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Anxiety, Stress, & Coping
An International Journal
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/gasc20
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: https://doi.org/10.1080/10615806.2021.1887481
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Inertia, innovation, and cross-lagged effects in negative affect
and rumination: daily diary study among people living with HIV
Marcin Rzeszutek
ª
and Ewa Gruszczyńska
b
ª
Faculty of Psychology, University of Warsaw, Warsaw, Poland;
b
Faculty of Psychology, SWPS University of Social
Sciences and Humanities, Warsaw, Poland
ABSTRACT
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.
ARTICLE HISTORY
Received 20 September 2020
Revised 30 January 2021
Accepted 3 February 2021
KEYWORDS
Emotional inertia; coping
flexibility; negative affect;
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 justification. One
of such rationales deals with the methodological limitations shared by majority of studies from
that field, 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 off, or as stable individual
traits. This was a predominant approach despite the fact that emotions have been defined 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
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://
creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the
original work is properly cited, and is not altered, transformed, or built upon in any way.
CONTACT Marcin Rzeszutek marcin.rzeszutek@psych.uw.edu.pl
ANXIETY, STRESS, & COPING
https://doi.org/10.1080/10615806.2021.1887481
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 affect 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 first introduced by Suls et al. (1998) to capture how a
current emotional state may be predicted from an individual’s previous emotional states. More pre-
cisely, this term describes an autocorrelation between two consecutive emotional states; being an
indicator of emotional flexibility, 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 individual’s 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
efforts 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 unverifiable (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 fluctu-
ations in coping in an individual’s 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 differences, as described by the concepts of inertia and inno-
vation (Hamaker, 2012; Suls et al., 1998). In this perspective, a flexibility 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 effectiveness (Cheng & Cheung, 2005). In most advanced
studies in this field, it was examined using the goodness of fithypotheses, 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 differences, 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 flexibility in this regard
or, differently 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 individual’s 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 defined 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 effect 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).
2M. RZESZUTEK AND E. GRUSZCZYŃSKA
Major advancements in the treatment of HIV infection have altered the social outlook on HIV/AIDS
from a definitely terminal condition to a chronic but manageable illness (Carrico, 2019). Nevertheless,
people living with HIV (PLWH) still suffer 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 PLWH’s distress level may dynamically change day-by-day, leading to substantial individual
differences in psychological adjustment over time. Some studies attribute these differences to
emotion dysregulation,defined as difficulty in the self-regulation of one’saffective 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 affect 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 affective adaptation,
especially if the HIV infection is properly controlled through treatment (Moskowitz et al., 2017).
Examining inertia and innovation in both negative affect 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 affect (NA) and rumi-
nation among PLWH. Although this link has been long and extensively studied mostly with respect
to affective 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 effects, describing between-person
differences 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 affect (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 reflect their trait-like characteristics across all of the
measurement points. These serve as an equilibrium over which daily affective states, as well as
intensity of rumination, fluctuate. Thus, these values refer to a trait-like level, describing individ-
ual differences in NA and rumination.
(b) The autoregressive effects for NA and rumination that reflect their emotional inertia and coping
inertia, respectively. They constitute a carryover effect and indicate how quickly a person
restores their equilibrium. The higher the inertia, the longer it takes, which suggests lower
flexibility.
(c) The cross-lagged effects from previous-day NA to next-day rumination and, analogically, from
rumination to NA, which reflects a potentially causal mechanism between these two variables.
Similar to traditional cross-lagged models, these spillover effects present how the changes in
one domain affect the changes in another domain day-by-day.
(d) The residuals that reflect innovation in NA and rumination. These are parts of the variance that
are not explained by their respective autocorrelation and spillover effects.
(e) A covariance of these innovations.
ANXIETY, STRESS, & COPING 3
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 flexibility. 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 effect (Watkins, 2009). There is also ongoing debate if NA is a
cause or an effect 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 effective regu-
lation (Aldao et al., 2010). Moreover, an individual’s 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 effect 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).
Methods
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 first author previously worked. For five consecutive
days (Monday–Friday), after providing informed consent, the participants filled out online question-
naires that were sent to them via hyperlinks to their email boxes each evening. They assessed their
negative affect state and rumination around a central hassle on a given day. To check if participants
were focused on one particular source of difficulty each day, they assigned it to one of five cat-
egories: health and symptoms of the illness, relationships with other people, professional work,
household chores, and others (to be specified). A single online survey took about three to five
minutes to fill 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 notifications 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 differences 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.
