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Objective. The aim of this study was to examine individual differences in the day-by-day relationship between negative affect (NA) and rumination in terms of their inertia, innovation, and cross-lagged effects among people living with HIV (PLWH). Methods. The participants were 217 PLWH with confirmed diagnoses of HIV and undergoing antiretroviral treatment. They assessed their NA and rumination for five consecutive days each evening via an online survey. Results. Results showed that inertia in NA is negatively related to inertia in rumination. Both innovations were unrelated. However, the individuals with relatively higher overall NA were also more reactive to external factors and/or had more variability in their daily lives, to which they respond with NA. Finally, the autoregressive effects were revealed to be important for spillover effects in a direction that is coherent with a given inertia. Thus, the direction of the cascade between daily NA and rumination depends on the area of major regulatory weakness. Conclusion. The results support the view that intensity, inertia, and innovation are distinct dimensions in spite of the common assumption that higher overall intensity of emotions and coping should be strongly related or even synonymous to their perseveration.
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Anxiety, Stress, & Coping
An International Journal
ISSN: (Print) (Online) Journal homepage:
Inertia, innovation, and cross-lagged effects in
negative affect and rumination: daily diary study
among people living with HIV
Marcin Rzeszutek & Ewa Gruszczyńska
To cite this article: Marcin Rzeszutek & Ewa Gruszczyńska (2021): Inertia, innovation, and cross-
lagged effects in negative affect and rumination: daily diary study among people living with HIV,
Anxiety, Stress, & Coping, DOI: 10.1080/10615806.2021.1887481
To link to this article:
© 2021 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis
Published online: 17 Feb 2021.
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Inertia, innovation, and cross-lagged eects in negative aect
and rumination: daily diary study among people living with HIV
Marcin Rzeszutek
and Ewa Gruszczyńska
Faculty of Psychology, University of Warsaw, Warsaw, Poland;
Faculty of Psychology, SWPS University of Social
Sciences and Humanities, Warsaw, Poland
Objective: The aim of this study was to examine individual dierences in
the day-by-day relationship between negative aect (NA) and rumination
in terms of their inertia, innovation, and cross-lagged eects among
people living with HIV (PLWH).
Methods: The participants were 217 PLWH with conrmed diagnoses of
HIV and undergoing antiretroviral treatment. They assessed their NA
and rumination for ve consecutive days each evening via an online
Results: Results showed that inertia in NA is negatively related to inertia in
rumination. Both innovations were unrelated. However, the individuals
with relatively higher overall NA were also more reactive to external
factors and/or had more variability in their daily lives, to which they
respond with NA. Finally, the autoregressive eects were revealed to be
important for spillover eects in a direction that is coherent with a
given inertia. Thus, the direction of the cascade between daily NA and
rumination depends on the area of major regulatory weakness.
Conclusion: The results support the view that intensity, inertia, and
innovation are distinct dimensions in spite of the common assumption
that higher overall intensity of emotions and coping should be strongly
related or even synonymous to their perseveration.
Received 20 September 2020
Revised 30 January 2021
Accepted 3 February 2021
Emotional inertia; coping
exibility; negative aect;
rumination; HIV/AIDS
The relationship between emotions and psychological well-being has been thoroughly examined in
dozens of studies that involved versatile samples and numerous research contexts (e.g., reviews and
meta-analysis: Fredrickson & Joiner, 2002; Hülsheger & Schewe, 2011; Lyubomirsky et al., 2005;
Watson et al., 1988). Therefore, invoking this subject again requires a convincing justication. One
of such rationales deals with the methodological limitations shared by majority of studies from
that eld, which refer collectively to the static perspective on emotions (see meta-analysis:
Houben et al., 2015). Alternatively, the traditional outlook on emotions was based on measuring
them as single emotional states that can be experimentally turned on and o, or as stable individual
traits. This was a predominant approach despite the fact that emotions have been dened in classic
theories of emotions as phenomena characterized by inherent dynamics in time, and not in terms of
static entities (Frijda, 1988). It seems that the advancements in theoretical models of emotions pre-
ceded the progress in the empirical ways of measuring them, stemming mostly from the limitations
in the available statistical methods at that time (Houben et al., 2015). The number of research using
an intensive longitudinal design (Bolger & Laurenceau, 2013) has been increasing rapidly, with a
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
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CONTACT Marcin Rzeszutek
stronger focus on the temporal characteristics of the processes revealed by the data gathered in the
natural environments of the participants (e.g., Hamaker & Wichers, 2017; Larsen et al., 2009; Scherer,
2009). Those studies showed that emotions should be operationalized as emergent processes since
short-term aect dynamics translates into various positive or negative long-term well-being out-
comes (Koval et al., 2016; Wichers, 2014). One of the parameters used to describe such dynamics
is called emotional inertia. This concept was rst introduced by Suls et al. (1998) to capture how a
current emotional state may be predicted from an individuals previous emotional states. More pre-
cisely, this term describes an autocorrelation between two consecutive emotional states; being an
indicator of emotional exibility, it also functions as a predictor of psychopathology (Houben &
Kuppens, 2020; Kuppens et al., 2010,2012). Emotional inertia can be operationalized in models
characterized by a repetitive measurement of the same set of variables for a given person within rela-
tively short periods of time. Yet there is a dearth of research on its accompanying phenomenon,
namely, emotional innovation, which illustrates what is new in an individuals emotions on a given
day. It is the part of emotional variance that cannot be explained by autoregression (Jongerling
et al., 2015).
