Naturally Occurring Expressive Suppression is Associated with Lapses in Instrumental Activities of Daily Living Among Community-Dwelling Older Adults.

OBJECTIVES: Expressive suppression (i.e., effortful regulation of overt affect) has a deleterious impact on executive functioning (EF). This relationship has potential ramifications for daily functioning, especially among older adults, because a close relationship exists between EF and functional independence. However, past research has not directly examined whether expressive suppression impacts instrumental activities of daily living (IADL). The present study examined this association among older adults. METHODS: One hundred ten community-dwelling older adults completed a self-report measure of acute (past 24 hr) and chronic (past 2 weeks) expressive suppression, a timed test of IADL, and the Behavioral Dyscontrol Scale as a measure of EF. RESULTS: High chronic expressive suppression was related to slow IADL performance beyond covariates (age, IQ, depression), but only for individuals with low EF. High acute expressive suppression was associated with lower accuracy on IADL tasks beyond covariates (IQ, depression), but this association was fully explained by EF. CONCLUSIONS: The current results suggest that expressive suppression is associated with less efficient and more error-prone IADL performance. EF fully accounted for the relationship between acute expressive suppression and IADL performance, showing that suppression is a risk factor for both poorer EF performance and functional lapses in daily life. Furthermore, individuals with weaker EF may be particularly vulnerable to the effect of chronic expressive suppression. (JINS, 2019, 25, 718-728).

Reported Expressive Suppression in Daily Life Is Associated with Slower Action Planning.

Objectives Growing evidence demonstrates that (a) executive functioning (EF) becomes deleteriously affected by engagement in the emotion regulation strategy known as expressive suppression and (b) EF shows considerable functional and neuroanatomical overlap with motor output. The current study aimed to bridge these two literatures by examining the relationships between naturally occurring expressive suppression and several different aspects of motor output, including action planning, action learning, and motor-control speed and accuracy. In addition, we investigated whether any identified relationships could be explained by EF. Methods Fifty-one healthy young adults completed selected subtests from the Delis-Kaplan Executive Function System as indices of EF, a self-report measure of expressive suppression, and a computerized motor sequencing task (Push Turn Taptap task; PTT) designed to assess action planning, action learning, and motor control speed and accuracy. Results Hierarchical regressions using each aspect of PTT performance as the dependent variable revealed that higher than usual self-reported expressive suppression on the day of testing (relative to the 2 weeks preceding testing) was associated with longer action-planning latencies. This relationship was fully explained by EF. No other PTT variables related to expressive suppression on the day of testing. Conclusions These results suggest that increased expressive suppression in daily life is associated with slower action planning, an aspect of motor output that is reliant on EF, highlighting the importance of factors that lead to intra-individual fluctuations in EF and motor performance. (JINS, 2016, 22, 671-681).

Individual differences and day-to-day fluctuations in perceived self-regulation associated with daily adherence in late adolescents with type 1 diabetes.

OBJECTIVE: To examine whether individual differences and intraindividual (within-person day-to-day) fluctuations in late adolescents' self-regulation were associated with daily adherence to the type 1 diabetes regimen. METHODS: 110 school seniors (M age = 17.78 years) and their mothers assessed adolescents' skills underlying self-regulation (executive function, attention, self-control, behavioral inhibition and activation, emotion regulation) and adherence, with glycosylated hemoglobin from medical records. Teens completed daily diaries reporting self-regulation failures surrounding monitoring blood glucose, adherence, and number of blood glucose checks each day for 14 days. RESULTS: Hierarchical Linear Models indicated that better daily adherence was associated with teen and mother reports of better self-regulation skills and teens' reports of fewer daily self-regulation failures. Daily adherence was unrelated to temperamental differences in behavioral inhibition and activation. CONCLUSIONS: Results indicate that both individual and intraindividual differences in self-regulation contribute to daily adherence highlighting the importance of daily self-regulatory challenges to adherence.

Intra-individual variability identifies individuals vulnerable to contextually induced executive lapses.

Contextual stressors, such as engagement in burdensome emotion regulation known as expressive suppression (ES), can result in transient but clinically meaningful decrement in performance on measures of executive functioning (EF). The goal of the present investigation was to examine whether intra-individual variability (IIV-I), which has been identified as an indicator of cognitive weakness, could serve as a marker of vulnerability to EF decrements due to both naturally-occurring and experimentally-manipulated ES.In Study 1, 180 cognitively healthy older adults completed the Push-Turn-Taptap (PTT) task to assess IIV-I, four Delis-Kaplan Executive Function System (D-KEFS) subtests to assess EF, and the Burden of State Emotion Regulation Questionnaire (B-SERQ) to assess naturally-occurring ES. In Study 2, a subset (n = 81) of participants underwent experimental manipulation to induce ES, followed by second administration of the D-KEFS to examine ES-induced decrements in EF.In Study 1, hierarchical linear regression yielded a significant interaction between ES and IIV-I as predictors of EF performance, demonstrating that high ES was associated with low EF only among individuals with high IIV-I. In Study 2, repeated measures ANOVA demonstrated an interaction between time (pre- vs. post- manipulation), group (ES vs. control), and IIV-I (high vs. low), such that only individuals who exhibited high IIV-I were negatively impacted by the ES manipulation.IIV-I moderates the association between ES and EF, such that only individuals with high IIV-I exhibit vulnerability to the impact of ES. Thus, IIV-I may act as a marker of vulnerability to temporary EF depletion.

