Measures of emotion regulation: Convergence and psychometric properties of the difficulties in emotion regulation scale and emotion regulation questionnaire.

OBJECTIVE: Investigating unique and shared aspects of measures of emotion regulation (ER) advances our understanding of ER as a multidimensional construct. This study aimed to investigate psychometric properties of three ER-measures: Difficulties in Emotion Regulation Scale (DERS-36), the abbreviated version DERS-16, and Emotion Regulation Questionnaire (ERQ). METHODS: In a community sample (N = 843; 56% females) we investigated their internal consistency, factor structure, convergence, and association with symptoms of depression, anxiety, stress and substance abuse. RESULTS: The proposed factor structures of the DERS-16 and the ERQ demonstrated an adequate fit. There were moderate correlations between the two DERS versions (36 and 16) and ERQ subscales Reappraisal and Suppression. Total scores of DERS-36 and DERS-16 demonstrated preferential associations with depression and anxiety. Corresponding associations between ERQ subscales and psychiatric symptoms were weak. CONCLUSION: The results indicate that DERS-16 could be useful as an alternative, easily administered measure of ER difficulties.

Emotion dysregulation across levels of substance use.

Emotion dysregulation has shown to be of importance in the onset and maintenance of psychiatric disorders, including substance use disorders. How difficulties in emotion regulation differ across levels of substance use, and whether these relations are influenced by co-occurring psychiatric disorders, is less clear. This study aimed to identify difficulties in emotion regulation across the spectrum of substance use and evaluate the influence of co-occurring psychiatric symptoms. Self-reported emotion regulation difficulties, substance use, and other psychiatric symptoms were assessed in one community sample (n = 843) and two inpatient clinics, with substance use disorder populations (n = 415). Data were merged and analyzed with regression models and correlations. Emotion dysregulation was distributed across different levels of substance use, and significantly associated with substance use severity and frequency. High substance use severity and frequency was significantly associated with high scores on the emotion dysregulation facet specifically involving difficulties controlling impulsive behaviors. Psychiatric symptoms did not significantly influence the association between substance use and emotion dysregulation. Results indicate an association between emotion dysregulation and the frequency and severity of substance use, and also suggest that difficulties controlling impulsive behaviors may be a potentially useful treatment target for individuals with substance dependence.

Olfactory Communication of Sickness Cues in Respiratory Infection.

Animals detect sick conspecifics by way of body odor that enables the receiver to avoid potential infectious transmission. Human observational studies also indicate that different types of disease are associated with more or less aversive smells. In addition, body odors from otherwise healthy human individuals smell more aversive as a function of experimentally induced systemic inflammation. To investigate if naturally occurring immune activation also gives rise to perceivable olfactory changes, we collected body odor samples during two nights from individuals with a respiratory infection as well as when they were healthy. We hypothesized that independent raters would rate the body odor originating from sick individuals as smelling more aversive than when the same individuals were healthy. Even though body odor samples from sick individuals nominally smelled more intense, more disgusting, and less pleasant and healthy than the body odor from the same individuals when healthy, these effects were not statistically significant. Moreover, raters filled out three questionnaires, Perceived Vulnerability to Disease, Disgust Scale, and Health Anxiety, to assess potential associations between sickness-related personality traits and body odor perception. No such association was found. Since experimentally induced inflammation have made body odors more aversive in previous studies, we discuss whether this difference between studies is due to the level of sickness or to the type of trigger of the sickness response.

Automated virtual reality exposure therapy for spider phobia vs. in-vivo one-session treatment: A randomized non-inferiority trial.

