Risk perception as a motivational resource during the COVID-19 pandemic: the role of vaccination status and emerging variants.

BACKGROUND: People's perceived risk of being infected and having severe illness was conceived as a motivational source of adherence to behavioral measures during the COVID-19 crisis. METHODS: We used online self-reported data, spanning 20 months of the COVID-19 crisis in Belgium (n = 221,791; 34.4% vaccinated; July 2020 - March 2022) to study the association between risk perception and motivation. RESULTS: Both perceived infection probability and severity fluctuated across time as a function of the characteristics of emerging variants, with unvaccinated persons perceiving decreasingly less risk compared to vaccinated ones. Perceived severity (and not perceived probability) was the most critical predictor of autonomous motivation for adherence to health-protective measures, a pattern observed at both the between-day and between-person level among both vaccinated and unvaccinated individuals. An integrated process model further indicated that on days with higher hospitalization load, participants reported being more adherent because risk severity and autonomous motivation for adherence were more elevated on these days. CONCLUSIONS: These findings suggest that risk severity served as a critical and dynamic resource for adherence to behavioral measures because it fostered greater autonomous regulation.

The role of self-compassion in loneliness during the COVID-19 pandemic: a group-based trajectory modelling approach.

Research has suggested an increase in loneliness during the COVID-19 pandemic, but much of this work has been cross-sectional, making causal inferences difficult. In the present research, we employed a longitudinal design to identify loneliness trajectories within a period of twelve months during the COVID-19 pandemic in Belgium (N = 2106). We were particularly interested in the potential protective role of self-compassion in these temporal dynamics. Using a group-based trajectory modelling approach, we identified trajectory groups of individuals following low (11.0%), moderate-low (22.4%), moderate (25.7%), moderate-high (31.3%), and high (9.6%) levels of loneliness. Findings indicated that younger people, women, and individuals with poor quality relationships, high levels of health anxiety, and stress related to COVID-19, all had a higher probability of belonging to the highest loneliness trajectory groups. Importantly, we also found that people high in two of the three facets of self-compassion (self-kindness and common humanity) had a lower probability of belonging to the highest loneliness trajectory groups. Ultimately, we demonstrated that trajectory groups reflecting higher levels of loneliness were associated with lower life satisfaction and greater depressive symptoms. We discuss the possibility that increasing self-compassion may be used to promote better mental health in similarly challenging situations.

The Role of Communication Style and External Motivators in Predicting Vaccination Experiences and Intentions: An Experimental Vignette Study.

This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated.

Towards a better integration of emotional factors in autobiographical memory.

While the role of emotion in autobiographical memory (ABM) is acknowledged in some models, its specific effects are blurred by narrow approaches towards emotion that are often limited to a distinction between intensity and valence. After presenting a critical review of the role assigned to emotion for the development of ABM, this paper surveys current perspectives which encourage a broader approach to emotion in the development of ABM. Research on Flashbulb memories provides an important context where the role of emotion has been the most extensively investigated. This paper makes three important recommendations for future research, which are to (1) provide an assessment of emotional responses that includes appraisals, action tendencies, bodily sensations, and emotion intensity; (2) investigate the role of specific emotional states; and (3) adopt systematically a multi-component approach of ABM measurement, which takes accuracy, consistency, vividness, degree of details, and confidence into account.

Prebiotic effect on mood in obese patients is determined by the initial gut microbiota composition: A randomized, controlled trial.