Similar to the relationship between emotions and well-being, extensive and highly hetero-
geneous studies on coping have been unable to provide a satisfactory answer on the fundamental
question of how to measure coping to cover all of its complexity (see for review: Aldao et al., 2010;
Richardson et al., 2017; Skinner et al., 2003). It seems that the classical Lazarus and Folkman (1984)
theoretical model, which highlighted that coping is not a unitary, easy to observe behavior, but
rather a multidimensional phenomenon consisting of dynamic cognitive, emotional, and behavioral
eorts displayed by the same person simultaneously, was way ahead of the statistical and methodo-
logical possibilities of its time, leaving it open to charges of being empirically unveriable (Cheng
et al., 2014). One of the main impediments in coping studies is the retrospective approach to
coping assessments that is devoid of ecological validity and mainly comprises coping dynamics
(Kato, 2013). To overcome this obstacle, an increasing number of studies, starting with a classical
paper by Stone et al. (1995), have implemented an intensive longitudinal design to underpin uctu-
ations in coping in an individuals natural life (Gunthert & Wenze, 2012). This approach enables the
capture of a variability of coping, not only between people, but also within people (Bolger et al.,
2003). It may even go a step further, that is, it leads to an understanding that intrapersonal variability
may also have the status of individual dierences, as described by the concepts of inertia and inno-
vation (Hamaker, 2012; Suls et al., 1998). In this perspective, a exibility of coping can be analyzed in
a brand-new conceptualization. Traditionally, it is an active adaptation of coping strategies to chan-
ging conditions, thereby enabling coping eectiveness (Cheng & Cheung, 2005). In most advanced
studies in this eld, it was examined using the goodness of thypotheses, where a given coping
behavior should match the characteristics of a situation, with controllability as the main element
(Finkelstein-Fox & Park, 2019). Although very promising, this method still examines concurrent
associations, and not between-person dierences, in terms of the ability to change coping accord-
ingly. This can be approximated by the inertia and innovation concepts. Flexibility refers to the
dynamics of coping, namely, the changes in this process from one moment to another. If an individ-
ual has a high autocorrelation for a coping strategy, it means there is a lack of exibility in this regard
or, dierently speaking, high inertia. On the contrary, a coping innovation would be an illustration of
what is new in coping on a given day, i.e., this part of its variance, which cannot be explained by
inertia (Jongerling et al., 2015). As these are parameters of an individuals stability of coping beha-
viors across time, a high inertia in coping is conceptually similar to a coping style, a trait-like prefer-
ence to use a given set of coping strategies. In this meaning, a coping style could be dened not only
as a frequency and intensity of coping, but also as a level of regulatory weakness. In particular, as
there are some evidence proving that an eect on a given strategy depends on who uses this strat-
egy: the use that is untypical to the preference may modify an emotional state to a greater extent
(Gruszczyńska & Knoll, 2015).
