Enhancing emotion regulation

Emotion dysregulation mediates the effect of borderline personality disorder on child psychopathology

BACKGROUND

Children of mothers with borderline personality disorder (BPD) face an increased risk of developing mental health issues. To prevent the intergenerational transmission of psychopathology, a thorough understanding of specific pathways is essential. BPD is characterized by symptoms such as difficulties in emotion regulation, impulsivity, and attachment insecurity, all of which have a detrimental impact on child development. Here, we explore the role of these three core characteristics as potential mediators for the impact of maternal BPD on child psychopathology.

METHODS

The study included 87 mothers (34 with and 53 without BPD) and their biological children aged 5-12 years. We employed two multiple parallel mediation models to identify the mediating role of the core characteristics for the effect of BPD on externalizing and internalizing child behavior. Our analyses were controlled for maternal early-life maltreatment.

RESULTS

Both models demonstrated significant effects of BPD on child psychopathology. We found a significant indirect effect of BPD on externalizing child behavior through emotion dysregulation, but not through impulsivity or attachment insecurity. None of the three characteristics proved to be significant mediators in the effect of BPD on internalizing child behavior.

CONCLUSION

Examining the distinct contributions of three common core characteristics of BPD, difficulties in emotion regulation appear to be the relevant pathway through which maternal BPD affects externalizing psychopathology in children. Specifically, children of mothers with BPD who exhibit externalizing psychopathology could benefit from additional parenting interventions focusing on improving maternal emotion regulation.

Neural subgroups in unaffected first-degree relatives of patients with bipolar disorder during emotion regulation

BACKGROUND

Impaired emotion regulation has been proposed as a putative endophenotype in bipolar disorder (BD). Functional magnetic resonance imaging (fMRI) studies investigating this in unaffected first-degree relatives (UR) have thus far yielded incongruent findings. Hence, the current paper examines neural subgroups among UR during emotion regulation.

METHODS

71 UR of patients with BD and 66 healthy controls (HC) underwent fMRI scanning while performing an emotion regulation task. Hierarchical cluster analysis was performed on extracted signal change during emotion down-regulation in pre-defined regions of interest (ROIs). Identified subgroups were compared on neural activation, demographic, clinical, and cognitive variables.

RESULTS

Two subgroups of UR were identified: subgroup 1 (39 UR; 55%) was characterized by hypo-activity in the dorsolateral, dorsomedial, and ventrolateral prefrontal cortex and the bilateral amygdalae, but comparable activation to HC in the other ROIs; subgroup 2 (32 UR; 45%) was characterized by hyperactivity in all ROIs. Subgroup 1 had lower success in emotion regulation compared to HC and reported more childhood trauma compared to subgroup 2 and HC. Subgroup 2 reported more anxiety, lower functioning, and greater attentional vigilance toward fearful faces compared to HC. Relatives from both subgroups were poorer in recognizing positive faces compared to HC.

CONCLUSIONS

These findings may explain the discrepancy in earlier fMRI studies on emotion regulation in UR, showing two different subgroups of UR that both exhibited aberrant neural activity during emotion regulation, but in opposite directions. Furthermore, the results suggest that impaired recognition of positive facial expressions is a broad endophenotype of BD.

Examining the Influence of Alexithymia, Gender, and Age on Drug Use among Iranian Students: the Mediating Role of Emotion Regulation Difficulties

The objective of the present study was to predict drug use among Iranian students on the basis of alexithymia, gender, age, and the mediating role of emotion regulation difficulty. This research employed a descriptive-correlational approach (structural equation modeling). The statistical population included 400 high school students studying during the 2023-2024 academic year in the cities of Khorramabad and Ardabil. The instruments used in this study included the short form of the Difficulties in Emotion Regulation Scale (DERS-SF), the Toronto Alexithymia Scale (TAS-20), and the Addiction Potential Scale (APS) in its Iranian version. The path coefficients related to the effect of alexithymia and the mediating role of emotion regulation difficulty were significant at the 0.05 level, except for the paths from gender and age to drug use tendency, which were not confirmed. Age, gender, and alexithymia collectively explained 52% of the variance in emotion regulation difficulty, whereas emotion regulation difficulty, age, gender, and alexithymia explained 46% of the variance in drug use propensity among students. Among the variables studied, only age and gender were not significant predictors of drug use in Iranian students, whereas alexithymia, both directly and through the mediating role of emotion regulation difficulty, significantly predicted drug use propensity.

Your brain on art, nature, and meditation: a pilot neuroimaging study

Objectives

Exposure to art, nature, or meditation, all transcending human experiences, has beneficial effects on health and wellbeing. Focusing inward or watching art and nature videos elicits positive emotions that can help heal stress-related conditions. In a pilot functional magnetic resonance (fMRI) study, we explored the effect of watching digital art or nature videos compared to contemplating the universal connectedness (also known as transcendental meditation). The instructions were to meditate on the connection to a Universal Soul linked to a sense of expansion and universal connectedness ("one with everything"), which was prompted by a video of the galactic nebula that also controlled for the visual stimuli of the two other conditions.