BACKGROUND AND AIMS: Metabolic and behavioural diseases, which are often related to obesity, have been associated to alterations of the gut microbiota considered as an interesting therapeutic target. We have analyzed in a cohort of obese patients treated with prebiotic inulin versus placebo the potential link between gut microbiota changes occurring upon intervention and their effect on psychological parameters (mood and cognition). METHODS: A randomized, single-blinded, multicentric, placebo-controlled trial was conducted in 106 obese patients assigned to two groups: prebiotic versus placebo, who received respectively 16 g/d of native inulin or maltodextrin combined with dietary advice to consume inulin-rich or -poor vegetables for 3 months as well as to restrict caloric intake. Anthropometric measurements, food intake, psychological questionnaires, serum measures, and fecal microbiome sequencing were performed before and after the intervention. RESULTS: Inulin supplementation in obese subjects had moderate beneficial effect on emotional competence and cognitive flexibility. However, an exploratory analysis revealed that some patients exhibiting specific microbial signature -elevated Coprococcus levels at baseline- were more prone to benefit from prebiotic supplementation in terms of mood. Positive responders toward inulin intervention in term of mood also displayed worse metabolic and inflammatory profiles at baseline (increased levels of IL-8, insulin resistance and adiposity). CONCLUSION: This study shows that inulin intake can be helpful to improve mood in obese subjects exhibiting a specific microbial profile. The present work highlights some microbial, metabolic and inflammatory features (IL-8, insulin resistance) which can predict or mediate the beneficial effects of inulin on behaviour in obesity. Food4gut, clinicaltrial.gov: NCT03852069, https://clinicaltrials.gov/ct2/show/NCT03852069.

Consistency and social identification: a test-retest study of flashbulb memories collected on the day of the 2016 Brussels bombings.

Flashbulb memories are consistent and vivid representations of the way people learnt of an important, surprising and consequential event. We had two main aims for this study. Our first aim was to evaluate the consistency of flashbulb memories as accurately as possible (by collecting data on the day and using an interview method at retest) and contrast these findings with other operationalisations such as vividness or confidence but also with event memory. Our second aim was to capitalise on the particular case-study that is Belgium to examine social identification. Within a few hours after the terrorist attacks in Brussels in March 2016, a small sample of students completed a questionnaire on the way they learnt about the event and their knowledge of it. Retest data was obtained fifteen months later, through an in-depth interview. Our results show a relatively high consistency over time as well as high vividness and confidence for their memory of the reception context. We also measured participants' identification at three levels: local (Brussels) - national (Belgium) - supranational (Europe). In the particular context of the Brussels bombings, social identification with Brussels and Europe correlated with measures of flashbulb memory while social identification with Belgium did not.

Cognitive-emotional processing in alexithymia: an integrative review.

Alexithymia is a multifaceted personality construct characterised by difficulties identifying one's feelings and distinguishing them from bodily sensations, difficulties describing one's feelings to others, and an externally oriented cognitive style. Over the past 25 years, a burgeoning body of research has examined how alexithymia moderates processing at the cognition-emotion interface. We review the findings in five domains: attention, appraisals, memory, language, and behaviours. The preponderance of studies linked alexithymia with deficits in emotion processing, which was apparent across all domains, except behaviours. All studies on behaviours and a proportion of studies in other domains demonstrated emotional over-responding. Analysis at the facet level revealed deficits in memory and language that are primarily associated with externally oriented thinking, while over-responding was most often linked to difficulty identifying feelings and difficulty describing feelings. The review also found evidence for contextual modulation: The pattern of deficits and over-responding was not restricted to emotional contexts but also occurred in neutral contexts, and in some circumstances, emotional over-responding in alexithymia was beneficial. Taken together, this review highlights alexithymia as a central personality dimension in the interplay between cognition and emotion.

Having no words for feelings: alexithymia as a fundamental personality dimension at the interface of cognition and emotion.

