The Emotion Regulation Questionnaire: Psychometric Properties and Relations with Affective Symptoms in a United States General Community Sample

Emotion regulation and mental health across cultures: a systematic review and meta-analysis

Emotion regulation (ER) plays a central role in mental health, but the effect differs across cultures. Here, expanding from extant literature's focus on Western-Eastern dichotomy or individualism-collectivism, this meta-analysis synthesized evidence on the associations between the two most-studied ER strategies (cognitive reappraisal and expressive suppression) and two mental health outcomes (psychopathology and positive functioning) and investigated the moderating roles of several cultural dimensions: Hofstede's national cultures dimensions, education, industrialization, richness and democracy (EIRDness), and sample demographics. A comprehensive literature search was conducted using electronic databases (CINAHL, Scopus, Web of Science, PsycINFO and MEDLINE) to identify eligible studies reporting relationships between ER and mental health outcomes (PROSPERO: CRD42021258190, 249 articles, n = 150,474, 861 effect sizes, 37 countries/regions). For Hofstede's national cultures and EIRDness, multimodel inference revealed that greater reappraisal propensity was more adaptive in more short-term-oriented, uncertainty-tolerant and competition-driven cultures, whereas greater suppression propensity was more maladaptive in more indulgent and competition-driven cultures. For demographics, greater reappraisal propensity was more adaptive for samples with more female (B = -0.19, 95% confidence interval (CI) -0.29 to -0.09) and more racial minority participants (B = -0.32, 95% CI -0.51 to -0.13), whereas greater suppression propensity was more maladaptive in younger samples (B = -0.004, 95% CI -0.005 to -0.002). These findings elucidate how cultures are associated with the function of ER and suggests ways in which future studies can integrate cultural characteristics when examining ER and psychological adjustment.

Latent Structure and Profiles of Emotion Regulation: Reappraisal and Suppression Patterns with the Polish Version of the Emotion Regulation Questionnaire

Background/Objectives: The Emotion Regulation Questionnaire (ERQ) is a 10-item self-report measure of two emotion regulation strategies, cognitive reappraisal (CR) and expressive suppression (ES). This study aimed to (1) examine the latent structure of the Polish version of the ERQ, and (2) use it to explore different profiles of emotion regulation strategy use and their links with mental health outcomes. Methods: Our sample was 1197 Polish-speaking adults from the general community in Poland. Results: A factor analysis showed that the ERQ had strong factorial validity, with an intended two-factor structure (CR and ES factors) that was invariant across gender, age, and education categories, as well as across different levels of psychopathology symptoms and alexithymia. Our latent profile analysis extracted four emotion regulation profiles (subtypes): a Mainly Reappraisal profile (high CR, low ES), a Mainly Suppression profile (low CR with high ES), a Generally Low Regulation profile (low CR, low ES), and a Generally High Regulation profile (high CR, high ES). People with the Mainly Reappraisal profile had the best mental health outcomes, whereas people with the Mainly Suppression profile had the poorest mental health outcomes. Conclusions: Conceptually, these findings support the process model of emotion regulation, illustrating the differential affective outcomes of various emotion regulation strategies. Our results highlight the importance of considering individual differences in strategy use patterns, including combinations of strategies within an emotion regulation profile. The Polish version of the ERQ appears to be a robust measure of these key emotion regulation processes across a variety of demographic groups. To facilitate its use, including score interpretations in clinical practice, we present Polish percentile rank norms for the ERQ.

A longitudinal analysis of physical exercise in shaping language learners' emotional well-being: a comparative analysis between L1 and L2 students

BACKGROUND

Students' psychological wellness is one of the key elements that improve their well-being and shape their academic progress in the realm of language learning. Among various strategies, physical exercise emerges as an effective approach, allowing learners to manage their emotions considerably.

METHODS

Employing a quasi-experimental research design, this study examines the impact of a three-month physical running exercise intervention on emotional regulation behaviors among L1 (Arabic language) and L2 (English as a foreign language learning) students. Data was collected at three (pre-test, mid-test, and post-test) intervals, focusing cognitive reappraisal (CR) and expressive suppression (ES) the key constructs of emotional regulation.

FINDINGS

The results showed that the emotional regulation abilities of both groups were considerably impacted by the physical running exertion and differed significantly, with students' CR skills significantly improving and their ES decreasing over time. However, no significant interaction effect between time and (L1 and L2) groups' CR was observed, suggesting that physical exercise universally benefits cognitive reappraisal regardless of the language learning context. Conversely, a significant interaction effect was observed in students' ES, with L2 students experiencing more reduction compared to their L1 counterparts, highlighting the unique emotional challenges faced by L2 learners and the effectiveness of physical activity in mitigating these challenges.

CONCLUSION

The results highlight the importance of physical exercise in enhancing emotional regulation abilities among students, particularly in a second language learning context. Given this, regular physical activity programs should be incorporated into educational curricula to support students' emotional well-being and academic success. It further offers insightful recommendations for teachers, students, administrators, and policymakers to optimize physical exercise integration in higher education.

