Feeling pressured to talk about trauma: How pressure to disclose alters the association between trauma disclosure and posttraumatic growth.

Talking with others about traumatic experiences (i.e., trauma disclosure) has been associated with increased posttraumatic growth (PTG). Although this association indicates the value of disclosing, there is evidence that external pressure to disclose can hinder the benefits of trauma disclosure. The aim of the current study was to examine the influence of pressure to disclose on the association between trauma disclosure and PTG. People who had experienced a traumatic event and disclosed their trauma to a close other were recruited using Amazon's Mechanical Turk (N = 208). Participants completed measures of trauma exposure, trauma disclosure, pressure to disclose, PTG, posttraumatic stress symptoms, and response to disclosure. The results indicated that the linear association between trauma disclosure and PTG was quadratically moderated by pressure to disclose, ηp 2 = .025. Pressure to disclose strengthened the positive association between trauma disclosure and PTG from low, B = 0.818 (SE = 0.267), to moderate levels of pressure, B = 2.109 (SE = 0.471). However, when pressure was high, the association between disclosure and PTG was not significant, B = -1.19 (SE = 1.327). These findings indicate that a moderate amount of pressure to disclose may facilitate the positive impact of disclosure on PTG, yet a high amount of pressure may impede the positive association between disclosure and PTG. This research furthers understanding of the nuances of trauma disclosure and how close others' involvement in disclosure can impact the process of PTG for trauma survivors.

Perfectionistic concerns and psychological distress: The role of spontaneous emotion regulation during college students' experience with failure.

Perfectionistic concerns are associated with various forms of distress, and research has shown that maladaptive emotion regulation mediates this relation. To our knowledge, this mediation process has not been studied in the lab when an individual experiences distress in the moment. This study was designed to determine (a) whether spontaneous emotion regulation mediates the relation between an experimentally induced experience of failure and distress and (b) whether perfectionistic concerns moderate this indirect effect. College students (N = 165) completed self-reports of perfectionistic concerns and past-week affect. They then completed one of the two anagram tasks that induced either a high degree of failure or a low degree of failure. Finally, spontaneous emotion regulation during the anagram task and post-task affect was measured. Spontaneous use of cognitive reappraisal mediated a positive indirect effect in the association between manipulated degree of failure and post-task negative affect at high levels of perfectionistic concerns but not at low levels. Moreover, spontaneous use of rumination mediated (a) a positive indirect effect for post-task negative affect and (b) a negative indirect effect for post-task positive affect at low levels of perfectionistic concerns but not at high levels. These findings suggest there is value in perfectionism research addressing the process of regulating emotions as it unfolds in the moment a person experiences failure. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Depression symptoms' impact on personality disorder treatment: Depression symptoms amplifying the interpersonal benefits of negative-affect expression.

BACKGROUND: While there is some evidence that patients with elevated depression symptoms experience greater benefits from negative-affect expression, this amplifying effect has not been investigated within a psychotherapeutic context. This is particularly notable considering the substantial evidence linking affect expression with desired outcomes across psychotherapeutic approaches. The primary purpose of the present study was to investigate if depression symptoms amplified (i.e., moderated) the association between negative-affect expression and reductions in interpersonal problems for patients in a psychiatric day treatment for personality disorders. The secondary purpose was to investigate milieu (i.e., other patients concurrently enrolled) negative-affect intensity and its association with patients' reductions in interpersonal problems. METHODS: Participants (N = 239) were patients consecutively admitted into a psychiatric day treatment program for people with personality disorders. Patients completed measures of (1) depression symptoms at pre-treatment, (2) interpersonal problems at pre- and post-treatment, and (3) negative-affect expression each week of treatment. RESULTS: The association between patient negative-affect expression and reductions in interpersonal problems was amplified by depression symptoms. Depression symptoms also amplified the association between milieu negative-affect intensity and reductions in interpersonal problems. CONCLUSIONS: Our findings indicate that depression symptoms amplified the therapeutic value of negative-affect expression and amplified the value of an affectively intense milieu. Practical and theoretical implications are discussed.

Distress Concealment and Depression Symptoms in a National Sample of Canadian Men: Feeling Understood and Loneliness as Sequential Mediators.

