Gene-Environment Interactions in Irrational Beliefs: The Roles of Childhood Adversity and Multiple Candidate Genes.

Cognitive behavioral therapy is based on the view that maladaptive thinking is the causal mechanism of mental disorders. While this view is supported by extensive evidence, very limited work has addressed the factors that contribute to the development of maladaptive thinking. The present study aimed to uncover interactions between childhood maltreatment and multiple genetic differences in irrational beliefs. Childhood maltreatment and irrational beliefs were assessed using multiple self-report instruments in a sample of healthy volunteers (N = 452). Eighteen single-nucleotide polymorphisms were genotyped in six candidate genes related to neurotransmitter function (COMT; SLC6A4; OXTR), neurotrophic factors (BDNF), and the hypothalamic-pituitary-adrenal axis (NR3C1; CRHR1). Gene-environment interactions (G×E) were first explored in models that employed one measure of childhood maltreatment and one measure of irrational beliefs. These effects were then followed up in models in which either the childhood maltreatment measure, the irrational belief measure, or both were substituted by parallel measures. Consistent results across models indicated that childhood maltreatment was positively associated with irrational beliefs, and these relations were significantly influenced by COMT rs165774 and OXTR rs53576. These results remain preliminary until independent replication, but they represent the best available evidence to date on G×E in a fundamental mechanism of psychopathology.

Assessing Measurement Consistency: A Study of the BPFSC Invariance Across Age and Sex in Romanian Adolescents.

The Borderline Personality Feature Scale for Children (BPFSC) is a widely used instrument and currently the only dimensional measure to investigate Borderline Personality features in children and adolescents. The present study aimed to investigate the factor structure and measurement invariance across age and sex in a community sample of 634 adolescents (mean age = 16.72, standard deviation = 1.31). To test for measurement invariance, we conducted multi-group confirmatory factor analysis (MG-CFA). Analysis showed residual invariance across age and sex. Based on the results, we conclude that BPFSC is a valid and reliable instrument to assess Borderline Personality features in adolescents. Implications for evidence-based assessment of Borderline Personality features in adolescence are discussed.

Serotonin and emotion regulation: the impact of tryptophan depletion on emotional experience, neural and autonomic activity.

The involvement of serotonin in emotion and psychopathology has been extensively examined. Studies using acute tryptophan depletion (ATD) have found limited effects on mood and aggression, and one of the explanations suggests that serotonin may be involved in higher-order functions, such as emotion regulation. However, there is very limited evidence for this hypothesis. The present study investigated the impact of ATD on emotion regulation in a double-blind, placebo-controlled, crossover design. A sample of psychiatrically healthy men (N = 28) completed a cognitive task assessing reappraisal ability (i.e., the success of using reappraisal, an emotion regulation strategy, to modulate emotional responses), following ATD and placebo. EEG frontal activity and asymmetry, as well as heart-rate variability (HRV), also were assessed in the reappraisal task. Both frequentist and Bayesian methods were employed for statistical analysis. Results indicated that ATD reduced plasma tryptophan, and reappraisal was effective in modulating emotional experience in the emotion regulation task. However, ATD had no significant effect on reappraisal ability, frontal activity, and HRV. These results offer direct and compelling evidence that decreasing serotonin synthesis through ATD does not alter an emotion regulation ability that is considered crucial in mood and aggression and has been linked with transdiagnostic risk of psychopathology.

Childhood Adversity, Resilience, and Paranoia During the COVID-19 Outbreak. The Mediating Role of Irrational Beliefs and Affective Disturbance.

Childhood adversity (CA) and resilience may impact on paranoia, but mechanisms underlying these associations are largely unknown. In this study, we investigated two potential candidates: irrational beliefs and affective disturbance. Moreover, we investigated the potential moderating role of COVID-19 perceived stress in these associations. A community sample (N = 419, m age = 27.32 years, SD = 8.98; 88.10% females) completed self-report measures. Results indicated that paranoia was significantly associated with CA and resilience (p < .05), and both irrational beliefs and affective disturbance (i.e., depressive and anxiety symptoms) mediated the associations between CA and paranoia. Moreover, depressive and anxiety symptoms partially explained the mediating role of irrational beliefs. These predictive models explained up to 23.52% of variance in paranoia (F(3,415) = 42.536, p < .001). Findings on resilience and paranoia replicated these results, and COVID-19 perceived stress moderated the association between resilience and ideas of persecution. Overall, these findings underscore the importance of irrational beliefs, depressive and anxiety symptoms in high CA or low resilience individuals experiencing paranoia. Supplementary Information: The online version contains supplementary material available at 10.1007/s10942-023-00511-4.

