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ABSTRACT: The past decade and a half has witnessed a renewed interest in the study of affective processes. James Gross' process model of emotion regulation has provided a theoretical framework for this approach. This model stipulates that individuals have a repertoire of emotion regulation strategies they use in order to modify their affect and/or the situations eliciting such affect. However, empirical investigations of the use of emotion regulation strategies have largely oversimplified this model by assuming that individuals use only one regulation strategy to manage the affect elicited by a given emotion-eliciting stimulus or situation. This is problematic because it has resulted in a limited understanding of the complex process by which individuals select and implement regulation strategies. In this brief report, we present findings suggesting that people spontaneously use multiple emotion regulation strategies in response to a brief disgust-eliciting film clip. We discuss implications for future empirical work on emotion regulation strategies.
Cognition and Emotion 11/2012; · 2.52 Impact Factor
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ABSTRACT: Rumination is a risk factor for depressive and anxiety symptoms in adolescents. Previous investigations of the mechanisms linking rumination to internalizing problems have focused primarily on cognitive factors. We investigated whether interpersonal stress generation plays a role in the longitudinal relationship between rumination and internalizing symptoms in young adolescents. Adolescents (Grades 6-8, N = 1,065) from an ethnically diverse community completed measures of depressive and anxiety symptoms, perceived friendship quality, and peer victimization at two assessments, 7 months apart. We determined whether rumination predicted increased exposure to peer victimization and whether changes in perceived friendship quality mediated this relationship. We also evaluated whether peer victimization mediated the association between rumination and internalizing symptoms. Adolescents who engaged in high levels of rumination at baseline were more likely to experience overt, relational, and reputational victimization at a subsequent time point 7 months later, controlling for baseline internalizing symptoms and victimization. Increased communication with peers was a significant partial mediator of this association for relational (z = 1.98, p = .048) and reputational (z = 2.52, p = .024) victimization. Exposure to overt (z = 3.37, p = .014), relational (z = 3.67, p < .001), and reputational (z = 3.78, p < .001) victimization fully mediated the association between baseline rumination and increases in internalizing symptoms over the study period. These findings suggest that interpersonal stress generation is a mechanism linking rumination to internalizing problems in adolescents and highlight the importance of targeting interpersonal factors in treatment and preventive interventions for adolescents who engage in rumination.
Journal of Clinical Child & Adolescent Psychology 08/2012; 41(5):584-97. · 1.92 Impact Factor
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ABSTRACT: Putatively adaptive emotion regulation strategies (e.g., acceptance, problem solving, reappraisal) show weaker associations with psychopathology than putatively maladaptive strategies (e.g., avoidance, self-criticism, hiding expression, suppression of experience, worry, rumination). This is puzzling, given the central role that adaptive strategies play in a wide range of psychotherapeutic approaches. We explored this asymmetry by examining the effects of context (i.e., emotion intensity, type of emotion, social vs. academic circumstances) on the implementation of adaptive and maladaptive strategies. We asked 111 participants to describe 8 emotion-eliciting situations and identify which strategies they used in order to regulate their affect. We found support for a contextual model of emotion regulation, in which adaptive strategies were implemented with more cross-situational variability than maladaptive strategies. In addition, the variability in implementation of two adaptive strategies (acceptance, problem solving) predicted lower levels of psychopathology, suggesting that flexible implementation of such strategies in line with contextual demands is associated with better mental health. We discuss these findings by underscoring the importance of adopting a functional approach to the delineation of contextual factors that influence the implementation of emotion regulation strategies.
Behaviour research and therapy 05/2012; 50(7-8):493-501. · 3.00 Impact Factor
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ABSTRACT: Rumination is a response to distress in which individuals focus repetitively on their feelings and the causes and consequences
of those feelings. When induced to ruminate, dysphorics exhibit more negative mood and recall more negative memories, but
these effects are not seen in nondysphorics. This pattern of results could be due to trait-like differences between dysphoric
and nondysphoric individuals, or to the high levels of negative affect that dysphorics are experiencing at the time of rumination.
The purpose of this study was to evaluate the effects of pre-rumination mood on post-rumination mood and subsequent memory.