Costs and benefits of item reduction: The abridgment of the Emotion Regulation Questionnaire (ERQ)

Shortening existing instruments is a highly required procedure, as short scales may have several advantages over the long versions, especially in time and/or resources restrictions. However, abbreviated forms may be weaker than their parent versions from both content coverage and psychometric robustness. Also, the abridgment of instruments is often lacking in methodological strictness, and the potential drawbacks of the shortened scales are rarely reported. The current study aims to describe the whole process of scale shortening, emphasizing the potential costs and benefits, in terms of balance between time-resource savings and loss of validity and reliability. We shortened the Emotion Regulation Questionnaire (ERQ), involving a sample of 459 participants (53.2% males). Item reduction was driven by searching to preserve the content breadth of the construct and scale's psychometric quality. Our results supported the two-factor structure of the measure (Cognitive Reappraisal and Expressive Suppression), χ2(8) = 11.357 ns, CFI = 0.995, TLI = 0.990, RMSEA = 0.030 (0.000-0.067), SRMR = 0.031, and three items were selected for each subscale. The two intended factors showed good levels of reliability (α > 0.710). A latent variable model was performed to evaluate how the original ERQ and our proposed short version (ERQS) were related to depression, anxiety, and stress: A similar pattern of associations was found, with Cognitive Reappraisal (negatively) and Expressive Suppression (positively) reporting significant but weak associations. The ERQ-S can be beneficial over the original version, as it effectively assesses the two emotion regulation strategies with a trivial loss in reliability and predictive validity.

Relationships Among Endorsement of the Superwoman Schema and Health Outcomes

OBJECTIVE

To examine associations among endorsement of elements of the superwoman schema (the obligation to manifest strength and the obligation to help others) and health outcomes and to test if stress mediates the association between the obligation to manifest strength and depression in adult Black women.

DESIGN

Cross-sectional design.

SETTING

Community space in the Chicago metropolitan area.

PARTICIPANTS

Ninety-one adult Black women.

METHODS

Participants completed questionnaires to assess endorsement of superwoman schema roles, physical activity, healthy eating, weight satisfaction, depression, and stress. Height and weight were collected by research assistants. We used descriptive statistics, bivariate correlations, multiple regression models, and linear mediation analysis to analyze data.

RESULTS

Higher levels of obligation to suppress emotions were associated with lower physical activity, r(88) = -0.25, p < .05. Obligation to manifest strength was associated with higher levels of stress, r(79) = 0.53, p < .01, and symptoms of depression, r(71) = 0.36, p < .01. Stress mediated the relationship between the obligation to manifest strength and depression with a significant indirect effect, β = 0.37, SE = 0.10, 95% confidence interval [0.20, 0.60].

CONCLUSION

Our findings offer insight into the psychological and social processes that affect Black women and may aid in the development of culturally responsive prevention and intervention programs at individual and community levels to reduce chronic diseases.

Differences by Emotion Regulation in the Association Between Discrimination and Tobacco Use Among Sexual Minority Young Adults

Little research has examined factors, such as emotion regulation strategies, that amplify or mitigate associations between discrimination and tobacco use among sexual minority young adults (SMYAs). SM-identifying YA (ages 18-34) women (N = 450; Mage = 24.11; 31.1% racial or ethnic minority) and men (N = 254; Mage = 24.68; 28.0% racial or ethnic minority) residing in 6 US metropolitan areas were surveyed. Bivariate analyses examined associations of sociodemographics (i.e. age, race, ethnicity, education), discrimination, and emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression) with tobacco use outcomes (i.e. past 30-day cigarette, e-cigarette, other tobacco [aggregated across cigars, hookah] use). Multivariable logistic regressions were built for each tobacco use outcome and included sociodemographic covariates, discrimination and emotion regulation strategies, and interactions between discrimination and emotion regulation strategies. Among SMYA women, a significant interaction of discrimination and cognitive reappraisal indicated that discrimination was associated with greater odds of past 30-day e-cigarette use only among women with lower levels of cognitive reappraisal. Discrimination and emotion regulation were not significantly associated with tobacco use among men. SMYA women with lesser use of cognitive reappraisal may be at heightened risk for e-cigarette use if they experience discrimination. Tobacco cessation programs for SM women should incorporate emotion regulation skills.

Emotion regulation strategies and depression in mother-adolescent dyads: An actor-partner interdependence model approach

Parent-adolescent emotion dynamics have attracted increasing attention in recent years because adolescence is a challenging period for both adolescents and parents. However, how emotions are coconstructed between parents and adolescents is less clear. This study examined whether mothers' and adolescents' emotion regulation strategy was linked with their own and each other's depression using the actor-partner interdependence model (APIM). The participants were 173 mother-adolescent pairs (Mother: Mage = 43.05 years old, SD = 3.78; Adolescent: Mage = 13.00 years old, SD = 0.90). The results showed that the more mothers used cognitive reappraisal, the lower their depression levels were; and the more mothers and adolescents used expressive suppression, the higher their levels of depression were. Additionally, maternal expressive suppression was associated with adolescent depressive symptoms. Moreover, the results revealed that for mothers with higher levels of expressive suppression, their adolescents' usage of expressive suppression was significantly positively related to adolescents' depression, while for those mothers with lower levels of expressive suppression, there was no significant correlation between adolescents' usage of expressive suppression and depression. The findings underscore the significance of recognising the interdependence and interconnected nature of emotions within parent-adolescent relationships for a comprehensive understanding of their emotional well-being.

Emotional Reactivity and Regulation Relate to Surgical Treatment Decision Making Among Newly Diagnosed Women With Breast Cancer

BACKGROUND

Despite bilateral mastectomy (BLM) for early-stage breast cancer (BC) showing no survival benefit and increased risk compared to breast conserving surgery, some patients still choose this treatment. This study examined whether emotion reactivity and regulation influence treatment decision making among newly diagnosed women with breast cancer.