Major advancements in the treatment of HIV infection have altered the social outlook on HIV/AIDS
from a denitely terminal condition to a chronic but manageable illness (Carrico, 2019). Nevertheless,
people living with HIV (PLWH) still suer from high levels of psychiatric disorders, among which
depression is the most prevalent (Tran et al., 2019). In addition, the aforementioned few studies
on the daily functioning of PLWH found that in spite of the same source of distress (i.e., HIV infection)
the PLWHs distress level may dynamically change day-by-day, leading to substantial individual
dierences in psychological adjustment over time. Some studies attribute these dierences to
emotion dysregulation,dened as diculty in the self-regulation of onesaective states and
emotion-driven behaviors (Brandt et al., 2017) stemming from the struggle with internalized HIV-
related stigma (Rendina et al., 2018). Emotion dysregulation is present mostly in newly diagnosed
PLWH (Bhatia et al., 2011), but is also related to maintaining high levels of negative aect many
years after HIV diagnosis (Do et al., 2014). Conversely, it should be underscored that other studies
on coping with HIV infection showed that long-infected PLWH may display aective adaptation,
especially if the HIV infection is properly controlled through treatment (Moskowitz et al., 2017).
Examining inertia and innovation in both negative aect and rumination may shed some new
light on these inconclusive results.
Current study
In the current study, we focus on the dynamic interplay over time between emotion and coping,
adopting a model based not on concurrent relationships, but on their variability, expressed by
inertia and innovation. That is, we examine the association between negative aect (NA) and rumi-
nation among PLWH. Although this link has been long and extensively studied mostly with respect
to aective disorders (see for review: DeJong et al., 2016; Nolen-Hoeksema et al., 2008), the majority
of studies followed a cross-sectional design. Even when a longitudinal framework was used (Michl
et al., 2018), it was still without a systematic focus on random eects, describing between-person
dierences in the above relationship (Hamaker et al., 2018). To date, only Koval et al. (2012)
studied emotional inertia and rumination in a non-clinical sample, and found that they are positively,
yet independently, related to depression. However, that study focused on only one trait-like assess-
ment of rumination at the beginning. Thus, real-life inertia in this regulatory process was not taken
into account.
To formulate the hypotheses, the adopted model requires a more detailed description. When
measuring negative aect (NA) and rumination day-by-day, the relationship between them for a
given person can be illustrated with:
(a) The mean values of NA and rumination that reect their trait-like characteristics across all of the
measurement points. These serve as an equilibrium over which daily aective states, as well as
intensity of rumination, uctuate. Thus, these values refer to a trait-like level, describing individ-
ual dierences in NA and rumination.
(b) The autoregressive eects for NA and rumination that reect their emotional inertia and coping
inertia, respectively. They constitute a carryover eect and indicate how quickly a person
restores their equilibrium. The higher the inertia, the longer it takes, which suggests lower
(c) The cross-lagged eects from previous-day NA to next-day rumination and, analogically, from
rumination to NA, which reects a potentially causal mechanism between these two variables.
Similar to traditional cross-lagged models, these spillover eects present how the changes in
one domain aect the changes in another domain day-by-day.
(d) The residuals that reect innovation in NA and rumination. These are parts of the variance that
are not explained by their respective autocorrelation and spillover eects.
(e) A covariance of these innovations.
Based on existing research (Koval et al., 2012), we assumed that inertia in NA is positively related
to inertia in rumination among PLWH (Hypothesis 1), but also that innovation in NA is positively
related to innovation in rumination (Hypothesis 2). These two patterns of reactions to daily
hassles are likely to co-occur, as both are characterized by personal exibility. Thus, they may
share the same underlying personality base (Bolger & Schilling, 1991). Even if a tendency to ruminate
describes a self-perceived perseverance in using this coping strategy (Nolen-Hoeksema, 2000), an
inertia, i.e., a regulatory weakness in extinguishing it for a longer period of time from the event trig-
gering it, can be regarded as a pathological core. Therefore, a person may tend to ruminate, but can
still master ways to reduce its carryover eect (Watkins, 2009). There is also ongoing debate if NA is a
cause or an eect of rumination. When NA can be a response to a variety of factors, sometimes ade-
quate and adaptive (Frijda, 1988), coping should be at least partially responsible for its eective regu-
lation (Aldao et al., 2010). Moreover, an individuals tendency to react with NA and to use rumination
should modify the resultant direction of this cascade (Schuurman et al., 2016). Thus, the magnitude
of a spillover eect may be related to the general level of NA and rumination, namely, a higher NA is
likely to enhance daily spillover from NA to rumination, whereas a higher rumination will likely
enhance the other direction, i.e., from daily rumination to NA (Hypothesis 3).