This special issue brings together two important reviews and seven cutting-edge empirical papers concerning the influence of alexithymia on cognitive and emotional processing. Alexithymia is a multifaceted construct that is characterised by difficulties identifying one's feelings; difficulties describing one's feelings to others; and an externally focused, utilitarian cognitive style. In this paper, we begin by considering how emotion science has evolved in its understanding of personality traits, before highlighting the potential importance of alexithymia research for the field of cognition and emotion. After summarising the historical context of alexithymia research, we consider the contributions of the featured papers to the literature of cognition and emotion. The collected works highlight that alexithymia influences several aspects of how one perceives and responds to neutral and emotional situations, by impacting upon multiple processes (attention, appraisals, memory, language and behaviour), showing the importance of drawing better connections amongst multiple processes, toward disentangling the effects of early processes on later ones. A lack of correspondence between processes, as well as amongst alexithymia facets, is another central finding of the special issue. This pattern is thought to lead to ineffective and inflexible emotion regulation and to pose significant risks for physical and mental illness.

Friend or foe? A qualitative study exploring the relationship of people with obesity and food consumption.

BACKGROUND: Obesity is a major health problem worldwide, and one of its causes is unhealthy eating. A healthy diet should ensure that energy intake (calories) is in balance with energy expenditure, but in this paper a subjective experience of healthy eating will be discussed. Research has revealed many determinants of food consumption, but a more holistic view of food consumption is often overlooked. AIM: The aim was to go beyond identifying determinants of eating by exploring the experience of (healthy) food for people with obesity. METHODS: Semi-structured interviews were conducted with eight patients with obesity. RESULTS: Interpretative phenomenological analysis identified four superordinate themes: ambivalence in the emotional relationship with food, an obesogenic environment where it is less acceptable to society to be obese, an experience of unfairness in the relationship to eating in comparison with other people, and the parental role as an existential motivation to eat healthier. CONCLUSION: The relationship of people with obesity and food is highly complex and personal, and is influenced by the uncontrollability of the social and physical environment. These personal experiences of people with obesity should be taken into account in the psychological treatment of obesity. The current research adds to the mostly motivational determinants discovered with social cognition models, by showing the subjective experience of (healthy) food consumption for people with obesity.

Relative stability of alexithymia and openness to emotions in one psychiatric day hospital setting.

Alexithymia (literally, difficulty finding words for emotions) and openness to emotions (OE: referring to the cognitive representation, communication, regulation, perception of internal and external bodily sensations, and social restriction of emotions) are strongly linked to psychopathology. The absolute and relative stability hypotheses were tested in order to determine whether significant changes occurred on these constructs after therapy, a condition where changes were expected for both constructs. Negative attitudes toward treatment (NTI) and perceived social support (PSS) were expected to significantly predict alexithymia and OE. Patients (N = 179) who participated in this longitudinal study filled in the Toronto Alexithymia Scale, the Dimensions of Openness to Emotions Scale, the NTI subscale, the Multidimensional Scale of Perceived Social Support, and the Social Desirability Scale. After treatment, we observed significant decrease of all alexithymia scores and significant increases of three OE scores, that is, cognitive representation, communication, and regulation of emotions. Regression analyses revealed that gender, age, NTI, and PSS were significant predictors of alexithymia and OE. NTI strongly predicted lower OE levels and higher alexithymia levels, whereas PSS had opposite predicting effects on these constructs. In conclusion, the significant changes, and the moderate to high correlational levels observed between before and after alexithymia and OE scores, strengthen the relative stability hypothesis for both constructs. In addition, PSS represents a protective factor and NTI a vulnerability indicator for therapists. Our aim is to optimize treatment by providing therapists treating emotion difficulties a more concrete array of variables that potentially either promote or subvert recovery.

Schadenfreude, malicious and benign envy are associated with low body mass index in restrictive-type anorexia nervosa.

