The role of trait reappraisal in response to emotional ambiguity: A systematic review and meta-analysis

Individuals exhibit a systematic valence bias-a specific form of interpretation bias-in response to emotional ambiguity. Accumulating evidence suggests most people initially respond to emotional ambiguity negatively and differ only in subsequent responses. We hypothesized that trait-level cognitive reappraisal-an emotion regulation strategy involving the reinterpretation of affective meaning of stimuli-might explain individual differences in valence bias. To answer this question, we conducted a random-effects meta-analysis of 14 effect sizes from 13 prior studies (n = 2,086), identified via Google Scholar searches. We excluded studies (a) in languages other than English, (b) from non-peer-reviewed sources, or (c) nonempirical sources. We included studies with (a) the Emotion Regulation Questionnaire, (b) a putative measure of valence bias prior to any study-specific manipulations, and (c) adult human participants (i.e., 17+). Supporting our prediction, we found individuals with higher trait reappraisal exhibited a less negative bias (r = -.18, z = -4.04, p < .001), whereas there was a smaller, opposite effect for trait expressive suppression (r = .10, z = 2.14, p = .03). The effects did, however, vary across tasks with stronger effects observed among studies using the scrambled sentences task compared to the valence bias task. Although trait reappraisal accounted for only a small amount of variance, reappraisal may be one mechanism contributing to variability in response to ambiguity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations between prenatal loss of control eating and cardiovascular health during pregnancy

OBJECTIVE

Loss of control (LOC) eating (feeling unable to control food type/amount eaten) during pregnancy is common and linked to risk for poor cardiovascular health (CVH), but it is unclear whether prenatal LOC eating directly relates to CVH during pregnancy. The current study tested associations between prenatal LOC eating and CVH during pregnancy in a sample with prepregnancy body mass index (BMI) ≥ 25.

METHOD

At 12-20 weeks' gestation, participants (N = 124) self-reported: prenatal LOC eating, diet, physical activity, nicotine use, sleep; height/weight were measured. Data were collected during 2015-2017. We dichotomized LOC eating (0 = absent; 1 = present) and scored CVH metrics using Life's Essential 8 to create a composite CVH score (range = 0-100; higher = better). Linear and binary logistic regression models tested if LOC eating is related to composite CVH score and odds of scoring low (0)/moderate-high (1) on each CVH metric, respectively. All models employed propensity score adjustment, since those with/without LOC eating may differ in ways affecting CVH, and covaried for: age, gestational age, prepregnancy BMI, ethnicity, race, education, and income.

RESULTS

Compared to those without, participants with LOC eating had significantly poorer composite CVH scores (b = -9.27, t(111) = -2.70, p < .01) and lower odds of scoring moderate-high on nicotine use (OR = 0.20, 95% CI [0.04, 0.85], p = .03) and sleep duration (OR = 0.19, 95% CI [0.04, 0.83], p = .03) CVH metrics.

CONCLUSIONS

Prenatal LOC eating was associated with poorer CVH during pregnancy in this sample with prepregnancy BMI ≥ 25, even after controlling for propensity of experiencing LOC eating and known risk factors for poor CVH. Thus, prenatal LOC may represent a modifiable factor related to prenatal health risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exposure to community violence as a mechanism linking neighborhood disadvantage to amygdala reactivity and the protective role of parental nurturance

Emerging literature links neighborhood disadvantage to altered neural function in regions supporting socioemotional and threat processing. Few studies, however, have examined the proximal mechanisms through which neighborhood disadvantage is associated with neural functioning. In a sample of 7- to 19-year-old twins recruited from disadvantaged neighborhoods (354 families, 708 twins; 54.5% boys; 78.5% White, 13.0% Black, 8.5% other racial/ethnic group membership), we found that exposure to community violence was related to increased amygdala reactivity during socioemotional processing and may be one mechanism linking neighborhood disadvantage to amygdala functioning. Importantly, parenting behavior appeared to modulate these effects, such that high parental nurturance buffered the effect of exposure to community violence on amygdala reactivity. These findings elucidate the potential impact of exposure to community violence on brain function and highlight the role parents can play in protecting youth from the neural effects of exposure to adversity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A qualitative exploration of minority stress, mental health, and sexual health among Arab immigrant sexual minority men in the United States

OBJECTIVES

To examine experiences of immigration, sexual minority stressors, and mental health and sexual health among first-generation (born outside of the United States) Arab immigrant sexual minority men (SMM) in the United States.

