal did not modulate this effect. In conclusion, this study reveals evidence for up-regulation effects in fear, which might be even more efficient than down-regulation on a physiological level and highlights the importance of catastrophizing thoughts for the maintenance of fear and anxiety.

PurposeThe purpose of this study is to examine the boundary condition roles of cognitive reappraisal and rumination in the link between abusive supervision and work effort.Design/methodology/approachSurvey data were collected from 545 highly skilled employees of manufacturing companies. We excluded 161 of these questionnaires because they were incomplete and used 384 questionnaires in the analyses. To assess the validity of proposed hypotheses, we conducted hierarchical regression analysis.FindingsThe results indicate that cognitive reappraisal weakens the negative link between abusive supervision and work effort. Moreover, individuals who ruminate tend to exhibit reduced work effort when they experience abusive behavior from their supervisors.Originality/valueThis study is the first to investigate the moderating roles of cognitive reappraisal and rumination in the link between abusive supervision and work effort. The findings can help organizations understand the situations when abusive supervision decreases levels of work effort among employees and when subordinates maintain their levels of work effort.

In the earliest months of 2020, the COVID-19 emergency reached a pandemic status of international concern. In this situation, people tended to think more about current difficulties and their negative consequences due to the fear of infection and changed daily life during quarantine. The aim of this study was to explore the severity of worry in relation to individual characteristics and emotions during COVID-19 outbreak in the Italian people. Socio-demographic questions and standardized self-report questionnaires were administered online. Results highlighted a moderate level of worry, anxiety and distress. People with higher perceptions of COVID-19 severity exhibited higher levels of worry in contrast to those who perceived a greater control over the possibility of infection. Multiple regression analysis indicated that coping styles, emotion regulation strategies and personality traits significantly contributed to explain the variance in worry scores. Findings supported that cognitive reappraisal, emotion-focused coping and extraversion were protective factors for worry, while expressive suppression, dysfunctional and problem-focused coping, and neuroticism were related to high worry. However, neuroticism and dysfunctional coping were particularly important predictors of worry. This paper also considers possible psychological interventions that might be implemented in order to deal with mental health issues emanating from the COVID-19 pandemic.

Background Rumination is an important feature of affective disorders. Relationships between rumination, cognitive function, emotion regulation, and psychological resilience have been examined in unipolar depression; but few studies have determined whether unipolar and bipolar depressive episodes are distinguishable in terms of these variables. This study examined rumination in relation to clinical and cognitive variables in patients with unipolar depression or bipolar depression, and healthy controls. Methods In total, 150 participants (50 bipolar, 50 unipolar, 50 controls) were included. Assessments comprised the Ruminative Response Scale-Short Form, Positive Beliefs about Rumination Scale, Negative Beliefs about Rumination Scale, Brief Resilience Scale, Emotion Regulation Questionnaire, Stroop Test, and Trail Making Test A and B. Results The unipolar group had significantly higher scores in ruminative response and performed better in a neuropsychological test (Trail Making Test Part A) than the bipolar group. When duration of illness was controlled, no significant difference was found between depression groups in terms of rumination. There was a negative relationship between rumination and emotion regulation (cognitive reappraisal subscale), and rumination and psychological resilience in both patient groups, but no significant relationship was found in healthy controls. Limitations Relatively small sample size: future studies in larger clinical samples would increase knowledge of rumination in both unipolar and bipolar depression. Conclusions Patients experiencing unipolar or bipolar depressive episodes are potentially distinguishable in terms of ruminative response levels and cognitive functions. This differentiation may help in developing targeted interventions for unipolar and bipolar depression.