Methods

Nine healthy adults (mean age = 29; range = 19-42; 5 women) underwent a block design fMRI scan using a Siemens 3T Prisma scanner. The blocks included (1) nature videos, (2) AI-generated digital art ("machine hallucinations" by Refik Anadol), and (3) videos of NASA Webb-produced images of galactic nebulas. Brain oxygen-level dependent (BOLD) images were processed using FSL Version 6.0 and a general linear model (GLM) tested the contrasts between art, nature, and meditation blocks, using a cluster-corrected p-value of 0.05.

Results

Compared to rest, meditation led to BOLD increases in bilateral lateral occipital and fusiform gyri, as well as right postcentral gyrus and hippocampus. Compared to viewing AI-generated digital art, increased BOLD responses during meditation were observed in left parietal and central operculum, and right pre- and postcentral gyri, and compared to nature, in the left parietal operculum, bilateral postcentral and supramarginal gyri, and bilateral lateral occipital cortices.

Conclusion

Meditation compared to rest showed brain activation in regions associated with object, sensory, and memory processing. Meditation compared to nature videos led to activity in bilateral sensory and object processing areas, as well as a left sensory integration region (error monitoring), while meditation compared to art showed activity in left sensory integration and right sensorimotor regions. Further studies are needed to delineate the distinct neural signature and therapeutic effects of inner contemplation using human connection to art, nature, or meditative transcendent practices, in the brain and its potential in clinical applications.

Discriminant Input Processing Scheme for Self-Assisted Intelligent Healthcare Systems

Modern technology and analysis of emotions play a crucial role in enabling intelligent healthcare systems to provide diagnostics and self-assistance services based on observation. However, precise data predictions and computational models are critical for these systems to perform their jobs effectively. Traditionally, healthcare monitoring has been the primary emphasis. However, there were a couple of negatives, including the pattern feature generating the method's scalability and reliability, which was tested with different data sources. This paper delves into the Discriminant Input Processing Scheme (DIPS), a crucial instrument for resolving challenges. Data-segmentation-based complex processing techniques allow DIPS to merge many emotion analysis streams. The DIPS recommendation engine uses segmented data characteristics to sift through inputs from the emotion stream for patterns. The recommendation is more accurate and flexible since DIPS uses transfer learning to identify similar data across different streams. With transfer learning, this study can be sure that the previous recommendations and data properties will be available in future data streams, making the most of them. Data utilization ratio, approximation, accuracy, and false rate are some of the metrics used to assess the effectiveness of the advised approach. Self-assisted intelligent healthcare systems that use emotion-based analysis and state-of-the-art technology are crucial when managing healthcare. This study improves healthcare management's accuracy and efficiency using computational models like DIPS to guarantee accurate data forecasts and recommendations.

Neural underpinnings of individual differences in emotion regulation: A systematic review

This review synthesises individual differences in neural processes related to emotion regulation (ER). It comprises individual differences in self-reported and physiological regulation success, self-reported ER-related traits, and demographic variables, to assess their correlation with brain activation during ER tasks. Considering region-of-interest (ROI) and whole-brain analyses, the review incorporated data from 52 functional magnetic resonance imaging studies. Results can be summarized as follows: (1) Self-reported regulation success (assessed by emotional state ratings after regulation) and self-reported ER-related traits (assessed by questionnaires) correlated with brain activity in the lateral prefrontal cortex. (2) Amygdala activation correlated with ER-related traits only in ROI analyses, while it was associated with regulation success in whole-brain analyses. (3) For demographic and physiological measures, there was no systematic overlap in effects reported across studies. In showing that individual differences in regulation success and ER-related traits can be traced back to differences in the neural activity of brain regions associated with emotional reactivity (amygdala) and cognitive control (lateral prefrontal cortex), our findings can inform prospective personalised intervention models.

Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18-64 years

INTRODUCTION

Individuals with chronic pain often receive prescription opioid medication, and they may use cannabis to treat pain as well, although the risks of cannabis-opioid co-use are significant. This study aimed to investigate whether two transdiagnostic factors, emotion regulation and distress tolerance, had significant indirect effects in the relationship between pain and cannabis use in adults with chronic pain and an opioid prescription.

METHODS

Participants (n = 450; mean age = 38.6 ± 11.09) were recruited using Qualtrics panel service and were 75 % female and 79 % White, non-Hispanic. Participants completed a 30-minute self-report survey capturing three-month cannabis use, the Difficulties in Emotional Regulation Scale (DERS), and the Distress Tolerance Scale (DTS). The Graded Pain Scale (GCPS) assessed pain severity/intensity and disability. Analyses used the SPSS PROCESS macro, with both single (i.e., one transdiagnostic factor) and parallel indirect effects (i.e., both the DERS and DTS) examined.