Men's tendency to conceal their distress has been linked with increased depressive symptoms. Although interpersonal connectedness has been associated with distress concealment and depression, it is unclear how connectedness mediates this association. The aim of the present study was to examine the mediating effects of feeling understood and loneliness-two facets of interpersonal connectedness-in the association between distress concealment and depressive symptoms in men. A sample of 530 Canadian men was selected based on age- and region-stratification that reflects the national population. Participants completed measures of depression symptoms, distress concealment, loneliness, and feeling understood. Mediation analyses were conducted. Results supported a sequential mediation model: concealing distress was associated with not feeling understood, not feeling understood was associated with loneliness, and loneliness was associated with depressive symptoms. These findings shed light on how distress concealment is associated with depressive symptoms among men. Implications for practice and theory are discussed.

Relational Aggression Victimization as a Predictor of Middle-School Girls' Self-Disclosure to Peers.

Being a victim of relational aggression is associated with many negative outcomes among adolescent girls, and diminished self-disclosure to peers may be one of them. Given this possibility, it is important to examine potential mediators of this relation. Middle-school girls (N = 180) completed paper-and-pencil measures of relational aggression victimization, self-disclosure to their peer group, and four potential mediators-outcome expectations about self-disclosure, loneliness, social anxiety, and self-esteem. Negative outcome expectations about disclosure and loneliness were significant mediators of the relation between being a victim of relational aggression and self-disclosing to the peer group. Despite the limitations of these cross-sectional data, the present findings suggest that relational aggression is associated with diminished disclosure to others because victimized girls experience heightened loneliness and because they believe that self-disclosure will lead to negative outcomes.

The attenuating effect of depression symptoms on negative-affect expression: Individual and group effects in group psychotherapy for personality disorders.

Across a breadth of psychotherapeutic approaches, feeling affect intensely and then talking about those feelings is a common means for increasing insight and other desired outcomes. While several naturalistic and laboratory studies have found that depression symptoms attenuate (i.e., weaken) the association between negative-affect intensity and negative-affect expression, depression's attenuating effect has not been examined in a psychotherapeutic context. The first aim of the present study was to examine if depression symptoms' attenuating effect on the association between negative-affect intensity and negative-affect expression extended into group psychotherapy. Our second aim was to examine group effects on patients' negative-affect expression. Participants (N = 239) were patients consecutively admitted into a psychodynamic group-psychotherapy day treatment program for people with personality disorders. Patients indicated their negative-affect intensity and negative-affect expression each week that they were in treatment. Depression symptoms were assessed at baseline. Results indicated that depression symptoms attenuated (i.e., moderated) the association between negative-affect intensity and negative-affect expression. Further, while the association between patient intensity and expression increased over the course of treatment, the moderating effect of depression on this association did not vary over treatment. Regarding group effects, group negative-affect intensity was associated with higher levels of patient negative-affect expression. Inversely, group affect expression was associated with lower levels of patient affect expression. Patient depression symptoms did not moderate the association between group negative-affect intensity and patient negative-affect expression. Our findings indicate that while group affect intensity and affect expression impacts patients' expression, depression's attenuating effect on negative-affect expression extends to patient effects but not group effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Attachment avoidance, alexithymia, and gender: Examining their associations with distress disclosure tendencies and event-specific disclosure.

Distress disclosure has been linked with reduced psychological distress, increased wellbeing, and successful psychotherapeutic outcome. Because of the importance of distress disclosure, researchers have worked to develop and improve theoretical models of disclosure to facilitate counseling practices that reduce impediments to disclosure. Presently, we conducted a 2-part study to investigate distress disclosure's associations with attachment avoidance, gender, and alexithymia-3 constructs frequently linked with disclosure. In Part 1, we examined the extent to which attachment avoidance, alexithymia, and gender predicted general disclosure tendencies. In Part 2, we examined the extent to which attachment avoidance, alexithymia, and gender predicted event-specific disclosure. Participants were recruited from a crowdsourcing website (N = 178 in Part 1; N = 108 in Part 2). In Part 1, alexithymia partially mediated the association between attachment avoidance and disclosure tendencies, and the link between attachment avoidance and alexithymia was stronger for men than women. In Part 2, the association between distress intensity and event-specific disclosure was weaker for people with high levels of alexithymia. Implications for counseling theory and practice are discussed. (PsycINFO Database Record

Distress disclosure and psychological functioning among Taiwanese nationals and European Americans: The moderating roles of mindfulness and nationality.

