No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
The interactive effects of emotional clarity and cognitive reappraisal in Posttraumatic Stress Disorder
Abstract
The goal of this investigation was to examine how emotional clarity and a specific emotion regulation strategy, cognitive reappraisal, interact to predict Posttraumatic Stress Disorder (PTSD) symptom severity and positive affect among treatment seeking military Veterans (N=75, 93% male) diagnosed with PTSD. PTSD is a highly relevant context because PTSD features include heightened stress reactivity, diminished ability to differentiate and understand emotions, and reliance on maladaptive forms of emotion regulation. We found that the combination of high levels of emotional clarity and frequent use of cognitive reappraisal were associated with (a) lesser total PTSD severity after accounting for shared variance with positive affect and the extent to which emotions are attended to (attention to emotions), and (b) greater positive affect after accounting for shared variance with total PTSD severity and attention to emotions. This is the first study to demonstrate interactive effects of emotional clarity and cognitive reappraisal.
... Given the high prevalence of PTSD and reported trauma among substance users, recent research has shown that individuals with PTSD/SUD face difficulties in emotion regulation; they exhibit higher rates of use in negative emotional situations (Staiger et al., 2009;Waldrop et al., 2007) and have more problems expressing emotions compared to those who have only one of these disorders (Blanco et al., 2013). Individuals attempt to avoid emotional experiences (Boden et al., 2012;Boden et al., 2013;Seligowski et al., 2015) and are thus drawn to substance and alcohol use due to the actual effects or expectations they have from substances (Brown et al., 1985;Christiansen et al., 1989;Cooper et al., 1995). Non-acceptance of emotions is another aspect of emotion regulation related to experiential avoidance (Gratz & Roemer, 2004;Hayes et al., 1996;Moore et al., 2008). ...
... Regarding the impact of emotion regulation on PTSD symptoms, studies indicate that individuals with PTSD exhibit more problems in emotion regulation and, consequently, turn to alcohol and substance use to cope with negative emotions, meaning that substance use is considered a form of emotion regulation strategy (Dixon-Gordon et al., 2015). Individuals with PTSD widely struggle with emotion regulation and impulse control, yet it remains debatable whether emotion regulation mediates between PTSD and substance use (Boden et al., 2012;Boden et al., 2013;Jerud et al., 2014;Weiss et al., 2013;Weiss et al., 2012). Given the limited research in this area, the present study addresses whether there is a significant difference in emotion regulation styles between women with PTSD and women with comorbid addiction and PTSD. ...
... The obtained finding supports the notion that PTSD significantly reduces emotion E-ISSN: 3041-8515 regulation style, independent of the effect of addiction. This finding is consistent with studies (Berking et al., 2014;Boden et al., 2012;Boden et al., 2013) that suggest emotion regulation style can be a risk factor for PTSD. ...
Objective: In this study, emotion regulation between two groups of women with PTSD, one group with addiction and one without, was examined. Methods and Materials: The sample size consisted of 179 individuals, including 56 individuals with PTSD without a history of addiction, 51 individuals with PTSD and addiction, 39 individuals with addiction, and 33 individuals from the general population. The tools used in the research were the Post-Traumatic Stress Disorder Checklist (PCL-5) and the Cognitive Emotion Regulation Questionnaire (CERQ). Findings: The results of the multivariate analysis of variance for positive and negative emotion regulation and their subscales indicated a significant difference between the addicted and non-addicted groups. Conclusion: The findings showed that when PTSD symptoms are checked over a longer period and the individual is not addicted, there are more problems in negative emotion regulation. Conversely, when PTSD is checked over a longer period but the individual is addicted, lower scores are obtained in positive emotion regulation.
... In the context of cognitive failures, emotional clarity may influence how effectively individuals can manage their emotions, thereby reducing the cognitive load associated with emotional regulation and minimizing the occurrence of cognitive lapses. Boden et al. (2012) highlighted that emotional clarity, in conjunction with cognitive reappraisal, significantly impacts posttraumatic stress disorder (PTSD) symptoms, underscoring the importance of emotional clarity in maintaining cognitive and emotional health under stress (Boden et al., 2012). ...
... In the context of cognitive failures, emotional clarity may influence how effectively individuals can manage their emotions, thereby reducing the cognitive load associated with emotional regulation and minimizing the occurrence of cognitive lapses. Boden et al. (2012) highlighted that emotional clarity, in conjunction with cognitive reappraisal, significantly impacts posttraumatic stress disorder (PTSD) symptoms, underscoring the importance of emotional clarity in maintaining cognitive and emotional health under stress (Boden et al., 2012). ...
... Conversely, those with low emotional clarity may be more vulnerable to stress, leading to increased cognitive failures due to the heightened cognitive load associated with emotional dysregulation (Hamilton et al., 2015). Boden et al. (2012) found that emotional clarity moderated the relationship between cognitive reappraisal and PTSD symptoms, suggesting that individuals with high emotional clarity were better able to utilize cognitive reappraisal strategies to manage stress and reduce PTSD symptoms. This finding indicates that emotional clarity may serve as a protective factor against the cognitive impairments associated with stress (Boden et al., 2012). ...
To investigate the relationships between emotional clarity, vulnerability to stress, and cognitive failures, and to determine the predictive value of emotional clarity and vulnerability to stress on cognitive failures. This cross-sectional study included 330 participants selected based on the Morgan and Krejcie table. Data were collected using the Cognitive Failures Questionnaire (CFQ), the Trait Meta-Mood Scale (TMMS) for emotional clarity, and the Perceived Stress Scale (PSS). Pearson correlation and linear regression analyses were conducted using SPSS version 27. Descriptive statistics indicated mean scores of 35.24 (SD = 9.87) for cognitive failures, 26.78 (SD = 7.65) for emotional clarity, and 29.43 (SD = 8.31) for vulnerability to stress. Pearson correlation analysis showed significant relationships between cognitive failures and emotional clarity (r = -0.45, p < 0.001) and vulnerability to stress (r = 0.53, p < 0.001). Regression analysis revealed that both emotional clarity (B = -0.48, SE = 0.09, β = -0.32, t = -5.31, p < 0.001) and vulnerability to stress (B = 0.67, SE = 0.08, β = 0.45, t = 8.37, p < 0.001) were significant predictors of cognitive failures, accounting for 38% of the variance (R² = 0.38, F(2, 327) = 99.65, p < 0.001). The study found that higher emotional clarity is associated with fewer cognitive failures, while higher vulnerability to stress is linked to increased cognitive failures. Both emotional clarity and vulnerability to stress significantly predict cognitive failures, highlighting their importance in cognitive performance. These findings suggest that interventions aimed at enhancing emotional clarity and managing stress could reduce cognitive failures.
... Indeed, traits related to emotion expressional (e.g. alexithymia, or the inability to identify and describe emotion) and, in turn, regulation can meaningfully impact the process of experiencing emotion, shaping a person's understanding of their emotion and what might be necessary in order to modulate affect (Boden et al., 2012;Feldman Barret & Gross, 2001;Moormann et al., 2012;Lane et al., 2022). Further, deficits in emotion regulation are proposed to maintain psychopathology transdiagnostically (Fernandez et al., 2016). ...
... However, this may also be due to the evidenced importance of emotional clarity in predicting symptomatology. Given the foundational importance of understanding one's emotions to adaptively regulate, it is possible that deficits in emotional clarity diminish one's ability to understand other facets of dysregulation (Boden et al., 2012;Feldman Barret & Gross, 2001;Lane et al., 2022). Similarly, this could be connected to the finding that the DERS-SF subscale of emotional awareness deficits was unrelated to other aspects of regulation, apart from difficulties with goals, and outcome variables. ...
... With items assessing an individuals' ability and desire to attend to their emotions, deficits in emotional awareness might influence their understanding of regulation, influence their experience following trauma, as well as their understanding of recovery (Frewen et al., 2012;Lane et al., 2022). Indeed, improved emotional clarity is proposed to reduce PTSD symptom severity and relate to attention to emotions, again suggesting that it may be challenging to be aware of emotions as well as evaluate the effects of other components of dysregulation when clarity is impaired (Boden et al., 2012;Vine & Aldao, 2014). Future work may address this by either exploring state regulation skills or by evaluating emotion regulation deficits across time after trauma (e.g. ...
Background: Emotion dysregulation is a hallmark characteristic of psychopathology following trauma. Yet, emotion dysregulation is multifaceted, and little is known about which aspects of emotion dysregulation predict depression and posttraumatic stress disorder (PTSD) symptom severity following traumatic injury.
Objective: The aim of this longitudinal study was to evaluate how facets of dysregulation differentially predicted the severity of PTSD symptom clusters and depressive symptoms six months after a traumatic injury requiring medical treatment.
Methods: Traumatically injured adults (N = 99) presenting to a Level 1 trauma centre completed a measure of emotion dysregulation 2 weeks post-injury, and PTSD and depression were assessed at 2-weeks and 6 months later.
Results: Using stepwise regressions controlling for baseline symptoms, age, gender, race, and injury severity, results showed baseline emotion dysregulation significantly predicted the four symptom clusters of PTSD 6 months post-injury. Notably, hyperarousal symptoms and negative alterations in mood and cognition were predicted by a lack of clarity. On the other hand, depressive symptoms were significantly predicted by difficulty accessing emotion regulation strategies.
Conclusion: Results highlight that specific facets of emotion dysregulation predict PTSD and depression symptom severity differentially after injury. Indeed, lack of emotional clarity appears to predict PTSD symptomatology, suggesting a potential mechanism driving worsening symptoms. Lack of clarity could also be detrimental to engagement in PTSD treatment. Conversely, lack of regulation strategies may represent a sense of helplessness in managing depression after trauma. As such, future research should elucidate whether interventions targeting aspects of emotion dysregulation based on symptom presentations are useful in treating PTSD and depression following injury.
... Bussell and Naus (2010) defined cognitive coping as including positive reappraisal, acceptance, and religious coping. Strategies that rely on cognitive processes have been associated with lower levels of posttraumatic stress, primarily in cross-sectional studies (e.g., Boden et al., 2012;Hanley et al., 2017). ...
... While limited research has identified cognitive coping strategies as useful, almost no research has examined how each cognitive coping strategy predicts subsequent changes in PTSS. The little literature that has examined associations of adaptive cognitive coping and PTSS were cross-sectional (Boden et al., 2012;Hanley et al., 2017). The few studies that examined cognitive coping longitudinally have typically considered only isolated components of cognitive coping for PTSS (Bryant-Davis et al., 2014;Wisco et al., 2013). ...
... Our research sought to determine how different forms of cognitive coping predict change in PTSS longitudinally. Our first hypothesis was partially supported as positive reinterpretation reduced PTSS over time, which is consistent with existing cross-sectional literature (Boden et al., 2012;Hanley et al., 2017;Kleim et al., 2013). Results regarding the direct effects of acceptance and religious coping were not entirely in line with existing literature. ...
Following a traumatic event, coping strategies may affect the natural course of posttraumatic stress symptoms (PTSS). In particular, cognitive-coping strategies (how one thinks about stressors) may reduce PTSS by increasing individuals’ perceived control over events, appraising them as less threatening, particularly for individuals who experience self-blame after trauma. Individuals who experience a traumatic event (n = 344) completed assessments at baseline (T1), 1 month (T2), and 2 months (T3). We tested whether T1 cognitive coping strategies (positive reinterpretation, acceptance, religious coping) predicted reduced T3 PTSS and whether this reduction was mediated by increased perceived control at T2. We tested whether this effect was particularly strong for individuals experiencing self-blame. Positive reinterpretation predicted decreases in, religious coping predicted increases in, and acceptance had no direct effect on PTSS. Overall, acceptance showed the greatest potential for reducing PTSS through increased perceived control over one’s life. In a fully moderated mediation model, positive reinterpretation significantly interacted and acceptance marginally interacted with self-blame to predict increased perceived control and, subsequently, decreased T3 PTSS. Specifically, acceptance and positive reinterpretation were most helpful for those with higher levels of self-blame. Religious coping interacted with self-blame to predict decreased perceived control and subsequent increased PTSS. For trauma survivors experiencing self-blame, cognitive coping strategies that utilize compassionate self-talk, such as positive reinterpretation and acceptance, may be particularly helpful at increasing perceived control after trauma, while religious coping may have deleterious effects.
... Thought suppression is theorized to be less effective in modifying emotions relative to cognitive reappraisal (Gross, 1998) and tends to be used by individuals with a history of childhood maltreatment (Krause et al., 2003) and PTSD relative to those without (Beck et al., 2006;Shipherd & Beck, 2005). Conversely, cognitive reappraisal is associated with less severe PTSD symptom presentation (Boden et al., 2012, Boden et al., 2013 and has been described as a marker of resilience among children exposed to adversity (Rodman, Jenness, Weissman, Pine, & McLaughlin, 2019). The concurrent effects of each strategy on PTSD symptoms among adults with childhood maltreatment has not been empirically demonstrated to date. ...
... Cognitive reappraisal entails flexibility in perspective taking (e.g., "I control my emotions by changing the way I think about the situation I'm in"), such that emotional situations are construed in a particular way to change the emotional impact (Boden et al., 2012). Cognitive reappraisal is an adaptive emotion regulation strategy in that unpleasant emotions can be downregulated following stressful events (Gross & John, 2003). ...