Background Internet-delivered cognitive behavior therapy (iCBT) is effective in treating anxiety and depression. Research on how these interventions operate is scarce. This study explored whether emotion regulation skills and positive beliefs about rumination were affected by iCBT and if these constructs mediated changes in depression and anxiety. Methods This is a secondary analysis of a pragmatic randomized waitlist-controlled trial testing the effectiveness of supported iCBT. Adults with at least mild symptoms of depression or anxiety were included. Depression (PHQ-9), anxiety (GAD-7), positive beliefs about rumination (PBRS-A) and two emotion regulation skills: cognitive reappraisal (ERQ-A) and expressive suppression (ERQ-S), were measured at baseline and 8-weeks post-treatment. Results The analyses included 358 participants, 71% were female. Median age was 29. Linear mixed models showed statistically significant differences along ERQ-A in favor of the iCBT group (b = 1.83, SE = 0.82, p = .026). Mediation analyses showed reductions in depression (b = 0.31, SE = 0.15, p = 0.043) and anxiety symptoms (b = 0.27, SE = 0.14, p = 0.057) were partially mediated by gains in ERQ-A. No effects were observed for PBRS-A and ERQ-S. Conclusions These results align with findings from face-to-face therapy and add to the scarce literature on mediators of effects of iCBT, contributing to the understanding of how these interventions operate. Since mediator and outcome variables were measured at the same time, partial mediation results should be interpreted with caution since the study design did not account for temporality and therefore causality effects cannot be confirmed. Trial Registration ISRCTN91967124.

Background Up to 40% of patients with bipolar disorder (BD) are initially diagnosed as having major depressive disorder (MDD), and emotional lability is a key aspect of both sets of mood disorders. However, it remains unknown whether differences in the regulation of emotions through cognitive reappraisal may serve to distinguish BD and MDD. Therefore, we examined this question in euthymic BD and MDD patients. Methods Thirty-eight euthymic BD, 33 euthymic MDD and 37 healthy control (HC) participants, matched for age, gender and depression severity, engaged in an emotion regulation (ER) cognitive reappraisal task during an fMRI scan were examined. Participants either reappraised (Think condition) or passively watched negative (Watch condition) or neutral (Neutral condition) pictures and rated their affect. Activation and connectivity analyses were used to examine group differences in reappraisal (Think vs Watch) and reactivity (Watch vs Neutral) conditions in ER-specific neural circuits. Results Irrespective of group, participants rated most negatively the images during the Watch condition relative to Think and Neutral conditions, and more negatively to Think relative to Neutral. Notably, BD participants exhibited reduced subgenual anterior cingulate activation (sgACC) relative to MDD during reappraisal, but exhibited greater sgACC activation relative to MDD during reactivity, whereas MDD participants elicited greater activation in right amygdala relative to BD during reactivity. We found no group differences in task-related connectivity. Conclusions Euthymic BD and MDD patients engage differential brain regions to process and regulate emotional information. These differences could serve to distinguish the clinical groups and provide novel insights into the underlying pathophysiology of BD.

Qualitative evidence points to the engagement of religious coping strategies when facing adversity, and evidence also highlights the effectiveness of cognitive reappraisal in reducing the impact of distressing emotions on well-being. It has been suggested that religious practices could facilitate the use of reappraisal, by promoting reframing of negative cognitions to alter emotional states. However, the link between religiosity and reappraisal in influencing resilience against symptoms of distress is not known. The current study (N = 203) examined connections among these aspects, using self-reported measures of religious coping, habitual use of specific coping strategies (positive reappraisal) and perceived confidence in using coping strategies, as well as questionnaires assessing symptoms of distress (anxiety and depression). Results point to a mediating role of reappraisal and coping self-efficacy as part of mechanisms that provide a protecting role of religious coping against emotional distress. These results provide novel scientific evidence further validating millennia-old traditional coping practices and shed light on psychological factors influencing adaptive behaviors that promote increased resilience, reduce symptoms of distress, and maintain emotional well-being. These findings inform general counseling practices and counseling of religious clients alike.

