A Variable-Centered and Person-Centered Evaluation of Emotion Regulation and Distress Tolerance: Links to Emotional and Behavioral Concerns

Interpersonal Trauma and Substance Use Severity: The Serial Mediation of Emotional Intolerance and Emotional Dysregulation

Substance use is highly prevalent in those with trauma histories, especially in women, which may be in part explained by high rates of interpersonal trauma in this population. Research examining the potential mechanisms underlying the relationship between co-occurring interpersonal trauma histories and substance use disorders (SUDs) is in its infancy. The current study examined whether the relationship between interpersonal trauma and SUD severity could be understood via the sequential ordering of two transdiagnostic emotional vulnerability factors: 1) emotional intolerance (anxiety sensitivity, distress intolerance), and 2) emotional dysregulation (negative urgency, lack of clarity, nonacceptance, limited strategies, difficulties with goal-directed behavior). A sample of 130 adult community-based women self-identifying as experiencing substance use problems completed the online survey. Mediation analyses suggest that as women's lifetime interpersonal trauma increases, so does their SUD severity by way of emotional intolerance and subsequent difficulties regulating their emotions. The findings suggests that transdiagnostic interventions targeting tolerance of aversive emotions may facilitate the ability to learn and employ healthy emotion regulation strategies among women with interpersonal trauma histories and SUDs.

Heightened adolescent emotional reactivity in the brain is associated with lower future distress tolerance and higher depressive symptoms

Distress tolerance, the ability to persist while experiencing negative psychological states, is essential for regulating emotions and is a transdiagnostic risk/resiliency trait for multiple psychopathologies. Studying distress tolerance during adolescence, a period when emotion regulation is still developing, may help identify early risk and/or protective factors. This study included 40 participants (mean scan age = 17.5 years) and using an emotional Go-NoGo functional magnetic resonance imaging task and voxel-wise regression analysis, examined the association between brain response during emotional face processing and future distress tolerance (two ± 0.5 years), controlling for sex assigned at birth, age, and time between visits. Post-hoc analyses tested the mediating role of distress tolerance on the emotional reactivity and depressive symptom relationship. Whole-brain analysis showed greater inferior occipital gyrus activation was associated with less distress tolerance at follow-up. The mediating role of distress tolerance demonstrated a trend-level indirect effect. Findings suggest that individuals who allocate greater visual resources to emotionally salient information tend to exhibit greater challenges in tolerating distress. Distress tolerance may help to link emotional reactivity neurobiology to future depressive symptoms. Building distress tolerance through emotion regulation strategies may be an appropriate strategy for decreasing depressive symptoms.

The Association of Emotion Regulation with Distress Tolerance Depends on a Neural Correlate of Cognitive Control

BACKGROUND

Distress tolerance is associated with transdiagnostic mental health problems. Theory and research implicate emotion regulation and cognitive control as factors in distress tolerance. But their unique contributions and interdependency have been unclear. This study tested how emotion regulation and the N2, a neural index of cognitive control, uniquely and interactively predicted distress tolerance.

METHODS

Undergraduate psychology students (N = 57) completed self-report measures and a Go-NoGo task, from which the N2 was extracted using PCA. The Go-NoGo task was counter-balanced to avoid confounding stimulus characteristics and frequency of stimulus presentation.

RESULTS

Emotion regulation predicted distress tolerance, but the N2 did not. The association of emotion regulation with distress tolerance was moderated by the N2, such that the association was larger at higher N2 amplitudes.

LIMITATIONS

The use of a non-clinical student sample limits the generalizability of the results. The data are cross-sectional and correlational, preventing conclusions about causality.

CONCLUSIONS

The findings indicate that emotion regulation is associated with better distress tolerance at higher levels of N2 amplitude, a neural correlate of cognitive control. Emotion regulation may be more effective at enabling distress tolerance in individuals with better cognitive control. This supports past work indicating that distress tolerance interventions may benefit by developing emotion regulation skills. Additional research is needed to test if such an approach is more effective in individuals with better cognitive control.