... The literature suggests childhood maltreatment is associated with less use of cognitive reappraisal, but increased engagement in cognitive reappraisal may be associated with less PTSD symptoms. Cognitive reappraisal is described as a marker of resilience among children exposed to adversity (Rodman et al., 2019), associated with less severe PTSD symptoms (Boden et al., 2012, Boden et al., 2013, and may contribute to post-traumatic growth (Johnson et al., 2007). A form of cognitive reappraisal, positive reframing, is also associated with greater adjustment (e.g., comfortable discussing trauma) among sexual abuse survivors (Himelein & McElrath, 1996). ...
Emotion regulation strategies may help explain the risk of experiencing
posttraumatic stress disorder (PTSD) symptoms among adults with a history of child
maltreatment. However, no study to date has examined the roles of both thought
suppression and cognitive reappraisal in the association between childhood
maltreatment and PTSD symptoms. Objective. The current study sought to understand
the associations between childhood maltreatment, thought suppression, cognitive
reappraisal, and PTSD symptoms while controlling for negative affect and gender.
Participants and Setting. Data were collected on 660 university students (71% female)
ages 18 - 25 between 2013 and 2014. Participants completed self-report measures of
childhood maltreatment, PTSD symptoms, and emotion regulation strategies. Method.
A structural equation model was tested to examine the direct and indirect effects from
childhood maltreatment to PTSD symptoms via thought suppression and cognitive
reappraisal, over and above gender and negative affect. Results. Childhood
maltreatment was directly associated with PTSD symptoms (β = 0.28, SE = 0.04, p <
.001). Childhood maltreatment also had a significant indirect effect on PTSD via
cognitive reappraisal (β = 0.01, CI 95% [0.00, 0.03]), but not through thought
suppression, although (β = 0.01, CI 95% [-0.00, 0.04]) thought suppression was
significantly positively associated with PTSD symptoms (β = 0.21, SE = 0.04, p < .001).
Conclusion. The present study sheds light on the effect of childhood maltreatment and
two commonly used emotion regulation strategies on PTSD symptoms.
... Awareness, clarity, and understanding of an emotion (1-3, which we will subsume as comprehension) and compassionate self-support (4, which we will shorten to self-support in the following) are stipulated to impact on the emotion regulation process indirectly by facilitating modification (5) and acceptance/tolerance (6; Berking and Whitley 2014). In support of this assumption, a cross-sectional study demonstrated the interaction of clarity and cognitive reappraisal to be negatively associated with PTSD symptoms (Boden et al. 2012) and an experimental study showed a moderating effect of self-support on the effect of cognitive reappraisal on depressive symptoms (Diedrich et al. 2016). Thus, taking these interactions into account might also inform our understanding of the nature of emotion regulation difficulties that drive psychotic symptoms, such as paranoid ideation. ...
... This is surprising, given the ACE model's assumption that comprehension of emotions and self-support lead to a more focused and targeted attempt to modify emotions (Berking and Whitley 2014) that has been partially confirmed in previous research (e.g. Boden et al. 2012;Diedrich et al. 2016;Kalokerinos et al. 2019). However, these previous studies have mostly tested moderating effects specifically for cognitive reappraisal rather than for modification in general, which might explain the diverging findings. ...
... Future research needs to clarify whether these adaptive patterns of emotion regulation are transdiagnositic or specific to paranoid ideation. Furthermore, it needs to be examined whether other adaptive emotion regulation patterns that are related to other psychopathology, such as PTSD or depressive sypmtoms (Boden et al. 2012;Diedrich et al. 2016), are also associated with paranoid ideation. It must be noted that this study along with the previous research investigates only one-directionally how emotion regulation strategies predict paranoid ideation. ...
Background: Research on emotion regulation and paranoid ideation has mostly focused on isolated regulation strategies and
has remained largely inconclusive. According to the emotion regulation model by Berking and Whitley (in: Afect Regulation Training, Springer, New York 2014) successful modifcation or acceptance/tolerance of emotions requires an adequate
comprehension (awareness, clarity, understanding) of emotions and adequate self-support.
Method: Building on this model, we investigated whether comprehension and self-support strengthen the negative association between modifcation and acceptance/tolerance and paranoid ideation. In study 1, we examined the hypotheses crosssectionally based on questionnaire data from a combined sample (N=125) consisting of people with a psychotic disorder,
people at risk of developing psychosis, and healthy controls. In study 2, we examined the same hypotheses longitudinally by
employing the experience sampling method in people with clinically relevant psychopathology below diagnostic threshold
(N=138).
Results: In study 1, the association between modifcation and paranoid ideation was not moderated by comprehension or
self-support. However, comprehension and self-support moderated the association between acceptance/tolerance and paranoid ideation. In study 2, the interaction efect between comprehension and acceptance/tolerance on paranoid ideation was
confrmed.
Conclusion: The results indicate that comprehending and accepting/tolerating emotions could be protective against paranoid
ideation.
... Both emotional awareness and emotional clarity have been found to have unique impacts on emotion processing and regulation among those with alexithymia (Mestre-Bach et al., 2023) and PTSD (Pugach & Wisco, 2023). Specifically, emotional clarity and awareness have been independently implicated in PTSD presentations and treatment outcomes (Boden et al., 2012;Pugach & Wisco, 2023;Viana et al., 2018). For example, Pugach and Wisco (2023) found that emotional clarity, but not emotional awareness, was associated with the adaptive use of emotion-regulation strategies for trauma-exposed adults, buffering them from the development of PTSD. ...
... Finally, although there was a slightly smaller effect size for negative alterations in cognition and mood for those high in alexithymia, the high and low alexithymia groups demonstrated treatment responses for this symptom cluster with large effect sizes. The marginally diminished effect size may be due to greater experiential avoidance, which may perpetuate negative affect and inhibit opportunities for learning or cognitive reappraisal of problematic cognitions (Boden et al., 2012). However, these factors appear to be largely mitigated upon completion of treatment. ...
Alexithymia is the inability to identify and recognize emotions. The present study examined the impact of alexithymia on prolonged exposure (PE) therapy. Participants (n = 68) with PTSD underwent 10 PE sessions. Alexithymia was assessed via the Toronto Alexithymia Scale (TAS-20) and the emotional clarity and awareness subscales of the Difficulties in Emotion Regulation Scale. Treatment outcomes were assessed via the PTSD checklist and Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition at posttreatment and 6-month follow-up. Those with high alexithymia were more likely to endorse experiencing a full PTSD diagnosis immediately posttreatment, χ²(1) = 12.53, p = .002, and at 6-month follow-up, χ²(1) = 11.21, p = .004. Alexithymia was associated with delayed treatment effects on avoidance, with a significant reduction in symptomology observed from pre- to follow-up, t(51) = 4.52, p < .001, and not from pre- to posttreatment. Although both the low and high alexithymia groups showed significant changes in negative changes in thinking and mood, F(2, 14) = 9.18, p = .001, d = 1.57 and F(2, 50) = 13.86, p = .001, d = 1.49, respectively, the high alexithymia group exhibited a marginally lesser magnitude of treatment effect. Although those with significantly greater difficulties with emotional clarity were more likely to drop out of PE treatment, emotional clarity and awareness did not moderate treatment response. Our results confirm the efficacy of PE but also highlight that those with alexithymia show a delayed treatment response and may be at greater risk of pathology after treatment.
... The association of alexithymia with elevated Negative Alterations in Cognition and Mood, along with Hyperarousal and Re-experiencing, may be explained by the propensity among those with alexithymia to use suppression-based emotion regulation strategies (Luminet and Zamariola, 2018), which may lead to persistent negative affect. Furthermore, our result of DIF being most strongly associated with Negative Alterations in Cognition and Mood over Re-experiencing symptoms supports the hypothesis that the association between alexithymia and PTS is best explained by secondary effects of alexithymia on emotion regulation and coping, as opposed to deficits in emotional memory processing (Boden et al., 2012). ...
... The highlighted link between DIF and PTS symptoms for our female sample is of clinical significance as difficulty in identifying feelings has been found to be a mediator in the development of transdiagnostic psychopathology (i.e., a shared mechanism across psychological disorders; Vine and Aldao, 2014). Specific to PTSD, the ability to identify feeling states has been found to predict adaptive emotion regulation (Boden et al., 2012). Deficits in knowing when and how to adaptively regulate emotions may explain the greater likelihood for women to experience PTSD, even though men are more likely to experience traumatic events (Knipscheer et al., 2020). ...
There is a demonstrated association between alexithymia and posttraumatic stress disorder (PTSD). However, work has largely focused on male-dominant, high-risk occupation populations. We aimed to explore the relationship between posttraumatic stress (PTS) and alexithymia among 100 trauma-exposed female university students. Participants completed a Life Events Checklist, the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PCL-5), and the Toronto Alexithymia Scale (TAS-20). Multiple regressions were run to examine whether alexithymia was associated with each of the PCL-5 subscales. The TAS-20 total scores were associated with total PTS scores, β = 0.47, t (99) = 5.22, p < 0.001. On a subscale level, Difficulty in Identifying Feelings (DIF) was positively associated (β = 0.50 to 0.41) with all PCL-5 subscales except for Avoidance. Our results align with research showing that for women, the DIF subscale is most strongly associated with PTS, in contrast with the literature on male samples, showing strongest associations with the Difficulties in Describing Feelings subscale, suggesting sex differences in associations between PTS and alexithymia. Our study supports the universality of the associations between alexithymia and PTS.
... In contrast, cognitive reappraisal did not significantly differ among the profiles, inconsistent with our third hypothesis. Our sample endorsed levels of cognitive reappraisal similar to other studies examining this construct in relation to PTSD (Boden et al., 2012;Moore et al., 2008). While cognitive reappraisal is typically conceptualized as a protective factor against psychopathology such as PTSD, it is known to be context-dependent (Aldao et al., 2013). ...
... Without knowing the context of the use of reappraisal, it is difficult to determine how useful cognitive reappraisal is in effectively regulating a person's emotional experience. It has also been found to interact with emotional clarity in order to enhance an individual's attention to emotion (Boden et al., 2012). Therefore, while individuals in our sample may be reappraising to similar degrees, the context and efficacy of their reappraisal in reducing PTSD-related distress may differ, and additional emotional awareness training may augment their reappraisal strategies. ...
Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are mental health conditions that often co-occur. The complexity of this comorbidity is well-documented, though the role of malleable cognitive-affective factors in PTSD/AUD warrants further study. Specifically, attaining a more comprehensive understanding of the role of malleable cognitive-affective factors in individuals with symptoms of PTSD/AUD may have important implications for future research, such as in treatment-seeking individuals. Extant examinations of cognitive-affective factors have demonstrated unique associations of cognitive reappraisal, expressive suppression, and rumination in PTSD symptom severity, though these effects had yet to be explored in subgroups of comorbid PTSD/AUD.
Methods: In a sample of trauma-exposed individuals (n = 334) recruited to participate through an internet labor market, we first empirically examined latent subgroups of PTSD/AUD symptoms using latent profile analysis, then included expressive suppression, cognitive reappraisal, and four dimensions in the model to elucidate their role in specific profile patterns of PTSD/AUD symptom typologies.
Results: Our results support a four-class model of PTSD/AUD symptoms, with unique predictive effects of expressive suppression, problem-focused thoughts, repetitive thoughts, and anticipatory thoughts on latent profile status.
Conclusions: These findings may have important implications for future research focused on examining cognitive-affective patterns as they apply to intervention techniques in treatment-seeking individuals with symptoms of PTSD/AUD.
... Reappraisal of an emotionally negative event to be less emotionally meaningful and intense has been shown to be effective at reducing PTSD symptoms [64,65]. For example, veterans with PTSD who were successfully trained to use reappraisal strategies and were self-aware of the emotions they were experiencing had lower PTSD symptom severity and greater positive affect [64]. ...
... Reappraisal of an emotionally negative event to be less emotionally meaningful and intense has been shown to be effective at reducing PTSD symptoms [64,65]. For example, veterans with PTSD who were successfully trained to use reappraisal strategies and were self-aware of the emotions they were experiencing had lower PTSD symptom severity and greater positive affect [64]. ...
This perspective piece reviews the clinical condition of posttraumatic stress disorder (PTSD), which is currently increasing due to the COVID-19 pandemic, and recent research illustrating how olfaction is being incorporated into virtual reality (VR) platforms. I then discuss the latest work examining the potential of olfactory virtual reality (OVR) for the treatment of PTSD. From this foundation I suggest novel ways in which OVR may be implemented in PTSD therapy and harnessed for preventing the development of PTSD. Perceptual and chemical features of olfaction that should be considered in OVR applications are also discussed.
... Cognitive reappraisal can also lead to increases in positive emotion and offers a means for change in patients with low hope. Furthermore, use of this adaptive emotion-regulation strategy can help protect individuals from emotional disorders (Alvarez & Leal, 2010;Larsen & Berenbaum, 2015), diminish the severity of Post-Traumatic Stress Disorder (PTSD) (Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012), and enhance the rate of PTG (Brans, Koval, Verduyn, Lim, & Kuppens, 2013; Orejuela-Dávila, Levens, Sagui-Henson, Tedeschi, & Sheppes, 2019). ...
... Another finding of the current study is the positive and significant relationship between emotion regulation and PTG, which is in line with that of Boden et al. (2012). Confirming that those who use the emotional regulation strategy of cognitive reappraisal to assess the situation in a more positive manner are also more likely to search for opportunities existing amid their stressful situation and look for greater meaning in the incident (Groarke et al., 2017;Jim & Jacobsen, 2008). ...