Childhood maltreatment and emotion regulation in everyday life: an experience sampling study.

Childhood maltreatment is a major risk factor for psychopathology, and increasing evidence suggests that emotion regulation is one of the underlying mechanisms. However, most of this evidence comes from single assessments of habitual emotion regulation, which may not overlap with spontaneous emotion regulation in daily life and which fail to account for within-individual variability in emotion regulation across multiple contexts. In the present study, we investigated the relation between history of childhood maltreatment, positive and negative affect, and multiple dimensions of spontaneous emotion regulation (strategy use, emotion regulation goals, emotion regulation success and effort) in everyday life, using experience sampling method (3 assessments/day, for 10 consecutive days), in a sample of healthy volunteers (N = 118). Multilevel modeling results indicated that childhood maltreatment was associated with lower positive affect and higher negative affect. Childhood maltreatment was also related to lower use of reappraisal and savoring (but not suppression, rumination and distraction), reduced emotion regulation success (but not effort), as well as lower levels of and higher within-individual variability of hedonic (but not instrumental) emotion regulation goals. These results provide ecological evidence for multiple differences in emotion regulation in individuals with a history of childhood maltreatment.

The association between adverse childhood events and cluster C personality disorders: A meta-analysis.

INTRODUCTION: Studies suggest that adverse childhood events (ACEs) may contribute to the onset and development of cluster C personality disorders. However, the association between ACEs and these disorders remains unclear in terms of consistency across studies and effect magnitude, as well as generalizability within cluster C. The current meta-analysis aimed to examine the associations between ACEs and cluster C personality disorders based on the available literature. METHODS: Systematic searches were conducted in PubMed, Scopus, Web of Science and PsychInfo. Forty-eight eligible studies were included in the analyses, and pooled effect sizes were estimated both at the level of cluster C and at the level of each specific disorder. Moderation and meta-regression analyses were also conducted. RESULTS: ACEs were consistently associated with overall cluster C, as well as each of the specific disorders in this cluster. Sources of heterogeneity included type of instrument used to assess ACEs (questionnaires > interviews) and type of instrument used to assess the personality disorders (clinical interviews > questionnaires, as well as their combination with interview). The associations between ACEs and all cluster C personality disorders decreased with age. CONCLUSIONS: ACEs are consistently associated with all cluster C personality disorders. Future work could approach the mechanisms underlying this association, preferably using longitudinal designs and considering the potential sources of effect variability identified in the present study.

Childhood adversity and impaired reward processing: A meta-analysis.

BACKGROUND: Childhood adversity (CA) is associated with increased risk of psychopathology, and reward processing (RP) may be one of the underlying mechanisms. However, evidence on impaired RP in childhood adversity is theoretically and methodologically heterogeneous. OBJECTIVE: To provide a quantitative overview of studies on the relation between childhood adversity and RP assessed at the behavioral and subjective levels, and identify differences between studies that influence the effect size. PARTICIPANTS AND SETTING: Twenty-seven studies (overall N = 6801) were included. METHODS: Peer-reviewed publications describing empirical studies on the relation between CA and behavioral and self-report measures of RP in humans were identified through systematic searches in six bibliographic databases. Effect sizes (r) were pooled using random-effects models. The potential moderator role of RP dimension, type of RP assessment, type of childhood adversity assessment, and age were examined. RESULTS: Results indicated a small, but consistent association between CA and impaired RP (r = 0.12; 95% CI: 0.07, 0.16), with medium heterogeneity (I2 = 62.43). The effect size was significantly larger (i.e., medium-sized) in studies that focused on reward learning rather than reward valuation and reward responsiveness; used cognitive tasks rather than self-report assessments of RP; and relied on official records rather than subjective reports of CA. There was evidence of publication bias, but overall effect size remained significant after imputation. CONCLUSIONS: These results suggest that multidimensional RP impairments (e.g., deficits in reward learning, biased reward valuation) are a consistent marker of CA, and may represent mechanisms underlying the increased risk of psychopathology.

Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis.

Childhood adversity is a major risk factor for multiple forms of psychopathology, and recent efforts have focused on understanding the underlying psychological mechanisms. One outstanding candidate is emotion regulation, which has been associated with both childhood adversity, and psychopathology. Based on the available evidence, the present meta-analysis set out to investigate the mechanistic involvement of emotion regulation in the relation between childhood adversity and psychopathology. Systematic searches in three databases (PubMed; PsycINFO; Web of Science) identified 215 eligible studies. Using meta-analytic structural equation modeling, we fitted a partial mediation model to the available data across studies, in which childhood adversity was related to psychopathology both directly and through emotion regulation. Multiple emotion regulation dimensions were analyzed, including emotion regulation difficulties and the habitual use of rumination, distraction, reappraisal, and suppression. Measures of psychopathology included a wide range of internalizing and externalizing symptoms in both clinical and non-clinical samples. The results indicated that childhood adversity was positively associated with emotion regulation difficulties, as well as with the habitual use of rumination and suppression. In turn, these measures of emotion regulation were positively associated with psychopathology. Habitual reappraisal use showed negative relations with both childhood adversity and psychopathology. All these emotion regulation measures were supported as mediators in the relation between childhood adversity and psychopathology. In contrast, distraction was not related to childhood adversity or psychopathology, and its mediator role was not supported. These results suggest that altered emotion regulation is a consistent marker of childhood adversity and contributes to risk of psychopathology.

Shame in Anxiety and Obsessive-Compulsive Disorders.

PURPOSE OF REVIEW: Studies on the relations between shame and anxiety and obsessive-compulsive and related disorders (OCRDs) are reviewed, with a focus on recent work. RECENT FINDINGS: Medium-sized positive correlations have been consistently found across anxiety disorders and OCRDs, suggesting that this relation is transdiagnostic. Most studies focused on shame-proneness and found similar relations across multiple types (e.g. internal, external) and domains (e.g. bodily, characterological, behavioural) of shame, with little variation between clinical and non-clinical populations and different age categories. However, most studies are cross-sectional and correlational and by separately studying clinical and non-clinical populations, they do not give a unitary dimensional view of the relation between shame and symptoms. Emerging findings suggest that shame may be a marker of the response to treatment in these disorders, and its relation with symptoms may be bidirectional. The consistent but medium-sized associations between shame and symptoms of anxiety and OCRDs warrant the future search for mediators and moderators.

Effects of acceptance and reappraisal on body dissatisfaction: an experimental comparison of two adaptive emotion regulation strategies.

BACKGROUND: In recent years, research has increasingly focused on body dissatisfaction, which is associated with numerous negative psychological and physical health consequences and, more importantly, with the development and maintenance of eating pathology. OBJECTIVE: In the present study, we focused on the effect of two adaptive emotion regulation strategies (acceptance and reappraisal) on body dissatisfaction compared to a control group, and pre- and post-induction of body dissatisfaction. METHODS: A total of 105 women [mean age (M) = 22.07; standard deviation (SD) = 6.11] were randomly assigned to one of the two emotion regulation conditions: acceptance (n = 35) and reappraisal (n = 35) or to a control group (n = 35). Participants were instructed accordingly with the condition that was assigned (acceptance or reappraisal). Participants were then induced body dissatisfaction by exposure to images representing the female thin-ideal and were asked to respond to their body-related feelings according to the instructions. Outcomes assessed were body dissatisfaction, and positive and negative affect. RESULTS: Results indicated a significant increase of body satisfaction in the acceptance and reappraisal conditions from pre- to post-induction of body dissatisfaction, compared to control group which suffered a significant decrease in body satisfaction. Moreover, in the control group, positive affect significantly decreased and negative affect increased from pre- to post-induction, and did not change significantly, neither in the acceptance nor in the reappraisal condition. CONCLUSIONS: Our findings highlight the positive effects of acceptance and reappraisal as emotion regulation strategies on body dissatisfaction and on positive and negative affect. LEVEL OF EVIDENCE: Experimental study, Level 1.