Identifying latent profiles of emotion dysregulation in a sample of primarily Black women with trauma exposure

BACKGROUND

Emotion dysregulation (ED) is a heterogenous, multi-dimensional transdiagnostic risk factor relevant to the development and maintenance of both internalizing and externalizing psychopathology, especially for those who have experienced trauma. The goals of the current study were to use person-centered analyses to identify distinct profiles of individuals characterized by unique patterns of ED dimensions, and to examine differences in internalizing and externalizing symptoms in a community sample.

METHODS

Participants (n = 783, 97% Black, 93% women) were recruited from an urban safety net hospital with high rates of trauma exposure. Latent profile analysis was used to uncover unique patterns of ED and multinomial logistic regression to evaluate the conditional distribution of our correlates across profiles.

RESULTS

The best-fitting model uncovered four classes: Low ED (42%), Low Awareness/Clarity (34%), Low Impulse Control (17%), and High ED (6%). All classes differed in terms of internalizing symptoms (anxiety sensitivity, depression, PTSD), with classes characterized by higher ED reporting more severe symptoms. For externalizing symptoms (food addiction behaviors, alcohol and drug abuse, aggressive behavior), the Low ED class reported fewer symptoms than all other profiles, while Low Awareness/Clarity, Low Impulse Control, and High ED did not differ from each other.

CONCLUSIONS

Patterns of emotion dysregulation ought to be assessed and considered as treatment targets for those experiencing both internalizing and externalizing psychopathology symptoms.

Outcomes From an Online Pilot Mindfulness Based Intervention with Adolescents: A Comparison by Categories of Risk

Comorbid psychiatric presentations, defined as those who present with more than one mental and/or behavioral health diagnosis at the same time, during adolescence are on the rise. Mindfulness-based interventions can alleviate psychological symptoms and improve emotion regulation in youth. Mindfulness is a multifaceted phenomenon, with five underlying facets (Observing, Describing, Acting with Awareness, Non-Judgment and Non-Reactivity of Inner Experience). Little evidence has documented which facets produce pronounced psychiatric symptom reduction for adolescents. This pilot study examined the efficacy of an online mindfulness-based intervention delivered to adolescents undergoing mental health treatment during COVID-19 to reduce psychiatric outcomes. Fifty-six adolescents (m = 14.5 years, 66.1% female) categorized as moderate-risk (treatment histories of outpatient therapy only) or high-risk (treatment histories with intensive service participation) participated in the 8-session mindfulness-based intervention. Significant reductions in psychiatric symptoms and increases in adaptive coping strategies were observed at post-test, particularly for those at moderate-risk. Multivariate stepwise regression found significant associations between mindfulness facet use and anxiety, depression, and somatic symptoms (R ² ranging from 42.5 to 52.8%). Results indicate preliminary efficacy for an online mindfulness-based intervention for adolescents, particularly those at moderate-risk, due to the introduction of new coping skills, given their history of less intense treatment. Further investigation is warranted to understand which mindfulness facet intervention components produce the most prominent outcomes.

The Role of Cognitive Emotion Regulation for Making and Keeping Friend and Conflict Networks

We used social network analysis (SNA) to examine how adaptive ER strategies (acceptance, positive reappraisal, refocusing, and putting in perspective) and maladaptive ER strategies (rumination, catastrophizing, self- and other-blame) predict the creation and maintenance of friendship and conflict relationships within a mixed-gender social group. Participants (n = 193, 53% female, M age = 19.4 years, 62.1% White) reported on emotion regulation, friendship, and conflict nominations at two time points. Stochastic actor-oriented models revealed that similarity in endorsement of adaptive ER strategies predicted maintenance of friendship and conflict relationships over time. However, new conflict relationships were more likely to form between those who differed in use of adaptive ER. Finally, more frequent use of maladaptive ER strategies was related to termination of existing conflict ties and the creation of new ones. Deploying social network analysis as a methodology for examining social relationships enables the unpacking the dynamics of multiple social relationships (friend and conflict), identifying the role of ER for structuring of social relationships among group members. Although cognitive ER is an intra-individual process, it fundamentally occurs within a social environment and our results advance the knowledge of how ER contributes to how this social environment is created in a first place.

Understanding the relationship between distress intolerance and problematic Internet use: The mediating role of coping motives and the moderating role of need frustration

INTRODUCTION

There is emerging research interest in exploring the relationship between distress intolerance and problematic Internet use, yet most of the existing studies are limited by cross-sectional design, convenience sampling method, and poor understanding of the potential mediating and moderating factors involved. Based on the distress intolerance theory of addictive behavior and the theory of compensatory internet use, this study investigated a moderated mediation model to explain the impact of distress intolerance on problematic Internet use in adolescents.