METHODS

Cross-sectional survey data were analyzed as part of a larger study. Measures included the Contralateral Prophylactic Mastectomy (CPM) survey, PROMIS Anxiety scale, and Emotion Regulation Questionnaire (ERQ) Cognitive Reappraisal and Emotional Suppression subscales. Primary analysis included a logistic regression model predicting treatment choice (BLM vs. non-BLM).

RESULTS

Participants (N = 137) with unilateral BC (Stages 0-III) were divided between BLM (n = 66) versus breast conserving surgery (i.e., non-BLM, n = 71) treatment groups. Compared to the non-BLM group, the BLM group was younger, more likely to be partnered, and had a higher household income. Women with high levels of BC-specific worry were 3.6 times more likely to choose BLM compared to women with low levels of worry (OR = 3.09, 95% CI: 1.07-0.8.93). Those who used cognitive reappraisal were 10% less likely to choose BLM compared to women who did not use cognitive reappraisal (OR = 0.90, 95% CI: 0.82-0.99). There were no group differences in levels of generalized anxiety (OR = 0.93, 95% CI: 0.87-0.99) or emotional suppression (OR = 1.02, 95% CI: 0.90-1.16).

CONCLUSIONS

Findings suggest the choice of BLM may be due, in part, to negative emotional experiences after a BC diagnosis and lesser use of reappraisal to reframe cancer-related fears. These may be important targets of intervention to support women making BC treatment decisions.

Idiographic bidirectional associations of stressfulness of events and negative affect in daily life as indicators for mental health: An experience sampling study

Evidence suggests that complex micro-dynamics occurring in daily life underly the development of mental distress. We aimed to (1) study the cross-lagged association between stressful events and negative affect (NA), (2) show that there is substantial between-person variability in idiographic associations and (3) show that idiographic associations are indicative of mental health. Experience sampling study assessing perceived stressfulness of events (PSE) and NA four times per day for 2 weeks in a non-clinical convenience sample (N = 70, mean age = 22.9, 61% female, 69% German). Bivariate vector autoregressive model implemented in dynamic structural equation modelling to model the associations between stressful events and NA and obtain idiographic associations. Stressfulness of events and NA were significantly reciprocally associated. Autocorrelations and cross-lagged associations from PSE to NA showed substantial variability and were significantly related with trait measures of depression, anxiety, well-being, and perceived stress. Contrary to expectations, cross-lagged associations from NA to stressfulness of events were not related to trait mental health. The approach outlined in this article is useful for studying idiographic dynamics in daily life. The findings increase our understanding of micro-dynamics underlying mental health and individual differences in these processes.

Emotion Regulation Frequency and Self-Efficacy: Differential Associations with Affective Symptoms

Successful emotion regulation is a critical component of mental health, and difficulties with emotion regulation have been associated with a wide range of disorders, including anxiety and depressive disorders. However, although much is known about commonly used forms of emotion regulation such as cognitive reappraisal and expressive suppression, the relative contribution of two important facets of emotion regulation-frequency and self-efficacy-is not yet clearly established. To address this issue, we conducted two studies. Study 1 employed a community sample (cross-sectional N = 431; 4- to 5-month longitudinal N = 182). Study 2 employed a clinical sample (cross-sectional N = 132). Both assessed emotion regulation frequency and self-efficacy, as well as affective outcomes (anxiety and depressive symptoms). Findings indicated cognitive reappraisal self-efficacy appears to be a relevant variable understanding negative affect outcomes, cross-sectionally, longitudinally and in the clinical sample. Our findings support the process model of emotion regulation in affective symptomatology. Implications for theory and treatment are discussed.

Assessing Emotion Regulation across Asian and Western Cultures: Psychometric Properties of Three Common Scales across Singaporean and Australian Samples

Given the differences in emotion regulation across cultures, it is paramount to ensure that measures of emotion regulation measure the same construct and that conceptualizations of emotion regulation are valid across cultures. Therefore, the present study assessed the measurement invariance (alongside other psychometric properties) of three popular emotion regulation questionnaires, the Emotion Regulation Questionnaire (ERQ), Difficulties in Emotion Regulation Scale (DERS), and the Perth Emotion Regulation Competency Inventory (PERCI), across 434 Singaporeans and 489 Australians. Our study showed that all three questionnaires were measurement invariant, had excellent internal consistency, and relatively good concurrent validity with psychopathology and alexithymia across our Singaporean and Australian sample, justifying their use in comparing Asian and Western cultures. Our findings suggest that measures of emotion regulation have utility across both individualistic and collectivistic cultures. Our findings supports the use of these measures in cross-cultural research and provides support for the utility for personality assessments across cultures.

Latent profile analysis of Eysenck's personality dimensions and psychological constructs in university students

Background

The exploration of personality traits in relation to psychological constructs has become increasingly relevant in understanding the mental health of university students (the emerging adulthood). Studies have focused on how dimensions intersect with various psychological parameters.

Aim

The study aims to identify distinct personality profiles among university students based on Eysenck's personality dimensions and investigate how these profiles differ across psychological constructs.

Method

A quantitative methodology was utilized, involving 708 university students from Wenzhou and Nanjing in China as participants. The research employed the Eysenck Personality Questionnaire along with other psychological measures. Latent Profile Analysis was applied to categorize the participants into distinct personality profiles.