Participants and procedure
The participants were composed of 217 PLWH (83% men) who were medically diagnosed and under-
going antiretroviral treatment in the outpatient clinic where they were recruited. The inclusion cri-
teria were lack of HIV-related cognitive disorders and absence of current substance abuse.
The study protocol was accepted by the Research Ethics Committee of the University of Econ-
omics and Human Sciences in Warsaw, where the rst author previously worked. For ve consecutive
days (MondayFriday), after providing informed consent, the participants lled out online question-
naires that were sent to them via hyperlinks to their email boxes each evening. They assessed their
negative aect state and rumination around a central hassle on a given day. To check if participants
were focused on one particular source of diculty each day, they assigned it to one of ve cat-
egories: health and symptoms of the illness, relationships with other people, professional work,
household chores, and others (to be specied). A single online survey took about three to ve
minutes to ll out. The items within a part of the survey devoted to an evaluation of a given variable
were randomly mixed to avoid habitual answering, and automatic notications facilitated the par-
ticipants to answer every question. Daily access to the diary was restricted to a given time, i.e., up
to seven hours starting from 6 pm, after which the link became inactive. This access time was estab-
lished on the basis of a pilot study and takes into account individual dierences in the typical daily
schedule as the participants were instructed to complete the questionnaires shortly before going to
bed. There was no possibility to modify already sent answers. The participants were not remunerated
for their participation.
The negative aect was evaluated using six items (upset,afraid, tired, unhappy, angry, sad) from the
PANAS-X by Watson and Clark (1994). The participants assessed how they felt at the end of each day
and provided their answers on a ve-point scale from 1 = very slightly or not at all to 5 = strongly. The
raw values for a given day were added and averaged. The multilevel reliability was assessed with an
omega coecient (Geldhof et al., 2014). The coecient values were satisfactory at the within- (ω
= .81) and between-person (ω
= .97) levels.
Rumination was assessed using two items taken from the Response Styles Questionnaire (Treynor
et al., 2003) for rumination (Ive been thinking about what Ive been doing to deserve this; Ive been
wondering why I have problems that other people dont have). They were rephrased to match the daily
evaluations. The participants were instructed to provide their answers on a ve-point scale from 1 = I
havent been doing this at all to 5 = Ive been doing this a lot, keeping in mind their coping with a
central hassle. The raw values for a given day were added and averaged, with higher values indicat-
ing higher rumination. The reliability of measurement was satisfactory, with lower values for within-
person omega coecient (ω
= .63; ω
= .98).
Data analysis
We used the dynamic structural equation modelling (DSEM) described by Hamaker et al. (2018). That
is, we tested a two-level bivariate cross-lagged model with random intercepts, random slopes,
random residual variance, and a random residual covariance (model 2 in Hamaker et al. (2018)
and an extension of example 9.32 in Muthén and Muthén (19982018)). It decomposes intensive
longitudinal data into within- and between-person parts. In the within-person part, emotional
inertia is dened as a random slope expressed by linear regression of NA on a previous-day NA
). Analogically, the coping inertia for rumination (φ
) is obtained. Next, the random cross-
lagged eects from a previous-day NA to rumination (φ
) and from a previous-day rumination to
NA (φ
) are established as a predictive relationship through linear regression. Finally, an innovation
in both NA and rumination is modeled as a residual variance. More specically, the logs are used to
ensure their positive values and allow for correlation with other parameters (for details, see: Hamaker
et al., 2018). To estimate a covariance between these residuals, a latent factor was created with the
factor loadings for NA and rumination xed at one. The random residual covariance is dened as the
log of variance in this factor. The rst represents the common part of both innovations (log (Ψ)) and
the latter a unique part for each of them (log (π
) and log (π
)). In the between-person part, these
seven xed within-person parameters together with the within-person means of NA (µ
) and rumi-
) are understood as individual dierences with random eects included. All of these par-
ameters are allowed to correlate with each other.
When reporting standardized values, they comprise the average of the standardized values across
clusters for each parameter. It means that they are rst standardized per person, and then these
values are averaged. All of the DSEM analyses were performed using the Mplus version 8.2
(Muthén & Muthén, 19982018) with Bayesian estimation, including also dealing with missing
data (50,000 draws, two Markov Chain Monte Carlo chains, default priors).
The univariate sample statistics are presented in Table 1. Missing data were noted for 327 cases out
of 1085 possible measurement points, which is a 30% attrition rate. These missing data can be
regarded as missing at random (Littles MCAR, χ
= 172.9, df = 152, p= .19).