Background
Despite the negative consequences of breast cancer, many women experience positive changes after diagnosis.
Objective
The aim of this study was to examine the mediating role of emotion regulation between post-traumatic growth (PTG), satisfaction of basic needs and maladaptive schemas.
Method
A total of 210 female patients diagnosed with breast cancer for at least six months were assessed using measures of the PTG Inventory, Basic Psychological Needs Satisfaction Scale, Young Schema Questionnaire–Short Form, and the Emotion Regulation Questionnaire. The collected data was analysed using structural equation modelling by SPSS and Amos 23.0.
Results
Basic needs and maladaptive schema paths to emotion regulation and PTG, and emotion regulation path to PTG were significant. In addition, maladaptive schemas path to emotion regulation was insignificant.
Conclusion
The current results show that focusing on satisfaction of basic needs and using positive emotion regulation strategies positively affect PTG. Additionally, activating maladaptive schemas and using negative emotion regulation strategies have a negative effect on PTG.
... We predicted that expressive suppression would mediate this link. Prior evidence of the relationship between cognitive reappraisal and psychopathology has been somewhat mixed (Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012;Forkmann et al., 2014). For instance, Forkmann et al. (2014) found that cognitive reappraisal was unrelated to suicidal ideation in their mixed-gender sample. ...
... For instance, Forkmann et al. (2014) found that cognitive reappraisal was unrelated to suicidal ideation in their mixed-gender sample. However, other work has found that cognitive reappraisal is negatively related to psychopathology in males (Boden et al., 2012) and females (Troy, Wilhelm, Shallcross, & Mauss, 2010). Given the ambiguity in the literature, we remained agnostic about whether cognitive reappraisal would attenuate the relation between disordered eating and suicidality. ...
Abstract
Objective
Although disordered eating is robustly associated with suicidal thoughts, it is not well understood why these conditions relate to each other. Emotion dysregulation is a shared risk factor for disordered eating and suicidal thoughts. Individuals with dysregulated emotions struggle to select appropriate strategies to modulate emotions and the strategies they use might explain some of the shared variances. Thus, we examined whether emotion regulation strategies mediated the relationship between disordered eating and suicidal ideation.
Method
Adult participants (N = 230) completed questionnaires on current disordered eating symptoms, emotion regulation strategies, and current suicidal ideation.
Results
Disordered eating symptoms positively associated with suicidal ideation. In addition, expressive suppression mediated the relation between disordered eating symptoms and current suicidal ideation. No relation was found for cognitive reappraisal.
Conclusions
The use of expressive suppression as an emotion regulation strategy may be related to increased suicidal ideation in individuals who express concerns about eating.
... Emotional clarity, the third distinct emotion-perception ability under investigation is a metaunderstanding of the path of one's emotions, including the causes of one's emotions and the biological and mental effects of one's emotions (Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012;Coffey, Berenbaum, & Kerns, 2003). One can be highly specific in naming emotions without having a deeper understanding of their source, and one can have this understanding of emotions without representing them dis-cretely. ...
... While clarity and differentiation do not predict one another (Boden, Thompson, Dizén, Berenbaum, & Baker, 2013), clarity is also related to emotion regulation. Low levels of clarity are related to poorer overall emotion regulation (Gratz & Roemer, 2008;Salovey et al., 1995), because understanding the source and consequences of one's emotions aids development of effective coping and regulation strategies (Boden et al., 2012). ...
When bad things happen people often seek out close others for support to help regulate their negative emotions. The degree to which support providers are responsive to the specific needs of support seekers is associated with many outcomes, including how effective that support is in regulating emotion. The ability of support providers to accurately assess the emotions experienced by support seekers seems crucial, yet few studies have examined the role this type of accuracy plays in support provision. We predicted that individuals who accurately assessed the emotions being experienced by a support seeker would provide more responsive support. Further, we predicted that individual differences in emotion differentiation (perceiving differences between similar emotions), range (experiencing a range of emotions), and clarity (understanding the cause and effect of one's emotions) would facilitate emotional accuracy and, in turn, responsiveness. Participants read scenarios depicting their romantic partners seeking support to help regulate different negative emotions; they then wrote supportive messages and indicated which emotions they thought their partners would be experiencing. Individual differences in emotional range and clarity (but not differentiation) predicted how accurate participants were in gaging the emotions depicted in the scenarios. In turn, accuracy predicted how responsive their messages were, as rated by independent coders. These results suggest that accuracy in perceiving a partner's emotions is crucial for providing responsive support and individual differences in one's own emotional experiences are associated both accuracy and responsiveness. Our findings have implications for research on interpersonal emotion regulation, close relationships, and social support. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
... In the case of PTSD specifically, a small but growing body of literature suggests that maladaptive ways of cognitively coping with a trauma (e.g., rumination, self-punishment) are associated with greater PTSD severity (e.g., Michael, Halligan, Clark, & Ehlers, 2007;Pietrzak, Harpaz-Rotem, & Southwick, 2011). Alternatively, greater use of adaptive cognitive coping strategies (such as cognitive reappraisal) has been shown to be associated with less severe PTSD symptoms in veterans (Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012). Another study examining cognitive coping strategies in a large sample of recently returning veterans with PTSD further found that greater baseline use of catastrophizing was significantly associated with greater symptoms on all the PTSD symptom clusters including intrusive thoughts, avoidance, negative alterations in cognitions/mood, and hyperarousal (Kaczkurkin et al., 2017). ...
... ASNAANI, KACZKURKIN, FITZGERALD, JERUD, AND FOA studies have examined the relationship between cognitive coping strategies and PTSD in general (e.g., Kaczkurkin et al., 2017;Boden et al., 2012), these previous studies did not examine subgroups of participants based on smoking status and our study only included smokers. Therefore, future studies might benefit from examining cognitive coping strategies in smokers versus nonsmokers with PTSD over the course of treatment. ...
Objective:
Numerous researchers have suggested that certain coping styles (e.g., maladaptive cognitive coping strategies) interfere with recovery from traumatic experiences and contribute to the onset/maintenance of posttraumatic stress disorder (PTSD). Further, given that individuals with PTSD have a high rate of smoking (e.g., Mahaffey et al., 2016) and that maladaptive coping strategies in general are associated with lower smoking quit rates, it is possible that use of maladaptive cognitive coping strategies are particularly problematic for the recovery of smokers with PTSD. The present study examined whether specific cognitive coping strategies are associated with poorer outcome among smokers with PTSD following an integrated treatment for both disorders.
Method:
Patients with chronic PTSD and nicotine dependence (N = 142) received up to 12 sessions of smoking cessation counseling combined with varenicline or integrated prolonged exposure therapy and cessation counseling combined with varenicline. We hypothesized that greater maladaptive, and lower adaptive, cognitive coping strategies at baseline would moderate degree of improvement in smoking and PTSD outcomes through to follow-up.
Results:
Multilevel modeling revealed that neither maladaptive nor adaptive cognitive coping strategies moderated smoking abstinence outcomes over the course of the study (ps ≥ .271). However, greater use of catastrophizing and lower use of positive reappraisal at baseline were associated with less improvement in the hyperarousal PTSD symptom cluster over the course of the study (ps ≤ .01).
Conclusions:
These findings suggest that maladaptive cognitive coping strategies are not necessarily a contraindication for overall outcomes in integrated PTSD and smoking treatment, although they may influence improvement in hyperarousal symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
... The extent to which emotions are attended to has a positive impact on emotion clarity and promotes building up of emotion knowledge 54,55 . High emotional clarity in turn appears to be related to a more frequent use of reappraisal 56,57 . ...
Little eye-tracking research has been conducted so far on the association of subtypes of childhood maltreatment and habitual emotion regulation with attention to emotions. To address this issue, gaze behavior of one hundred women with experiences of childhood maltreatment was examined in a free-viewing task in which pairs of faces consisting of an emotional (happy, surprised, angry, disgusted, fearful, and sad) and a neutral face were displayed. Participants’ childhood maltreatment experiences, emotion regulation strategies (reappraisal and suppression), anxiety, depression, stress perception, level of alexithymia, and intelligence were assessed. Fixation durations were used to assess attentional bias. A mixed linear model with post-hoc pairwise comparisons was used to investigate research questions. Results indicated that, at high levels of maltreatment severity, attentional preference for positive over other emotional faces was found to be diminished for physical and emotional abuse but not for emotional neglect. At a severe level of emotional abuse, a bias away from disgusted faces was observed. Suppression was linked to reduced and reappraisal was related to heightened attention allocation to facial emotions. Our data indicates that attention to social emotional information in adulthood could depend on the type and severity of childhood trauma and habitual emotion regulation strategy.
... On the one hand, the inability to focus on and accomplish important tasks due to negative emotions may indicate maladaptive reactions to stressful situations which likely fosters behavioural avoidance. On the other hand, the inability to identify emotions may hinder the cognitive and emotional processing required for PTS to naturally alleviate (Boden et al., 2012). ...
Background: Upon arrival in the host country, refugees and asylum seekers (RAS) experience a range of post-migration living difficulties (PMLD), which are often linked to psychological symptoms such as post-traumatic stress (PTS). Initial research suggests that attachment insecurity partly explains the association between PMLD and psychological symptoms in RAS. However, the mechanisms through which attachment insecurity may act as a mediator are not well understood, though emotion dysregulation is one of the potential candidates.
Objectives: This study investigated (1) whether attachment insecurity (i.e. anxiety and avoidance) mediate the association between PMLD and PTS, and (2) whether this mediation model can be extended to emotion dysregulation.
Methods: 134 treatment-seeking RAS living in Switzerland completed questionnaires assessing PMLD, attachment insecurity, emotion dysregulation, and PTS. Two models were tested: (1) a parallel mediation analysis with attachment anxiety and avoidance as mediators, and (2) a serial mediation analysis with attachment anxiety as the first and emotion dysregulation as the second mediator.
Results: First, PMLD was indirectly associated with PTS through attachment anxiety but not avoidance. Second, the association between PMLD and PTS was further explained by a pathway through attachment anxiety and emotion dysregulation.
Conclusions: Although this study is limited by its cross-sectional design, we identified attachment anxiety and emotion dysregulation as potential mechanisms explaining how PMLD affects symptoms of PTS in RAS. Systematically assessing attachment style and addressing emotion regulation may therefore help improve treatment of refugee and asylum-seeking patients.
... While this narrative would not be intended to help family members process past trauma, it has the potential to change the meaning of those events by helping family members connect with their strengths. Such interventions may lead to cognitive reappraisal of traumatic events, which has been linked with a decrease in posttraumatic symptoms (Boden et al., 2012). ...
In their manuscript, “Addressing Child Maltreatment by Infusing Multicultural, Feminist Tenets to Standard Clinical Approaches: The Cases of ‘Bashiir’ and ‘Jaquann,’” Dr. Rachel Singer, Dr. Renee DeBoard-Lucas, and Dr. Milton Fuentes (2024) exemplified how clinicians can be cognizant and respectful of the many familial, socio-cultural, and systemic contexts that contribute to a client's difficulties and that must be considered for successful treatment. As such, they made relevant clinical adjustments to overcome possible barriers to treatment and to foster safe, culturally responsive therapeutic environments. In this Commentary, I propose another clinical adjustment, congruent with a multicultural feminist lens, that has the potential to be beneficial to families that face barriers to parental involvement in treatment: working with the sibling subsystem. While interventions with siblings have received minimal attention in the clinical literature, work with the sibling subsystem has the potential of benefiting individuals and families alike, particularly in the context of trauma-focused therapy with youth. To illustrate how clinicians can work jointly with siblings, I propose pivotal themes and junctures in therapy with Bashiir and Jaquann where sibling involvement may be beneficial.
... It can effectively mitigate emotional exhaustion and the resulting health issues. Numerous empirical studies have demonstrated that the use of cognitive reappraisal strategies can help traumatised individuals improve quality of life [34,35], alleviate PTSS [36], and reduce academic burnout [28]. ...
Background
The COVID-19 pandemic has had a significant negative impact on public health, prompting scholarly research in related fields. In this context, the present study reveals the psychological characteristics of adolescents in ethnic minority areas of China approximately five months after the 2020 outbreak of the COVID-19 pandemic, explores the relationship between intrusive rumination and academic burnout, and examines the role of post-traumatic stress symptoms (PTSS) and cognitive reappraisal in the relationship to provide an empirical foundation for developing effective psychological interventions for adolescents in the wake of the pandemic.
Methods
Based on cluster sampling, 941 middle school students (65.36% female, 74.71% senior high, Mage=15.95) in ethnic minority areas of China were surveyed using the Event Related Rumination Scale, Adolescent Academic Burnout Scale, Post-traumatic Stress Checklist Scale, Emotion Regulation Strategy Scale, and a self-designed demographic questionnaire.
Results
During the COVID-19 pandemic, 7.44% of Chinese ethnic minority adolescents in our study sample were classified as PTSD positive, and 10.95% exhibited partial PTSD. Intrusive rumination significantly predicted academic burnout, and PTSS played a key mediating role between the two, accounting for 58.51% of the total effect. After controlling for PTSS, cognitive reappraisal moderated the effects of intrusive rumination on academic burnout. Specifically, the effect of intrusive rumination on academic burnout decreased with improvement in cognitive reappraisal.
Conclusions
Intrusive rumination indirectly affected academic burnout in adolescents through PTSS as a crucial mediator, and the remnant direct effect was alleviated by cognitive reappraisal. This finding emphasises the importance of adopting a comprehensive approach that encompasses cognitive, emotional, and physiological symptoms to understand and address academic burnout among adolescents during the COVID-19 pandemic.