Participants scoring high or low in depressive symptoms were assigned to either a positive or negative emotion induction prior
to ruminating and completing an autobiographical memory task. Analysis of self-reported mood indicates that both emotion inductions
were effective. Surprisingly, all participants returned to baseline mood levels following the rumination induction, and emotion
induction had no effect on the negativity of the memories recalled. Dysphorics recalled significantly more negative memories
than nondysphorics, regardless of whether positive, neutral, or negative memories were specifically prompted. Our results
indicated that the prolonged experience of dysphoria may have greater effects on post-rumination mood and memory than the
transitory experience of sadness.
Journal of Rational-Emotive and Cognitive-Behavior Therapy 04/2012; 27(3):144-159.
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ABSTRACT: The present study sought to test predictions of the response styles theory in a sample of children and adolescents. More specifically,
a ratio approach to response styles was utilized to examine the effects on residual change scores in depression and anxiety.
Participants completed a battery of questionnaires including measures of rumination, distraction, depression, and anxiety
at baseline (Time 1) and 8–10weeks follow-up (Time 2). Results showed that the ratio score of rumination and distraction
was significantly associated with depressed and anxious symptoms over time. More specifically, individuals who have a greater
tendency to ruminate compared to distracting themselves have increases in depression and anxiety scores over time, whereas
those who have a greater tendency to engage in distraction compared to rumination have decreases in depression and anxiety
symptoms over time. These findings indicate that a ratio approach can be used to examine the relation between response styles
and symptoms of depression and anxiety in non-clinical children and adolescents. Implications of the results may be that engaging
in distractive activities should be promoted and that ruminative thinking should be targeted in juvenile depression treatment.
European Child & Adolescent Psychiatry 04/2012; 18(10):635-642. · 2.82 Impact Factor
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ABSTRACT: Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents.
Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N=1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology.
The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation.
Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk.
Behaviour research and therapy 06/2011; 49(9):544-54. · 3.00 Impact Factor
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Benjamin Kelmendi,
Márcia Holsbach-Beltrame,
Andrew M McIntosh,
Lori Hilt,
Elizabeth D George,
Robert R Kitchen,
Becky C Carlyle,
Christopher Pittenger,
Vladimir Coric, Susan Nolen-Hoeksema,
Gerard Sanacora,
Arthur A Simen
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ABSTRACT: Hyperpolarization activated cyclic nucleotide-gated (HCN) potassium channels are implicated in the control of neuronal excitability and are expressed widely in the brain. HCN4 is expressed in brain regions relevant to mood and anxiety disorders including specific thalamic nuclei, the basolateral amygdala, and the midbrain dopamine system. We therefore examined the association of HCN4 with a group of mood and anxiety disorders. We genotyped nine tag SNPs in the HCN4 gene using Sequenom iPLEX Gold technology in 285 Caucasian patients with DSM-IV mood disorders and/or obsessive compulsive disorder and 384 Caucasian controls. HCN4 polymorphisms were analyzed using single marker and haplotype-based association methods. Three SNPs showed nominal association in our population (rs12905211, rs3859014, rs498005). SNP rs12905211 maintained significance after Bonferroni correction, with allele T and haplotype CTC overrepresented in cases. These findings suggest HCN4 as a genetic susceptibility factor for mood and anxiety disorders; however, these results will require replication using a larger sample.
Neuroscience Letters 06/2011; 496(3):195-9. · 2.11 Impact Factor
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ABSTRACT: When engaging in self-reflection, the visual perspective one adopts has important effects on emotional reactivity. Specifically, adopting a distanced stance, or viewing oneself from a third-person perspective, has been found to reduce emotional reactivity to negative autobiographical memories. The effect of adopting this perspective is moderated by depression such that reactivity is not reduced for individuals with particularly low levels of depressive symptoms. In the current study, we examine the effects of visual perspective on two forms of mental imagery in dysphoric and nondysphoric individuals. We attempt to replicate previous findings for recall of sad autobiographical memories and extend this research to interpretation of ambiguous situations. The results suggest that the effects of adopting a distanced stance are not moderated by depressive symptoms and do not extend from memories to interpretations of ambiguous situations.