Results

Four distinct personality profiles emerged: 'The Reserved Analyst,' 'The Social Diplomat,' 'The Unconventional Pragmatist,' and 'The Impulsive Truth-Teller.' Significant differences were found among these profiles on various psychological constructs. 'The Social Diplomat' exhibited the most adaptive psychological profile, with higher cognitive reappraisal (F = 45.818, p < 0.001, η2 = 0.163), meaning in life (F  = 17.764, p < 0.001, η2 = 0.070), and positive coping (F = 40.765, p < 0.001, η2 = 0.148) compared to other profiles. Conversely, 'The Reserved Analyst' showed higher intolerance of uncertainty (F = 13.854, p  < 0.001, η2 = 0.056) and state anxiety (F = 26.279, p  < 0.001, η2 = 0.101).

Conclusion

This study enriches the understanding of personality traits in relation to psychological constructs within the context of university student populations. By identifying distinct personality profiles, it lays the groundwork for developing tailored mental health strategies that cater to the specific needs of different student groups.

The Protective Role of Curiosity Behaviors in Coping with Existential Vacuum

An existential vacuum is experienced as a kind of crisis that one can cope with using his/her strengths. The related literature suggests that the important determinants of coping with existential emptiness include positive emotional and personality resources, and among these-Curiosity Behaviors. The purpose of this study is to describe the role of curiosity as an important factor in relation to emotional resources in individuals experiencing an existential vacuum. A survey was conducted using online tools (n = 484). The hypotheses about the direct and indirect relationships between Curiosity Behaviors and existential vacuum were tested using multiple regression analyses and mediations. The study involved a sample of adult participants representing the general population. The participants completed five questionnaires, the first one focusing on Curiosity Behaviors, such as seeking out novel and challenging experiences and engagement in activities that capture one's attention (The Curiosity and Exploration Inventory), and the other tools being the Multidimensional Existential Meaning Scale, the Emotional Regulation Questionnaire, the Flourishing Scale, and the Depression Anxiety Stress Scale. The results indicate that Curiosity Behaviors characteristically negatively predict existential vacuum. In addition, other variables, such as Flourishing, seem to be useful in explaining the relationships between these factors. Flourishing along with Curiosity increases a sense of Meaning in Life. Our results present evidence showing the importance of Curiosity Behaviors in coping with the existential vacuum.

The effect of emotion regulation on empathic ability in Chinese nursing students: The parallel mediating role of emotional intelligence and self-consistency congruence

AIM

This study aims to explore the influence of emotion regulation on empathic ability among undergraduate nursing students, as well as the mediating role of emotional intelligence and self-consistency congruence.

DESIGN

A cross-sectional study was employed to examine the relationship between the emotion regulation and empathic ability in Chinese nursing students.

METHODS

A total of 761 undergraduate nursing students were surveyed using the Interpersonal Reactivity Index (Chinese version), the Gross Emotion Regulation Questionnaire, Wang and Law's Emotional Intelligence Scale and the Self-Harmony Scale.

RESULTS

There was a significant positive correlation between emotion regulation, empathic ability and self-harmony. Significant positive correlations were also found between emotion regulation, empathic ability and emotional intelligence. Mediation analysis revealed that self-harmony and emotional intelligence partially mediated the predictive relationship between emotion regulation and empathic ability, with self-harmony showing a more significant mediating effect.

CONCLUSION

The findings suggest that emotion regulation among undergraduate nursing students indirectly influences their empathic ability through parallel mediating effects of self-harmony and emotional intelligence.

Self-reported autistic traits and psychosocial outcomes among university students in Malaysia

LAY ABSTRACT

Most research on autism spectrum conditions is done on young children and not as much on young adults with autism spectrum conditions. Because of this, not much is known about how common autism spectrum conditions are in young adults and how they affect their mental and social health, especially in Southeast Asia. Based on self-reports, 2.8% of the 2732 university students we looked at in Malaysia might have been diagnosed or thought to have an autism spectrum condition. Students who said they had or thought they had autism spectrum conditions had lower self-efficacy, more stress and a lower quality of life than students who said they did not have autism spectrum conditions. The results showed that university students with autism spectrum condition are more likely to have bad psychological and social outcomes than their peers without autism spectrum condition. Also, the link between autistic traits and psychosocial outcomes could depend on the culture.

The Emotion Regulation Questionnaire-Short Form (ERQ-S): A 6-item measure of cognitive reappraisal and expressive suppression

BACKGROUND

Emotion regulation plays a crucial role in affective functioning. One of the most commonly used measures of emotion regulation is the Emotion Regulation Questionnaire (ERQ), a 10-item self-report measure assessing frequency of use of two common emotion regulation strategies: cognitive reappraisal and expressive suppression. In this study, we aimed to optimize the utility of the ERQ for time-pressured settings by introducing and validating a 6-item short form called the Emotion Regulation Questionnaire-Short Form (ERQ-S).

METHOD

General community (N = 508) and college student (N = 245) samples from the United States completed online surveys containing a range of psychometric self-report measures. For each sample, we examined the factor structure, internal consistency, and concurrent validity of the ERQ-S.

RESULTS

Our confirmatory factor analyses supported the intended 2-factor structure of the ERQ-S (cognitive reappraisal and expressive suppression factors), with all items loading well on their intended factor in both samples. As expected, the ERQ-S correlated highly with the ERQ. A profile of low cognitive reappraisal use and high expressive suppression use on the ERQ-S was significantly associated with higher levels of emotion regulation difficulties, alexithymia, and affective symptoms.