Table 2 presents the xed and random eects in the model. As shown in the table, an inertia for
NA is insignicant, which means that in our sample, the overall transition of negative aect from one
day to another is close to zero. However, a variance of this parameter can be regarded as substantial,
suggesting that individual dierences are observed. Thus, for some people, this autoregressive eect
can still be signicant and, more importantly, it may have dierent directions. The averaged standar-
dized value for inertia in NA was equal to 0.09 (95% CI = [0.20, 0.22]). This proved to be small and
Table 1. Univariate higher-order moment descriptive statistics.
Variable Mean SD Skewness Kurtosis Range
NA 1.70 0.88 1.05 0.24 15
RU 2.48 0.91 .10 0.51 15
Note: NA: negative aect; RU: rumination; SD: standard deviation.
diversied in terms of direction, especially in comparison to an averaged standardized inertia in
rumination, which was equal to 0.24 (95% CI = [0.07, 0.40]) and was positive.
Similarly, both cross-lagged eects are insignicant in the sample, but with observed variability
across persons. The average standardized eect for a predictive relationship from NA to rumination
was 0.04 (95% CI = [0.23, 0.11]), whereas from rumination to NA, it was 0.06 (95% CI = [0.05,
0.15]). The within-person averaged proportion of the explained variance was 0.44 (95% CI = [0.40,
0.50]) for NA and 0.31 (95% CI = [0.26, 0.36]) for rumination.
Table 3 presents correlations of random eects at the between-person level, which served as the
basis for the hypothesis verication. In our sample, inertia in NA is negatively, not positively, related
to inertia in rumination, which is contradictory to the assumption in Hypothesis 1. Thus, a higher car-
ryover in NA corresponds to a lower carryover in rumination.
Similarly, as innovations in NA and rumination were independent, there was no conrmation for
Hypothesis 2 in the data. Further analyses of other correlations suggest that individuals who are rela-
tively higher in overall NA are also more reactive to external factors or have more variability in their
daily lives, to which they respond with NA, as both explanations are valid in this case (Hamaker et al.,
2018). On the contrary, being higher in overall rumination is related to lower innovation in NA, but
only in terms of its unique part.
When it comes to Hypothesis 3, overall NA was unrelated to both cross-lagged eects. The same
result was obtained for overall rumination. Instead, the autoregressive eects were revealed to be
important for the spillover eects. That is, a higher carryover in NA was related to a higher spillover
from NA to rumination and lower spillover from rumination to NA. For higher carryover in
Table 2. Fixed and radom eects obtained in dynamic structural equation modeling of relationship between negative aect and
Fixed eects (means) Random eects (variances)
Estimate SD 95% CI Estimate SD 95% CI
1.59 0.06 [1.41, 1.63] 0.14 0.04 [0.09, 0.23]
2.59 0.09 [2.43, 2.77] 0.37 0.09 [0.22, 0.56]
0.07 0.08 [0.09, 0.22] 0.26 0.06 [0.16, 0.41]
0.25 0.09 [0.07, 0.44] 0.31 0.08 [0.18, 0.49]
0.01 0.10 [0.18, 0.21] 0.32 0.10 [0.18, 0.55]
0.12 0.08 [0.04, 0.28] 0.21 0.06 [0.11, 0.35]
log (π
)2.03 0.19 [2.41, 1.65] 4.37 0.68 [3.20, 5.86]
log (π
)1.10 0.11 [1.33, 0.88] 0.46 0.18 [0.23, 0.88]
log (ψ)5.34 0.34 [6.02, 4.67] 0.16 0.16 [0.20, 0.63]
Note: μ
and μ
: random means for daily negative aect and rumination; φ
and φ
:random autoregressive regression coe-
cients for daily negative aect and rumination; φ
and φ
: cross-lagged regression coecients between daily negative aect
and rumination; log(π
) and log(π
): random log of the variance of the unique parts of the innovations in negative aect and
rumination; log(ψ): random log of covariance between the innovations; SD: standard deviation; 95% CI: 95% credible intervals.
Table 3. Correlations between standardized values of random eects.