METHOD

We conducted in-depth one-on-one virtual interviews with 16 cisgender men residing in different U.S. states. Interview transcripts were analyzed using thematic analysis to identify the most salient themes and relationships among them.

RESULTS

The experiences of Arab immigrant SMM centered around five themes: "my whole plan was to come to the U.S. to be open to who I am," "not fitting in" (homophobia, racism, sexual racism, xenophobia), "a lot of impact on my mental health," sexual health (inconsistent condom use, multiple sexual partners, preexposure prophylaxis use, testing), and coping strategies.

CONCLUSIONS

Participants reported multiple forms of stressors related to their intersectional identities that affected their mental health, sexual health, and coping strategies. Many stressors were experienced before immigrating to the United States; however, several stressors persisted, and some new ones emerged after immigration. Results call for the development of mental health interventions informed by the unique experiences of Arab immigrant SMM and integrated within community-based organizations to foster adaptive coping strategies, social support, and community belonging. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Proposing a model whereby negative valence bias increases the risk for more severe dysphoric posttraumatic stress disorder and depression symptomology

Experiencing trauma increases risk for posttraumatic stress disorder (PTSD) and depression, and individuals who experience psychopathology after a traumatic event often experience symptoms from both disorders. Because a tendency to view events in a more negative light and a propensity toward threat appraisals are risk factors for both PTSD and depression, negative valence bias-a tendency to appraise emotional ambiguity as having a more negative (less positive) meaning-may be a transdiagnostic risk factor. In other words, we expect individuals with a negative valence bias experience greater PTSD and depression symptoms. We measured valence bias and self-reported PTSD and depression symptoms in a sample of college students in 2021 (n = 287; 72.5% reported experiencing trauma). Although valence bias was not associated with PTSD symptoms as a whole, we found in our exploratory model that more negative bias was associated with greater dysphoria-related PTSD symptoms and greater depression symptoms (indirect effect p = .03). Thus, we propose a model whereby a more negative valence bias contributes to increased susceptibility for maladaptive stress responses, which may be associated with greater likelihood of symptoms of dysphoria-related PTSD and depression. These findings suggest that valence bias represents a transdiagnostic affective risk factor, warranting future research examining the impacts of bias-altering interventions (e.g., mindfulness-based treatments) as a means for managing symptoms in individuals with heightened dysphoria-related PTSD and/or depression symptoms. Additionally, in post hoc analyses it emerged that Latinx participants displayed a more negative valence bias, indicating the need for more research in diverse samples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The role of memory in counterfactual valuation

Value-based decisions are often guided by past experience. If a choice led to a good outcome, we are more likely to repeat it. This basic idea is well-captured by reinforcement-learning models. However, open questions remain about how we assign value to options we did not choose and which we therefore never had the chance to learn about directly. One solution to this problem is proposed by policy gradient reinforcement-learning models; these do not require direct learning of value, instead optimizing choices according to a behavioral policy. For example, a logistic policy predicts that if a chosen option was rewarded, the unchosen option would be deemed less desirable. Here, we test the relevance of these models to human behavior and explore the role of memory in this phenomenon. We hypothesize that a policy may emerge from an associative memory trace formed during deliberation between choice options. In a preregistered study (n = 315) we show that people tend to invert the value of unchosen options relative to the outcome of chosen options, a phenomenon we term inverse decision bias. The inverse decision bias is correlated with memory for the association between choice options; moreover, it is reduced when memory formation is experimentally interfered with. Finally, we present a new memory-based policy gradient model that predicts both the inverse decision bias and its dependence on memory. Our findings point to a significant role of associative memory in valuation of unchosen options and introduce a new perspective on the interaction between decision-making, memory, and counterfactual reasoning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prefrontal and medial temporal interactions in memory functions in the rhesus monkey