LIMITATIONS

We did not examine psychometric performance in a clinical sample, or other cultural groups outside the US. All concurrent validity markers were self-report questionnaires.

CONCLUSIONS

Our data suggest that the ERQ-S successfully retains the psychometric strengths of the ERQ. The shorter format of the ERQ-S should therefore help to optimize the measurement of emotion regulation in time-pressured settings.

A prospective study on body image disturbances during pregnancy and postpartum: the role of cognitive reappraisal

Background

During pregnancy, body size rapidly modifies over a relatively short period. Literature emphasizes the need to identify the factors that influence body image during peripartum as the extent of women's adaptation to these changes has significant repercussions on both mother's and newborn's health. Emotion regulation strategies (i.e., expressive suppression and cognitive reappraisal) were linked to body image in the general and clinical population, but no studies were conducted in the peripartum. The present study aims to investigate the longitudinal impact of prepartum body image disturbances on postpartum body image disturbances and to evaluate the mediational role of emotional regulation strategies.

Methods

A total of 133 pregnant women completed a three-phase longitudinal study. Women answered online questionnaires during the second (T1) and the third (T2) trimesters of pregnancy, and at about 6 months postpartum (T3).

Results

Findings indicated that body image disturbances at T1 were a significant predictor of body image disturbances in the postpartum (1 year after the first assessment). Moreover, cognitive reappraisal measured at T2 partially mediated this relationship: body image disturbances in the second trimester of pregnancy were linked to less use of cognitive reappraisal in the third trimester of pregnancy, and this, in turn, was associated with worse body image disturbances at 6 months after birth.

Conclusion

Findings of this longitudinal study highlight the importance of assessing body image disturbances during pregnancy to early identify women at risk, and suggest cognitive reappraisal as a possible target intervention.

Efficacy of an Unguided, Digital Single-Session Intervention for Internalizing Symptoms in Web-Based Workers: Randomized Controlled Trial

BACKGROUND

The Common Elements Toolbox (COMET) is an unguided digital single-session intervention (SSI) based on principles of cognitive behavioral therapy and positive psychology. Although unguided digital SSIs have shown promise in the treatment of youth psychopathology, the data are more mixed regarding their efficacy in adults.

OBJECTIVE

This study aimed to investigate the efficacy of COMET-SSI versus a waiting list control in depression and other transdiagnostic mental health outcomes for Prolific participants with a history of psychopathology.

METHODS

We conducted an investigator-blinded, preregistered randomized controlled trial comparing COMET-SSI (n=409) with an 8-week waiting list control (n=419). Participants were recruited from the web-based workspace Prolific and assessed for depression, anxiety, work and social functioning, psychological well-being, and emotion regulation at baseline and at 2, 4, and 8 weeks after the intervention. The main outcomes were short-term (2 weeks) and long-term (8 weeks) changes in depression and anxiety. The secondary outcomes were the 8-week changes in work and social functioning, well-being, and emotion regulation. Analyses were conducted according to the intent-to-treat principle with imputation, without imputation, and using a per-protocol sample. In addition, we conducted sensitivity analyses to identify inattentive responders.

RESULTS

The sample comprised 61.9% (513/828) of women, with a mean age of 35.75 (SD 11.93) years. Most participants (732/828, 88.3%) met the criteria for screening for depression or anxiety using at least one validated screening scale. A review of the text data suggested that adherence to the COMET-SSI was near perfect, there were very few inattentive respondents, and satisfaction with the intervention was high. However, despite being powered to detect small effects, there were negligible differences between the conditions in the various outcomes at the various time points, even when focusing on subsets of individuals with more severe symptoms.

CONCLUSIONS

Our results do not support the use of the COMET-SSI in adult Prolific participants. Future work should explore alternate ways of intervening with paid web-based participants, including matching individuals to SSIs they may be most responsive to.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05379881, https://clinicaltrials.gov/ct2/show/NCT05379881.

"Talk and Chalk": An emotion regulation intervention for anger after acquired brain injury

Uncontrollable anger is a debilitating consequence of acquired brain injury (ABI). This proof-of-concept study investigated the preliminary efficacy of an emotion regulation intervention for managing post-ABI anger. A secondary objective was to determine which participant characteristics were related to intervention gains. With a pre-post intervention design and three-month follow-up, there were five individually administered meetings on Zoom, over a four-month period. 24 adults who had sustained an ABI were enrolled. Participants were mostly males, from 24 to 85 years old. A series of one-way repeated-measures ANOVAs were conducted to determine the intervention's efficacy, and Spearman's rho bivariate correlations for the association between participant characteristics and intervention gains. Significant differences were observed in external anger from baseline to post-treatment; there were no further changes from post-treatment to follow-up. Of the participant characteristics, only readiness to change and anxiety were correlated. The proposed intervention presents a brief, feasible, and preliminary efficacious alternative for regulating post-ABI anger. Intervention gains are associated with readiness to change and anxiety, which has important implications for clinical delivery.

Emotion regulation in young adults with family history of harmful alcohol use: A fMRI study

BACKGROUND

Alcohol use disorder is associated with difficulties in emotion regulation and cognitive reappraisal. Family history of harmful alcohol use increases risk of substance use disorders, but no studies have examined whether family history is associated with altered neural activation during cognitive reappraisal relative to passive viewing of negative images in a sample of young adults without current substance use disorders.