... Prior research has documented cognitive reappraisal as an adaptive emotion regulation strategy, such that it is associated with lower levels of depressive symptoms (Troy et al., 2013) and higher levels of psychological well-being (Boden et al., 2012;Gross & John, 2003). In an experimental study, individuals with greater cognitive reappraisal who participated in an anger-inducing task experienced an adaptive cardiovascular response compared to those with low levels of cognitive reappraisal (Mauss et al., 2007). ...
Objectives: The present study has two aims: (a) to examine the frequency of various microaggression types experienced by Asian and Black Americans and (b) to examine cognitive reappraisal as a moderator of the relationship between microaggression types and general health. Method: Two hundred seventy-one Black and Asian American participants recruited from Amazon Mechanical Turk completed a cross-sectional online survey. The Racial and Ethnic Microaggressions Scale was used to assess the frequency with which participants experienced six different types of microaggressions. Cognitive reappraisal was assessed by the cognitive reappraisal subscale of the Emotion Regulation Questionnaire. General health was assessed by the RAND 36-item Short Form Health Survey. Results: We found that Black Americans experienced higher levels of Inferiority, Criminality, Workplace/School Microaggressions and Microinvalidations than Asian Americans. In contrast, Asian Americans experienced greater Exoticization and Environmental Microaggressions. There were ethnic/racial group differences in whether cognitive reappraisal moderated the relationships between microaggression types and general health. Conclusions: Our findings highlight important differences in the types of microaggressions experienced across ethnic/racial groups, and the role of cognitive reappraisal in influencing the detrimental effects of microaggressions on general health.
... One cognitive emotion regulatory technique trained in MORE is reappraisal-the process of reinterpreting a situation to attenuate its negative emotional impact 55,56 . Reappraisal has been identified as a core mechanism of change in PTSD interventions 57 , with increases in reappraisal predicting decreased PTSD symptoms 58,59 . Theory and empirical evidence suggest that mindfulness training enhances cognitive reappraisal in healthy individuals and those with psychiatric disorders [60][61][62] , as well as in opioid-treated patients with chronic pain 63,64 . ...
... As such, evidence-based psychotherapies (EBP) target PTSD through approach-related ER strategies such as exposure, cognitive reappraisal, and memory processing (Foa et al., 2006;Resick et al., 2008). The impact of specific ER strategies on PTSD has been studied within and between combat-exposed or combat-PTSD samples (e.g., Boden et al., 2012;Fitzgerald et al., 2017;Kashdan et al., 2010;Rodin et al., 2017). Several studies have also examined the associations between specific ER strategies, combat, and PTSD (Blackburn & Owens, 2016;Kelley et al., 2019;Nassif et al., 2019), generally finding that either increased avoidance (i.e., rumination) or decreased approach (i.e., mindfulness) strategies are associated with combat exposure and interact to confer risk for PTSD. ...
Objective:
This study examined whether posttraumatic stress disorder (PTSD) diagnostic groups in veterans were differentiated by combat severity and specific avoidance and approach-related emotion regulation (ER) strategies.
Method:
In a cohort study, 725 participants (Mage = 58.39, SD = 11.27, 94.5% male, 58.2% White) recruited from VHA facilities completed the Clinician Administered PTSD Scale (CAPS), Combat Exposure Scale (CES), and Emotion Regulation Questionnaire (ERQ). Participants were categorized into three PTSD groups: Current, Remitted, and Never.
Results:
Multinomial logistic regressions adjusting for age, sex, and race, showed combat severity significantly differentiated all groups from each other (ps < .001). Specifically, combat severity was significantly associated with increased odds of Current PTSD versus Remitted (OR: 1.02, 95% CI [1.01, 1.05]) and Never PTSD (OR: 1.14, [1.12, 1.17]) and odds of Remitted compared with Never PTSD (OR: 1.11, [1.09, 1.14]). Suppression, but not reappraisal, was significantly associated with increased odds of Current PTSD compared with Remitted (OR: 1.15, [1.06, 1.24]) and Never PTSD (OR: 1.14, [1.06, 1.22]; ps < .001). Lower reappraisal was only significantly associated with the likelihood of Remitted PTSD compared with Never PTSD (OR: 0.93, [0.88, 0.99], p = .03).
Conclusions:
Increasing levels of combat severity differentiated veterans with current, remitted, and no history of PTSD, suggesting screening for severity of combat may be helpful. Greater habitual suppression distinguished current versus non-current PTSD status, whereas only less reappraisal distinguished non-current groups from each other. Lower suppression may be an important treatment target for veterans with moderate and high combat severity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
... Indeed, Wells and Sembi (2004a) note negative appraisal as a maladaptive strategy in the metacognitive model of PTSD. However, elsewhere, reappraisal has been associated with less PTSD symptom severity (Aase et al., 2018;Bennett et al., 2009;Boden et al., 2012;Jenness et al., 2016;Roussis and Wells, 2006), and in a meta-analysis by Seligowski et al. (2015), reappraisal did not show an effect on posttraumatic stress outcomes. These differing findings may suggest that reappraisal is either a helpful or unhelpful strategy, depending on whether the thoughts are framed as positive or negative. ...
This study aimed to investigate the relationships among self-reported meta-memory beliefs, thought control strategies (i.e., distraction, reappraisal, worry, social control, and punishment), and posttraumatic stress disorder (PTSD) symptomology, among a sample of earthquake survivors (N = 412). Correlational analysis and structural equation modeling were used on the responses and showed that stronger positive and negative meta-memory beliefs, and greater worry and punishment, were associated with greater PTSD symptom severity. The results also indicated that meta-memory beliefs had a prominent indirect influence toward PTSD symptomology via their effects toward thought control strategies. Follow-up analysis of variance indicated that those with a history of mental health difficulties reported higher levels of PTSD symptom severity, were more likely to score in the range of clinically relevant PTSD, and had a stronger tendency to negatively appraise unwanted thinking styles. The results of this research provide overall support for the validity of the metacognitive model for PTSD.
... Moreover, it changes the perception of personal meaning of such occurrences to positively impact social behaviors. As an effective technique to suppress negative emotions, it helps to improve life satisfaction (Gong et al., 2013); moreover, it is closely related to wellbeing and mental health (Boden et al., 2012;Xu et al., 2020). ...
This study aimed to explore the mechanism of college students’ meaning of life. The Emotion Regulation Questionnaire, the Gratitude Questionnaire Six-Item Form, the General Wellbeing Schedule, the Meaning in Life Questionnaire were used as measurement instruments. In total, 1,312 valid responses were obtained. The results showed that the cognitive reappraisal and expression suppression strategies were significantly positively and negatively correlated with gratitude, subjective wellbeing, and the sense of life meaning, respectively. Further, Emotion regulation strategies can affect college students’ sense of life meaning through three paths: the mediating effect of gratitude; the mediating effect of subjective wellbeing; the chain mediating effect of gratitude and subjective wellbeing. This study illuminated the roles of gratitude, and subjective wellbeing in influencing the sense of life meaning among the Chinese college students. Limitations and future research directions are discussed.
... Regulation by cognitive or arousal reappraisal, which aims to change the type of stress response, encourages individuals to reconceptualize stress as a coping tool (57). This technique has been explored in both therapeutic contexts (58), resulting in decreased PTSD symptom severity (59), and academic contexts (41), showing effectiveness in improving student outcomes (60). Compared to other regulation strategies, specifically suppression, cognitive reappraisal was associated with lesser symptom severity in PTSD (58) and lower levels of academic burnout (56). ...
Background:
Trigger warnings - advance notification of content so recipients may prepare for ensuing distress - feature in discussions in higher education. Students' expectations for warnings in some circumstances are recognised and some educators and institutions have adopted use. Medical education necessitates engagement with potentially distressing topics. Little is known about medical students' expectations regarding warnings in education.
Methods:
All students from a 4-year graduate-entry UK medical degree programme were contacted via digital message outlining study details and were openly sampled. Qualitative methodology was chosen to explore participant expectations, experiences, and meanings derived from experiences. Students participated in semi-structured interviews exploring perspectives on functions, benefits, and drawbacks of trigger warnings in classroom-based medical education. We analysed interview transcripts using thematic analysis.
Results:
Thirteen semi-structured, qualitative interviews were undertaken. Themes in the following areas were identified; 1) students' experiences influence understanding of trauma and trigger warnings, 2) warnings as mediators of learning experiences , 3) professional responsibilities in learning, 4) exposure to content, 5) professional ethos in medical education, 6) how to issue trigger warnings. Students recognised the term "trigger warning" and that warnings are an accommodation for those affected by trauma. Students' conceptualisation of warnings was influenced by personal experiences and peer interactions both within and outside education. Students expressed both support and concerns about use of warnings and their ability to influence learning, assuming of responsibility and professional development.
Discussion:
Diverse student opinions regarding warnings were identified. Most students suggested that warnings be used prior to topics concerning recognised traumas. Incremental exposure to distressing content was recommended. Students should be supported in managing own vulnerabilities and needs, while also experiencing sufficient formative exposure to develop resilience. Greater understanding of trauma prevalence and impacts, and underpinnings of warnings amongst students and educators is recommended to optimise education environments and professional development.
... Conversely, individuals who change their appraisals of the negative events, so as to develop a more positive and acceptable interpretation of the events, tend to experience less distress and better psychological adjustment (Gan et al., 2013;Janoff-Bulman, 1992;Park, 2013). Studies suggest that cognitive reappraisals of negative and traumatic events highly contribute to psychological health and well-being (Cutuli, 2014;Garnefski & Kraaij, 2006;Gross & Thompson, 2007;Kraaij et al., 2002), particularly in individuals with PTSD (Boden et al., 2012;Nickerson et al., 2017). This entails that as an upshot of meaning making, the ability to change their beliefs and appraisals about the negative event may be necessary in order to reduce the wide inconsistency between the police officers' morally held beliefs and the morally injurious events (i.e., moral injury) and potentially helps prevent the development of distress symptoms (i.e., decrease of PTSD severity). ...
The association between moral injury and the development of serious social, behavioral, and psychological problems has been demonstrated in a limited but growing body of literature. At present, there is a dearth of evidence pertaining to the mechanism in explaining the relationship between moral injury and posttraumatic stress disorder. This study seeks to examine the serial mediating roles of meaning making and change in situational beliefs in the relationship between moral injury and PTSD. A sample of 737 police officers deployed on fieldwork who have experienced at least one morally injurious event were given psychometric scales assessing moral injury, meaning making, change in situational beliefs, and PTSD. Serial mediation analysis reveals that the positive association between the experience of morally injurious events and PTSD could be accounted for by the decrease in meaning making process and lack of change in situational beliefs. The findings highlight the importance of meaning making and changing situational beliefs in resolving inconsistent thoughts or actions against one’s moral code (i.e., moral injury) that ultimately affects one’s psychological health.
... Emotional clarity has been found to predict PTSD symptom severity over and above awareness, other facets of alexithymia, and emotion dysregulation (Ehring & Quack, 2010;Tull et al., 2007). Furthermore, clarity interacts with ER strategies to predict PTSD severity (Boden et al., 2012). Consistent with the notion of regulatory flexibility (Bonanno & Burton, 2013), emotional clarity may help individuals identify situations in which engaging with emotional material (e.g., trauma-cues) is adaptive. ...
Objective:
Emotion regulation (ER) plays a prominent role in the development and maintenance of posttraumatic stress disorder (PTSD). Although links between ER strategies and PTSD symptoms are well documented, recent advancements in ER research emphasize the need to move beyond examining ER strategies as isolated processes. Instead, there is a growing movement to understand ER repertoires, or the patterns in which individuals report habitually using the multiple ER strategies available to them. Additionally, awareness and clarity of one's emotional experiences might play a key role in the effective use of ER strategies.
Method:
The current study examined person-centered repertoires of the habitual use of eleven ER strategies among 372 undergraduates exposed to Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) Criterion A trauma-and their relations to PTSD symptoms, emotional awareness, and emotional clarity.
Results:
Latent profile analysis yielded a three-profile solution (Adaptive, Average, and Maladaptive Regulators) and profiles differed on mean levels PTSD symptoms. Emotional clarity, but not emotional awareness, emerged as a significant predictor of profile classification, even after adjusting for negative affect.
Conclusions:
Findings suggest that emotional clarity might help foster healthy repertoires of ER strategy use and buffer against the development of PTSD among trauma-exposed individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... These findings are in line with the common symptom profile of the dissociative subtype of PTSD, which is marked by emotional detachment, numbness, and blunted arousal. Such notions would also be consistent with dissociation being strongly negatively correlated with self-concept clarity (Evans, Reid, Preston, Palmier-Claus, & Sellwood, 2015), as well as cognitive reappraisal gains being partially dependent on having increased emotional clarity (Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012). This appears to be supported by an RCT evaluating changes in PTSD symptoms and diagnosis among 121 chronic PTSD patients randomly assigned to cognitive therapy, waitlist, or emotion-focused supportive therapy, which targeted clarifying the patient's emotions without cognitive restructuring or elaboration of the trauma memories (Ehlers et al., 2014). ...
Background
Post-traumatic stress disorder affects 9% of individuals across their lifetime and increases nearly fourfold to 35% in Canadian public safety personnel (PSP). On-the-job experiences of PSP frequently meet criteria for traumatic events, making these individuals highly vulnerable to exposures of trauma and the negative consequences of PTSD. Few studies have reported on the clinical characteristics of Canadian samples of PSP and even fewer have examined the dissociative subtype of PTSD, which is associated with more severe, chronic traumatic experiences, and worse outcomes.