Both the medial temporal lobe and the dorsolateral prefrontal cortex have been implicated in learning and memory. However, it has been difficult to ascertain the degree to which the two structures are dependent on each other or interact in subserving these cognitive functions. To investigate this question directly, we prepared two group of monkeys. First, the contralateral frontal-hippocampal split group (CFHS) received a unilateral lesion of the hippocampus and surrounding posterior parahippocampal cortices (H +), combined with a contralateral lesion of the dorsolateral prefrontal cortex (DLPFC) plus transection of the corpus callosum and anterior commissure. This preparation functionally "disconnects" the remaining intact H + from the sole intact DLPFC in the opposite hemisphere. As a surgical control group, a second set of animals, the ipsilateral frontal-hippocampal split group, was prepared with a unilateral lesion of the DLPFC and an ipsilateral H + lesion together plus transection of the corpus callosum and anterior commissure. This preparation matches the locus and extent of damage in the cross-lesion group but allows the intact H + and intact DLPFC to interact ipsilaterally. Following recovery from surgery, all animals were then tested on the delayed nonmatching to sample task (DNMS), a test of recognition memory. The crossed-lesion split-brain group (CFHS) was markedly impaired on DNMS in both acquisition (rule learning) and performance over delays (recognition memory). The results provide evidence of a functionally dependent interaction between the medial temporal lobe and the dorsolateral prefrontal cortex in learning and memory. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Caregiver support buffers posttraumatic stress disorder symptoms following a natural disaster in relation to binge drinking

OBJECTIVE

We investigate if posttraumatic stress disorder (PTSD) symptoms mediate the effects of disaster severity or prior trauma on binge drinking following disaster exposure and test if support from caregiver moderates the relation between disaster severity and PTSD symptoms as well as prior trauma and PTSD symptoms.

METHOD

A population-based clinical trial used address-based sampling to enroll 1,804 adolescents and parents from communities affected by tornadoes in Missouri and Alabama. Data collection via baseline (averaging 8 months postdisaster), 4-month postbaseline, and 12-month postbaseline semistructured telephone interviews was completed between September 2011 and August 2013. Longitudinal analyses, testing the indirect effects of disaster severity and prior traumatic events on alcohol use through PTSD symptoms, as potentially moderated by support from caregiver, were conducted.

RESULTS

PTSD symptoms mediated the effect of prior trauma, but not disaster severity, on binge drinking. Specifically, those with more prior traumas reported more PTSD symptoms, which in turn increased risk for binge drinking. Support from caregiver moderated the effect of disaster severity, but not prior trauma, on PTSD symptoms. Specifically, the effect of disaster severity on PTSD symptoms was significant for adolescents with average or below-average caregiver support.

CONCLUSION

Findings suggest that PTSD symptomatology is one mechanism by which prior trauma can impact binge drinking among adolescents following exposure to a natural disaster. Caregiver support can serve as a buffer for reducing PTSD symptomatology related to the severity of a natural disaster, which can decrease the likelihood of adolescent binge drinking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Which adolescents are well-suited to app-based mindfulness training? A randomized clinical trial and data-driven approach for personalized recommendations

OBJECTIVE

Rumination heightens risk for depression and anxiety, which increase substantially during adolescence. Smartphone apps offer a convenient and cost-effective means for adolescents to access mindfulness training, which may reduce rumination. Despite their increasing popularity, it is unclear which adolescents benefit from mindfulness apps.

METHOD

Adolescents (n = 152) with elevated trait rumination were randomly assigned to 3 weeks of app-based mindfulness training or a mood-monitoring control. Multilevel models tested group differences in state rumination change, assessed via ecological momentary assessment. Baseline adolescent characteristics were submitted to elastic net regularization models to develop a "Personalized Advantage Index" indicating an individual's expected outcome from the mindfulness app relative to the mood-monitoring control. Finally, we translated a predictive model (developed in an external sample) for personalized recommendations of expected benefit from the mindfulness app.