METHODS

Participants (N = 75 with positive [n = 31] or negative [n = 44] family histories of harmful alcohol use) completed the emotion regulation task during an MRI scan, and the Emotion Regulation Questionnaire to assess use of emotion regulation and suppression strategies. Whole-brain analyses and amygdala region of interest analyses using linear mixed-effects models assessed family history group and cue effects on neural activation during the task.

RESULTS

The groups did not differ on trait reappraisal, suppression, or negative emotion following reappraisal. In general, group effects in whole-brain and amygdala activation during the cognitive reappraisal contrast indicated small effect sizes (2.2% of voxels had d>0.20) that were not significantly different. Participants with positive family histories engaged the right middle and superior frontal gyri to a greater extent than participants with negative family histories during the decrease-negative cue (t = 4.14, p = .001).

CONCLUSIONS

For at-risk young adults without current harmful substance use, family history of harmful alcohol use does not appear to be associated with disrupted emotion regulation when instructed to apply cognitive reappraisal. Reappraisal may be a feasible therapeutic target for those who develop a substance use disorder with associated emotion dysregulation.

Acceptability and Outcomes of Transdiagnostic Guided Self-help Bibliotherapy for Internalizing Disorder Symptoms in Adults: A Fully Remote Nationwide Open Trial

Introduction

Doing What Matters in Times of Stress (DWM) is a five-module transdiagnostic guided self-help (GSH) intervention developed by the World Health Organization, originally in a group-based format. In a sample of individuals recruited from across the United States, we conducted an open trial to study the feasibility and acceptability of an adaptation of DWM in which guidance was provided individually and remotely via phone and videoconferencing.

Methods

We assessed internalizing symptoms, psychological well-being, work and social functioning, usability of the intervention, and emotion regulation over the course of 6 weeks.

Results

A total of 263 individuals completed our screening. Of those, 75.29% (n = 198) qualified for the intervention. We reached most participants who qualified (71.21%, n = 141) via phone to schedule a GSH session. Most of those scheduled attended a study session (84.4%, n = 119), and most of those who attended a session completed more than half the treatment (84.03%, n = 100). Retention rates were comparable to meta-analytic estimates of dropout rates in GSH. Participants showed improvement on internalizing symptoms, psychological well-being, work and social functioning, usability of the intervention, and emotion regulation.

Conclusion

DWM is a freely available, seemingly efficacious transdiagnostic intervention for internalizing disorder symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-022-10338-5.

Reappraising cognitive reappraisal: The taxing impact of emotion regulation on executive functioning in older adults

OBJECTIVE

Cognitive reappraisal (CR) and expressive suppression (ES) are two common emotion regulation strategies that share similar cognitive and neural underpinnings. Prior research has consistently shown that recent engagement in ES (both self-reported and experimentally manipulated) is associated with subsequent temporary decrements in executive functioning (EF). Thus far, only one study has examined the association between CR and EF, with null results. However, that study was limited by examining only zero-order correlations and by assessing only the speed, not accuracy, of EF performance. The present study examined multivariate relationships among recent CR, recent ES, and EF (both speed and accuracy), as well as the potential impacts of more chronic engagements in, and trait-level preferences between, the two emotion regulation strategies.

METHOD

Participants were 201 community-dwelling older adults aged 60 to 93 who had participated in three separate studies examining the relationship between self-reported emotion regulation and EF.

RESULTS

Recent CR was associated with EF performance accuracy above and beyond chronic CR. Both recent CR and ES contributed to EF performance accuracy uniquely beyond each other and beyond chronic and preferred emotion regulation.

CONCLUSIONS

Both recent ES and CR appear to have a deleterious impact on EF performance accuracy, potentially due to utilization of similar resources; both should be accounted for when assessing emotion regulation and its impacts on EF.

The Effect of Persistence of Physical Exercise on the Positive Psychological Emotions of Primary School Students under the STEAM Education Concept

The effect of persistence of physical exercise on the psychological and emotional aspects of primary school students is studied to improve the comprehensive quality of current Chinese primary school students and explore the effect of physical exercise on students' emotions under the science, technology, engineering, art, mathematics (STEAM) education concept. First, students in a primary school in Nanchang are taken as the survey participants. Second, by formulating a physical exercise scale and a psychological and emotional scale, the current situation of physical exercise of primary school students is investigated by means of mathematical statistics. Finally, the current situation of physical exercise and the overall situation of positive psychological emotions of primary school students are analyzed, and the effect of physical exercise on the positive psychological emotions of primary school students is studied. The data show that there are significant differences in the amount of exercise and its three dimensions of intensity, time, and frequency, as well as the scores of positive emotions in the gender dimension, with the boys scoring higher than the girls. In terms of grades, students in grades 1, 2, and 6 are higher than students in grades 3, 4, and 5 on the level of a small amount of exercise, while students in grades 3, 4, and 5 are higher than the other three grades in terms of a moderate amount of exercise. Moreover, in the aspect of positive psychological emotions, the lower-grade students are obviously higher than the upper-grade students, and the second- and third-grade students present marginal significance, p = 0.058. The correlation and regression between physical exercise and positive psychological emotions are calculated and analyzed, and it is found that there is a significant positive correlation between physical exercise indicators and positive psychological emotions, with a correlation coefficient of 0.297. Physical exercise explains 8.8% of positive emotions. This research also makes relevant recommendations for students and schools and has played a role in strengthening the physical exercise and mental health of primary and secondary school students. Greater attention to the physical exercise of primary school students is recommended.

Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure

Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49-95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M age = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M age = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals.