METHODS

A three-wave longitudinal survey was conducted with 709 adolescents in Shanghai, China. The gender distribution was even, 50.2% were boys and 49.8% were girls. The mean age at T1 was 14.79 years (SD = 2.87).

RESULTS

Distress intolerance at Time 1 was found to positively predict problematic Internet use at Time 3. This prospective relation was mediated by adolescents' coping motives for Internet use at Time 2. Further, the mediation effect of coping motives for Internet use was moderated by need frustration at Time 2. The moderated mediation model was statistically equivalent for both genders.

CONCLUSIONS

Findings of this study contribute to new knowledge and have practical implications for prevention and intervention of adolescent problematic Internet use.

Profiles of mindfulness and difficulties in emotion regulation and links to work-family-school conflict

Objective We explored latent profiles based on mindfulness and difficulties in emotion regulation scores, and investigated each profiles' relations to work-family-school conflict (WFSC). Participants: A total of 194 first year college students (64.4% women) participated in this study. Methods: Latent profile analysis was utilized. Results: Three profiles emerged, characterized as the "healthy" profile (57.5%), the "observant yet judgmental" profile (33.3%) and the "unhealthy without strategies" profile (9.2%). The "healthy" profile showed (a) significantly lower scores on all conflict domains compared to the "observant yet judgmental" profile, and (b) significantly lower scores on all behavior-based conflicts regardless of the domains, compared to the "unhealthy without strategies" profile. The difference between the "observant yet judgmental" profile and "unhealthy without strategies" profile appeared in family-school time. Results indicate that mindfulness and healthy emotion regulation capacity function as protective factors to WFSC. Conclusions: Our findings hold strength in explicating profiles that would otherwise have not been detected when exploring mindfulness and difficulties in emotion regulation independently.

Ability to tolerate distress moderates the indirect relationship between emotion regulation difficulties and loss-of-control over eating via affective lability

INTRODUCTION

Loss-of-control eating (LOCE), inability to refrain from or cease eating, may contribute to significant distress and dysfunction, yet research is lacking specificity on vulnerabilities contributing to LOCE as an independent construct. Preliminary evidence indicates potential roles of distress tolerance, emotion regulation, and affective lability, but the relationship between these variables and LOCE has been under-assessed.

MATERIAL AND METHODS

A sample (N = 3968) consisting of university students completed an assessment of pathological eating and affiliated affective vulnerabilities. A latent variable structural equation model (SEM) was generated to predict LOCE by way of affective lability and indirectly, emotion regulation difficulties and low distress tolerance, controlling for general eating pathology.

RESULTS

Findings indicated a significant direct effect of affective lability on LOCE, as well as significant indirect effects of emotion regulation difficulties and distress tolerance on LOCE, via affect lability. Additionally, distress tolerance moderated the relationship between emotion regulation difficulties and affective lability, such that lower ability to tolerate distress strengthened the relationship and higher distress tolerance capability attenuated it.

DISCUSSION

Findings suggest an influence of distress tolerance on the relationship between poor emotion regulation and affective lability, which in turn may affect LOCE. Clinical implications and suggestions for future research are discussed.

Implicit Theories of Emotion, Goals for Emotion Regulation, and Cognitive Responses to Negative Life Events

Why do some people routinely respond to emotional difficulty in ways that foster resilience, while others habitually engage in responses associated with deleterious consequences over time? This study examined relations between emotion controllability beliefs and goals for emotion regulation (ER) with peoples' multivariate profile of cognitive ER strategy use. Cluster analysis classified 481 university students (81% female) as adaptive, maladaptive, or low regulators based on their multivariate profile of engagement in five adaptive and four maladaptive cognitive ER strategies. A discriminant function analysis predicting the multivariate profiles supported that lower emotion controllability beliefs and lower performance-avoidance goals for ER significantly distinguished maladaptive regulators from adaptive regulators. Moreover, lower learning, performance-avoidance, and performance-approach goals for ER significantly distinguished low regulators from maladaptive and low regulators. Taken together, findings support that emotion-related beliefs and goals may help to clarify why some people habitually engage in more adaptive patterns of cognitive ER in response to negative life events than others.