Variable μ
log (π
) log (π
.33 1
.04 .20 1
.19 .32 .77 1
.13 .39 .87 .86 1
.05 .02 .80 .67 .63 1
log (π
).92 .37 .12 .01 .08 .19 1
log (π
) .23 .28 .07 .10 .07 .21 .30 1
log (ψ) .64 .23 .10 .01 .09 .11 .67 .24
Note: μ
and μ
: random means for daily negative aect and rumination; φ
and φ
:random autoregressive regression coe-
cients for daily negative aect and rumination; φ
and φ
: cross-lagged regression coecients between daily negative aect
and rumination; log(π
) and log(π
): random log of the variance of the unique parts of the innovations in negative aect and
rumination; log(ψ): random log of covariance between the innovations.
Only for bolded values 95% credible interval does not contain zero.
rumination, the direction was the opposite: higher spillover from rumination to NA and lower from
NA to rumination were noted.
The obtained ndings were quite unexpectedly inconsistent with our hypotheses. More specically,
the inertias in NA and rumination were negatively (not positively) related: a higher carryover in NA
was associated with a lower carryover in rumination. Moreover, a higher general level in NA and
rumination was unrelated to the spillover eects. Finally, the innovations in NA and rumination
were independent of each other. These results are not only counter-intuitive, but mostly in contrast
to a large body of literature pointing to the well-recognized vicious circle between negative aect
and rumination (e.g., Lyubomirsky & Nolen-Hoeksema, 1995; Nolen-Hoeksema, 2000,2008). The
overall picture seems likely to be more complex than a predisposition of individuals with high NA
to ruminate, which, in turn, further stimulates NA (Suls & Martin, 2005). On a daily basis, these pro-
cesses appear to be interrelated in an advanced manner, as higher inertia enhances the cross-lagged
eect in a direction consistent with this inertia and suppresses the opposite one. This holds true for
both inertia in NA and inertia in rumination, and sheds light on how carryover eect may be related
to spillover eect. Thus, the direction of the cascade between daily NA and rumination depends on
the area of major regulatory weakness.
These ndings support the notion that intensity of emotion and, analogically, intensity of
emotion-focused coping, is not necessarily crucial for well-being, but rather, the previously men-
tioned lack of exibility in these processes (Cheng & Cheung, 2005). Again, it is vital to go back to
basics, i.e., to Lazarus and Folkmans(1984) stress and coping theory, which posits that there is no
single coping strategy that is denitively adaptive or maladaptive across all stressful situations.
Several studies have shown that coping exibility may be related to lower levels of depression
and anxiety (Lougheed & Hollenstein, 2012) or better adaption to traumatic events (Galatzer-Levy
et al., 2012), and might even facilitate post-traumatic growth (Cohen & Katz, 2005). However, the
central problem with this concept is not only the scarcity of prospective studies, which precludes
analyzing its temporal dynamics (Bonanno & Burton, 2013), but operationalizing this construct
only at a trait-like level with a single measurement, which ignores its idiosyncratic
character, varying within the individual, situation, and time (Lazarus & Folkman, 1984). To our knowl-
edge, this study is the rst example to utilize inertia and innovation in the context of coping.
Additionally, the ndings show that the trait-like levels of NA and rumination were unrelated to
inertia eects and were signicant for innovation eect only in NA. In other words, a higher NA and a
higher rumination do not necessarily translate into higher carryover eects, but may modify fresh
reactions in NA. This supports the view that intensity and inertia are distinct dimensions in spite of
the common assumption that higher overall intensity of emotions and coping should be strongly
related or even synonymous to their perseveration. In fact, intense but limited-time reactions may
have a dierent impact on well-being than less intense but long-lasting reactions. Similarly, an indi-
viduals sensitivity, understood as the strength of a new response, i.e., not explained by autoregres-
sive and spillover eects, cannot be straightforwardly deduced from a general trait-like level of a
given variable. In this light, although speculative, neuroticism, for instance, could be described as
a specic combination of three dimensions, namely, intensity, inertia, and innovation, assuming
co-existence for the same person across many situations high level of NA, high carryover of NA,
and high innovation of NA. Analogously, a pathological ruminative style should consist of a combi-
nation of high intensity of rumination, low exibility, and high sensitivity to react with rumination.