It’s all about beliefs: Believing emotions are uncontrollable is linked to symptoms of anxiety and depression through cognitive reappraisal and expressive suppression

The aim of this study was to examine the link between personal beliefs about emotion controllability and symptoms of anxiety and depression, with a particular focus on the mediating role of emotion regulation. To date, there has been little research examining the mediating role of cognitive reappraisal or expressive suppression in the link between beliefs about emotion controllability and symptoms of anxiety. Online questionnaires measuring emotion regulation, beliefs about emotion controllability, and depression and anxiety, were completed by 1227 participants (n = 336 males; Mage = 25.3, SD = 10.1; range = 16 to 83 years). The results indicated that perceived control over one’s own emotions predicted better psychological health (fewer symptoms of anxiety and depression). This link between beliefs about emotion controllability and psychological heath was partially mediated by cognitive reappraisal and expressive suppression, with cognitive reappraisal predicting a reduction in clinical symptoms and expressive suppression predicting an increase in clinical symptoms. These findings suggest that individuals’ beliefs about emotion controllability, leads to the use of certain emotion regulation strategies which in turn, have important consequences for psychological health.

Mental health in the post-lockdown pandemic phase: Relief or exacerbation of psychological distress? A cross-sectional study in the general population in Italy

This study is one of the first aiming at investigating the mental health in the post-lockdown period in an Italian adult population and detecting demographic and psychological predictors for a worse outcome. 1401 participants answered a web-based survey including the Emotional Reaction Questionnaire (ERQ), the Positive Affect and Negative Affect Scale (PANAS), the Impact of Event Scale-Revised (IES-R), the General Health Questionnaire (GHQ), the Depression, Anxiety and Stress Scale (DASS-21), and the Dutch Work Addiction Scale (DUWAS). Simple slope analyses highlighted that women, lower age, and suppression were related to higher scores for the PANAS negative affect scale, the DASS-21, the IES-R, the GHQ, and the DUWAS. In our sample, 1.2% of participants showed depressive symptoms, 0.5% anxiety symptoms, and 2% stress symptoms. Moreover, 5.4% of participants reported post-traumatic symptoms and 15% signs of psychological distress. Compared with data on the lockdown period, our results show lower levels of depressive, anxiety, and stress symptoms, possibly due to the slackening of preventive measures adopted since June. Despite this, post-traumatic symptoms and signs of psychological distress were still present. Our data suggest the necessity to monitor psychological adaption over time in general and at-risk subjects.

Is Activation the Active Ingredient of Transdiagnostic Therapies? A Randomized Clinical Trial of Behavioral Activation, Acceptance and Commitment Therapy, and Transdiagnostic Cognitive-Behavioral Therapy for Emotional Disorders

Studying the usefulness of contextual and cognitive transdiagnostic therapies calls for an analysis of both their differential efficacy and their specificity when acting on the transdiagnostic conditions on which they focus. This controlled trial compares the post-treatment and 3- and 6-month follow-up effects of Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Transdiagnostic Therapy (TD-CBT) on emotional symptomatology, and analyses the role played by Experiential Avoidance, Cognitive Fusion, Activation and Emotion Regulation in the clinical change. One hundred twenty-eight patients who fulfilled diagnostic criteria for anxiety and/or depression (intention-to-treat sample) were randomly assigned to three experimental group-treatment conditions (BA, n = 34; ACT, n = 27; TD-CBT n = 33) and one control group (WL, n = 34). Ninety-nine (77.34%) completed the treatment (per-protocol sample). In the post-treatment, all therapies reduced anxiety and depression symptomatology. In the follow-ups, the reduction in emotional symptomatology was greater in the condition which produced greater and more prolonged effects on Activation. Activation appears to be the principal condition in modifying all the transdiagnostic patterns and BA was the most efficacious and specific treatment. The trial was registered at ClinicalTrials.gov NCT04117464. Raw data are available online http://dx.doi.org/10.17632/krj3w2hfsj.1 .

Psychometric Properties of the Korean version of the Emotion Regulation Questionnaire (K-ERQ) in a Clinical Sample

OBJECTIVE

The Emotion Regulation Questionnaire (ERQ) is one of the widely used instruments to assess emotion regulation skills in many countries, including Korea. However, its psychometric properties have not been validated within this population. Also, the ERQ has increasingly been used in studies with psychiatric patients despite a general lack of validation in clinical settings. Therefore, the present study aimed to investigate the psychometric properties of the Korean version of the ERQ (K-ERQ) using a clinical sample in Korea.

METHODS

One hundred and ninety-three psychiatric patients completed a packet of self-report measures, including K-ERQ, K-BDI-II, K-ASI-3, PCL-5-K, AUDIT-K. Confirmatory factor analysis (CFA) was administered to investigate the factor structure of the K-ERQ, and internal reliability and validity were examined.

RESULTS

Results of the CFA supported the two-factor structure, but only after the removal of one item. The K-ERQ showed good internal consistency reliability, and its concurrent validity was also confirmed. Cognitive reappraisal was negatively correlated with depression and alcohol use disorder-related symptoms, and expressive suppression was positively correlated with depression, anxiety sensitivity, posttraumatic stress disorder (PTSD)-related symptoms and alcohol use disorder-related symptoms. Significant group differences were found in the use of emotion regulation strategies; patients with PTSD reported the higher level of cognitive reappraisal than patients with depressive disorders, bipolar disorders, and attention-deficit hyperactivity disorder.