Behaviour research and therapy 06/2011; 49(6-7):406-12. · 3.00 Impact Factor
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ABSTRACT: In recent work, we showed that putatively adaptive emotion regulation strategies, such as reappraisal and acceptance, have a weaker association with psychopathology than putatively maladaptive strategies, such as rumination, suppression, and avoidance (e.g., Aldao & Nolen-Hoeksema, 2010; Aldao, Nolen-Hoeksema, & Schweizer, 2010). In this investigation, we examined the interaction between adaptive and maladaptive emotion regulation strategies in the prediction of psychopathology symptoms (depression, anxiety, and alcohol problems) concurrently and prospectively. We assessed trait emotion regulation and psychopathology symptoms in a sample of community residents at Time 1 (N = 1,317) and then reassessed psychopathology at Time 2 (N = 1,132). Cross-sectionally, we found that the relationship between adaptive strategies and psychopathology symptoms was moderated by levels of maladaptive strategies: adaptive strategies had a negative association with psychopathology symptoms only at high levels of maladaptive strategies. In contrast, adaptive strategies showed no prospective relationship to psychopathology symptoms either alone or in interaction with maladaptive strategies. We discuss the implications of this investigation for future work on the contextual factors surrounding the deployment of emotion regulation strategies.
Journal of Abnormal Psychology 05/2011; 121(1):276-81. · 4.86 Impact Factor
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Susan Nolen-Hoeksema
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ABSTRACT: This review addresses three questions regarding the relationships among gender, emotion regulation, and psychopathology: (a) are there gender differences in emotion regulation strategies, (b) are emotion regulation strategies similarly related to psychopathology in men and women, and (c) do gender differences in emotion regulation strategies account for gender differences in psychopathology? Women report using most emotion regulation strategies more than men do, and emotion regulation strategies are similarly related to psychopathology in women and men. More rumination in women compared to men partially accounts for greater depression and anxiety in women compared to men, while a greater tendency to use alcohol to cope partially accounts for more alcohol misuse in men compared to women. The literature on emotion regulation is likely missing vital information on how men regulate their emotions. I discuss lessons learned and questions raised about the relationships between gender differences in emotion regulation and gender differences in psychopathology.
Annual Review of Clinical Psychology 04/2011; 8:161-87. · 9.11 Impact Factor
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ABSTRACT: OBJECTIVE: Increased impulsivity has been demonstrated to be a trait feature of adults with bipolar disorder (BD), yet impulsivity has received little study in adolescents with BD. Thus, it is unknown whether it is a trait feature that is present early in the course of the disorder. We tested the hypotheses that self-reported impulsiveness is increased in adolescents with BD, and that it is present during euthymia, supporting impulsiveness as an early trait feature of the disorder. METHODS: Impulsiveness was assessed in 23 adolescents with BD and 23 healthy comparison (HC) adolescents using the self-report measure of impulsivity, the Barratt Impulsiveness Scale (BIS), comprised by attentional, motor and nonplanning subscale scores. Effects of subscale scores and associations of scores with mood state and course features were explored. RESULTS: Total and subscale BIS scores were significantly higher in adolescents with BD than HC adolescents. Total, attentional and motor subscale BIS scores were also significantly higher in the subset of adolescents with BD who were euthymic, compared to HC adolescents. Adolescents with BD with rapid-cycling and chronic mood symptoms had significantly higher total and motor subscale BIS scores than adolescents with BD without these course features. CONCLUSION: These results suggest increased self-reported impulsiveness is a trait feature of adolescents with BD. Elevated impulsivity may be especially prominent in adolescents with rapid-cycling and chronic symptoms.
Acta Neuropsychiatrica 04/2011; 23(2):57-61. · 0.58 Impact Factor
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ABSTRACT: Co-occurring alcohol use disorder and major depression (C-ALDP) is a major public health problem. Yet, the available evidence is mixed regarding the implications of C-ALDP for alcohol involvement. The purpose of this research was to examine the associations between past 12-month co-occurring AUDs (abuse and dependence) and major depressive episode (MDE) and alcohol involvement in a representative community sample.
The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is a national household survey of 43,093 adults ages 18 and older. For the NESARC, the target population is the civilian noninstitutionalized population, 18 years of age and older, living in the United States and the District of Columbia.
All NESARC interviews were conducted with the Alcohol Use Disorder and Associated Disabilities Interview Schedule--DSM IV Version (AUDADIS-IV; Grant et al., 2003a).