RESULTS

There were statistically significant indirect effects for both the DERS and DTS in the relationship between pain intensity or disability and three-month cannabis use in single factor models. In the parallel indirect effect model, only the DERS was statistically significant (intensity indirect effect coefficient = 0.0195 % confidence interval [95 %CI] = 0.0065, 0.390; disability indirect effect coefficient = 0.0147, 95 %CI = 0.0055, 0.0274).

CONCLUSIONS

When examining parallel indirect effects, only emotional regulation and not distress tolerance mediated the relationship between chronic pain and cannabis use among those with an opioid prescription. Clinically, interventions aimed at improving emotional regulation in individuals with chronic pain can help limit cannabis and opioid co-use.

Psychotherapy Works - An Inclusive and Affirming View to a Modern Mental Health Treatment

Psychotherapy is a highly collaborative and individualized mental health practice developed in (post-) modern societies. The mental health outcomes of psychotherapy cover a broad range of psychological factors including the reduction of suffering/symptoms as well as the promotion of well-being, personal values, and personal strengths. There is extensive meta-analytic evidence that legitimate psychotherapy works remarkably well and robustly for most common mental disorders. In addition, there is a large body of meta-analytic evidence supporting the potential relevance of transdiagnostic relationship principles and transtheoretical psychotherapy factors. Based on this ongoing empirical evidence, we propose four relevant implications for future training and practice in transdiagnostic psychotherapy: 1) the development of a transtheoretical legal framework for psychotherapeutic treatments, 2) the formulation of evidence-based transtheoretical interpersonal skills, 3) an orientation toward transtheoretical therapeutic factors, and 4) the exploration of comprehensive psychotherapy outcomes. We conclude with some more general guidance for future directions.

Effectiveness of intensive short-term dynamic psychotherapy for Tension-Type Headache (TTH): A randomized controlled trial of effects on emotion regulation, anger, anxiety, and TTH symptom severity

Research has demonstrated the potential efficacy of intensive short-term dynamic psychotherapy (ISTDP) in addressing medically unexplained symptoms (MUS). However, the specific application of ISTDP for tension-type headache (TTH), a prevalent and common MUS, has not been extensively studied. In light of this gap in the literature, the current study investigated the effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in treating TTH. The study assessed ISTDP's impact on emotion regulation (ER) capacities, levels of anxiety and anger, and TTH symptoms. 30 patients from the neurology clinic at Hazrat Rasool Hospital in Tehran were randomly assigned to either the intervention (n = 15) or control (n = 15) group. Pre- and post-treatment evaluations were conducted, followed by a ten-week follow-up assessment. Data were analyzed using repeated measures analyses of variance. The results indicated that ISTDP led to significant improvements in ER, reductions in anxiety and anger levels, and a significant decrease in TTH symptoms (ps < 0.001). Findings underscore the effectiveness of ISTDP as a valuable therapeutic approach for addressing TTH.

Psychotherapie wirkt

Psychotherapie ist eine kooperative und individualisierte Behandlung zur Förderung der psychischen Gesundheit, die sich in (post-)modernen Gesellschaften weiterentwickelt. Psychotherapieerfolg umfasst ein breites Spektrum von Kriterien, wie beispielsweise die Verringerung von symptombezogenem Leidensdruck sowie die Förderung von Wohlbefinden, persönlichen Werten, Stärken und psychosozialer Partizipation. Es liegen umfangreiche metaanalytische Belege dafür vor, dass Psychotherapie bei den häufigsten psychischen Störungen und deren Komorbidität bemerkenswert gut und stabil wirkt. Darüber hinaus gibt es eine Vielzahl metaanalytischer Belege für die potenzielle Relevanz transtheoretischer Beziehungs- und Wirkprinzipien. Ausgehend von der Darstellung des sich kontinuierlich entwickelnden evidenzbasierten Konsolidierungsprozesses werden im vorliegenden Beitrag Schlussfolgerungen für die zukünftige Aus- und Weiterbildung sowie die Praxis einer transtheoretisch orientierten Psychotherapie gezogen. Der Beitrag schließt mit allgemeineren Hinweisen auf zukünftige Ziele in transtheoretischer Psychotherapie.

Early maladaptive schemas, emotion regulation difficulties and alexithymia: A systematic review and meta-analysis

BACKGROUND

Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia.

METHOD

PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain.

RESULTS

A total of 19 studies published between 2008 and 2022 were included (Pooled N = 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) = .28, 95% CI [.13, .42] to negativity pessimism r(5) = .53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) = .34, 95% CI [.08, .56] to disconnection rejection r(5) = .44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) = .40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) = .21, 95% CI [.12, .28] to emotional inhibition r(5) = .50, 95% CI [.34, .63]).

CONCLUSIONS

The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.