Objective
This study aimed to characterize dissociative symptoms, PTSD symptom severity, and other clinical variables among Canadian PSP with presumptive PTSD.
Methods
We sampled current and past PSP in Canada from both inpatient and outpatient populations (N = 50) that were enrolled in a psychological intervention. Only baseline testing data (prior to any intervention) were analysed in this study, such as PTSD symptom severity, dissociative symptoms, emotion dysregulation, and functional impairment.
Results
In our sample, 24.4% self-reported elevated levels of dissociation, specifically symptoms of depersonalization and derealization. Depersonalization and derealization symptoms were associated with more severe PTSD symptoms, greater emotion dysregulation, and functional impairment.
Conclusions
Nearly a quarter of this sample of Canadian PSP reported experiencing elevated levels of PTSD-related dissociation (depersonalization and derealization). These high levels of depersonalization and derealization were consistently positively associated with greater illness severity across clinical measures. It is imperative that dissociative symptoms be better recognized in patient populations that are exposed to chronic traumatic events such as PSP, so that treatment interventions can be designed to target a more severe illness presentation.
... . In the wider PTSD literature, reappraisal has been differentially found to have negative(Aase et al., 2018;Boden et al., 2012;Jenness et al., 2016) and positive (Canetti et al., 2016; Meiser-Stedman et al., 2014; Scarpa et al., 2009; Valdez & Lilly, 2012; Wilson & Scarpa, 2012) associations with PTSD symptom severity, while Seligowski et al.'s (2015) meta-analysis found that reappraisal did not have any effect on post-traumatic stress symptoms. Wells and Sembi (2004a) have described negative appraisal as a maladaptive strategy in the metacognitive model of PTSD, and it is possible, therefore, that the varying findings across the literature regarding the association between reappraisal and PTSD symptoms may be due to the helpfulness of this strategy being dependent upon whether the thoughts are reappraised as positive or negative in nature. ...
The metacognitive model of PTSD implicates metacognitive beliefs, meta-memory beliefs, and metacognitive control strategies in perpetuating and maintaining symptoms of PTSD. Despite this expanding area of research, the evidence for the metacognitive model of PTSD has not been reviewed. A systematic review according to the PRISMA statement was conducted. Searches across Medline, PubMed and PsycNET, as well as reference lists of the included studies (2004-March 2020) yielded 221 records. Two independent reviewers screened articles, which were included where the impact of the constructs of interest on PTSD symptoms were investigated within the framework of the metacognitive model for PTSD. Eighteen articles were included in the review. Eleven studies were determined to have good methodological robustness. Metacognitive therapy for PTSD demonstrated reductions in symptoms from pre- to post-treatment, which were maintained at follow-up. Predictors of greater PTSD symptom severity included metacognitive beliefs, meta-memory beliefs, and worry, punishment, thought suppression, experiential avoidance, and rumination. Overall, support was found for the validity of the metacognitive model of PTSD.
... Additionally, emotional clarity (or the lack thereof) may show interactive or additive influence when investigated alongside other variables. For instance, researchers reported the beneficial influence of combined high levels of emotional clarity and the use of cognitive reappraisal on PTSD (Boden et al., 2012). In contrast, problems with emotional clarity lead to fears regarding anxiety-related sensations which results in higher PTSD symptom levels (Viana et al., 2018). ...
The present study tested the impact of family context on psychological functioning and its mediating and moderating variables in a sample of Filipino emerging adults who have been exposed to Typhoon Haiyan. Particularly, the current study examined the moderating role of trauma type in the indirect effect family functioning (FF) on Posttraumatic Stress Disorder (PTSD) symptoms via emotion regulation difficulties (ERD). Trauma-exposed students (N = 324, aged 19–28 years) from various regions devastated by Typhoon Haiyan participated in this study. The mediation analyses demonstrated that out of the six aspects of ERD, nonacceptance of emotional responses (Nonacceptance) and lack of emotional clarity (Clarity) successfully mediated the association between low FF and higher PTSD scores. Subsequent moderated mediation analysis showed that Typhoon Haiyan survivors with additional exposure to interpersonal trauma showed higher levels of PTSD symptoms from the indirect impact of unhealthy family functioning via difficulties in accepting negative emotional responses. This study demonstrates the continued relationship of family functioning and psychological adjustment occurring in emerging adulthood and suggests the role of trauma type as a potential contextual factor in further understanding the relationship between emotion regulation difficulties and PTSD symptoms. Empirical contributions and clinical implications are discussed.
... As described above, one of the hallmark symptoms of PTSD involves alterations in cognition and mood, where individuals with PTSD frequently experience persistent negative traumarelated emotions and associated changes in perception of the self and the world (Foa et al., 1999;Cox et al., 2014;Frewen et al., 2017). Here, cognitive functions such as emotion regulation may be negatively impacted in individuals with PTSD, as multisensory integration of internal and external sensory information plays a pivotal role in generating adaptive emotional responses when individuals interact with the external world (Cloitre et al., 2005;Ehring and Quack, 2010;Boden et al., 2012;Ford, 2017). Indeed, several neurophysiological studies in PTSD reveal that PTSD is often associated with extreme sensory processing patterns, including sensory hypersensitivity and hyposensitivity to stimuli associated with traumatic memories (such as specific sounds, images, touch stimulation) (Näätänen and Alho, 1995;Grillon and Morgan, 1999;Shalev et al., 2000;Engel-Yeger et al., 2013). ...
Post-traumatic stress disorder (PTSD) is triggered by an individual experiencing or witnessing a traumatic event, often precipitating persistent flashbacks and severe anxiety that are associated with a fearful and hypervigilant presentation. Approximately 14–30% of traumatized individuals present with the dissociative subtype of PTSD, which is often associated with repeated or childhood trauma. This presentation includes symptoms of depersonalization and derealization, where individuals may feel as if the world or self is “dream-like” and not real and/or describe “out-of-body” experiences. Here, we review putative neural alterations that may underlie how sensations are experienced among traumatized individuals with PTSD and its dissociative subtype, including those from the outside world (e.g., touch, auditory, and visual sensations) and the internal world of the body (e.g., visceral sensations, physical sensations associated with feeling states). We postulate that alterations in the neural pathways important for the processing of sensations originating in the outer and inner worlds may have cascading effects on the performance of higher-order cognitive functions, including emotion regulation, social cognition, and goal-oriented action, thereby shaping the perception of and engagement with the world. Finally, we introduce a theoretical neurobiological framework to account for altered sensory processing among traumatized individuals with and without the dissociative subtype of PTSD.
... Myerson states that simple language can reduce complexity and make difficult concepts accessible (Ivanova, 2018). Others link Clarity to emotional awareness and emotional intelligence (Bodet et al., 2011), mindfulness and wellbeing (Hanley & Garland, 2017), and conscientiousness (Campbell et al., 1996). Clarity principles were used to: ...
Creative Leadership (CL) is a leadership model comprising the three values of Empathy, Clarity and Creativity, which are considered baseline operational and leadership attributes in a Fourth Industrial Revolution (4IR) world. This paper presents a case study charting the application of CL principles within delivery of a complex research project involving international collaboration between The Helen Hamlyn Centre for Design (HHCD) at London's Royal College of Art (RCA), a strategic partner-TATA Consultancy Services (TCS), and an airline client [the Airline]. The purpose of the design research was to improve the operational efficiency of the Airline, whilst improving staff and customer experience. This addressed three discrete, yet interlinked areas of delivery within the Airline Operations Control Centre (OCC), namely Technology, Environment and People. The three values of CL-Empathy, Clarity and Creativity-were exercised to align physical, technological and psychological factors. These were implemented in the design of a UX technology that made complex information accessible at a glance, and the redesign of the OCC office environment to enable better communication and personal wellbeing. This paper captures the process and outcomes, whilst reflecting on the efficacy of the CL model as a progressive framework for innovation, growth and development.
... For instance, increased positive affect, combined with fewer posttrauma cognitions, could play a role in reducing PTSD symptom severity following positive memory processing. Such hypotheses need empirical examinations, although they are supported by established interactive effects of affect and cognitions on PTSD symptoms (e.g., cognitive reappraisal and emotional clarity; Boden et al., 2012). Furthermore, the current study had a modest sample size (resulting in limited power to detect significant relationships), was not a full longitudinal design (i.e., we had assessments across two timepoints), and had low baseline PTSD symptom severity, which may have influenced variation in scores over a short period; such methodological parameters could have influenced study findings. ...
Objective: Posttraumatic stress disorder (PTSD) symptoms may impact cognitive processes underlying encoding and retrieval of positive memories. Contractor and colleagues thus proposed a Positive Memory–PTSD model outlining hypothesized pathways (e.g., improved cognitions and affect) linking active processing of positive memories and PTSD symptoms. In the current study, we empirically explored direct and indirect pathways of the Positive Memory–PTSD model including relations between presence/types of processing memory methodology, posttrauma maladaptive cognitions, positive/negative affect, and PTSD symptom severity. Methods: We randomly assigned 65 students reporting trauma histories to time-matched narrating (identifying and sharing details of elicited positive memories), writing (identifying and writing details of elicited positive memories), or control conditions. Participants completed self-report measures (T0) and repeated their assigned task condition and self-report measures 6–8 days later (T1). Results: Half-longitudinal models demonstrated direct associations of (1) being in the narrating versus other conditions with decreases in posttrauma maladaptive cognitions and negative affect, and increases in positive affect; and (2) increases in posttrauma maladaptive cognitions and negative affect with greater PTSD symptom severity. Although, when controlling for posttrauma maladaptive cognitions and negative/positive affect, being in the narrating versus other conditions was associated with decreases in PTSD symptom severity, these constructs did not explain examined relations. Conclusions: Results suggest beneficial impacts of narrating positive memories on PTSD symptom severity (accounting for cognitions/affect) and improved cognitions/affect, and a need to examine moderating variables (e.g., emotion regulation) in the Positive Memory–PTSD model.
... Similarly, in the context of viewing possibly traumatising material, positive reappraisal was found to be negatively associated with PTSD symptoms in adolescents exposed to media depicting a terrorist attack [99]. Along the same lines, cognitive reappraisal was associated with lesser total PTSD severity and greater positive affect [100], lower depression and lower state and trait anxiety [101], fewer subsequent trauma-related intrusions [102], and more effective down regulation of negative emotions [103]. ...
This study aimed to extend previous research on the experiences and factors that impact law enforcement personnel when working with distressing materials such as child sexual abuse content. A sample of 22 law enforcement personnel working within one law enforcement organisation in England, United Kingdom participated in anonymous semi-structured interviews. Results were explored thematically and organised in the following headings: “Responses to the material”, “Impact of working with distressing evidence”, “Personal coping strategies” and “Risks and mitigating factors”. Law enforcement professionals experienced heightened affective responses to personally relevant material, depictions of violence, victims’ displays of emotions, norm violations and to various mediums. These responses dampened over time due to desensitisation. The stress experienced from exposure to the material sometimes led to psychological symptoms associated with Secondary Traumatic Stress. Job satisfaction, self-care activities, the coping strategies used when viewing evidence, detachment from work outside working hours, social support and reducing exposure to the material were found to mediate law enforcement professionals’ resilience. Exposure to distressing material and the risks associated with this exposure were also influenced by specific organisational procedures implemented as a function of the funding available and workload. Recommendations for individual and organisational practices to foster resilience emerged from this research. These recommendations are relevant to all organisations where employees are required to view distressing content.
... Without being able to identify and differentiate between one's emotions or understand causes and consequences associated with those emotions, the ability to use appropriate ER strategies may be compromised (Van Beveren et al., 2019). In support of this notion, greater levels of interoceptive awareness (Füstös et al., 2012) and emotional clarity (Barrett et al., 2001;Boden et al., 2012) have been associated with greater use and efficacy of cognitive reappraisal. As such, parents who are adept in these ER skills may be better equipped to reappraise stressful situations and engage in supportive response behaviors. ...
Background
Parental emotion regulation (ER) and emotion socialization have been identified as key factors contributing to children's emotional competence; however, only a handful of studies have assessed the relationship between these constructs.
Objective
The goal of the present study was to determine whether parental ER would predict parents' self‐reported emotion socialization practices above and beyond the influence of personality.
Method
Parents completed a series of self‐report measures online. After data cleaning, 104 mothers of children between the ages of 8 and 12 years were retained for analyses.
Results
Hierarchal regressions revealed that mothers who reported higher levels of ER skills and more frequent use of cognitive reappraisal were more likely to report engaging in supportive response behaviors when controlling for personality. Moreover, maternal reappraisal was significantly and inversely associated with reports of unsupportive emotion socialization.
Conclusion
Findings provide evidence to support the association between maternal ER and emotion socialization behaviors.
Implications
Results are discussed with respect to their implications for emotion‐focused interventions aimed at promoting supportive parenting practices.
... Moreover, although emotion regulation is an integrated and systematic process consisting of clear emotion identification and subsequent selection and implementation of emotion regulation strategies, most studies did not address emotional clarity and emotion regulation strategy simultaneously. Only one study suggested the association between emotional clarity and emotion regulation strategies by examining the interaction effect of emotional clarity and cognitive reappraisal in predicting PTSD (Boden et al., 2012). A few recent studies have begun to investigate the sequential effect of emotion regulation in depression using a mediation model (Vine and Aldao, 2014;Boden and Thompson, 2015), but no studies have found the mediation effect of emotion regulation strategies in the relationship between emotional clarity and PTSD. ...