Although definitions of emotion dysregulation infer difficulties in selecting and implementing emotion regulation (ER) strategies, surprisingly few studies have examined the relationship between trait emotion dysregulation and a wide range of specific ER strategies. The present study used a data-driven approach to assess trait- and state-related ER strategy use in 99 women (aged 18–55) recruited from the community with varying levels of trait emotion dysregulation. Participants completed self-report questionnaires assessing habitual ER strategy implementation and self-ratings of ER strategy use in vivo during negative mood inductions. Principal components analysis revealed four self-report questionnaire-based and three mood-induction-based groupings comprising both optimal and suboptimal strategies. After adjusting for demographic and clinical variables, results from self-report questionnaires indicated that trait emotion dysregulation was significantly associated with higher endorsements of suboptimal strategies in two groupings (e.g., self-criticism, rumination, and social withdrawal; catastrophizing and blaming others) and lower endorsements of optimal ER strategies in one grouping (e.g., cognitive reappraisal and problem solving). In the context of mood induction, trait emotion dysregulation was significantly associated with higher endorsements of suboptimal ER strategies from one cluster only (e.g., expressive suppression, thought avoidance, and self-criticism). Such transdiagnostic, data-driven approaches can uncover how the application of specific ER strategies both habitually and during negative mood states is associated with trait emotion dysregulation.

To minimize distress associated with choices with uncertain consequences, individuals with high levels of anxiety may continue with familiar choices rather than seek out novel choices. As a result, they might be more vulnerable to sunk cost fallacy, the inability to ignore unrecoverable prior investments when making decisions about the future. Considering that cognitive reappraisal may mitigate the association between anxiety and poor decision making, the present study examined the relations between cognitive reappraisal, anxiety, and resistance to sunk cost. To this end, 108 undergraduates completed questionnaires assessing their tendency to engage in cognitive reappraisal, severity of anxiety, and resistance to sunk cost. Participants’ tendency to engage in cognitive reappraisal moderated the relation between the severity of anxiety and resistance to sunk cost. However, in individuals who typically engaged in cognitive reappraisal, only lower levels of anxiety were associated with higher resistance to sunk cost. Individuals with high vs. low levels of anxiety might differ in how they reappraise negative situations, which can consequently affect resistance to sunk cost.

© The Author(s), under exclusive licence to Springer Nature Limited 2021, corrected publication 2022, The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world., This project was supported by funds from: the Amazon Web Services (AWS) Imagine Grant (to E.M.B.); the Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research (JSPS KAKENHI; 16h03079, 17h00875, 18k12015, and 20h04581 to Y.Y.); the research programme Dipartimenti di Eccellenza from the Ministry of Education University and Research (MIUR to N. Cellini and G.M. and the Department of General Psychology of the University of Padua); statutory funds of the University of Wroclaw (to A. Sorokowska); the Charles University Research Programme PROGRES (Q18 to M. Vranka); the Knut and Alice Wallenberg Foundation (2016:0229 to J.K.O.); the Rubicon Grant (019.183sg.007 to K.v.S.) from the Netherlands Organisation for Scientific Research; the Australian Research Council (dp180102384 to R.M.R.); the US National Institutes of Health (NIMH111640 to M.N.-D.), the Huo Family Foundation to N.J.; the NSF Directorate for Social, Behavioral and Economic Sciences, Division of Social and Economic Sciences (1559511 to J.S.L.); the US National Institutes of Health (RO1-CA-224545 to J.S.L.); Eesti Teadusagentuur–Estonian Research Council (PSG525 to A. Uusberg); the J. William Fulbright Program (to F. Azevedo); the HSE Basic Research Program (to D. Dubrov); Dominican University (a Faculty Development Grant to A. Krafnick); and the French National Research Agency Investissements d’avenir supporting PSF (ANR-15-IDEX-02 to H.I.); the Slovak Research and Development Agency (project no. APVV-20-0319 to M. Adamkovič); the programme FUTURE LEADER of Lorraine Université d’Excellence within the French National Research Agency Investissements d’avenir (ANR-15-IDEX-04-LUE to S.M.). Computation for this research was assisted by: the Harvard Business School compute cluster (HBSGrid); and the Open Science Grid. The Open Science Grid is supported by the National Science Foundation award 1148698 and the US Department of Energy’s Office of Science, as well as by the compute resources and assistance of the UW-Madison Center For High Throughput Computing (CHTC) in the Department of Computer Sciences. The CHTC is supported by UW-Madison, the Advanced Computing Initiative, the Wisconsin Alumni Research Foundation, the Wisconsin Institutes for Discovery, and the National Science Foundation, and is an active member of the Open Science Grid, which is supported by the National Science Foundation and the U.S. Department of Energy’s Office of Science.