OBJECTIVE: This study compared the efficacy of a technician-assisted single-session virtual reality exposure therapy (VRET) for the treatment of spider phobia featuring low-cost consumer-available hardware and novel automated software to gold-standard in-vivo one-session treatment (OST), using a parallel group randomized non-inferiority design. Method Participants (N = 100) were randomized to VRET and OST arms. Assessors blinded to treatment allocation evaluated participants at pre- and post-treatment as well follow-up (3 and 12 months) using a behavioral approach test (BAT) and self-rated fear of spider, anxiety, depression and quality-of-life scales. A maximum post-treatment difference of 2-points on the BAT qualified as non-inferiority margin. Results Linear mixed models noted large, significant reductions in behavioral avoidance and self-reported fear in both groups at post-treatment, with VRET approaching the strong treatment benefits of OST over time. Non-inferiority was identified at 3- and 12- months follow-up but was significantly worse until 12-months. There was no significant difference on a questionnaire measuring negative effects. Conclusions Automated VRET efficaciously reduced spider phobia symptoms in the short-term and was non-inferior to in-vivo exposure therapy in the long-term. VRET effectiveness trials are warranted to evaluate real-world benefits and non-specific therapeutic factors accruing from the presence of a technician during treatment. ClinicalTrials.gov (NCT02533310).

Symptom shifting and associations with mental illness: A transdiagnostic approach applied to eating disorders.

Diagnostic comorbidity is common among psychiatric patients. One approach to obtain an improved understanding of this phenomenon is to explore diagnostic transitions, across time. In the present study, we aim to take this methodology further within the specific context of eating disorders by investigating whether there are individuals who shift not only between different eating disorder symptoms, but also shift to deliberate self-harm and substance use over time, and relations of this to other indicators of mental illness. Retrospective longitudinal registry data from the Swedish Stepwise national quality assurance platform for eating disorders were analyzed, including self-report measurements and clinical assessments. Individuals (N = 3,159 adults) were selected for analysis based on available data at admission and 12 months postadmission, and grouped based on occurrence of a "symptom shift" (defined as a decrease in one symptom and increase in another over time). In this sample of patients, 422 (13%) demonstrated symptom shifting among eating disorder symptoms. As hypothesized, "symptom shifters" were more prone to engage in deliberate self-harm and shifted to both deliberate self-harm and substance use across time. They had higher reported levels of symptoms indicative of mental illness (e.g., anxiety and compulsivity) and more pronounced functional impairment (clinician rated and self-rated), compared to nonshifters. Taken together, this study demonstrates that a subgroup of individuals diagnosed with eating disorder(s) shift between distinct psychiatric symptoms across time, indicating that they may share a common vulnerability to engaging in problem behaviors and a need for a more comprehensive and individualized treatment plan. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Sleep during naturally occurring respiratory infections: A pilot study.

There is strong experimental support that infections increase the drive for sleep in animals, and it is widely believed that more sleep is part of an adaptive immune response. While respiratory infections (RI) are very prevalent in humans, there is a striking lack of systematic knowledge on how it affects sleep. We recruited 100 people, among whom 28 became sick with an RI during the study period (fulfilling criteria for influenza-like illness, ILI, or acute respiratory infection, ARI). We measured sick participants' sleep at home, both objectively (actigraphy) and subjectively (diary ratings), for one week as well as four weeks later when healthy. During the week with RI, people spent objectively longer time in bed and had a longer total sleep time compared to the healthy week. During the infection, participants also had more awakenings, but no significant differences in sleep latency or sleep efficiency. While sick, people also reported increased difficulties falling asleep, worse sleep quality, more restless sleep and more shallow sleep, while they did not report sleep to be less sufficient. Most problems occurred at the beginning of the sickness week, when symptoms were strong, and showed signs of recovery thereafter (as indicated by interactions between condition and day/night of data collection for all the 10 sleep outcomes). The degree of symptoms of RI was related to a worse sleep quality and more restless sleep, but not to any of the objective sleep outcomes or the other subjective sleep variables. Having a higher body temperature was not significantly related to any of the sleep variables. This study suggests that having a respiratory infection is associated with spending more time in bed and sleeping longer, but also with more disturbed sleep, both objectively and subjectively. This novel study should be seen as being of pilot character. There is a need for larger studies which classify pathogen type and include baseline predictors, or that manipulate sleep, in order to understand whether the sleep alterations seen during infections are adaptive and whether sleep interventions could be used to improve recovery from respiratory infections.