Research using Western samples shows that talking about unpleasant emotions-distress disclosure-is associated with fewer psychological symptoms and higher well-being. These benefits of distress disclosure may or may not be observed in East Asia where emotional control is valued. Instead, mindfulness may be more relevant to emotion regulation in East Asia (e.g., Taiwan). In the present study, cultural context (Taiwanese nationals vs. European Americans) and mindfulness were examined as moderators of the relation between distress disclosure and both depression symptoms and life satisfaction. A sample of 256 Taiwanese college students and a sample of 209 European American college students completed self-report measures in their native language. Moderated multiple regression analyses revealed significant interaction effects of mindfulness and distress disclosure on both depression symptoms and life satisfaction for Taiwanese participants but not for European Americans. Specifically, distress disclosure was negatively associated with depression symptoms and positively associated with life satisfaction for Taiwanese low in mindfulness but not for Taiwanese high in mindfulness. For European Americans, distress disclosure was not associated with depression symptoms but was associated with higher life satisfaction, regardless of one's level of mindfulness. These findings suggest that the potential benefits of disclosing distress are a function of one's cultural context as well as, for those from Taiwan, one's mindfulness. (PsycINFO Database Record

Causal Effects of Language on the Exchange of Social Support in an Online Community.

The provision of social support is a common function of many online communities, but a full understanding of the causal effect of emotion language on the provision of support requires experimental study. The frequency of positive- and negative-emotion words in simulated posts requesting emotional support was manipulated and presented to a sample of college students (N = 442) who were randomly assigned to read one of four simulated posts. Participants completed measures of the original poster's (OP's) distress, and they provided a response to the simulated post. These responses were subjected to a computerized text analysis, and their overall effectiveness was rated by two independent judges. Fewer positive-emotion and more negative-emotion words in the simulated post led to perceptions that the OP was distressed and unable to cope. Participant-generated responses to the post were highest in positive-emotion words when the simulated post was high in positive-emotion words, but low in negative-emotion words. Finally, simulated posts that were low in positive-emotion words received responses that were judged to be more effective than did simulated posts that were high in positive-emotion words. These findings have implications for understanding the role of emotion language on the exchange of online social support.

Exposure to family violence and attachment styles as predictors of dating violence perpetration among men and women: a mediational model.

This study examined a multiple mediator model explaining how sibling perpetration and one's attachment style mediate the relation between parent-to-child victimization and dating violence perpetration. A sample of undergraduate students (n = 392 women, n = 89 men) completed measures of the aforementioned variables on an Internet survey. For men, path analyses found no mediation; parent-to-child victimization had a direct association with dating violence perpetration, no association was found between sibling perpetration and dating violence perpetration, and attachment anxiety, but not attachment avoidance, was positively associated with dating violence perpetration for men. For women, the hypothesized mediation model was supported; parent-to-child victimization had a direct association with dating violence perpetration, and sibling perpetration and attachment anxiety served as mediating variables. Attachment avoidance was not associated with dating violence perpetration for women. Implications for future research and clinical practice are discussed.

It's the destination and it's the journey: using multilevel modeling to assess patterns of change in psychotherapy.

BACKGROUND: The pairing of analysis of variance (ANOVA)-based analyses with designs lacking multiple measurement of client change may lead to conclusions that are inconsistent with theoretical expectations about how change will occur. Multilevel modeling (MLM), when used with multiple assessments of client outcomes, provides a flexible set of tools to analyze trajectories of client change. PURPOSE: The authors present an overview of MLM and growth curve analysis as applied to psychotherapy outcome. Results from a simulated data set illustrate how MLM-specifically, growth curve analysis-can be used to test hypotheses from randomized clinical trials. RESULTS: Growth curve analyses were applied to simulated data from an experimental design (treatment versus control group) with multiple assessments of client distress and a client individual difference variable. Results of growth curve analyses confirmed what was found with a pretreatment/posttreatment repeated-measures ANOVA but provided additional information not available from the ANOVA framework. CONCLUSIONS: Given its flexibility, MLM is the recommended method to assess patterns of change in studies of psychotherapy outcome.