Prolonged grief disorder, characterized by severe, persistent, and disabling grief, has recently been included in the International Classification of Diseases-11 (ICD-11). Emotional disturbances are central to such complicated grief responses. Accordingly, emotion regulation is assumed critical in the development, persistence, and treatment of complicated grief. Yet, a comprehensive review on this topic is lacking. We conducted a systematic review (PROSPERO: CRD42017076061) searching PsycInfo, Web of Science, and PubMed to identify quantitative research examining relationships between emotion regulation and complicated grief. Sixty-four studies on 7,715 bereaved people were identified, focusing on a variety of emotion regulation strategies (i.e., experiential avoidance, behavioral avoidance, expressive suppression, rumination, worry, problem solving, cognitive reappraisal, positive thought, and mindfulness). Our synthesis showed strong evidence that experiential avoidance and rumination play a role in the persistence of complicated grief. More generally, surveys support positive associations between putative maladaptive emotion regulation strategies and complicated grief, and negative associations between putative adaptive emotion regulation strategies and complicated grief. Laboratory research yielded mixed results. Emotion regulation is critical in complicated grief, and in particular experiential avoidance and rumination form important targets in complicated grief treatments. We advise expanding current knowledge, by employing more advanced, intensive data collection methods and experiments across diverse samples. Increasing knowledge in this domain will improve clinical practice.

Although many previous studies have examined factors associated with depression, there has been a lack of studies examining the role of external shame and lack of emotion regulation. Therefore, the present study examined these potential risk factors alongside other risk factors in a group that may be more prone to depression (i.e., married Muslim mothers). Married Muslim mothers (n = 971) residing in the urban area of Kuala Lumpur (Malaysia) were surveyed. Using various psychometric instruments, the survey assessed psychiatric problems (including depression), insecure attachment styles, external shame, severe life events, emotional regulation, and vulnerable factors for depression. Results indicated that married Muslim mothers were more vulnerable to depression if they had high external shame, less cognitive reappraisal, had at least one severe life event, had low income, and were unemployed. External shame was the most significant risk factor for depression. In future studies and psychotherapy practice, external shame, cognitive reappraisal, severe life events, low income, and unemployment should be taken into account with regard to depression among this cohort.

Beliefs about how much people can change their attributes – implicit theories – influence affective and cognitive responses to performance and subsequent motivation. Those who believe their attributes are fixed view setbacks as threatening and avoid challenging situations. In contrast, those who believe these attributes are malleable embrace challenges as opportunities to grow. Although implicit theories would seem to have important mental health implications, the research linking them with clinical applications is limited. To address this gap, we assessed how implicit theories of anxiety, emotion, intelligence, and personality related to various symptoms of anxiety and depression, emotion-regulation strategies, and hypothetical treatment choices (e.g., medication versus therapy) in two undergraduate samples. Across both samples, individuals who believed their attributes could change reported fewer mental health symptoms, greater use of cognitive reappraisal, and were more likely to choose individual therapy over medication. These findings suggest that implicit theories may play an important role in the nature and treatment of mental health problems.