PURPOSE: According to the Cognitive-Interpersonal Maintenance Model of anorexia nervosa, social factors are involved in the maintenance and development of this disorder. Therefore, this study aimed to test whether patients with restrictive-type anorexia nervosa (AN-R) experience malicious envy (negative emotions associated with the wish that others lack their superior quality), benign envy (negative emotions associated with the desire to reach and obtain the others' superior quality) and Schadenfreude (pleasure at the misfortunes of others) with a higher intensity than healthy controls (HC). METHODS: 26 AN-R patients and 32 HC completed scenarios that aimed to induce envy and Schadenfreude and completed questionnaires measuring envy, self-esteem and social comparison. RESULTS: AN-R patients reported more benign envy than HC. Interestingly, higher body mass index (BMI) was associated with less Schadenfreude, malicious and benign envy in AN-R only. CONCLUSIONS: This study shows that AN-R patients present higher motivation to evolve when facing others' superior quality (i.e., benign envy). It also underlines the importance of considering social factors in the maintenance of AN-R and the role of BMI when examining emotions related to others' fortune. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Does it help to feel your body? Evidence is inconclusive that interoceptive accuracy and sensibility help cope with negative experiences.

In four studies (total N = 534), we examined the moderating impact of Interoceptive Accuracy (i.e. IAcc, as measured with the heartbeat counting task) and Interoceptive Sensibility (IS, assessed via questionnaire) on negative affect, following social exclusion or after receiving negative feedback. Results from an integrative data analysis combining the four studies confirmed that the manipulations were successful at inducing negative affect. However, no significant interaction between mood induction (control versus negative affect induction) and interoception on mood measures was observed, and this was true both for objective (i.e. IAcc) and subjective (i.e. IS) measures of interoception. Hence, previous conclusions on the moderating impact of interoception in the relationship between mood induction and self-reported mood were neither replicated nor generalised to this larger sample. We discuss these findings in light of theories of emotion regulation as well as recent concerns raised about the validity of the heartbeat counting task.

Cognitive factors and post-partum depression: What is the influence of general personality traits, rumination, maternal self-esteem, and alexithymia?

OBJECTIVES: The objective was to assess the impact of cognitive factors on post-partum depression (PPD) symptoms. Because most of the literature data concern the immediate post-partum period or the first year post-partum, we notably sought to assess the longer term impact of cognitive factors on the symptoms of PPD. METHODS: Two studies were performed. In a pilot study, 1-month post-partum, 63 women filled out a sociodemographic information sheet and completed the abbreviated, revised Eysenck Personality Questionnaire, the Ruminative Responses Scale, the Maternal Self-Report Inventory, and the Edinburgh Post-Natal Depression Scale. In the main study, 124 women additionally completed the Toronto Alexithymia Scale. The main study population was divided into 2 subgroups: women in the first year post-partum (n = 74) and those in the second year post-partum (n = 50). RESULTS: In the pilot study performed 1-month post-partum, brooding rumination and low self-esteem were significant predictors of the PPD symptom intensity. Neuroticism, brooding rumination, and low maternal self-esteem were also significant predictors of the PPD symptoms reported in the first year post-partum. Lastly, ruminative thoughts and alexithymia were significant predictors of the PPD symptoms reported in the second year post-partum. CONCLUSIONS: Our results suggest that alexithymia may be an important predictor of the incidence of this condition. The observation of differences in the PPD models as a function of the post-partum period may open up opportunities for developing novel PPD prevention/treatment programs.

Gender Differences in Affects and Craving in Alcohol-Dependence: A Study During Alcohol Detoxification.

BACKGROUND: Alcohol craving is a major cause of relapse in alcohol-dependent (AD) patients. It is closely related to the high depression and anxiety symptoms that are frequently observed at the early stages of abstinence, and these comorbid symptoms might thus constitute a relapse factor when they persist after detoxification. As these negative affects are known to evolve during the detoxification process, the aim of this study was to investigate the course of the relation between affects and craving during detoxification, with a particular attention given to gender in light of the known differences in affects between AD men and women. METHODS: AD patients (n = 256) undergoing a detoxification program were evaluated for positive (PA) and negative affectivity (NA), depression and anxiety symptoms, and craving, twice within a 3-week interval (on the first [T1] and the eighteenth day [T2] of abstinence). RESULTS: Detoxification course was associated with improvements regarding NA, depression and anxiety symptoms, and craving. Moreover, these negative affects were related to craving intensity. However, for men, the relation was only present at the beginning of detoxification, while, for women, it persisted at the end of detoxification as did high levels of depression. Furthermore, only with women was the level of craving at T2 proportional to negative affects reported at T1, and depression symptoms experienced at T1 were reliable predictors of craving at T2. CONCLUSIONS: Given the importance of craving in relapse, special care should be given to improve depressive symptoms in AD women to promote long-term abstinence. Also, the remaining portion of AD women who still exhibit substantial symptoms of anxiety and depression at the end of detoxification could benefit from an integrated treatment simultaneously tackling mood and alcohol-dependence disorders.