CONCLUSION

The 9-itemed K-ERQ is a reliable and valid tool to assess the emotion regulation strategies in a Korean clinical sample. Our study also adds preliminary evidence on the usefulness of the ERQ in clinical settings.

Affective Styles and their Association with Anxiety and Depression in a Japanese Clinical Sample

Affective styles are assumed to play an important role in maintaining negative affect, including anxiety and depression. However, little is known about the longitudinal relationship between affective styles and symptoms. Therefore, we conducted a longitudinal study to examine the influence of affective styles, assessed using the Affective Style Questionnaire, on anxiety and depression among clinical populations in Japan. Using an online survey, 1,521 participants (406 with major depressive disorder; 479 with one or more anxiety disorders; 636 with both) answered the Affective Style Questionnaire and measures of emotion regulation, anxiety, and depression symptoms. Data were collected twice over two months. Confirmatory factor analyses replicated the same four-factor structure found in a previous sample of Japanese university students. Hierarchical regression analyses revealed that the affective styles had a slightly greater effect on anxiety symptoms but not on depression compared to other common emotion regulation strategies, such as suppression and reappraisal measured by the ERQ. Limitations of this study were that it used online surveys, in which, participants' diagnostic statuses were based on unverifiable self-reports. In conclusion, the association of affective styles with anxiety and depression among the clinical populations was prospectively confirmed. Further study is needed to examine the association considering the combination or profiles of affective styles among different emotional disorders.

Cross-cultural and gender invariance of emotion regulation in the United States and India

BACKGROUND

The ability to effectively regulate one's emotions has been established as an important transdiagnostic mechanism in the development and maintenance of psychopathology. To date, much of the research on emotion regulation (ER) has been conducted in Western, educated, industrialized, rich, and democratic (WEIRD) samples. Specifically, there is a dearth of cross-cultural construct equivalence studies on measures of ER. Establishing measurement equivalence is an important first step to facilitate future research on ER in culturally diverse samples.

METHODS

The present study sought to validate the latent structures of three commonly used ER measures: the Emotion Regulation Questionnaire (ERQ), Ruminative Responses Scale (RRS-10), and Acceptance subscale of the Five-Facet Mindfulness Questionnaire (FFMQ-AS). Measurement equivalence was examined across 123 American and 121 Indian participants (M_age = 36.60) and across gender.

RESULTS

Cross-cultural confirmatory factor analyses revealed configural equivalence (i.e., same factor structures) in both cultural groups across all three measures. The RRS-10 met weak invariance across cultures; however, factor loadings were not equal across the two samples for all items on the ERQ or FFMQ-AS. Consequently, a partial invariance solution was identified, and all measures subsequently met criteria for Level 2 strict cross-cultural invariance. Across gender, full invariance was found on all measures except the FFMQ-AS.

CONCLUSION

Findings suggest that the structure of ER processes is largely invariant across these two cultural groups, with a few notable exceptions, pointing to the importance of continued work in this area.

Reappraisal-but not Suppression-Tendencies Determine Negativity Bias After Laboratory and Real-World Stress Exposure

Higher reactivity to stress exposure is associated with an increased tendency to appraise ambiguous stimuli as negative. However, it remains unknown whether tendencies to use emotion regulation strategies—such as cognitive reappraisal, which involves altering the meaning or relevance of affective stimuli—can shape individual differences regarding how stress affects perceptions of ambiguity. Here, we examined whether increased reappraisal use is one factor that can determine whether stress exposure induces increased negativity bias. In Study 1, healthy participants (n = 43) rated the valence of emotionally ambiguous (surprised) faces before and after an acute stress or control manipulation and reported reappraisal habits. Increased negativity ratings were milder for stressed individuals that reported more habitual reappraisal use. In Study 2 (n = 97), we extended this investigation to real-world perceived stress before and during the COVID-19 pandemic. We found that reappraisal tendency moderates the relationship between perceived stress and increased negativity bias. Collectively, these findings suggest that the propensity to reappraise determines negativity bias when evaluating ambiguity under stress.

Psychometric properties and measurement invariance of the emotion regulation questionnaire in Chinese left-behind children

Left-behind children (LBC) is a group of children who live without their parents and receive less parental care and education. Compared with non-left-behind children (NLBC), LBC are more likely to develop emotional or behavior problems. This study aimed to explore the psychometric properties and measurement invariance of the Chinese version of the Emotion Regulation Questionnaire (ERQ) in Chinese LBC. A sample of 2960 middle school students (44.35% male, 55.28% female; age: 12 to 20 years) including LBC (n = 1365) and NLBC (n = 1595) was used. The exploratory factor analysis (EFA); confirmatory factor analyses (CFA); tests of measurement invariance; t-tests of gender and left-behind experience differences; tests of reliability and convergent, discriminant, and criterion validity were conducted. The results showed that two factors were extracted, and the CFA replicated the original two-factor structure (S-Bχ2/df ≈ 106.778/34, P < .001, CFI = .948, TLI = .932, RMSEA = .056 [.044, .068]). The measurement invariance of the ERQ across genders, LBC and NLBC was also confirmed. Males use expressive suppression (ES) significantly more than females (t = 2.63, p < .01), and LBC use ES significantly more than NLBC (t = 2.11, p < .05). The internal consistency coefficients for ES and cognitive reappraisal (CR) were acceptable, and the test-retest reliability was .62 and .68, respectively. Good convergent, discriminant and criterion validity were also demonstrated. It can be concluded that the ERQ is a valid measure for investigating the use of two different emotion regulation strategies among Chinese left-behind children.