Background The process of COVID-19 outbreak has affected Turkey as it has affected the whole world. The purpose of the current study is to investigate individuals' health anxiety and emotion regulation during the period of COVID-19 outbreak in Turkey in relation to some variables. The study also aims to explore the relationship between emotion regulation and health anxiety. Subjects and methods The study was conducted on 874 individuals reached online through the google e-forms. The participants were administered the "Health Anxiety Scale and Emotion Regulation Scale" to collect data. In the analysis of the collected data, Mann- Whitney U Test, Kruskal Wallis-H Test, Spearman Correlation Coefficient were used. Results In the current study, healthy anxiety scores of the participants were analyzed depending on some variables. Health anxiety was found to be higher in women, 18-30 age group, singles, students, and groups with physical and mental health problems. The research also found that there is a low and negative relationship between health anxiety and cognitive reappraisal. It is understood that men's suppression scores are higher than women. There is no significant difference between suppressing emotions and health anxiety. It was found that educators received the highest scores in terms of cognitive reappraisal. The cognitive reappraisal level of the group without mental disorder was found to be higher than the other group. Conclusion According to the results of the research, more supportive services should be provided for the groups with the higher health anxiety. Considering that especially students and young people are affected more, it can be said that mental health preventive services should be included more in these groups. At the same time, the fact that men have higher emotion suppression scores than women shows that this situation should also be taken into consideration in mental health services.

Music and instruction-guided relaxation (MIGR) is a complementary therapeutic tool used in the treatment of the major depressive disorder (MDD). However, the neural mechanism that underlies the effect of MIGR on MDD patients is not known. Twenty-three right-handed MDD patients and 23 age-, sex-, handedness-, and educational level-matched healthy controls were enrolled. Resting-state functional MRI data were acquired from patients before and after MIGR and from healthy controls. The relationships between insular subregion-based functional connectivity and Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAM-A), Automatic Thoughts Questionnaire, and Ruminative Responses Scale scores were examined. One-way analysis of variance exhibited significant differences among the three groups in functional connectivity between the left dorsal anterior insula (dAI) and left superior medial frontal gyrus (SMFG), left dAI and left precuneus, left posterior insula and left gyrus rectus, right ventral anterior insula (vAI) and left posterior cingulate cortex (PCC), right vAI and right inferior frontal gyrus (R-IFG). Further comparisons in regions of interest showed that MDD patients before MIGR showed decreased functional connectivity between the left dAI and left SMFG, left dAI and left precuneus, left posterior insula, and left gyrus rectus, right vAI and left PCC, right vAI and R-IFG relative to those in healthy controls. The strength of functional connectivity between the right dAI and left putamen also exhibited a negative correlation with the HAM-A score in MDD cases before MIGR. MIGR may result in enhanced functional connectivity in insular subregions, thereby potentially increasing the regulatory influence of cognitive reappraisal.

Math anxiety (MA) describes feelings of tension, apprehension and fear that interfere with math performance. High MA (HMA) is correlated with negative consequences, including lower math grades, and ultimately an avoidance of quantitative careers. Given these adverse consequences, it is essential to explore effective intervention strategies to reduce MA. In the present functional magnetic resonance imaging (fMRI) study, we investigated the efficacy of cognitive reappraisal as a strategy to alleviate the effects of MA. Cognitive reappraisal, an emotion regulation strategy, has been shown to decrease negative affect and amygdala responsivity to stimuli that elicit negative emotion. We compared a reappraisal strategy to participants’ natural strategy for solving math problems and analogies. We found that HMA individuals showed an increase in accuracy and a decrease in negative affect during the reappraisal condition as compared to the control condition. During math reappraise trials, increased activity in a network of regions associated with arithmetic correlated with improved performance for HMA individuals. These results suggest that increased engagement of arithmetic regions underlies the performance increases we identify in HMA students when they use reappraisal to augment their math performance. Overall, cognitive reappraisal is a promising strategy for enhancing math performance and reducing anxiety in math anxious individuals.

Social inhibition may be associated with individual differences in emotion regulation. Mechanisms relating emotion regulation to social inhibition are largely unknown. We therefore examined how social inhibition is associated with emotional, sympathetic, and parasympathetic responses during sadness induction, and while employing emotion regulation strategies during social interaction after sadness induction. Undergraduate students (N = 216; 72% female) completed the Social Inhibition Questionnaire and participated in a sadness induction and emotion regulation (i.e., suppression and reappraisal) social interaction task, while emotional states, and sympathetic and parasympathetic reactivity were assessed. Repeated measures ANCOVAs showed that during sadness induction, social inhibition was unrelated to the emotional response, but social inhibition was associated with a blunted parasympathetic withdrawal response, due to an already withdrawn parasympathetic tone at rest. This may be suggestive of increased allostatic load with higher social inhibition, and may contribute to stress-related health risks. Both suppression and reappraisal tasks successfully diminished sadness, and this reduction was smaller with increasing levels of social inhibition. Physiological responses to emotion regulation efforts were independent of social inhibition. Elevated sadness in response to instructed emotion regulation in socially inhibited individuals may indicate more emotional distress during social interaction due to heightened threat sensitivity they experience.