Taken together, it calls for more in-depth and multidimensional characteristics of both phenomena,
namely, aect and coping, especially in the face of ambiguous results concerning their relationship
(Aldao et al., 2010). Perhaps, at least to some degree, an explanation lies in a parametrization of the
processes, with temporal descriptors as crucial factors in covering the dynamics of real life (Bos et al.,
Finally, it is truly challenging to discuss the obtained results in the context of the uniqueness of
our sample consisting of PLWH. It is not only due to an absence of studies on emotional inertia
among PLWH specically, but also due to very scarce research on this phenomenon in the clinical
context (Dejonckheere et al., 2019). Struggling with somatic illness poses chronic psychological dis-
tress, but several studies have pointed out the aective adaptation to such conditions according to
the hedonic treadmill model (Lyubomirsky, 2010), which describes a stability despite lossof well-
being in reaction to disease or other critical life event (Schilling & Wahl, 2006). In the case of
PLWH, several authors have observed that despite HIV-related distress, PLWHs positive and negative
aect are remarkably stable even many years after their HIV diagnosis; they are also not associated
with the HIV-related clinical variables, at least in the samples with good control of infection pro-
gression through antiretroviral treatment (e.g., Carrico & Moskowitz, 2014; Moskowitz et al., 2017;
Rzeszutek & Gruszczyńska, 2018). Thus, individual dierences in this regard should be directly
related to the mechanisms based on emotional, cognitive, and behavioral exibility.
In this perspective, a relationship between emotional inertia and coping inertia may be an under-
lying factor of depression in these patients (Moskowitz et al., 2009,2017; Rendina et al., 2018), a
possibility that needs further research. The nding that for PLWH with higher inertia in NA, the spil-
lover is from NA to rumination, whereas for those with higher inertia in rumination, that direction is
the opposite, is not only theoretically relevant but may be clinically meaningful for creating better
targeted interventions in this patient group (Moskowitz et al., 2017; Wilson et al., 2016).
Strengths and limitations
Our study has several strengths, including a theory-driven, dynamic, multilevel modeling of daily
functioning in a clinical sample of PLWH. The major novelty of the study lies in the use of the
concept of inertia and innovation to examine coping. Furthermore, surprisingly few studies so far
have concerned daily rumination, especially outside the context of depressive symptoms.
However, some limitations should also be underscored. First, there was a low number of measure-
ment points, which, apart from sample uniqueness, can shape the obtained ndings. Therefore, it is
reasonable to look at it as a preliminary study. Second, we were not able to avoid sample selection
bias that is typical for diary studies as it can be assumed that only highly functional PLWH were
accessible during the recruitment process. Finally, all results should be treated with caution as
they omit other variables inuencing daily functioning. In addition, the time lag can be regarded
as perhaps too long for a valid reection of dynamics. Thus, the results should be conrmed in eco-
logical momentary assessment with a few measurements on each day, varying randomly across and
within individuals (Hamaker & Wichers, 2017).
The results of our study undermine the traditional outlook on the existence of a vicious circle
between NA and rumination, examined here for the rst time in the clinical context of living with
HIV/AIDS. These constructs are probably interrelated in a more complex manner, including temporal
parameters of aect and coping as a process, just like inertia, innovation, and spillover eects, which
should be taken into account in both theory and practice. In a broader perspective, it is also impor-
tant to note that people dier in their ability to identify and report small uctuations in their
emotional, cognitive, and behavioral responses (Houben & Kuppens, 2020). These individual dier-
ences may inuence results either directly or indirectly through interaction with a research method
and design. Hence, this problem occurs to some extent in any self-descriptive study, and we have no
reason to assume that our study is particularly aected by it. However, the question of whether such
self-awareness modies daily or momentary reports and through them inertia and innovation, is
worth further investigation.
When planning interventions probably greater focus would be needed not only on intensity and
adequacy of, cognitive, emotional and behavioral responses (Campbell-Sills & Barlow, 2007), but also
directly on their immediate exibility, making it a part of systematic diagnosis and targeted actions.
Recently some authors showed the promising role of mindfulness in the aforementioned process,
i.e., promoting adaptive patterns of aective changes by stimulating adaptive coping in daily life
(Keng & Tong, 2016). This approach may be of particular relevance to PLWH, as daily struggle
with chronic and incurable disease in some of them leads to dysregulation and maladaptive
response patterns, also as a result of HIV/AIDS stigma (Rendina et al., 2018).
The authors wish to thank Ewa-Firląg Burkacka, PhD, from the Warsaws Hospital for Infectious Disease for help in par-
ticipants recruitment.
Disclosure statement
No potential conict of interest was reported by the author(s).
This work was supported by National Science Center, Poland (Narodowe Centrum Nauki): [grant number: 2016/23/D/
Data availability statement
All the data are available upon the request from the corresponding author.