Prevalence of past 12-month co-occurring AUD (abuse or dependence) and MDE was 1.2%, corresponding to about 2.4 million adults ages 18 and older. Among males with alcohol dependence, comorbid MDE was associated with a greater number of days drinking at home alone. Among females and males with alcohol abuse and dependence, comorbid MDE was associated with higher prevalence of drinking to enhance depressed mood. Comorbid MDE was also associated with lower levels of some drinking behaviors among those with alcohol abuse.
Co-occurring AUDs and MDE are associated with specific dimensions of alcohol involvement, and this association is more consistent for alcohol dependence than abuse.
Drug and alcohol dependence 03/2011; 117(2-3):145-51. · 3.60 Impact Factor
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ABSTRACT: The high rate of comorbidity among mental disorders has driven a search for factors associated with the development of multiple types of psychopathology, referred to as transdiagnostic factors. Rumination is involved in the etiology and maintenance of major depression, and recent evidence implicates rumination in the development of anxiety. The extent to which rumination is a transdiagnostic factor that accounts for the co-occurrence of symptoms of depression and anxiety, however, has not previously been examined. We investigated whether rumination explained the concurrent and prospective associations between symptoms of depression and anxiety in two longitudinal studies: one of adolescents (N=1065) and one of adults (N=1317). Rumination was a full mediator of the concurrent association between symptoms of depression and anxiety in adolescents (z=6.7, p< .001) and was a partial mediator of this association in adults (z=5.6, p< .001). In prospective analyses in the adolescent sample, baseline depressive symptoms predicted increases in anxiety, and rumination fully mediated this association (z=5.26, p< .001). In adults, baseline depression predicted increases in anxiety and baseline anxiety predicted increases in depression; rumination fully mediated both of these associations (z=2.35, p= .019 and z=5.10, p< .001, respectively). These findings highlight the importance of targeting rumination in transdiagnostic treatment approaches for emotional disorders.
Behaviour research and therapy 03/2011; 49(3):186-93. · 3.00 Impact Factor
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ABSTRACT: Cognitive theories of depression emphasize negatively biased interpretations as an important target of therapy. Much of the research on interpretation bias in depression has focused on selection, or deciding which of several interpretations is likely. However, depressive biases may also exist in the generation of possible interpretations, or the ability to think of positive alternatives. If biases exist for generation as well as selection, therapeutic techniques to encourage the generation of more positive interpretations would be warranted. Asking therapy clients to consider someone else in a similar situation is a commonly used therapy strategy but has not been sufficiently examined empirically. In the current studies, we examine interpretation generation and selection in dysphoric and nondysphoric individuals, and contrast interpretations made for the self to interpretations made for two types of "other." Our studies reveal depressive biases in both interpretation generation and selection, and indicate that interpretation valence is highly sensitive to the type of other considered. All participants generated and selected significantly more positive interpretations for friends than for themselves, but generated significantly more negative interpretations for hypothetical others than for themselves. Our results suggest that encouraging dysphoric individuals to imagine others can be beneficial, but the type of "other" used is critically important, with instructions to consider a close friend most likely to be effective in decreasing negativity in interpretation.
Behaviour research and therapy 11/2010; 48(11):1113-22. · 3.00 Impact Factor
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ABSTRACT: Despite growing interest in the role of regulatory processes in clinical disorders, it is not clear whether certain cognitive emotion regulation strategies play a more central role in psychopathology than others. Similarly, little is known about whether these strategies have effects transdiagnostically. We examined the relationship between four cognitive emotion regulation strategies (rumination, thought suppression, reappraisal, and problem-solving) and symptoms of three psychopathologies (depression, anxiety, and eating disorders) in an undergraduate sample (N=252). Maladaptive strategies (rumination, suppression), compared to adaptive strategies (reappraisal, problem-solving), were more strongly associated with psychopathology and loaded more highly on a latent factor of cognitive emotion regulation. In addition, this latent factor of cognitive emotion regulation was significantly associated with symptoms of all three disorders. Overall, these results suggest that the use of maladaptive strategies might play a more central role in psychopathology than the non-use of adaptive strategies and provide support of a transdiagnostic view of cognitive emotion regulation.