Due to the COVID-19 pandemic's consequences and the state of alarm, literature has shown that people worldwide have experienced severe stressors that have been associated with increased prevalence of emotional distress. In this study, we explored psychological distress (depression, anxiety, and somatization symptoms) using an online survey platform in a sample of 1,781 Spanish adults during the confinement due to COVID-19, relationships between distress and sleep problems, affect, pain, sleep, emotional regulation, gender, type of housing, history of psychopathology, and living alone during the confinement, and differences depending on demographic and psychological variables. Results showed that between 25% and 39% of the sample referred to clinically significant levels of distress. In addition, women showed higher levels of distress, negative affect, perception of pain, and cognitive reappraisal and lower levels of emotional suppression and sleep quality than men. A history of psychopathology, being younger, living alone or in a flat was associated with higher distress. Finally, the variables most strongly related to distress were negative and positive affect, levels of pain, sleep quality, and emotional suppression. Our results highlight the important role of emotional suppression, cognitive reappraisal, and loneliness and the impact of being a woman and younger in Spain during the COVID-19 pandemic. Therefore, it would be necessary to provide assessments of distress levels in these population groups and focus psychological preventive and therapeutic online interventions on expressing emotions and preventing loneliness.

The vagally-mediated heart rate variability (HRV), an indicator of the autonomic nervous system (ANS), has been proposed as a transdiagnostic marker for emotion regulation (ER). In people with psychotic disorders (PSY), HRV is profoundly reduced compared to healthy controls (HC). Similarly, questionnaire-based assessments of adaptive ER point to a deficit in PSY. To address HRV as a potential marker for ER in psychosis, we investigated a large sample including PSY (n = 40) and HC (n = 32) as well as vulnerable (n = 19 clinical high-risk) and clinical (n = 28 anxiety disorders) controls. We tested the differential effectiveness of an instructed adaptive ER strategy, whether resting-state HRV predicts adaptive ER, and whether HRV serves as a state index of ER effort. The participants repeatedly played a social exclusion ballgame while they applied either cognitive reappraisal or no regulation (“just-play”) in randomized order. PSY displayed overall higher levels of negative affect and paranoia than HC but both groups applied reappraisal successfully (i.e., more benefit: lower negative affect and paranoia after reappraisal compared to “just-play”). Resting-state HRV did not predict successful reappraisal in the total sample. However, within PSY, a higher resting-state HRV predicted more benefit from reappraisal. State HRV did not differ between the reappraisal and “just-play” condition. Contrary to our expectations, participants with psychosis applied an instructed adaptive ER strategy successfully. As expected, the ANS marker of HRV predicted that benefit; however, this was only the case in PSY. Overall, HRV was not a robust but a tentative marker of ER in the present investigation.

Inner speech processes are thought to be associated with decreases in cognitive performance in autism spectrum disorder (ASD). Although verbal thinking is also a key component in emotional responses, no studies have investigated whether inner speech is linked to emotion regulation in ASD. The aim of this study was to investigate whether inner speech moderates the relationship between ASD traits and emotion regulation strategies. Our results indicate that only the evaluative/motivational form of inner speech moderates the relationship between ASD traits and cognitive reappraisal; inner speech processes did not moderate the association between ASD traits and expressive suppression. These findings are a first step to further investigate the role of inner speech in affective and self-regulatory processes in ASD.

This study analyzes the relationship of differentiation of self with emotional self-regulation and anxiety, and the differences in these variables based on the sex and the age of the participants. ...