Practitioner Review: Emotional dysregulation in attention-deficit/hyperactivity disorder - implications for clinical recognition and intervention

BACKGROUND

Because emotional symptoms are common in attention-deficit/hyperactivity disorder (ADHD) patients and associate with much morbidity, some consider it to be a core feature rather than an associated trait. Others argue that emotional symptoms are too nonspecific for use as diagnostic criteria. This debate has been difficult to resolve due, in part, to the many terms used to describe emotional symptoms in ADHD and to concerns about overlap with mood disorders.

METHODS

We sought to clarify the nature of emotional symptoms in ADHD by reviewing conceptual and measurement issues and by examining the evidence base regarding specificity of such symptoms for ADHD. We reviewed the various terms used to define emotional symptoms in ADHD, clarify how these symptoms are demarcated from mood disorders, and assess the possibility that symptoms of emotional impulsivity and deficient emotional self-regulation should be considered as core symptoms. We addressed psychiatric comorbidities, the effects of ADHD treatments on associated emotional dysregulation, and the utility of current rating scales to assess emotional symptoms associated with ADHD.

RESULTS

Emotional symptoms are common and persistent in youth and adults with ADHD. Although emotional symptoms are common in other psychiatric disorders, emotional impulsivity (EI), and deficient emotional self-regulation (DESR) may be sufficiently specific for ADHD to function as diagnostic criteria.

CONCLUSIONS

Emotional symptoms in ADHD cause clinically significant impairments. Although there is a solid theoretical rationale for considering EI and DESR to be core symptoms of ADHD, there is no consensus about how to define these constructs sin a manner that would be specific to the disorder. An instrument to measure EI and DESR which demarcates them from irritability and other emotional symptoms could improve the accuracy of diagnostic criteria for ADHD.

Examining components of emotion regulation in relation to sleep problems and suicide risk

BACKGROUND

Sleep has emerged as an important factor in elevated risk for suicide and suicidal behaviors; however, the mechanisms accounting for this relationship are poorly understood. Emotion regulation is a well-established correlate of self-injurious behaviors; however, the broad construct has recently been shown to provide limited predictive utility. More nuanced investigations into the processes involved in emotion regulation may address this gap. This study sought to examine the mediating role of emotion regulation between sleep disturbances and suicide risk, as well as to evaluate a moderated mediation model in which down- and up-regulation of emotions would moderate this mediation.

METHODS

Participants were 972 adults recruited from a crowdsourcing website (Amazon's Mechanical Turk) who completed self-report questionnaires regarding nightmares, suicide risk, and emotion regulation.

RESULTS

Emotion regulation mediated the direct effect of nightmares on suicide risk and suicide attempts. Downregulation of negative affect moderated the mediation of nightmares on suicide risk more clearly than upregulation of positive affect, and neither component of emotion regulation exhibited moderated mediation in the suicide attempt model.

LIMITATIONS

Generalizability of our findings from an online community sample will need to be established with replication in other samples. Additionally, we used cross-sectional measures in our mediation models.

CONCLUSIONS

Downregulation of negative emotions may be particularly salient in relation to the severity of suicide risk and, as a result, relative deficits in this area should be considered when making risk determinations.

Missing Data Techniques and the Statistical Conclusion Validity of Survey-Based Alcohol and Drug Use Research Studies: A Review and Comment on Reproducibility

The goal of the present review was to examine whether or not the use of modern missing data techniques impacts the statistical conclusion validity of research on alcohol and drug use outcomes in survey-based research studies. We identified 28 papers and received complete case data from the authors of 12 studies. Seven studies (25%) reported the missing data pattern (missing not at random [MNAR], missing at random [MAR], missing completely at random [MCAR]), 15 studies (53.6%) indicated the amount of missing observations in the data set, and a significant proportion of studies ( n = 13, 46.4%) did not report any of the conditions or assumptions under which the missing data analysis was performed or implemented. Six of the 12 (50%) studies analyzed reported a different number of statistically significant associations between the complete case and full sample analyses. Efforts should be made to make missing data analysis more accessible, easy to implement and report to improve transparency and reproducibility of findings.