Difficulties in emotion regulation reportedly contribute to the development and maintenance of PTSD following exposure to natural disasters. Based on the extended process model of emotion regulation, the present study hypothesized that maladaptive emotion regulation strategies will mediate the relationship between emotional clarity and posttraumatic stress symptoms in a sample of earthquake survivors. A total of 195 adult residents of Gyeongju and Pohang, southeastern coastal cities in Korea, who had experienced recent earthquakes participated in an online survey study. They completed questionnaires assessing emotional clarity, emotion regulation, and posttraumatic stress symptoms a year and 10 months after the Gyeongju earthquake and 7 months after the Pohang earthquake. Bootstrapping procedures were used to test for a mediation effect. The results suggest that emotional clarity was indirectly associated with posttraumatic stress symptoms through maladaptive emotion regulation strategies, especially catastrophizing. The findings suggest that individuals with low emotional clarity tend to use maladaptive strategies, catastrophizing in particular, which may contribute to posttraumatic stress symptoms. This may reflect the mechanism underlying emotional clarity and offer suggestions for target of treatment in the management of long-term psychological difficulties in earthquake survivors. Replication of the current results in a sample of patients diagnosed with PTSD is necessary to better understand the development and progression of the disorder, as well as effective interventions for PTSD.
... Observed effect sizes for this association ranged from r .16 to 0.76, with significant heterogeneity in effect sizes across studies, Q (20) Lastly, analyses examined correlation statistics on the association between posttraumatic stress and each of the alexithymia subdimensions. After adjusting to account for random variance, weighted mean effect sizes suggested a moderate association between posttraumatic stress and difficulties in identifying feelings, ES ¯ Zr 0.36, SE Zr 0.02, 95% CI [0.31, 0.40], k 19, FSN 49; a slightly smaller association between posttraumatic stress and Freeman et al., 2000 (A) Ramirez et al., 2001Jakupcak et al., 2006 Freeman et al., 2000 (B) Brady et al., 2017Reynolds et al., 2017Gaher et al., 2016Simpson et al., 2006Miller & Johnson, 2012Zeng et al., 2018Frewen et al., 2008Evren et al., 2010Frewen et al., 2012Mazza et al., 2015Yehuda et al., 1997Cloitre et al., 2002 (A) Cloitre et al., 2002 (B) Spitzer et al., 2007Demers et al., 2015Boden et al., 2012Schechter et al., 2015Simeon et al., 2009 Total 30 40 50 60 70 80 Figure 1. Alexithymic trait severity in individuals with PTSD. ...
Objective:
Improving treatment outcomes for posttraumatic stress necessitates consideration of factors that may impede treatment progress. Previous research suggests alexithymia-an emotion-processing deficit characterized by difficulties in identifying, describing, and attending to emotional information-may be a therapeutically relevant correlate of posttraumatic stress.
Method:
Building upon previous work in this area, meta-analysis was used to investigate (a) how alexithymic traits typically present among those with a posttraumatic stress disorder (PTSD) diagnosis, (b) the strength of association between alexithymic trait severity and posttraumatic stress severity independent of diagnosis, and (c) alexithymia subdimensions most closely associated with posttraumatic stress. A total of 43 samples encompassing 5,069 participants were included in analyses.
Results:
Results suggest individuals diagnosed with PTSD tend to experience alexithymic traits that, while just below the clinical cutoff, are 1.32 standard deviations more severe than the general population. These alexithymic traits are particularly prominent in male and veteran samples and for difficulties in identifying feelings. Independent of diagnosis, posttraumatic stress was moderately associated with alexithymic traits, and stronger associations were noted between posttraumatic stress and difficulties in identifying feelings than between posttraumatic stress and difficulties in describing feelings or externally oriented thinking.
Conclusions:
Results attest to the importance of considering, conceptualizing, and treating posttraumatic stress and alexithymia in tandem. Implications for ongoing treatment development for posttraumatic stress are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
... Indeed, there have been a few attempts to identify individual difference moderators of the well-documented adaptive role of emotional clarity (e.g. Boden, Bonn-Miller, Kashdan, Alvarez, & Gross, 2012;Vine & Marroquín, 2018;Vine, Aldao, & Nolen-Hoeksema, 2014). One plausible moderator that has not been sufficiently explored is neuroticism and the closely-related trait negative affectivity, which are both characterised by a tendency to experience negative emotions. ...
Low emotional clarity has been a target for psychological interventions due to its association with increased internalising symptoms. However, theory suggests that very high emotional clarity may also lead to increased symptoms, particularly in combination with high levels of neuroticism. As an initial empirical test of this hypothesis, the present study examined curvilinear associations of emotional clarity with internalising symptoms (i.e. dysphoria, social anxiety, panic, traumatic intrusions) and a moderating role of neuroticism/negative affect in the association across two student samples and two clinical samples (total N = 920). Evidence of curvilinear associations and moderation varied across samples, with some supporting evidence in three samples. Specifically, neuroticism/negative affect moderated the curvilinear association of emotional clarity with traumatic intrusions in Clinical Sample 2 as well as the linear association between emotional clarity and dysphoria in Student Sample 2 and Clinical Sample 1. Simple slope analyses indicated that high emotional clarity was not consistently associated with lower symptoms. Also, the hypothesised quadratic effects of emotional clarity were found in Student Sample 2 and Clinical Sample 1 for panic, and in Clinical Sample 1 for dysphoria. Implications and limitations of these findings for conceptualisations of emotional clarity and current treatments were discussed.
Aim: The 2023 Great Southeast Türkiye Earthquake was a disastrous event with profound psychological effects on those who endured it. This study aims to assess the psychological impact of this earthquake on survivors from Hatay, focusing on correlations between anxiety, depression, hopelessness, and perceived stress. Method: Conducted between July 2023 and September 2023, the research involved 384 survivors, using the Beck Anxiety, Depression, Hopelessness, and Perceived Stress Scales for a thorough analysis of correlations among these mental health conditions. Results: The analysis confirmed significant correlations among all examined psychological conditions (p
The present study was intended to explore the impact of emotional regulation techniques on academic performance at the secondary level. The study was quantitative. The population of the research comprised all secondary school students of the public as well as private sector schools in Lahore. A self-developed research tool was used by adhering to the research objectives. The questionnaire was split into two sections: one for demographic information and the other for student demographics. The second section contained fifteen statements. Five choices of the people who responded were asked to provide primary data using a Likert scale. The study's findings revealed that the majority of students in the study agreed, according to the results, that playing with their peers, enjoying time alone, making friends in class, and talking with friends are ways for them to decompress when they're feeling down. Teachers can guide kids when there is an emotional disturbance. Students who have too much homework in class become stressed out and good emotional regulation techniques improve student performance. Some students disagreed, though, saying that they prefer to leave in the event of an emotional issue. They confide in their friends about their feelings whenever they're distressed. In addition to participating in extracurricular activities at school, which aids in their emotional regulation, they do not consult a psychologist when they are depressed. The gathered data was analyzed using both inferential (such as ANOVA and the independent-[ 582 ] sample t-test) and descriptive (such as percentage, mean, and SD) statistics. It may be recommended to assess students frequently to keep an eye on their emotional health and stress levels related to their studies. Give educators instruction so they can spot indicators of pupils' emotional distress and academic stress. Provide teachers with the tools they need to help children create healthy coping techniques and express their feelings in healthy ways.
When faced with negative emotions, the higher people are in alexithymia, the more likely they are to disengage from their emotions rather than engage with their emotions in an adaptive way. This emotion regulation profile is thought to explain links between alexithymia and negative life outcomes. What is not yet clear, however, is why alexithymia is linked to this emotion regulation profile. One possible explanation is greater emotional intensity. After all, initial evidence suggests that alexithymia is related to greater negative emotional intensity, and it is widely thought that greater negative intensity predicts the use of disengagement over engagement emotion regulation strategies. To address this issue, we conducted two intensive longitudinal studies (N = 273) to test three propositions, namely that in daily life (1) alexithymia is related to greater negative emotional intensity, (2) alexithymia is related to using more disengagement and less engagement emotion regulation, and (3) negative emotional intensity is a mediator explaining the link from alexithymia to using more disengagement and less engagement emotion regulation. In Study 1, we employed a daily diary design where participants reported on a negative event from their day. In Study 2, we used an intensive experience sampling design (nine surveys per day over seven days) to examine whether negative emotion intensity mediated the relationship from alexithymia to subsequent emotion regulation orientation. As expected, we found in both studies that greater negative intensity mediated the relationship between total alexithymia and more disengagement. However, only the difficulty identifying and describing emotion facets, but not externally oriented thinking, were related to negative emotion and disengagement. Contrary to expectation, total alexithymia was unrelated to engagement in both studies. Though in Study 2 alone, we found that externally oriented thinking predicted less reappraisal.
Understanding the individual differences that can buffer the impact of combat and other adverse exposures on deleterious behavioral health outcomes could lead to more targeted prevention and intervention efforts. Cognitive reappraisal, an antecedent-focused emotion regulation strategy, is linked to positive health outcomes such as lower levels of post-traumatic stress disorder, anxiety, and depression. This study examined the moderating effect of individual differences in cognitive reappraisal use on the association between combat exposure and behavioral health outcomes in active-duty U.S. Soldiers (N = 2,290). This study utilized survey data collected approximately 18 months following a combat deployment to Afghanistan in 2014. Results showed that individual differences in cognitive reappraisal use significantly moderated the effect of combat exposure on anxiety and post-traumatic stress symptoms but not depressive symptoms. Specifically, increasing combat exposures predicted a steeper increase in negative behavioral health symptoms for Soldiers reporting lesser (versus greater) cognitive reappraisal use. These findings highlight a role for cognitive reappraisal as a targetable factor that can mitigate the behavioral health consequences of exposure to combat stressors.
The COVID‐19 pandemic had a huge impact on people's lives due to the fear of getting infected and having the disease, as well as the necessary prevention and containment measures. University students were one of the most affected groups, as they were forced to cope with significant life changes. However, not all displayed symptoms of psychological distress, which means that internal resources such as emotional regulation and resilience may have acted as protective variables. This cross‐sectional study aimed to examine the extent to which the relationship between emotion regulation and stress, anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms was mediated by resilience in a sample of university students. Results showed that emotion regulation strategies were positively associated with lower mental health. Some resilience dimensions mediated these relationships, with perception‐of‐self mediating all associations. Planned future mediated the association between emotion regulation and depression, family cohesion mediated the relation between emotion regulation and stress, and social resources mediated the association of cognitive reappraisal with anxiety and PTSD by suppressing the direct positive relationship. These results highlight the relevance of resilience as a key resource in coping effectively with the uncertainties, and changes that arise during stressful periods such as a pandemic.
Previous work has generally conceptualized emotion regulation as contributing to mental health outcomes, and not vice versa. The present study challenges this assumption by using a prospective design to investigate the directionality of underlying relationships between emotion regulation and mental health in the context of a major population-level stressor. We surveyed a large nationally representative sample of adults (18–91 years, N = 704) at three 1-month intervals across the acute lockdown phase of the COVID-19 pandemic in Australia, using standardized measures of depression and anxiety symptoms. At each time point, we also measured the use of two emotion regulation strategies—cognitive reappraisal and emotional suppression—previously associated with adaptive and maladaptive mental health outcomes, respectively. We found cognitive reappraisal was unrelated to mental health symptoms. In contrast, greater emotional suppression was robustly associated with higher symptom levels for both depression and anxiety. Longitudinal analyses revealed this association reflected bidirectional relationships. Higher symptoms of depression and anxiety each predicted greater subsequent use of emotional suppression, and greater use of emotional suppression predicted higher subsequent symptoms. This bidirectionality suggests emotional suppression is both symptomatic and predictive of psychological distress. The lack of a relationship for cognitive reappraisal is discussed with respect to the pandemic context and evidence that high stress might reduce people’s ability to use this strategy effectively. Given the strong emphasis on reappraisal in clinical practice, there is a critical need to understand for whom, what and when this strategy is helpful.
Objective: This study aims to investigate the relationship between emotion regulation methods and post-traumatic stress symptoms in children. Method: 712 children aged 8-14 years, (Mage=11.45, SD=1.37; 32.9% male) who experienced an explosion accident completed the Trauma Screening Questionnaire (TSQ) and the Emotion Regulation Questionnaire (ERQ). Results: Results showed that expressive suppression was positive significantly associated with cognitive reappraisal (r = 0.27, p < 0.001) and positive significantly associated with post-traumatic stress symptoms (r = 0.13, p < 0.01).
Studies have found that anxiety is among the common negative emotions in individuals with substance use disorders. Anxiety affects drug abstention motivation, but the mechanism underlying this effect is still unclear. The current study aimed to examine the relationship among anxiety, regulatory emotional self-efficacy, psychological resilience and drug abstention motivation in an attempt to explore the mechanism underlying drug abstention motivation. The participants were 732 men with substance use disorders who were sent to compulsory rehabilitation in China. All participants completed measures of anxiety, regulatory emotional self-efficacy, psychological resilience and drug abstention motivation through questionnaires. The results indicated that anxiety negatively predicts drug abstention motivation. Regulatory emotional self-efficacy mediates the relationship between anxiety and drug abstention motivation. In addition, psychological resilience moderates the mediation between anxiety and regulatory emotional self-efficacy. The current results are not only helpful for understanding the relationship between anxiety and drug abstention motivation from the perspective of emotion but also of great significance for guiding individuals with substance use disorders in enhancing their drug abstention motivation by reducing negative emotion.