RESULTS

Adolescents in the mindfulness app condition reported significantly greater reductions in rumination than adolescents in the control condition. Individuals predicted to have better outcomes from the mindfulness app relative to mood monitoring had significantly greater reductions in rumination if randomly assigned to the mindfulness condition. In contrast, between-condition differences in outcome were not significant for adolescents predicted to have better outcomes in the mood-monitoring condition.

CONCLUSIONS

Findings support the efficacy of a mindfulness app to reduce state rumination in adolescents, particularly among adolescents high in trait rumination. A predictive model is put forth, which could be used to objectively communicate expected mindfulness app outcomes to adolescents prior to engagement in app-based mindfulness training. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Whiteness pandemic behind the racism pandemic: Familial Whiteness socialization in Minneapolis following #GeorgeFloyd's murder

Family socialization into the centuries-old culture of Whiteness-involving colorblindness, passivity, and fragility-perpetrates and perpetuates U.S. racism, reflecting an insidious Whiteness pandemic. As a poignant case study, this mixed methods study examined Whiteness socialization among White mothers (N = 392, M = 37.99 years, SD = 4.34) in Minneapolis, Minnesota in the month following the May 2020 police killing of unarmed Black resident, George Floyd. Using Helms' (1984, 2017) White racial identity development theory (WRID), content analyses of qualitative responses classified participants into lower versus higher levels of WRID, after which thematic analyses compared their Whiteness socialization beliefs/values, attitudes, practices, and emotions, and analyses of variance compared their demographics, multiculturalism, and psychological distress. There was strong convergence across qualitative and quantitative findings and results aligned with the WRID model. Racially silent participants (i.e., no mention of Floyd's murder or subsequent events on open-ended questions: 53%) had lower multiculturalism scores and lower psychological distress. Among mothers who were racially responsive (i.e., mentioned Floyd's murder or subsequent events: 47%), those with more advanced WRID (17%) had higher multiculturalism scores; lower ethnic group protectiveness scores; a more effective coping style featuring empathy, moral outrage, and hope; more color- and power-conscious socialization beliefs/values; and more purposeful racial socialization practices than their less advanced peers (30%). Collectively, color-evasion and power-evasion-pathogens of the Whiteness pandemic-are inexorably transmitted within families, with White parents serving as carriers to their children unless they take active preventive measures rooted in antiracism and equity-promotion. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Family resilience and psychological distress in the COVID-19 pandemic: A mixed methods study

Many changes were thrust upon families by the COVID-19 pandemic, including mandated quarantines, social distancing, transitions to distance learning for children, and remote work. The current study used mixed methods to examine the challenges and resilience of families in the United States during the pandemic (May-July 2020), as well as predictors and moderators of parent/child psychological distress. Our sample included 469 parents (459 mothers) of children aged ∼2-13 years (239 girls, 228 boys, one nonbinary child, one "prefer not to answer" selection), who completed an online survey with closed-ended and open-ended portions. The sample had middle-to-high socioeconomic status and 86% of families were White/non-Hispanic. Qualitative (content and thematic analyses) and quantitative (descriptive statistics and regressions) findings revealed that, even in this relatively privileged sample, parents and families were experiencing struggles in many life domains (e.g., family, school) and shifts in family dynamics and routines, which were related to emotional and mental health. Families experienced many changes in their lives, some positive and some negative, and often exhibited resilience through managing these changes. Our moderation analyses indicated that COVID-19's daily impact was significantly associated with psychological distress for children and parents, and this association was stronger for older versus younger children. Less active/instructive parental media mediation was also related to less child psychological distress. Moving forward, practitioners can focus on preventive efforts including psychoeducation regarding healthy outlets for negative emotions during COVID-19, and practical help troubleshooting childcare and health care challenges impacting many families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sleep in a pandemic: Implications of COVID-19 for sleep through the lens of the 3P model of insomnia