Emotion regulation across eating pathology: A meta-analysis.

The goal of this meta-analysis was to examine the associations between specific emotion regulation abilities (emotional awareness, emotional clarity) and strategies (acceptance of emotions, reappraisal, problem-solving, rumination, avoidance of emotions, and suppression), and eating pathology. A total of 96 studies and 239 effect sizes were included in the analysis. Relations between global and specific emotion regulation abilities and strategies and eating disorders and eating-related symptoms were examined. Results indicated medium-to-large effect sizes for the associations between adaptive emotion regulation and eating disorder and eating-related symptoms, and medium-to-large effect sizes for the associations between maladaptive emotion regulation and eating disorders and eating-related symptoms. In terms of specific emotion regulation strategies, large magnitude of associations were identified for the relations between lack of emotional awareness, clarity, acceptance, reappraisal, problem-solving, and eating disorders. Rumination, avoidance of emotions, and suppression also showed large associations with anorexia nervosa and bulimia nervosa. Overall, emotion regulation did not differ across eating disorders, a finding supporting the transdiagnostic character of emotion regulation problems in eating pathology. These findings have important theoretical and practical implications for prevention and intervention programs.

Cognitive-behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial.

OBJECTIVE: Cognitive-behavior therapy (CBT) is considered the "golden standard" psychotherapy for generalized anxiety disorder (GAD) but, at this point, we have little information about differences among various CBT approaches. METHOD: We conducted a randomized controlled trial to compare three CBT protocols for GAD: (a) Cognitive Therapy/Borkovec's treatment package; (b) Rational Emotive Behavior Therapy, and (c) Acceptance and Commitment Therapy/Acceptance-based behavioral therapy. A number of 75 patients diagnosed with GAD, aged between 20 and 51 (m = 27.13; standard deviation = 7.50), 60 women and 11 men, were randomized to the three treatment arms. RESULTS: All treatments were associated with large pre-post intervention reductions in GAD symptoms and dysfunctional automatic thoughts, with no significant differences between groups. Correlation analyses showed similar associations between changes in symptoms and changes in dysfunctional automatic thoughts. CONCLUSIONS: All three approaches appear to be similarly effective. Implications for the theoretical models underlying each of the three cognitive-behavior therapy approaches are discussed.

Shame-proneness, guilt-proneness and anxiety symptoms: A meta-analysis.

There is a growing body of investigations showing that shame and guilt are important features of various psychological problems including anxiety disorders. This study quantitatively summarized the magnitude of the associations of shame and guilt with anxiety symptoms. We looked both at the associations with broader categories of anxiety symptoms (i.e., undifferentiated anxiety symptoms, trait and state anxiety), but also with symptoms specific to individual anxiety disorders. In most cases, shame was more strongly associated with anxiety symptoms (in general medium effect sizes) than guilt (in general small effect sizes). When controlling for the shared variance of shame and guilt, in most cases only shame remained significantly associated with anxiety symptoms. Moderation analyses testing for the effect of subtype of shame/guilt, type of measurement, clinical status, age and gender were conducted. Two types of guilt seem to be equally maladaptive as shame, generalized guilt (involving a free-floating guilt separated from specific contexts) and contextual-maladaptive guilt (involving an inappropriate or exaggerated feeling of responsibility). External shame (perceived negative evaluations of others) seems to be more strongly associated with social anxiety symptoms than internal shame (negative self-evaluations). Results for other moderators and implications are discussed in light of the existing theoretical and empirical data.

Childhood trauma and emotion regulation: The moderator role of BDNF Val66Met.