Measures
The negative affect 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 five-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 coefficient (Geldhof et al., 2014). The coefficient values were satisfactory at the within- (ω
w
= .81) and between-person (ω
b
= .97) levels.
Rumination was assessed using two items taken from the Response Styles Questionnaire (Treynor
et al., 2003) for rumination (I’ve been thinking about what I’ve been doing to deserve this; I’ve been
4M. RZESZUTEK AND E. GRUSZCZYŃSKA
wondering why I have problems that other people don’t have). They were rephrased to match the daily
evaluations. The participants were instructed to provide their answers on a five-point scale from 1 = I
haven’t been doing this at all to 5 = I’ve 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 coefficient (ω
w
= .63; ω
b
= .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 (1998–2018)). It decomposes intensive
longitudinal data into within- and between-person parts. In the within-person part, emotional
inertia is defined as a random slope expressed by linear regression of NA on a previous-day NA
(φ
NN
). Analogically, the coping inertia for rumination (φ
RR
) is obtained. Next, the random cross-
lagged effects from a previous-day NA to rumination (φ
NR
) and from a previous-day rumination to
NA (φ
RN
) are established as a predictive relationship through linear regression. Finally, an innovation
in both NA and rumination is modeled as a residual variance. More specifically, 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 fixed at one. The random residual covariance is defined as the
log of variance in this factor. The first represents the common part of both innovations (log (Ψ)) and
the latter a unique part for each of them (log (π
NA
) and log (π
RU
)). In the between-person part, these
seven fixed within-person parameters together with the within-person means of NA (µ
NA
) and rumi-
nation(µ
RU
) are understood as individual differences with random effects 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 first standardized per person, and then these
values are averaged. All of the DSEM analyses were performed using the Mplus version 8.2
(Muthén & Muthén, 1998–2018) with Bayesian estimation, including also dealing with missing
data (50,000 draws, two Markov Chain Monte Carlo chains, default priors).
Results
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 (Little’s MCAR, χ
2
= 172.9, df = 152, p= .19).
Table 2 presents the fixed and random effects in the model. As shown in the table, an inertia for
NA is insignificant, which means that in our sample, the overall transition of negative affect from one
day to another is close to zero. However, a variance of this parameter can be regarded as substantial,
suggesting that individual differences are observed. Thus, for some people, this autoregressive effect
can still be significant and, more importantly, it may have different 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 1–5
RU 2.48 0.91 .10 −0.51 1–5
Note: NA: negative affect; RU: rumination; SD: standard deviation.
ANXIETY, STRESS, & COPING 5
diversified 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 effects are insignificant in the sample, but with observed variability
across persons. The average standardized effect 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 effects at the between-person level, which served as the
basis for the hypothesis verification. 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 confirmation 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 effects. The same
result was obtained for overall rumination. Instead, the autoregressive effects were revealed to be
important for the spillover effects. 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 effects obtained in dynamic structural equation modeling of relationship between negative affect and
rumination.
Variable
Fixed effects (means) Random effects (variances)
Estimate SD 95% CI Estimate SD 95% CI
μ
NA
1.59 0.06 [1.41, 1.63] 0.14 0.04 [0.09, 0.23]
μ
RU
2.59 0.09 [2.43, 2.77] 0.37 0.09 [0.22, 0.56]
φ
NN
0.07 0.08 [−0.09, 0.22] 0.26 0.06 [0.16, 0.41]
φ
RR
0.25 0.09 [0.07, 0.44] 0.31 0.08 [0.18, 0.49]
φ
NR
−0.01 0.10 [−0.18, 0.21] 0.32 0.10 [0.18, 0.55]
φ
RN
0.12 0.08 [−0.04, 0.28] 0.21 0.06 [0.11, 0.35]
log (π
NA
)−2.03 0.19 [−2.41, −1.65] 4.37 0.68 [3.20, 5.86]
log (π
RU
)−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
NA
and μ
RU
: random means for daily negative affect and rumination; φ
NN
and φ
RR
:random autoregressive regression coeffi-
cients for daily negative affect and rumination; φ
NR
and φ
RN
: cross-lagged regression coefficients between daily negative affect
and rumination; log(π
NA
) and log(π
RU
): random log of the variance of the unique parts of the innovations in negative affect 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 effects.