The coronavirus disease 2019 (COVID-19) pandemic has fundamentally altered daily life across the globe, and the stress associated with these changes is likely to impact sleep. Sleep is critical for physical and mental health; thus, understanding the factors that may contribute to poor sleep during the pandemic represents a first step in identifying behavioral health targets for intervention efforts during and after the pandemic. This review first summarizes the developing research on sleep during the pandemic. The impact of the pandemic on sleep is then examined through the lens of the 3P model of insomnia by proposing pandemic-specific predisposing, precipitating, and perpetuating factors. The potential consequences of sleep disturbance on physical and mental health conditions most relevant to the pandemic are also reviewed. Finally, recommendations for reducing or eliminating pandemic-specific perpetuating factors are detailed, highlighting the potential utility of behavioral sleep medicine interventions in the integration of behavioral health responses and public health initiatives during and after the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Symptoms as rapidly fluctuating over time: Revealing the close psychological interconnections among borderline personality disorder symptoms via within-person structures

Despite the clinical emphasis on processes happening within individuals, investigations into the psychological, structural connections between mental health symptoms have almost exclusively analyzed differences between people. These investigations have revealed important findings; however, they do not reveal the close connections among symptoms in an individuals' psychology. This study thus examined the psychological connections between symptoms directly, using borderline personality disorder (BPD) symptoms as an example. Participants (252; 74 with BPD) reported their momentary BPD symptoms five times daily, and 165 did so again 18 months later. In support of personalized medicine (Wright & Woods, 2020), individuals' BPD symptom structures differed considerably from each other and from the between-person structure. A novel technique revealed that differences were greater than expected by chance. Within-person structures tended to exhibit more symptom granularity (more factors and lower variance explained) and differing symptom meanings (patterns of loadings). For example, some individuals exhibited close connections between relationship turmoil and identity uncertainty, whereas other individuals exhibited close connections between relationship turmoil and impulsivity. Thus, conceptions of any given person's psychopathological processes using between-person structural findings will most likely be inaccurate. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Retrosplenial cortex damage impairs unimodal sensory preconditioning

The retrosplenial cortex (RSC) is positioned at the interface between cortical sensory regions and the structures that compose the medial temporal lobe memory system. It has recently been suggested that 1 functional role of the RSC involves the formation of associations between cues in the environment (stimulus-stimulus [S-S] learning; Bucci & Robinson, 2014). This suggestion is based, in part, on the finding that lesions or temporary inactivation of the RSC impair sensory preconditioning. However, all prior studies examining the role of the RSC in sensory preconditioning have used cues from multiple modalities (both visual and auditory stimuli). The purpose of the present experiment was to determine whether the RSC contributes to unimodal sensory preconditioning. In the present study we found that both electrolytic and neurotoxic lesions of the RSC impaired sensory preconditioning with auditory cues. Together with previous experiments, these findings indicate that the RSC contributes to both multisensory and unimodal sensory integration, which suggests a general role for the RSC in linking sensory cues in the environment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Modeling the suicidal behavior cycle: Understanding repeated suicide attempts among individuals with borderline personality disorder and a history of attempting suicide

OBJECTIVE

Suicide remains a leading cause of death in the United States, and recent reports have suggested the suicide rate is increasing. One of the most robust predictors of future suicidal behavior is a history of attempting suicide. Despite this, little is known about the factors that reduce the likelihood of reattempting suicide. This study compares theoretically derived suicide risk indicators to determine which factors are most predictive of future suicide attempts.

METHOD

We used data from a randomized, controlled trial comparing 3 forms of dialectical behavior therapy (DBT; Linehan et al., 2015). Participants (N = 97, mean age = 30.3 years, 100% female, 71% White) met criteria for borderline personality disorder and had repeated and recent self-injurious behavior. Assessments occurred at 4-month intervals throughout 1 year of treatment and 1 year of follow-up. Time-lagged generalized linear mixed models (GLMMs) were used to evaluate relationship satisfaction, emotion dysregulation, and coping styles as predictors of suicide attempts.

RESULTS

Both univariate and multivariate models suggested that higher between-person variance in problem-focused coping and lack of access to emotion regulation strategies were weakly associated with additional suicide attempts over the 2-year study. Within-person variance in the time-lagged predictors was not associated with subsequent suicide attempts.