Disentangling the effects of depression symptoms and adult attachment on emotional disclosure.

Individuals with high levels of depression symptoms and individuals with insecure attachment orientations have been shown to limit their use of emotional disclosure as a means of emotion regulation. However, little is known about how depression symptoms and insecure attachment orientations might jointly predict whether individuals engage in emotional disclosure. The authors addressed this question using both inter- and intraindividual approaches. College students (N = 121) completed measures of depression symptoms, adult attachment orientation, and generalized disclosure tendencies. To obtain an intraindividual measure of emotional disclosure, participants also completed an online daily diary in which they rated the intensity of the day's most unpleasant event and their disclosure of that event for 7 days. Results indicated that depression symptoms were negatively related to generalized disclosure tendencies and to intraindividual daily intensity-disclosure slopes. Attachment avoidance was negatively related to both generalized disclosure tendencies and to daily disclosure, and attachment anxiety moderated the relation between daily event intensity and disclosure. The authors discuss the implications for theory and counseling psychology practice.

The Distress Disclosure Index: a research review and multitrait-multimethod examination.

The Distress Disclosure Index (DDI; J. H. Kahn & R. M. Hessling, 2001) is a brief self-report measure of one's tendency to disclose personally distressing information. The purpose of this article was to summarize what is known about the DDI, present new validity evidence, and make recommendations for use of the DDI. This article reviews research on the DDI from the past decade that indicates that distress disclosure is associated with well-being, professional help-seeking attitudes and intentions, and success in brief psychotherapy. On the basis of the reviewed literature, the authors report a reliability generalization study of DDI scores that strongly supports the internal consistency and test-retest reliability of DDI scores, and they review criterion-related and construct validity evidence. Next, the authors present a new multitrait-multimethod validity study of the DDI. Participants (N = 153) and peer informants (N = 153)--one per participant--completed paper-and-pencil questionnaire packets. Convergent validity of self-reported DDI scores was supported by a strong association with self-reports of emotional self-disclosure in response to a specific, unpleasant event, and self- and peer reports on the DDI were moderately correlated. DDI scores were not strongly associated with cognitive reappraisal and ambivalence over emotional expression, thus supporting discriminant validity. DDI scores were strongly associated with expressive suppression, and correlations between DDI scores and affect, depression symptoms, coping, and emotional expressivity were similar to those found with expressive suppression. The authors offer possible hypotheses explaining the overlap between distress disclosure and expressive suppression and present recommendations for future use of the DDI.

Multilevel modeling: overview and applications to research in counseling psychology.

Multilevel modeling (MLM) is rapidly becoming the standard method of analyzing nested data, for example, data from students within multiple schools, data on multiple clients seen by a smaller number of therapists, and even longitudinal data. Although MLM analyses are likely to increase in frequency in counseling psychology research, many readers of counseling psychology journals have had only limited exposure to MLM concepts. This paper provides an overview of MLM that blends mathematical concepts with examples drawn from counseling psychology. This tutorial is intended to be a first step in learning about MLM; readers are referred to other sources for more advanced explorations of MLM. In addition to being a tutorial for understanding and perhaps even conducting MLM analyses, this paper reviews recent research in counseling psychology that has adopted a multilevel framework, and it provides ideas for MLM approaches to future research in counseling psychology.

Intraindividual relations between the intensity and disclosure of daily emotional events: The moderating role of depressive symptoms.

Individuals with high levels of depressive symptoms tend to engage in lower levels of emotional disclosure than individuals who are lower in depressive symptoms. However, little is known about how depressive symptoms relate to the intraindividual relation between daily disclosure and the intensity of the daily events. The authors addressed these relations using a daily diary methodology. College students (N = 239) completed a measure of depression symptoms. They then completed measures of the intensity of the day's most unpleasant event and their disclosure of that event each day for 7 days. Results indicated that depression moderated the intensity-disclosure relation such that depression symptoms were associated with diminished emotional disclosure for high-intensity events but not for low-intensity events. Individuals with relatively higher levels of depressive symptoms also experienced unpleasant daily events at a higher intensity level than did individuals with relatively fewer symptoms. Sex differences emerged such that men were less likely than women to disclose high-intensity negative events. These findings extend the use of the diary methodology to the study of emotional disclosure and also suggest possible interventions for counseling psychology practitioners.