Greater naturally occurring expressive suppression is associated with poorer executive functioning and motor-sequence learning among older adults.

Objectives: Unusually high engagement in expressive suppression (i.e., purposeful regulation of overt affect) has been associated with poorer performance on executive functioning (EF) and motor-sequence learning tasks. As such, expressive suppression represents one possible source of fluctuations in executive test performance. However, the relationship between expressive suppression and EF and motor performance has not yet been examined in older adults, who are more prone to EF and motor fluctuations than are younger adults. The purpose of this study was to test whether greater self-reported, naturally occurring expressive suppression is related to poorer EF performance and motor-sequence learning in older adults. Method: One hundred and ten community-dwelling older adults completed a self-report measure of expressive suppression, a battery of EF tests, and a computer-based measure of motor-sequence learning. Results: As expected, higher self-reported burden of expressive suppression in the 24 hours prior to testing was related to poorer performance on EF tests and on multiple aspects of motor-sequence learning (action planning latencies and sequencing errors) even after accounting for age, depressive symptoms, and component processes (e.g., processing speed). Conclusions: The current results suggest that naturally occurring expressive suppression depletes EF, which builds on previous findings from experimental studies that show that expressive suppression leads to reduced EF performance. Furthermore, this effect can be captured using self-report methods. These findings highlight expressive suppression as one source of intraindividual fluctuations in executive and motor functioning, which likely place older adults at risk for both functional and motor lapses (e.g., medication mistakes, falls).

Exaggerated reaction to novelty as a predictor of incipient cognitive decline among community-dwelling older adults.

OBJECTIVE: The ability to detect covert markers of incipient cognitive decline among older adults before cognitive decline becomes overtly evident on traditional cognitive tests represents an important topic of research. Exaggerated reactions to novelty, reflected in novelty-induced increases in action planning latencies ("novelty effect"; NE) and low openness to experience (openness), have been previously associated with incipient cognitive decline among older adults who appeared cognitively normal at baseline. The purposes of the present study were to extend prior research on the utility of these markers by examining whether (a) NE and openness each predict cognitive change uniquely, and (b) whether these indices predict cognitive change above and beyond measures of memory, executive functions, processing speed/efficiency, premorbid IQ, and depressive symptoms. METHOD: Sixty-one cognitively normal community-dwelling older adults were administered a battery of tests assessing the relevant constructs at baseline and one-year follow up. Changes in cognitive status were assessed using the Demetia Rating Scale, 2nd Edition, NE was assessed using the Push-Turn-Taptap task (an electronic motor sequence learning task), and openness using the NEO Personality Inventory-Revised. The Test of Premorbid Functioning, and subtests from Repeatable Battery for the Assessment of Neuropsychological Status, Delis-Kaplan Executive Function System, and Wechsler Adult Intelligence Scale, 4th Edition, were used for additional assessment of baseline cognition. Depressive symptoms were assessed using the Geriatric Depression Scale. RESULTS: Results confirmed our hypothesis that both NE and openness contribute to prediction of cognitive change beyond baseline cognition and depressive symptoms, but none of the covariates (i.e., depression, executive functions, processing efficiency, or memory) themselves contributed to the model. NE and openness each contributed unique variance and were independent of each other. CONCLUSIONS: Openness and NE have the potential to provide evidence-based methods for estimating risk of future cognitive change in persons with currently normal standardized test scores.

The Relation of Questionnaire and Performance-Based Measures of Executive Functioning With Type 1 Diabetes Outcomes Among Late Adolescents.