Research involving human participants
The study protocol was accepted by the institutional ethics committee (decision made 2016/06/06).
Written informed consent was obtained from all participants before participation in the study.
Marcin Rzeszutek
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Full-text available
Depression in people living with HIV (PLWH) has become an urgent issue and has attracted the attention of both physicians and epidemiologists. Currently, 39% of HIV patients are reported to suffer from depression. This population is more likely to experience worsening disease states and, thus, poorer health outcomes. In this study, we analyzed research growth and current understandings of depression among HIV-infected individuals. The number of papers and their impacts have been considerably grown in recent years, and a total of 4872 publications published from 1990-2017 were retrieved from the Web of Science database. Research landscapes related to this research field include risk behaviors and attributable causes of depression in HIV population, effects of depression on health outcomes of PLWH, and interventions and health services for these particular subjects. We identified a lack of empirical studies in countries where PLWH face a high risk of depression, and a modest level of interest in biomedical research. By demonstrating these research patterns, highlighting the research gaps and putting forward implications, this study provides a basis for future studies and interventions in addressing the critical issue of HIV epidemics.
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Patterns of emotional change in daily life have been consistently linked to depressive and borderline personality disorder (BPD) features. However, dynamic measures and average affect show considerable statistical overlap, and depressive and BPD features are comorbid. Moreover, the prospective nature of these relationships is unclear. We used a measurement burst design in which 202 young adults with varying levels of psychopathological features participated in a week-long experience sampling at baseline and 1-year follow-up. Taking overlap into account, we found that BPD traits were uniquely and specifically linked to higher levels of variability in negative affect (NA). For depressive features, indications were found for a specific association with inertia of NA, but these results were not robust and consistent. In fact, overall, incremental predictive power of the dynamic measures above mean affect was limited, especially for depressive features. Prospective relationships showed that psychopathological features predicted stronger emotion dynamic patterns 1 year later rather than the other way around.
Chronic illnesses such as cancer, diabetes, and chronic pain often create intense and pervasive stress. Although much research has focused on the importance of coping in managing chronic illness, the importance of controllability appraisals in determining the efficacy of various coping strategies (i.e., the ‘goodness-of-fit hypothesis;’ Lazarus & Folkman, 1984) for individuals living with chronic illness has yet to be established. To evaluate support for the goodness-of-fit hypothesis, we conducted a systematic literature review, identifying and synthesizing results of 15 studies that reported on conditional effects of problem-, emotion-, and meaning-focused coping strategies, depending on controllability appraisals. Results across studies were mixed, with some coping strategies but not others demonstrating significant interaction effects with controllability appraisals in models predicting psychological and physiological markers of health. Studies demonstrated considerable heterogeneity in design and measurement, with the majority reliant on cross-sectional design and thus unable to infer temporality in the effects of coping on adjustment. In addition, lack of consensus regarding the measurement and categorization of coping precluded definitive conclusions regarding contextual effects of many strategies. To better understand these patterns of coping as they unfold in daily experience, future work should incorporate contemporary methods such as experience sampling and multilevel statistical modeling.
Objective: We conducted a randomized controlled trial to determine whether IRISS (Intervention for those Recently Informed of their Seropositive Status), a positive affect skills intervention, improved positive emotion, psychological health, physical health, and health behaviors in people newly diagnosed with HIV. Method: One-hundred and fifty-nine participants who had received an HIV diagnosis in the past 3 months were randomized to a 5-session, in-person, individually delivered positive affect skills intervention or an attention-matched control condition. Results: For the primary outcome of past-day positive affect, the group difference in change from baseline over time did not reach statistical significance (p = .12, d = .30). Planned secondary analyses within assessment point showed that the intervention led to higher levels of past-day positive affect at 5, 10, and 15 months postdiagnosis compared with an attention control. For antidepressant use, the between group difference in change from baseline was statistically significant (p = .006, d = -.78 baseline to 15 months) and the difference in change over time for intrusive and avoidant thoughts related to HIV was also statistically significant (p = .048, d = .29). Contrary to findings for most health behavior interventions in which effects wane over the follow up period, effect sizes in IRISS seemed to increase over time for most outcomes. Conclusions: This comparatively brief positive affect skills intervention achieved modest improvements in psychological health, and may have the potential to support adjustment to a new HIV diagnosis. (PsycINFO Database Record