Variable μ
NA
μ
RU
φ
NN
φ
RR
φ
NR
φ
RN
log (π
NA
) log (π
RU
)
μ
NA
1
μ
RU
−.33 1
φ
NN
−.04 −.20 1
φ
RR
.19 .32 −.77 1
φ
NR
−.13 −.39 .87 −.86 1
φ
RN
−.05 −.02 −.80 .67 −.63 1
log (π
NA
).92 −.37 .12 −.01 .08 −.19 1
log (π
RU
) .23 .28 .07 −.10 .07 −.21 .30 1
log (ψ) .64 −.23 .10 −.01 .09 −.11 .67 .24
Note: μ
NA
and μ
RU
: random means for daily negative affect and rumination; φ
NN
and φ
RR
:random autoregressive regression coeffi-
cients for daily negative affect and rumination; φ
NR
and φ
RN
: cross-lagged regression coefficients between daily negative affect
and rumination; log(π
NA
) and log(π
RU
): random log of the variance of the unique parts of the innovations in negative affect and
rumination; log(ψ): random log of covariance between the innovations.
Only for bolded values 95% credible interval does not contain zero.
6M. RZESZUTEK AND E. GRUSZCZYŃSKA
rumination, the direction was the opposite: higher spillover from rumination to NA and lower from
NA to rumination were noted.
Discussion
The obtained findings were quite unexpectedly inconsistent with our hypotheses. More specifically,
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 effects. 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 affect
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
effect 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 effect may be related
to spillover effect. Thus, the direction of the cascade between daily NA and rumination depends on
the area of major regulatory weakness.
These findings 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 flexibility in these processes (Cheng & Cheung, 2005). Again, it is vital to go back to
basics, i.e., to Lazarus and Folkman’s(1984) stress and coping theory, which posits that there is no
single coping strategy that is definitively adaptive or maladaptive across all stressful situations.
Several studies have shown that coping flexibility 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 first example to utilize inertia and innovation in the context of coping.
Additionally, the findings show that the trait-like levels of NA and rumination were unrelated to
inertia effects and were significant for innovation effect only in NA. In other words, a higher NA and a
higher rumination do not necessarily translate into higher carryover effects, 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 different impact on well-being than less intense but long-lasting reactions. Similarly, an indi-
vidual’s sensitivity, understood as the strength of a new response, i.e., not explained by autoregres-
sive and spillover effects, 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 specific 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 flexibility, and high sensitivity to react with rumination.
Taken together, it calls for more in-depth and multidimensional characteristics of both phenomena,
namely, affect 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.,
2019).
ANXIETY, STRESS, & COPING 7
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 specifically, 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 affective adaptation to such conditions according to
the hedonic treadmill model (Lyubomirsky, 2010), which describes a “stability despite loss”of 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, PLWH’s positive and negative
affect 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 differences in this regard should be directly
related to the mechanisms based on emotional, cognitive, and behavioral flexibility.
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 finding 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 findings. 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 influencing daily functioning. In addition, the time lag can be regarded
as perhaps too long for a valid reflection of dynamics. Thus, the results should be confirmed in eco-
logical momentary assessment with a few measurements on each day, varying randomly across and
within individuals (Hamaker & Wichers, 2017).
Conclusion
The results of our study undermine the traditional outlook on the existence of a vicious circle
between NA and rumination, examined here for the first time in the clinical context of living with
HIV/AIDS. These constructs are probably interrelated in a more complex manner, including temporal
parameters of affect and coping as a process, just like inertia, innovation, and spillover effects, which
should be taken into account in both theory and practice. In a broader perspective, it is also impor-
tant to note that people differ in their ability to identify and report small fluctuations in their
emotional, cognitive, and behavioral responses (Houben & Kuppens, 2020). These individual differ-
ences may influence 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 affected by it. However, the question of whether such
self-awareness modifies daily or momentary reports and –through them –inertia and innovation, is
worth further investigation.
8M. RZESZUTEK AND E. GRUSZCZYŃSKA
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 flexibility, 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 affective 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).
Acknowledgements
The authors wish to thank Ewa-Firląg Burkacka, PhD, from the Warsaw’s Hospital for Infectious Disease for help in par-
ticipants recruitment.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Funding
This work was supported by National Science Center, Poland (Narodowe Centrum Nauki): [grant number: 2016/23/D/
HS6/02943].
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.
ORCID
Marcin Rzeszutek http://orcid.org/0000-0002-4230-3806
Ewa Gruszczyńska http://orcid.org/0000-0003-1293-9798
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