The emotional content of client disclosures and session impact: An analogue study.

The authors examined the relation between a client's disclosure of emotional material in an analogue psychotherapy session and the depth and smoothness of that session. Transcripts of 33 prepracticum psychotherapy sessions (3 sessions each from 11 volunteer clients) were coded for client disclosures, and the text of these disclosures was subjected to a computer analysis to count the number of positive and negative emotion words. While controlling for client functioning, sessions in which clients disclosed more and used more positive-emotion words in their disclosures were rated as having more depth. Clients' use of emotion in their disclosures was not related to session smoothness. Findings from this study suggest aspects of client disclosure that are associated with deeper sessions. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Measuring emotional expression with the Linguistic Inquiry and Word Count.

The Linguistic Inquiry and Word Count (LIWC) text analysis program often is used as a measure of emotion expression, yet the construct validity of its use for this purpose has not been examined. Three experimental studies assessed whether the LIWC counts of emotion processes words are sensitive to verbal expression of sadness and amusement. Experiment 1 determined that sad and amusing written autobiographical memories differed in LIWC emotion counts in expected ways. Experiment 2 revealed that reactions to emotionally provocative film clips designed to manipulate the momentary experience of sadness and amusement differed in LIWC counts. Experiment 3 replicated the findings of Experiment 2 and found generally weak relations between LIWC emotion counts and individual differences in emotional reactivity, dispositional expressivity, and personality. The LIWC therefore appears to be a valid method for measuring verbal expression of emotion.

Familial predictors of sibling and romantic-partner conflict resolution: comparing late adolescents from intact and divorced families.

The present study examined whether predictors of romantic-partner conflict may vary as a function of family structure. Using a cross-sectional design, we tested a mediation model of conflict resolution behaviours among late adolescents from intact (n=185) and divorced (n=87) families. Adolescents rated conflict resolution behaviours in five dyadic relationships: interparental, mother-adolescent, father-adolescent, sibling, and romantic partner. Mother-adolescent and father-adolescent conflict resolution behaviours mediated the relationship between interparental and sibling conflict resolution. Moreover, both mother-adolescent and sibling conflict resolution behaviours mediated the relationship between interparental and romantic-partner conflict resolution behaviours. This model was supported for both positive and negative behaviours, and it applied equally well to adolescents from intact and divorced families. Results are discussed in the context of social learning theories and support conflict resolution behaviours within the family spilling over into romantic relationships for adolescents from both intact and divorced families.

Working alliance, treatment satisfaction, and patterns of posttreatment use among adolescent substance users.

This longitudinal study examined the relationships among the working alliance, treatment satisfaction, and posttreatment use among adolescents in treatment for substance abuse. Adolescents (N = 600) from the Cannabis Youth Treatment study (M. L. Dennis et al., 2002) completed measures of working alliance and treatment satisfaction as well as substance use and substance-related problems at intake and 3, 6, 9, 12, and 30 months' postintake. When controlling for initial substance use and substance-related problems, working alliance, but not treatment satisfaction, predicted use at 3 and 6 months' postintake. Neither working alliance nor treatment satisfaction were predictive of longitudinal patterns of posttreatment use. Implications for the assessment of working alliance and treatment satisfaction are discussed.

The stability and impact of environmental factors on substance use and problems after adolescent outpatient treatment for cannabis abuse or dependence.

Because alcohol or other drug use following adolescent substance abuse treatment is common, understanding mediators of posttreatment outcome could help improve treatment interventions. The authors conducted path analyses based on data from 552 adolescents (aged 12-18; 82% male) with cannabis abuse or dependence who participated in outpatient treatment. The analysis used the Family Conflict and Cohesion subscales, from the Family Environment Scale, and several scales and indices from the Global Appraisal of Individual Needs. Family conflict, family cohesion, and social support indirectly predicted substance use and substance-related problems as mediated by recovery environment and social risk. This model replicated across 4 follow-up waves (3, 6, 9, and 12 months postintake). These results support the idea of targeting environmental factors during continuing care as a way to improve treatment outcomes for adolescents with cannabis disorders.