CONCLUSIONS

Among individuals with a recent suicide attempt, problem-focused coping and specific deficits in emotion regulation may differentiate those likely to reattempt from those who stop suicidal behavior during and after psychotherapy. These results suggest that treatments for recent suicide attempters should target increasing problem-focused coping and decreasing maladaptive emotion regulation skills. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Implementing CommonGround in a community mental health center: Lessons in a computerized decision support system

OBJECTIVE

Although shared decision making (SDM) is a key element of client-centered care, it has not been widely adopted. Accordingly, interventions have been developed to promote SDM. The aim of this study was to explore the implementation process of one SDM intervention, CommonGround, which utilizes peer specialists and a computerized decision support center to promote SDM.

METHOD

As part of a larger study, CommonGround was implemented in 4 treatment teams in a community mental health center. The implementation process was examined by conducting semistructured interviews with 12 staff members that were integral to the CommonGround implementation. Responses were analyzed using content analysis. Program fidelity and client program use were also examined.

RESULTS

Although key informants identified several client and staff benefits to using CommonGround, including improved treatment engagement and availability of peer specialists, most clients did not use CommonGround consistently throughout the implementation. Key informants and fidelity reports indicated a number of program (e.g., technological difficulties, increased staff burden) and contextual barriers (e.g., poor fit with service structure, decision support center location, low staff investment and high turnover) to the successful implementation of CommonGround. Strategies to maximize the implementation by increasing awareness, buy-in, and utilization are also reported.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

This implementation of CommonGround was limited in its success partly as a result of program and contextual barriers. Future implementations may benefit from incorporating the strategies identified to maximize implementation in order to obtain the full program benefits. (PsycINFO Database Record

Test-retest reliability of the facial expression labeling task

Recognizing others' emotional expressions is vital for socioemotional development; impairments in this ability occur in several psychiatric disorders. Further study is needed to map the development of this ability and to evaluate its components as potential transdiagnostic endophenotypes. Before doing so, however, research is required to substantiate the test-retest reliability of scores of the face emotion identification tasks linked to developmental psychopathology. The current study estimated test-retest reliability of scores of one such task, the facial expression labeling task (FELT) among a sample of twin children (N = 157; ages 9-14). Participants completed the FELT at two visits two to five weeks apart. Participants discerned the emotion presented of faces depicting six emotions (i.e., happiness, anger, sadness, fear, surprise, and disgust) morphed with a neutral face to provide 10 levels of increasing emotional expressivity. The present study found strong test-retest reliability (Pearson r) of the FELT scores across all emotions. Results suggested that data from this task may be effectively analyzed using a latent growth curve model to estimate overall ability (i.e., intercept; r's = 0.76-0.85) and improvement as emotions become clearer (i.e., linear slope; r's = 0.69-0.83). Evidence of high test-retest reliability of this task's scores informs future developmental research and the potential identification of transdiagnostic endophenotypes for child psychopathology. (PsycINFO Database Record

Stakeholder perspectives on a toolkit to enhance caregiver participation in community-based child mental health services

Client engagement in services is a critical element of effective community-based child and family mental health service delivery. Caregiver engagement is particularly important, as caregivers often serve as gatekeepers to child mental health care and typically must consent for services, facilitate service attendance, and are often the target of intervention themselves. Unfortunately, caregiver engagement has been identified as a significant challenge in community-based child mental health services. To address this gap, the Parent And Caregiver Active Participation Toolkit (PACT), which includes therapist training and participation tools for caregivers and therapists, was developed. Stakeholders' perspectives regarding the delivery of interventions designed to improve the quality and effectiveness of community-based care are essential to understanding the implementation of such interventions in routine service settings. As such, this mixed methods study examined the perspectives of 12 therapists, 8 caregivers, and 6 program managers who participated in a community-based randomized pilot study of PACT. Therapists, caregivers, and program managers agreed that PACT was acceptable, appropriate, and feasible to use in community settings and that both changes in therapist practices and caregiver participation resulted from implementing PACT. Some variable perceptions in the utility of the therapist training components were identified, as well as barriers and facilitators of PACT implementation. Results expand the parent pilot study's findings as well as complement and expand the literature on training community providers in evidence-based practices. (PsycINFO Database Record