Behaviour research and therapy 10/2010; 48(10):974-83. · 3.00 Impact Factor
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ABSTRACT: This study examined the Response Styles Theory in a large, racially and ethnically diverse sample (N = 722) of 6th, 7th, and 8th graders. We examined the role of response styles (rumination, distraction, and problem-solving) as predictors of changes in depressive symptoms over a seven-month period. Higher levels of rumination and lower levels of problem-solving and distraction were associated with increases in depressive symptoms over time. Response style ratio scores (rumination scores divided by the sum of distraction and problem-solving scores) also predicted increases in depressive symptoms over time. Girls reported greater depressive symptoms compared to boys, and both rumination and response style ratio score statistically accounted for the gender difference in depressive symptoms. Clinical implications include the importance of problem-solving training and rumination reduction techniques in preventive interventions.
Journal of Abnormal Child Psychology 05/2010; 38(4):545-56. · 3.09 Impact Factor
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ABSTRACT: According to the World Health Organization (WHO, 2008), depression is the leading cause of disability among all diseases or
illnesses. Depression differentially affects certain groups, however. In particular, women (Nolen-Hoeksema & Hilt, 2009) and
sexual minorities1 (Meyer, 2003) are twice as likely to suffer depression as men and heterosexuals, respectively. Previous research has identified
several factors that confer risk for depression within these groups, but few attempts have been made to identify common vulnerabilities
across groups.
12/2009: pages 133-151;
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ABSTRACT: Members of stigmatized groups are at increased risk for mental health problems, and recent research has suggested that emotion dysregulation may be one mechanism explaining the stigma-distress association. However, little is known regarding characteristics that predict vulnerabilities to emotion dysregulation and subsequent distress. We examined whether anti-gay attitudes would predict poorer emotion regulation and greater psychological distress in 31 lesbian, gay, and bisexual (LGB) respondents. Respondents completed implicit and explicit attitude measures at baseline, and participated in an experience sampling study examining stigma-related stressors, emotion regulation strategies, and mood over the course of ten days. Implicit and explicit attitude measures were not correlated. LGB respondents with greater implicit anti-gay attitudes engaged in significantly more rumination and suppression and reported more psychological distress. Rumination fully mediated the prospective association between implicit prejudicial attitudes and psychological distress, and suppression was a marginally significant mediator.
Journal of Experimental Social Psychology 11/2009; 45(6):1316-1320. · 2.31 Impact Factor
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ABSTRACT: We examined the relationships between six emotion-regulation strategies (acceptance, avoidance, problem solving, reappraisal, rumination, and suppression) and symptoms of four psychopathologies (anxiety, depression, eating, and substance-related disorders). We combined 241 effect sizes from 114 studies that examined the relationships between dispositional emotion regulation and psychopathology. We focused on dispositional emotion regulation in order to assess patterns of responding to emotion over time. First, we examined the relationship between each regulatory strategy and psychopathology across the four disorders. We found a large effect size for rumination, medium to large for avoidance, problem solving, and suppression, and small to medium for reappraisal and acceptance. These results are surprising, given the prominence of reappraisal and acceptance in treatment models, such as cognitive-behavioral therapy and acceptance-based treatments, respectively. Second, we examined the relationship between each regulatory strategy and each of the four psychopathology groups. We found that internalizing disorders were more consistently associated with regulatory strategies than externalizing disorders. Lastly, many of our analyses showed that whether the sample came from a clinical or normative population significantly moderated the relationships. This finding underscores the importance of adopting a multi-sample approach to the study of psychopathology.
Clinical psychology review 11/2009; 30(2):217-37. · 4.90 Impact Factor
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ABSTRACT: Stigma is a risk factor for mental health problems, but few studies have considered how stigma leads to psychological distress. The present research examined whether specific emotion-regulation strategies account for the stigma-distress association. In an experience-sampling study, rumination and suppression occurred more on days when stigma-related stressors were reported than on days when these stressors were not reported, and rumination mediated the relationship between stigma-related stress and psychological distress. The effect of social support on distress was moderated by the concealability of the stigma: Lesbian, gay, and bisexual (LGB) respondents reported more isolation and less social support than African American respondents subsequent to experiencing stigma-related stressors, whereas African Americans reported greater social support than LGB participants. Social isolation mediated the stigma-distress association among LGB respondents. In a second experimental study, participants who ruminated following the recall of an autobiographical discrimination event exhibited prolonged distress on both implicit and explicit measures relative to participants who distracted themselves; this finding provides support for a causal role of rumination in the stigma-distress relationship.
Psychological Science 09/2009; 20(10):1282-9. · 4.43 Impact Factor