Objective
This study examined whether expressive suppression (ES), a maladaptive regulation strategy, was more strongly associated with PTSD diagnosis and symptom clusters in veterans than cognitive reappraisal (CR), an adaptive regulation strategy.
Method
In a cohort study, 746 participants recruited from VHA facilities completed Clinician Administered PTSD Scale-IV, Emotion Regulation Questionnaire, and Patient Health Questionnaire. Participants were categorized into groups: Current, Remitted/Lifetime, and Never PTSD.
Results
One-way ANOVA revealed significant differences between Current PTSD and both Remitted and Never PTSD for ES, but not CR. The Remitted and Never PTSD groups did not vary significantly from each other and were collapsed into one group for regressions. Adjusting for sex, race, employment, and comorbid depression, binary logistic regression showed ES, but not CR, was associated with increased likelihood of Current PTSD (p < .001, OR: 1.43). ES was also significantly associated with increased odds of meeting criteria for all symptom clusters (ps < .001). CR was not significantly associated with meeting criteria for Current PTSD or any symptom cluster.
Limitations
Cross-sectional design and use of self-report limit causality inferences that can be drawn.
Conclusions
ES is associated with increased odds of Current PTSD diagnosis and symptom clusters. Veterans in the Remitted and Never PTSD groups did not differ significantly. Greater suppression of emotional expression is more strongly linked with PTSD criteria in veterans than decreased cognitive reappraisal.
Background
Emotion regulation (ER) is associated with posttraumatic stress symptoms (PTSS). However, most findings are from cross-sectional studies and are hence unable to clarify whether deficits in ER longitudinally contribute to the worsening and maintenance of PTSS. In addition, no studies consider the process of how ER affects PTSS. To further clarify causal pathways, we tested prospective associations between ER and subsequent PTSS by gender in individuals who had experienced traumatic events.
Methods
We used data from an online survey of 1,794 Japanese participants aged 18–83 years who had experienced at least one traumatic event. They completed the Emotion Regulation Skills Questionnaire at baseline, as well as the PTSD Checklist for DSM-5 at baseline and four months later.
Results
Multi-group structural equation modeling by gender revealed that participants’ ER predicted their PTSS four months later, even after controlling for symptoms at baseline. The findings indicate that identifying undesired emotions and then dealing with them decreases subsequent PTSS. ER had a greater effect on later PTSS in males than in females.
Limitations
The use of an online survey and the exclusive use of self-report instruments might limit the generalizability of our results and the validity of the assessment.
Conclusions
Deficits in ER likely contribute to worsening and maintenance of PTSS. The process of identifying and subsequently dealing with emotions may be important for the clinical suppression of PTSS.
Cognitive Reactivity (CR), an established diathesis for depression, has been defined as the within-person strength of association between sad affect and dysfunctional attitudes. Watson and Tellegen (1985) proposed that sad affect is a combination of high negative affect (NA) and low positive affect (PA). The current study integrated the CR and the affect literatures by examining the differential and conjoint roles of cognitive reactivity to high negative affect (CR-highNA) and cognitive reactivity to low positive affect (CR-lowPA). In the current study, college student participants completed daily diary measures of CR-highNA, CR-lowPA, and CR to sadness (CR-Sad). Results showed that naturally occurring NA and PA accounted for the relation of sadness to dysfunctional cognitions. Further, the relation of depressive symptoms to CR-Sad was explained by high levels of CR-highNA and CR-lowPA. Born out of the integration of research on CR and affective structures, the current results have implications for both theory and treatment of depression.
Addressing shortcomings of the self-report Toronto Alexithymia Scale (TAS), two studies were conducted to reconstruct the item domain of the scale. The first study resulted in the development of a new twenty-item version of the scale—the TAS-20. The TAS-20 demonstrated good internal consistency and test-retest reliability, and a three-factor structure theoretically congruent with the alexithymia construct. The stability and replicability of this three-factor structure were demonstrated in the second study with both clinical and nonclinical populations by the use of confirmatory factor analysis.
In two samples of college students (Ns = 116 and 141), this research investigated the ways in which individuals differ in their experience of emotion. Four latent traits emerged from scales assessing such differences—Intensity, Attention, Expression, and Clarity. In both samples, these latent traits were found to be involved in reports of personality, well-being, coping, and explanatory style. Clarity was positively associated with measures of positive well-being and nega- tively associated with measures of negative well-being. Individuals who experi- ence intense emotions (Intensity), who attend to them often (Attention), or who notably express them (Expression), reported coping by focusing on and venting their emotions and by seeking social support. Individuals who are adept at iden- tifying their emotions (Clarity) reported engaging in active, planful coping and in positive reinterpretations of events. Individuals high on Clarity made self- affirming attributions for good events.
Several literatures converge on the idea that approach and positive affect related to goal pursuit are managed by one self-regulatory system and that avoidance (or withdrawal) and negative affect related to threats are managed by a second self-regulatory system. After briefly reviewing these literatures, the authors consider the relation of these themes to the broader domain of personality. In particular, they map individual differences in the responsivity of the approach system onto the personality dimension of extraversion and map individual differences in the responsivity of the withdrawal system onto the dimension of neuroticism. This mapping requires a slight refocusing of current conceptions of extraversion and neuroticism. However, such a refocusing brings a gain as well as a cost: In particular, it would embed these dimensions more explicitly in a process-oriented conceptualization of action control.
Increasing interest in individual differences related to emotion is evident in the recent appearance of a large number of self-report instruments designed to assess aspects of the feeling experience. In this article, the authors review a sample of 18 of these scales and report technical information on each (e.g., length, format, reliability, construct validity, and correlates). They propose that this domain of individual differences can be usefully structured into five conceptual categories, including measures of absorption, attention, clarity, intensity, and expression. The measures were administered to a sample of individuals, and the coherence of the proposed categories was examined through hierarchical cluster analyses. The results confirmed the proposed structure of this domain of individual difference measures. The authors argue for the usefulness of an individual differences approach to theory testing and specify some of the information-processing roles that might be played by the categories of individual differences found in the data.
This article describes the concept of posttraumatic growth. its conceptual founda- tions, a/id supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life cri- ses. It is manifested in a variety ofways, including an increased appreciationfor life in general, more meaningful interpersonal relationships, an increased sense ofpersonal strength. cha/lged priorities, and a richer existential and spiritual life. Although the term is ne..", the idea that great good can come from great suffering is ancient. We pro- pose a nlOdelfor understanding the process ofposttraumatic growth in which individ- ual characteristics, support and disclosure, a/Id more centrally, significant cognitive processing involving cognitive structures threatened or nullified by the traumatic events, play an important role. It is also suggested that posttraumatic growth mutually interacts with life wisdoma,1d the development of the life narrative, and that it is an on- going process, not a static outcome. In his memoir, No Such Thing as a Bad Day, Hamil- ton Jordan (2000) described some of the changes he experienced following his battle with cancer:
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
This study investigated 3 broad classes of individual-differences variables (job-search motives, competencies, and constraints) as predictors of job-search intensity among 292 unemployed job seekers. Also assessed was the relationship between job-search intensity and reemployment success in a longitudinal context. Results show significant relationships between the predictors employment commitment, financial hardship, job-search self-efficacy, and motivation control and the outcome job-search intensity. Support was not found for a relationship between perceived job-search constraints and job-search intensity. Motivation control was highlighted as the only lagged predictor of job-search intensity over time for those who were continuously unemployed. Job-search intensity predicted Time 2 reemployment status for the sample as a whole, but not reemployment quality for those who found jobs over the study's duration. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
How might a practice that has its roots in contemplative traditions, seeking heightened awareness through meditation, apply to trauma-related mental health struggles among military veterans? In recent years, clinicians and researchers have observed the increasing presence of mindfulness in Western mental health treatment programs. Mindfulness is about bringing an attitude of curiosity and compassion to present experience. This review addresses the above question in a detailed manner with an emphasis on the treatment of military veterans suffering from posttraumatic stress disorder (PTSD) and related psychopathology. In addition, the integration of mindfulness with current empirically supported treatments for PTSD is discussed with specific attention to directions for future research in this area.
We propose a taxonomy of emotional disturbances composed of (a) emotional valence disturbances, (b) emotional intensity/regulation disturbances, and (c) emotion disconnections. Our rationale for developing such a taxonomy is that it can draw additional attention to the importance of emotional disturbances and can provide a framework for organizing both what we already know and what we have yet to explore. We believe such an effort is important because emotional disturbances, which are ubiquitous among individuals with psychopatholog-ical conditions, can provide incremental predictive power above and beyond traditional diagnostic categories. We discuss the potential clinical utility of our proposed taxonomy and provide recommendations for future research.
Individuals differ considerably in their emotion experience. Some experience emotions in a highly differentiated manner, clearly distinguishing among a variety of negative and positive discrete emotions. Others experience emotions in a relatively undifferentiated manner, treating a range of like-valence terms as interchangeable. Drawing on self-regulation theory, we hypothesised that indivi-duals with highly differentiated emotion experience should be better able to regulate emotions than individuals with poorly differentiated emotion experience. In particular, we hypothesised that emotion differentiation and emotion regulation would be positively related in the context of intense negative emotions, where the press for emotion regulation is generally greatest. To test this hypothesis, parti-cipants' negative and positive emotion differentiation was assessed using a 14-day diary protocol. Participants' regulation of negative and positive emotions was assessed using laboratory measures. As predicted, negative emotion differentiation was positively related to the frequency of negative emotion regulation, particularly at higher levels of emotional intensity.
This study examined how elevated levels of worry and anhedonic depression are associated with affect intensity, attention
to emotion, and clarity of emotion. University students (N=923) completed the Affect Intensity Measure, the Trait Meta Mood Scale, the Penn State Worry Questionnaire and the anhedonic
depression subscale from the Mood and Anxiety Symptom Questionnaire. Control individuals with worry and depression scores
below the median (n=158) were compared with three distress groups—elevated worry without elevated depression (n=58), elevated depression without elevated worry (n=35), and elevated levels of both worry and depression (n=39). The control and distress groups each differed significantly from one another, and these differences could not be accounted
for by gender or neuroticism. Controls resembled individuals described in past research as being cerebral, the depression-only
group resembled individuals described as being cool, the worry-only group resembled individuals described as hot, and the
dual-distress group resembled individuals described as overwhelmed.
KeywordsDepression–Worry–Emotion–Emotional awareness–Affect intensity
Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable "lack of clarity of emotions." Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.
Some people are adept at using discrete emotion categories (anxious, angry, sad) to capture their felt experience; other people merely communicate how good or bad they feel. We theorized that people who are better at describing their emotions might be less likely to self-medicate with alcohol. During a 3-week period, 106 underage social drinkers used handheld computers to self-monitor alcohol intake. From participants' reported experiences during random prompts, we created an individual difference measure of emotion differentiation. Results from a 30-day timeline follow-back revealed that people with intense negative emotions consumed less alcohol if they were better at describing emotions and less reliant on global descriptions. Results from ecological momentary assessment procedures revealed that people with intense negative emotions prior to drinking episodes consumed less alcohol if they were better at describing emotions. These findings provide support for a novel methodology and dimension for understanding the influence of emotions on substance-use patterns.
In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.
Previous research has found that understanding one's emotions and attending to them are 2 dimensions of emotional awareness. In this research, we examined whether improved subscales for measuring clarity of and attention to emotions could be developed by selecting the best items from 2 frequently used measures of emotional awareness. Using multidimensional scaling and confirmatory factor analysis, we analyzed the Toronto Alexithymia Scale-20 (Bagby, Parker, & Taylor, 1994) and the Trait Meta-Mood Scale (Salovey, Mayer, Goldman, Turvey, & Palfai, 1995) data from 867 college students. Results supported distinct clarity and attention constructs. New subscales were internally consistent and fared as well as or better than previous versions in terms of internal consistency and convergent validity.
Cognitive processing therapy (CPT) was developed to treat the symptoms of posttraumatic stress disorder (PTSD) in rape victims. CPT is based on an information processing theory of PTSD and includes education, exposure, and cognitive components. Nineteen sexual assault survivors received CPT, which consists of 12 weekly sessions in a group format. They were assessed at pretreatment, posttreatment, and 3- and 6-month follow-up. CPT subjects were compared with a 20-subject comparison sample, drawn from the same pool who waited for group therapy for at least 12 weeks. CPT subjects improved significantly from pre- to posttreatment on both PTSD and depression measures and maintained their improvement for 6 months. The comparison sample did not change from the pre- to the posttreatment assessment sessions.
A previous paper described the development of the twenty-item Toronto Alexithymia Scale (TAS-20) and reported preliminary evidence of reliability and factorial validity of the scale. This paper describes a study that further evaluated the construct validity of the TAS-20 by examining its relationship with measures of personality traits theoretically related or unrelated to the alexithymia construct, as well as its relationship with an observer-rated measure of alexithymia. Evidence of convergent and discriminant validity of the TAS-20 was demonstrated in samples of university students by a pattern of correlations with the scales of the NEO Personality Inventory and separate measures of psychological mindedness and need-for-cognition that was consistent with theoretical predictions. The concurrent validity of the scale was demonstrated by positive correlations with observer-ratings of alexithymia in a sample of behavioural medicine out-patients.
