You Name It: Interpersonal Affect Labeling Diminishes Distress in Romantic Couples

Simple Interventions for Pediatric Residents' Moral Distress: A Randomized, Controlled Experiment

BACKGROUND AND OBJECTIVES

Pediatric residents are at high risk for moral distress, knowing the moral or ethically right thing to do but feeling unable to do it, which is associated with poor patient care and burnout. Researchers have proposed numerous interventions to reduce distress, but few (if any) have been supported by experimental evidence. In this study, we used an experimental method to provide proof-of-concept evidence regarding the effect of various simple supports on pediatric residents' reported degree of moral distress.

METHODS

We conducted a study of pediatric residents using a split sample experimental design. The questionnaire contained 6 clinical vignettes describing scenarios expected to cause moral distress. For each case, participants were randomly assigned to see 1 of 2 versions that varied only regarding whether they included a supportive statement. After reading each of the 6 cases, participants reported their level of associated moral distress.

RESULTS

Two hundred and twenty respondents from 5 residency programs completed the experiment. Cases were perceived to represent common scenarios that cause distress for pediatric residents. The addition of a supportive statement reduced moral distress in 4 of the 6 cases.

CONCLUSIONS

In this proof-of-concept study, simple yet effective interventions provided support by offering the resident empathy and shared perspective or responsibility. Interventions that were purely informational were not effective in reducing moral distress.

Evidence for cultural differences in affect during mother-infant interactions

Maternal care is considered a universal and even cross-species set of typical behaviors, which are necessary to determine the social development of children. In humans, most research on mother-infant bonding is based on Western cultures and conducted in European and American countries. Thus, it is still unknown which aspects of mother-infant behaviors are universal and which vary with culture. Here we test whether typical mother-infant behaviors of affect-communication and affect-regulation are equally represented during spontaneous interaction in Palestinian-Arab and Jewish cultures. 30 Palestinian-Arab and 43 Jewish mother-infant dyads were recruited and videotaped. Using AffectRegulation Coding System (ARCS), we behaviorally analyzed the second-by-second display of valence and arousal in each participant and calculated the dynamic patterns of affect co-regulation. The results show that Palestinian-Arab infants express more positive valence than Jewish infants and that Palestinian-Arab mothers express higher arousal compared to Jewish mothers. Moreover, we found culturally-distinct strategies to regulate the infant: increased arousal in Palestinian-Arab dyads and increased mutual affective match in Jewish dyads. Such cross-cultural differences in affect indicate that basic features of emotion that are often considered universal are differentially represented in different cultures. Affect communication and regulation patterns can be transmitted across generations in early-life socialization with caregivers.

Affect labeling: The role of timing and intensity

A growing number of studies have shown that labeling negative feelings can down-regulate distress. The present study aimed to test the effectiveness of affect labeling while manipulating two factors known to influence the emotion regulation process, namely timing, and emotional intensity. In Experiment 1, sixty-three participants completed a performance-based affect labeling paradigm in which they had to choose between two labels that best describe their feeling. Participants were randomly assigned to one of three experimental conditions: (1) Simultaneous labeling- the labeling occurs while watching the aversive picture. (2) Subsequent labeling- the labeling occurs immediately after watching the aversive picture. (3) Delayed labeling- the labeling occurs 10 seconds after watching the aversive picture. We found that affect labeling efficiently down-regulated distress independent of the labeling timing. In Experiment 2, seventy-nine participants utilized simultaneous labeling for aversive pictures with low and high intensity. We revealed that while affect labeling reduces distress in high-intensity aversive conditions, it increases distress in low-intensity conditions. The results question the standard advice, which calls to count to 10 before you speak in highly aversive states. In addition, it suggests that affect labeling can be beneficial in high-intensity conditions. However, it should be used with caution in low-intensity conditions.

"I'm listening, did it make any difference to your negative emotions?" Evidence from hyperscanning

Hyperscanning refers to simultaneously recording the brain activity of two or more people participating in the same cognitive activity to reveal the underlying processes. Active listening is a necessary and important part of interpersonal emotional regulation; however, few studies have addressed the corresponding brain activity. Therefore, this study aims to explore the regulatory effect of active listening and changes in the brain using functional near-infrared optical spectroscopy(fNIRS) in real situations requiring interpersonal emotional regulation. Behavioral results show that active listening has a significant effect on improving individuals' negative emotions. According to the neuroimaging results, the orbitofrontal cortex (OFC), right dorsolateral prefrontal cortex (right dlPFC), right temporoparietal junction (right TPJ), and left dorsolateral prefrontal cortex (left dlPFC) were significantly activated. In addition, band analysis showed interpersonal brain synchronization (IBS) increments at the orbitofrontal cortex (OFC), right dlPFC, right TPJ, and left dlPFC at different frequencies. Measurements of IBS and behavioral coherence showed that the increases of IBS at the OFC, right dlPFC, right TPJ, and left dlPFC were not significantly correlated with depression, anxiety, and the empathy level of the emotional regulator. The present study provides brain imaging evidence for the effectiveness of active listening in interpersonal emotional regulation.

Perceived teacher empathy and teenagers’ positive academic emotions: The mediating effect of interpersonal emotion regulation

Although teacher empathy has an important influence on adolescents’ positive academic emotions, the mediating mechanism between these two factors remains unclear. This study examines whether interpersonal emotion regulation plays a mediating role in the relationship between perceived teacher empathy and teenagers’ positive academic emotions. A total of 755 teenagers completed the Interpersonal Reactivity Index, the Adolescents’ Academic Emotions Questionnaire, and the Interpersonal Regulation Questionnaire. The results revealed significant correlations between two subscales of the Interpersonal Reactivity Index, perspective-taking and empathic concern; two dimensions of the Adolescents’ Academic Emotions Questionnaire, high and low positive arousal; and two dimensions of the Interpersonal Regulation Questionnaire, positive and negative emotion interpersonal emotion regulation. Perceived teacher empathy positively predicted teenagers’ positive academic emotions, and interpersonal emotion regulation played a mediating role.

Acting against your own interests: The tension between emotion regulation preference and efficacy and its implications for individuals with depressive symptoms

The aim of this study was twofold: first, to compare individuals' strategy choices in low and high intensity conditions and the actual efficacy of these strategies; second, to assess whether and how perceived intensity levels of aversive situations moderate the relationship between depressive symptoms and a strategies' efficacy. In Experiment 1A (N = 58), we replicated previous results, showing that individuals prefer distraction in high- and reappraisal in low-intensity conditions, irrespective of depressive symptom levels. Experiment 1B (N = 50) assessed the efficacy of distraction and reappraisal strategies in aversive conditions with low and high intensity. Contrary to our prediction, reappraisal was more effective than distraction, independent of the intensity of the aversive conditions. In Experiment 2 (N = 113), we tested the interactive relationship between perceived intensity levels and depression on the relative effectiveness of reappraisal and distraction. We found that while in perceived low-intensity situations the advantage of distraction over reappraisal increased as depressive symptoms increased, no such relationship was found in high-intensity situations. The results suggest that while all individuals prefer to apply reappraisal in both low- and high-intensity conditions, for those with high level of depressive symptoms, such a preference acts against their own interests. The study highlights the need to distinguish between emotion regulation preferences and their actual efficacy, while illuminating possible implications for individuals with depressive symptoms.