A systematic review and meta-analysis of the effectiveness of nudging to increase fruit and vegetable choice.

Background: Nudging refers to interventions that organize the choice architecture in order to alter people's behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. As a strategy to encourage healthy behaviour, nudging can serve as a complement to health education. However, the empirical evidence regarding the effectiveness of nudging as a way to influence food choice remains contradictory. To address this issue, a systematic review and meta-analysis was conducted to test the effects of nudging to encourage people to select more fruit and vegetables. Methods: A systematic literature search was performed on PubMed, Medline, PsycInfo, Cochrane library, Scopus and Google Scholar. After quality assessment, 20 articles (23 studies) were retained for narrative synthesis. Twelve articles (14 studies) contained enough information to calculate effect-sizes for meta-analysis using Comprehensive Meta-analysis software. Results: The meta-analysis shows that nudging interventions that aim to increase fruit and/or vegetable choice/sales/servings have a moderately significant effect (d = 0.30), with the largest effect for altering placement (d = 0.39) and combined nudges (d = 0.28). Conclusion: The results of this review provide an indication of the effectiveness of nudging on fruit and vegetable choice in terms of actual effect-sizes, while also highlighting the problems that must be addressed before more definitive conclusions can be drawn.

Principled Disagreements: Adhesion to Intergroup Justice Standards in the Context of the Belgian Linguistic Conflict.

According to the "Waffle" model of the Belgian Linguistic Conflict (Klein et al., 2012), this conflict centres around two main dimensions: One concerns the use of language across the territory and the second concerns the distribution of resources between the two main linguistic communities, Dutch-speakers and French-speakers. The model suggests that the two groups adhere to different justice principles regarding these issues and that these disagreements are a function of the intensity of the conflict. With respect to the first dimension, Dutch-speakers are expected to adhere more to a principle of linguistic territoriality than French-speakers who should be more in favor of a free choice of one's idiom across the territory. With respect to the second dimension, the model posits that Dutch-speakers will adhere more to an equity principle whereas French-speakers should adhere more to a need principle. We tested these hypotheses in the context of a large-scale survey involving two waves: in May 2011 in the middle of a political crisis, and in June 2014, when the conflict was appeased. The pattern of "disagreements" in a subsample that participated in both waves of the survey (N = 378) is consistent with the Waffle model and, as expected, more severe at the heart of the conflict (in 2011) than after pacification (in 2014). However, differences were driven mostly by supporters of the Flemish nationalist party N-VA. Moreover, endorsement of principles on both dimensions are predictive of separatist attitudes in the Dutch-speaking sample whereas only the first dimension plays a role for the French speaking sample.

Emotion Regulation in Alcohol Dependence.