Emotion regulation difficulties have been involved in multiple forms of psychopathology and may represent an important focus for current efforts to understand the biological mechanisms underlying transdiagnostic symptoms. The present study investigated a gene-environment interaction (G × E) in reappraisal, a form of emotion regulation that has been extensively linked to psychopathology. In light of recent meta-analytic evidence of its consistent role in depression and anxiety disorders, this study focused on the Val66Met (rs6265) single-nucleotide polymorphism in the brain-derived neurotrophic factor (BDNF) gene and examined its moderator role in the relation between childhood trauma and reappraisal. A sample of N = 266 participants were genotyped for BDNF Val66Met, filled in a self-report measure of childhood trauma, and underwent a cognitive task designed to assess reappraisal ability. The results indicated that, as expected, BDNF Val66Met was a significant moderator in the relation between childhood trauma and reappraisal. There was a negative relation between the number of childhood traumatic events and reappraisal ability in BDNF Met carriers, but not Val homozygotes. This finding suggests that BDNF Val66Met contributes to susceptibility to childhood stress, with long term impact on emotion regulation.

Early-life adversity and cortisol response to social stress: a meta-analysis.

Early-life adversity has been associated with a life-long increased risk for psychopathology and chronic health problems. These long-term negative effects have been explained through stress sensitization, which may involve dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis through either increased or decreased reactivity. The present meta-analysis assessed for the first time the effect of early-life adversity on cortisol response to social stress. Thirty data sets were included in the meta-analysis, in which early-life adversity and salivary cortisol response to social stress were assessed in 4292 individuals of different ages. Results indicated a moderate effect size (g = -0.39) in overall cortisol levels across studies. Separate analyses of cortisol at different stages of response showed large effect sizes at peak and recovery, and a moderate effect at baseline. Heterogeneity was large in this sample of studies and several moderators were identified. The effect size was larger in studies that focused on maltreatment compared to those that included other adversities, and in adults compared to children and adolescents. Percent of women in each sample and methodological quality were positive predictors of the effect size. Publication bias may be present, but the analysis was hampered by the high heterogeneity. Therefore, these results support the association between early-life adversity and blunted cortisol response to social stress, and they suggest that the long-term negative effects of early-life adversity may reach maximum levels in adults.

Prediction of pre-exam state anxiety from ruminative disposition: The mediating role of impaired attentional disengagement from negative information.

Rumination is a maladaptive form of repetitive thinking that enhances stress responses, and heightened disposition to engage in rumination may contribute to the onset and persistence of stress-related symptoms. However, the cognitive mechanisms through which ruminative disposition influences stress reactivity are not yet fully understood. This study investigated the hypothesis that the impact of ruminative disposition on stress reactivity is carried by an attentional bias reflecting impaired attentional disengagement from negative information. We examined the capacity of a measure of ruminative disposition to predict both attentional biases to negative exam-related information, and state anxiety, in students approaching a mid-term exam. As expected, ruminative disposition predicted state anxiety, over and above the level predicted by trait anxiety. Ruminative disposition also predicted biased attentional disengagement from, but not biased attentional engagement with, negative information. Importantly, biased attentional disengagement from negative information mediated the relation between ruminative disposition and state anxiety. These findings confirm that dispositional rumination is associated with difficulty disengaging attention from negative information, and suggest that this attentional bias may be one of the mechanisms through which ruminative disposition influences stress reactivity.

Correction: Individual Differences in Emotion Regulation, Childhood Trauma and Proneness to Shame and Guilt in Adolescence.

[This corrects the article DOI: 10.1371/journal.pone.0167299.].

Shame as a predictor of post-event rumination in social anxiety.

Evidence shows that people with high social anxiety levels ruminate about distressing social events, which contributes to the maintenance of social anxiety symptoms. The present study aimed to explore the role of shame in maintaining post-event rumination (PER) following a negative social event (an impromptu speech with negative feedback) in a student sample (N = 104). Participants reported negative rumination related to the event one day and one week after the speech. PER measured one day after the speech was not associated with social anxiety symptoms and state anxiety. One week later, participants with clinically relevant social anxiety symptoms experienced greater PER. State shame was the only significant predictor of PER in a regression equation that also included social anxiety symptoms, state anxiety and self-evaluation of performance. Possible explanations and implications are discussed in light of cognitive models of social anxiety.

Using a smartphone app to reduce cognitive vulnerability and mild depressive symptoms: Study protocol of an exploratory randomized controlled trial.