OBJECTIVE: Successfully managing Type 1 diabetes involves adherence to a complex daily medical regimen, requiring self-regulatory skills that rely on neurocognitive processes known as executive functioning (EF). Adolescents with poorer rated EF abilities display poorer diabetes outcomes. The purpose of this study was to examine the relationship of EF questionnaire and performance measures with adherence and glycemic control, after controlling for IQ and general questionnaire response style. METHOD: Adolescents with Type 1 diabetes (M age = 17.74, SD = .38 years) and their mothers (N = 196) completed a self/mother-report questionnaire assessing adolescents' ratings of EF abilities (Behavior Rating Inventory of Executive Functioning-Self-Report). Adolescents also completed performance-based tests of EF (Delis-Kaplan Executive Function System) and intellectual functioning (Wechsler Adult Intelligence Scale, 4th ed., Vocabulary). Adherence was indexed via 2 self-report inventories and the number of daily blood glucose checks, and glycemic control via HbA1c obtained from assay kits. RESULTS: Self/mother-reports of EF ability were associated with self/mother-reported adherence. Both questionnaire and performance-based measures of EF were associated with glycemic control. However, once IQ was taken into consideration, performance-based EF was no longer associated with glycemic control; IQ independently shared variance with glycemic control. CONCLUSION: Our findings suggest that self-reports of EF may be useful in identifying late adolescents who need assistance in managing diabetes in daily life. The finding that performance-based EF measures were not related to glycemic control independent of underlying intellectual capacity raises questions about the specific role of EF in diabetes outcomes. (PsycINFO Database Record

Naturally-occurring expressive suppression in daily life depletes executive functioning.

The depleting impact of experimentally manipulated expressive suppression (ES) on cognition (especially executive functioning and related processes) has been well established (Baumeister, 2002a). However, the impact of ES that occurs naturally in the course of daily life has not been examined. Sixty two adults (M = 22.89 years old) completed questions about recent ES burden (over the past 2 weeks and on the test day) and completed cognitive measures assessing executive functioning, working memory, and speed of information processing. Individuals with higher-than-usual burden of ES on the test day exhibited poorer executive performance and those with high ES over the past 2 weeks exhibited poorer processing speed above and beyond depression, suggesting that ES burden as it occurs in the course of daily life is associated with compromised cognitive performance.

Understanding processing speed weaknesses among pedophilic child molesters: response style vs. neuropathology.

Research shows that pedophilic (PED) child molesters exhibit slower performance speed and greater performance accuracy when compared to nonpedophilic (N-PED) child molesters or other criminal and noncriminal controls. The purpose of the present study was to examine whether these differences reflect a slow/deliberate response style among PEDS (as we have previously hypothesized; Eastvold, Suchy, & Strassberg, 2011; Suchy, Whittaker, Strassberg, & Eastvold, 2009a, 2009b), or a fundamental neuropathological weakness in processing speed. Data came from a larger study examining neurocognition among sex offenders. Processing speed in three different domains (motor speed, visual-perceptual speed, and visual-motor integration) was examined in 20 phallometrically identified PEDs, 20 N-PEDs, and 20 nonsexual offenders, using both clinical (Finger Tapping, Symbol Search, Digit Symbol Coding) and experimental measures (Inspection Time Task [ITT]). The ITT assessed speed of visual-perceptual processing independent of response speed. On clinical measures, PEDs exhibited slower visual perception [F(2, 57) = 5.24, p = .008] and visual-motor integration [F(2, 57) = 5.02, p = .010] than the other groups, with no differences for simple motor speed. On the ITT, PEDs performed less accurately than the other groups [F(2, 57) = 3.95, p = .025], clearly indicating that slow processing speed cannot be explained by a deliberate response style. Group differences persisted after controlling for other potential confounds (age, estimate IQ, working memory, ethnicity, and substance use). PEDs' slower performance is due to a fundamental neurocognitive weakness, rather than a slow/deliberate response style. These results are consistent with Cantor et al.'s (2008) work identifying white matter abnormalities among PEDs and provide further support for a neurodevelopmental etiology of pedophilia.

Confronting patients about insufficient effort: the impact on subsequent symptom validity and memory performance.

Symptom validity tests (SVTs) are commonly used to assess effort in neuropsychological evaluations. However, no empirical research or official guidelines exist about how clinicians should proceed if a patient produces a non-valid SVT result. The purpose of this study was to examine whether confronting patients immediately after scoring in a non-valid range on a SVT would have an impact on subsequent symptom validity and memory tests performance. Archival patient data for 507 adults with clinically definite multiple sclerosis (MS) (ages 18-76) were examined. All patients completed the Victoria Symptom Validity Test (VSVT), the Wechsler Memory Scale, 3rd edition (WMS III), and the Beck Depression Inventory, 2nd edition (BDI II). Although the majority (89%) of patients produced valid VSVT scores (the Valid group), 56 patients produced non-valid VSVT scores. Due to a change in clinical procedure, 28 of the 56 were confronted regarding their non-valid VSVT performances and were asked to complete the test a second time (the CONF group), while the remaining 28 proceeded with testing as usual following a non-valid score (the N-CONF group). Results showed that 68% of the CONF group produced valid VSVT scores on re-administration, as well as memory performances that were comparable to those of the Valid group. In contrast the N-CONF group produced memory scores that were significantly below the Valid group. This is the first study to provide empirical support for the effectiveness of intervention when patients exhibit inadequate effort on SVTs in clinical, non-forensic settings.