BACKGROUND: The main aim of this study was to investigate, in alcohol-dependent (AD) patients, the use of the 5 emotion regulation strategies specified in Gross's (1998, Rev Gen Psychol, 2, 271) process model of emotion regulation with the use of a semi-structured interview allowing a detailed and high-quality assessment of emotion regulation strategies. A secondary aim was to examine the possible influence of protracted abstinence and detoxification on emotion dysregulation. Finally, the association between the level of craving and the types of regulation strategies was investigated. METHODS: Forty-four treatment-seeking AD patients with varying time spent in rehabilitation, and 26 healthy controls were interviewed using a version of the Emotion Regulation Interview (Werner et al., 2011, J Psychopathol Behav Assess, 33, 346) adapted to alcohol dependence. RESULTS: Compared to controls, AD patients reported significantly greater use of response modulation and attentional deployment, but lesser use of cognitive change. Among patients, (1) rehabilitation duration was positively correlated with the use of cognitive change and (2) the use of response modulation was positively associated with the level of craving. CONCLUSIONS: These findings clarify the specific pattern of emotion dysregulation associated with alcohol dependence. They also suggest that (1) abstinence is associated with a shift toward more adaptive emotion regulation patterns and that (2) inefficient regulation strategies may lead to craving and the maintenance of alcohol use. If these findings are confirmed through longitudinal and mediation designs, they will have important clinical implications.

Evidence of Contrasting Patterns for Suppression and Reappraisal Emotion Regulation Strategies in Alexithymia.

Alexithymia generally refers to difficulties in identifying and describing emotions. In this paper, two studies explored whether the emotion deficits observed in alexithymia may be related to the use of emotion regulation strategies. Relations with various sociodemographic variables were also explored. In the first study, 255 students completed the Emotion Regulation Questionnaire (ERQ) and the Toronto Alexithymia Scale-20. For the second study, 1107 participants from the general population completed the ERQ and the Bermond-Vorst Alexithymia Questionnaire. Results demonstrated that alexithymia was related to the use of a suppression strategy and in particular to difficulties verbalizing emotions, suggesting that the capacity to communicate and name one's emotion is a central aspect in alexithymia. Concerning sociodemographic variables, alexithymia and the use of a suppression strategy were found to be related to age and to be higher in males. The results of these studies and their clinical implications for treatment are discussed.

Alexithymia impairs the cognitive control of negative material while facilitating the recall of neutral material in both younger and older adults.

We investigated the moderating impact of the personality construct alexithymia on the ability of younger and older adults to control the recall of negative and neutral material. We conducted two experiments using the directed forgetting paradigm with younger and older adults. Participants studied negative (Experiment 1) or neutral (Experiment 2) words. Participants were instructed to forget the first half and remember the second half of an entire list of words. Overall, we found that alexithymia impairs the ability of both younger and older adults to cognitively control negative material (through both recall and inhibition). The "externally oriented thinking" factor of alexithymia appears to play a particularly pertinent role in terms of inhibiting negative material. Furthermore, older adults recalled fewer sought after negative items, but this was not evident in terms of inhibition. In contrast, only age (older adults) negatively impacted the recall of sought after neutral items. Interestingly, alexithymia had the opposite effect: the "difficulty in identifying emotions" factor of alexithymia was associated with an increased recall of neutral items. We discuss these results in terms of alexithymia and its impact on cognitive control.

Stress, Psychosocial Mediators, and Cognitive Mediators in Parents of Child Cancer Patients and Cancer Survivors: Attention and Working Memory Pathway Perspectives.

OBJECTIVE: This review examines stress and its consequences on attention and working memory, stress symptoms in parents of child cancer patients and survivors and long-term consequences of stress on cognitive processing in parents of child cancer survivors. METHOD: Eligible studies were experimental, meta-analyses, and qualitative (2000-2013) from Pubmed, Medline, the Cochrane Library, PsycArticles, and Google Scholar. RESULTS: We identified 92 eligible papers. They showed that elevated stress can impede performances on tasks requiring attention and memory patterns. In pediatric oncology, parental stress increased shortly after diagnosis involving depression and anxiety. Consequences of stress on cognitive performances were observed mainly among depressed individuals. As regards parents of child cancer survivors, female gender, low Socioeconomic Status (SES), and innate traits of anxiety/anger predicted the development of PTSS. CONCLUSION: Evidence of stress on attention and working memory processes in parents of child cancer survivors is insufficiently developed.