Addressing shortcomings of the self-report Toronto Alexithymia Scale (TAS), two studies were conducted to reconstruct the item domain of the scale. The first study resulted in the development of a new twenty-item version of the scale--the TAS-20. The TAS-20 demonstrated good internal consistency and test-retest reliability, and a three-factor structure theoretically congruent with the alexithymia construct. The stability and replicability of this three-factor structure were demonstrated in the second study with both clinical and nonclinical populations by the use of confirmatory factor analysis.
Although interaction effects are frequently found in experimental studies, field researchers report considerable difficulty in finding theorized moderator effects. Previous discussions of this discrepancy have considered responsible factors including differences in measurement error and use of nonlinear scales. In this article we demonstrate that the differential efficiency of experimental and field tests of interactions is also attributable to the differential residual variances of such interactions once the component main effects have been partialed out. We derive an expression for this residual variance in terms of the joint distribution of the component variables and explore how properties of the distribution affect the efficiency of tests of moderator effects. We show that tests of interactions in field studies will often have less than 20% of the efficiency of optimal experimental tests, and we discuss implications for the design of field studies.
The purpose of this study was to measure the longitudinal course of specific symptoms of posttraumatic stress disorder (PTSD) and related symptoms of alcohol and substance abuse and the effects of alcohol and substances on the symptoms of PTSD.
A structured interview for the assessment of PTSD and alcohol and substance abuse, as well as other factors such as life stressors and treatment, was administered to 61 Vietnam combat veterans with PTSD.
Onset of symptoms typically occurred at the time of exposure to combat trauma in Vietnam and increased rapidly during the first few years after the war. Symptoms plateaued within a few years after the war, following which the disorder became chronic and unremitting. Hyperarousal symptoms such as feeling on guard and feeling easily startled developed first, followed by avoidant symptoms and finally by symptoms from the intrusive cluster. The onset of alcohol and substance abuse typically was associated with the onset of symptoms of PTSD, and the increase in use paralleled the increase of symptoms. Patients reported a tendency for alcohol, marijuana, heroin, and benzodiazepines to make PTSD symptoms better, while cocaine made symptoms in the hyperarousal category worse. There was no relationship between treatment interventions and the natural course of PTSD.
These findings suggest that symptoms of PTSD begin soon after exposure to trauma, that hyperarousal symptoms are the first symptoms to occur, that the natural course of alcohol and substance abuse parallels that of PTSD, and that specific substances have specific effects on PTSD symptoms.
This study examined the prevalence and predictors of posttraumatic stress disorder (PTSD) symptoms in 70 men and women treated with bone marrow transplantation for cancer. Findings indicated that the number of symptoms present ranged from 0 to a possible high of 17 (M = 3.0, SD = 3.9). As predicted. lower social support and higher avoidance coping I month pretransplant predicted greater PTSD symptom severity an average of 7 months posttransplant. These variables remained significant predictors of symptom severity even after accounting for pretransplant levels of psychological distress. Additional analyses indicated the presence of a significant interaction between social support and avoidance coping, with patients high in avoidance coping and low in social support reporting the most severe symptoms. These findings identify patients at risk for psychological disturbance posttransplant and can serve to guide future intervention efforts.
Five studies tested two general hypotheses: Individuals differ in their use of emotion regulation strategies such as reappraisal and suppression, and these individual differences have implications for affect, well-being, and social relationships. Study 1 presents new measures of the habitual use of reappraisal and suppression. Study 2 examines convergent and discriminant validity. Study 3 shows that reappraisers experience and express greater positive emotion and lesser negative emotion, whereas suppressors experience and express lesser positive emotion, yet experience greater negative emotion. Study 4 indicates that using reappraisal is associated with better interpersonal functioning, whereas using suppression is associated with worse interpersonal functioning. Study 5 shows that using reappraisal is related positively to well-being, whereas using suppression is related negatively.
We examined the psychometric properties of the PTSD Checklist (PCL), a self-report instrument designed to assess symptoms of posttraumatic stress disorder. Three hundred ninety-two participants recruited in a university setting completed the PCL in addition to several well-established self-report instruments designed to assess various forms of psychopathology (e.g., depression, general anxiety, PTSD). Ninety participants returned for readministration of selected measures. Findings provided support for psychometric properties of the PCL, including internal consistency, test-retest reliability, convergent validity, and discriminant validity. Additional strengths of the PCL are discussed.
This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life. Although the term is new, the idea that great good can come from great suffering is ancient. We propose a model for understanding the process of posttraumatic growth in which individual characteristics, support and disclosure, and more centrally, significant cognitive processing involving cognitive structures threatened or nullified by the traumatic events, play an important role. It is also suggested that posttraumatic growth mutually interacts with life wisdom and the development of the life narrative, and that it is an on-going process, not a static outcome.
Foreword James S. Grotstein Acknowledgements Introduction Graeme Taylor 1. The development and regulation of affects Graeme Taylor, Michael Bagby and James Parker 2. Affect dysregulation and alexithymia Michael Bagby and Graeme Taylor 3. Measurement and validation of the alexithymia construct Michael Bagby and Graeme Taylor 4. Relations between alexithymia, personality, and affects James Parker and Graeme Taylor 5. The neurobiology of emotion, affect regulation and alexithymia James Parker and Graeme Taylor 6. Somatoform disorders Graeme Taylor 7. Anxiety and depressive disorders and a note on personality disorders Michael Bagby and Graeme Taylor 8. Substance use disorders Graeme Taylor 9. Eating disorders Graeme Taylor 10. Affects and alexithymia in medical illness and disease Graeme Taylor 11. Treatment considerations Graeme Taylor 12. Future directions James Parker, Michael Bagby and Graeme Taylor References Index.
This study examined the relationship between emotional intelligence and life satisfaction. To determine the nature of this relationship, personality constructs known to predict life satisfaction were also assessed (positive and negative affect). Emotional intelligence was assessed in 107 participants using a modified version of the Trait Meta-Mood Scale [TMMS; Salovey, P, Mayer, J., Goldman, S., Turvey, C. & Palfai, T.1995. Emotional attention, clarity and repair: exploring emotional intelligence using the Trait Meta-Mood Scale. In J. W. Pennebaker (Ed), pp. 125–154. Washington, DC: American Psychological Association] and the Twenty-Item Toronto Alexithymia Scale [TAS-20; J. Psychosom Res, 38 (1994) 26]. Life satisfaction was assessed using the Satisfaction With Life Scale [SWLS; J. Pers. Social Psycol., 69 (1985) 71]. Only the Clarity sub-scale of the TMMS (which indexes perceived ability to understand and discriminate between moods and emotions), and the Difficulty Identifying Feelings sub-scale of the TAS-20 were found to significantly correlate with life satisfaction. Subsequent analyses revealed that only the Clarity sub-scale accounted for further variance in life satisfaction not accounted for by positive and negative affect. This finding provides further evidence that components of the EI construct account for variance in this important human value not accounted for by personality. Implications and directions for further research are discussed.
Remember when categorizations for emotional responsiveness were simple—type A vs type B, or introverted vs extroverted? Once you read Handbook of Emotion Regulation, edited by respected Stanford psychologist James J. Gross, you’ll long for those days of simplicity. As stated in the book, the complexity of emotion regulation is like a “riddle wrapped in a mystery inside an enigma” (p 87), words used by Churchill to describe Russia. Although several definitions are presented in the text, emotion regulation generally refers to the modification of emotional reactions in the form of activation, inhibition, or more graded modifications.
In this chapter, the authors consider the place of emotional processes in intelligent behavior, a domain now known as the study of emotional intelligence. The authors' goal is not to provide a general review of the emotional intelligence area, but rather to suggest more focused treatment that is rooted in the processes associated with emotion generation and modulation. The general thesis is that emotional intelligence requires that individuals appreciate (1) how they are responding emotionally and (2) how they can shape the emotion as it unfolds. Emotions can be generated and regulated in better or worse ways, and how individuals go about doing this shapes their adaptive success. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
How can we understand the diverse roles played by different forms of emotion regulation in different types of psychopathology? What is needed is a basic framework for organizing the mounting research on emotion and emotion regulation. Our goal in this chapter is to provide such a framework for researchers and clinicians who are interested in understanding the role of emotion regulation processes in psychopathology. In the first section, we describe core features of emotion and emotion regulation and review a process model of emotion regulation that distinguishes among five families of emotion regulatory strategies. From the perspective of the process model of emotion regulation, many features of psychopathology may be construed as involving problematic situation selection, situation modification, attentional deployment, cognitive change, or response modulation. In the second section, we use this emotion regulation framework to examine diverse forms of psychopathology and treatment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study examined the different facets of emotional intelligence, alexithymia, and mood awareness. Undergraduate students (N=129) completed the Trait Meta-Mood Scale (TMMS), the Toronto Alexithymia Scale (TAS-20), and the Mood Awareness Scale (MAS). A factor analysis revealed two dimensions, attention to and clarity of emotions, that cut across all three instruments. These two dimensions were differentially associated with personality, as measured by the neuroticism, extraversion, and openness to experience portions of the NEO-FFI, and with performance on an emotional Stroop task. We discuss the implications for the conceptualisation of broad constructs such as emotional intelligence and alexithymia, as well as the potential utility of more narrowly defined individual differences. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M(age) = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.
Traditionally, positive emotions and thoughts, strengths, and the satisfaction of basic psychological needs for belonging, competence, and autonomy have been seen as the cornerstones of psychological health. Without disputing their importance, these foci fail to capture many of the fluctuating, conflicting forces that are readily apparent when people navigate the environment and social world. In this paper, we review literature to offer evidence for the prominence of psychological flexibility in understanding psychological health. Thus far, the importance of psychological flexibility has been obscured by the isolation and disconnection of research conducted on this topic. Psychological flexibility spans a wide range of human abilities to: recognize and adapt to various situational demands; shift mindsets or behavioral repertoires when these strategies compromise personal or social functioning; maintain balance among important life domains; and be aware, open, and committed to behaviors that are congruent with deeply held values. In many forms of psychopathology, these flexibility processes are absent. In hopes of creating a more coherent understanding, we synthesize work in emotion regulation, mindfulness and acceptance, social and personality psychology, and neuropsychology. Basic research findings provide insight into the nature, correlates, and consequences of psychological flexibility and applied research provides details on promising interventions. Throughout, we emphasize dynamic approaches that might capture this fluid construct in the real-world.
This research investigated whether combat veterans' daily strivings are related to the presence of post-traumatic stress disorder (PTSD) and well-being. Veterans created a list of their most important strivings, which were content-analyzed for emotion regulation and approach or avoidance themes. It was hypothesized that veterans pursuing strivings with themes of emotion regulation or avoidance experience deleterious consequences compared with other veterans. For all veterans, devoting finite time and energy in daily life to regulating emotions was associated with less purpose, meaning, and joy compared with other strivings. Veterans with PTSD endorsed more strivings related to emotion regulation and devoted considerable effort to emotion regulation and avoidance strivings. Yet, these efforts failed to translate into any discernible benefits; veterans without PTSD derived greater joy and meaning from strivings focusing on approac- oriented behavior and themes other than emotion regulation. The presence of PTSD and a high rate of emotion regulation strivings led to the lowest global well-being and daily self-esteem during a 14-day assessment period. The presence of PTSD and a high rate of avoidance strivings also led to lower emotional well-being. Results indicate that strivings devoted to regulating emotions or avoidance efforts influence the mental health of veterans with and without PTSD. Studying personality at different levels of analysis-traits, strivings, and life narratives-allows for a fine-grained understanding of emotional disorders.
Emotion regulatory strategies such as higher expressive suppression and lower cognitive reappraisal may be associated with increased psychopathology (Gross & John, 2003). Yet, it is unclear whether these strategies represent distinct cognitive styles associated with psychopathology, such that there are individuals who are predominantly "suppressors" or "reappraisers." Using cluster analysis, we examined whether women with and without exposure to potentially traumatic events evidence distinct patterns of emotion regulation frequency, capacity, suppression, and cognitive reappraisal. Four patterns emerged: high regulators; high reappraisers/low suppressors; moderate reappraisers/low suppressors; and low regulators. Individuals who reported infrequently and ineffectively regulating their emotions (low regulators) also reported higher depression, anxiety, and posttraumatic stress disorder (PTSD). In contrast, individuals who reported frequently and effectively using reappraisal and low levels of suppression (high reappraisers/low suppressors) reported the lowest levels of these symptoms, suggesting that this specific combination of emotion regulation may be most adaptive. Our findings highlight that the capacity to regulate emotions and the ability to flexibly apply different strategies based on the context and timing may be associated with reduced psychopathology and more adaptive functioning.
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
The author's goal was to explore the historical, political, and social forces that have played a major role in the acceptance of the idea of trauma as a cause of the specific symptoms of posttraumatic stress disorder (PTSD) and to discuss the impact that current research findings have had on some of the initial conceptualizations of the disorder.
The conceptual origins of PTSD are described, and the literature on the prevalence, longitudinal course, phenomenology, and neurobiology of PTSD is reviewed.
Paradoxically, there are a series of findings that support the idea that PTSD is a distinct diagnostic entity, but these are different from those originally developed from psychosocial theory and stress research.
PTSD has been a controversial diagnosis and is again at a vulnerable point. It is imperative that the field address how current findings challenge the original conceptualizations of this disorder so that the next generation of conceptual issues can be formulated.
The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.