BACKGROUND: Depression is a major challenge worldwide, with significant increasing personal, economic, and societal costs. Although empirically supported treatments have been developed, they are not always available for patients in routine clinical care. Therefore, we need effective and widely accessible strategies to prevent the onset of the very first depressive symptoms. Mental health apps could prove a valuable solution for this desideratum. Although preliminary research has indicated that such apps can be useful in treating depression, no study has attempted to test their utility in preventing depressive symptoms. The aim of this exploratory study is to contrast the efficacy of a smartphone app in reducing cognitive vulnerability and mild depressive symptoms, as risk factors for the onset of depression, against a wait-list condition. More specifically, we aim to test an app designed to (1) decrease general cognitive vulnerability and (2) promote engagement in protective, adaptive activities, while (3) counteracting (through gamification and customization) the tendency of premature dropout from intervention. METHODS/DESIGN: Romanian-speaking adults (18 years and older) with access to a computer and the Internet and who own a smartphone are included in the study. Two parallel randomized clinical trials are conducted: in the first one, 50 participants free of depressive symptoms (i.e., who obtain scores ≤4 on the Patient Health Questionnaire, PHQ-9) will be included, while in the second one 50 participants with minimal depressive symptoms (i.e., who obtain PHQ-9 scores between 5 and 9) will be included. Participants undergoing therapy, presenting with substance abuse problems, psychotic symptoms, and organic brain disorders, or serious legal or health issues that would prevent them from using the app, as well as participants reporting suicidal ideation are excluded. Participants randomized to the active intervention will autonomously use the smartphone app for 4 weeks, while the others will be given access to the app after 4 weeks from randomization. The primary outcomes are (1) cognitive vulnerability factors as defined within the cognitive behavioral therapy (CBT) paradigm (i.e., dysfunctional cognitions, irrational beliefs, and negative automatic thoughts) (for the first trial), and (2) level of depressive symptomatology (for the second trial). The app includes self-help materials and exercises based on CBT for depression, presented in a tailored manner and incorporating gamification elements aimed at boosting motivation to use the app. DISCUSSION: This study protocol is the first to capitalize on the ubiquity of smartphones to large-scale dissemination of CBT-based strategies aimed at preventing depression in non-clinical populations. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02783118 . Registered on 26 May 2016.

Individual Differences in Emotion Regulation, Childhood Trauma and Proneness to Shame and Guilt in Adolescence.

Dispositional shame and guilt have been associated with psychopathology and an increasing number of studies have traced this relation back to adolescence. This developmental period is thought to be characterized by maturational changes in emotion regulation, which also play an important role in vulnerability to psychopathology, but little is known about the links between emotion regulation and dispositional shame and guilt. The current study investigated the relations between individual differences in the habitual use of a wide range of emotion regulation strategies and proneness to shame and guilt in a large sample of adolescents (N = 706), aged 13 to 17 years. History of childhood trauma was also assessed. Our results showed that emotion regulation independently explained about 20% of the variance of shame-proneness and guilt-proneness. Higher use of maladaptive (e.g., Self-Blaming, Catastrophizing) and lower use of adaptive (e.g., Refocus on Planning, Positive Reappraisal) emotion regulation strategies were positively associated with shame-proneness. In contrast, lower use of maladaptive (e.g., Catastrophizing, Blaming Others) and higher use of adaptive (e.g., Refocus on Planning, Positive Reappraisal) emotion regulation strategies were associated with guilt-proneness, independent of the influence of childhood trauma, which also explained a relatively minor portion of guilt-proneness. Although there were age differences (i.e., rumination was used more by older adolescents) and sex differences (i.e., girls reported higher use of Putting into Perspective and lower use of Other Blaming compared to boys) in emotion regulation, age and sex were not significantly associated with proneness to shame and guilt. The positive relations with maladaptive emotion regulation underscore the dysfunctional nature of shame-proneness. Future studies could use longitudinal measures to establish that emotion regulation drives dispositional shame and guilt, and also investigate whether emotion regulation optimization is able to normalize proneness to shame and guilt and reduce risk for psychopathology.