Social perceptions and the stigmatization towards fifteen mental illnesses in France: a preliminary study on the role of vital force and burden.

Introduction: This study examined social perceptions and rejection towards fifteen mental illnesses, as well as a preliminary test of the SUBAR model, that hypothesized perceptions of both vital forces and burden would be negatively and positively related to social rejection, respectively. Methods: Using an online survey with participants from France (n = 952), social rejection was assessed using a feeling thermometer and a social distance scale, while social perceptions were measured using visual analog scales. Results: A stigma map for these different disorders is drawn up, revealing the social perceptions and levels of stigmatization specific to certain mental illnesses. Controlling for relevant social perceptions (i.e., danger, warmth, competence), we found that perception of burden was positively and significantly associated to social distance and negative feeling for 73% and 67% of mental illnesses, respectively. The perception of vital force was negatively and significantly related to social distance and negative feeling for 87% and 20% of mental illnesses, respectively. The change in R2 between model 1 (i.e. perception of danger, warmth, competence) and model 2 (i.e. model 1 + perceptions of vital force and burden) significantly improved in 100% of cases for social distance and 67% of cases for negative feeling. Conclusion: These preliminary data provide support for the SUBAR model and call for further investigations to better understand the social rejection of people with mental illnesses.

Anorexia nervosa: Enhancing motivation to change with self-determination theory.

Motivational deficits (little or no motivation to change) are often reported in patients with eating disorders, particularly anorexia nervosa. The motivational approaches frequently used by French clinicians rely solely on a dichotomous view of motivation (intrinsic vs. extrinsic). In self-determination theory, certain forms of extrinsic motivation can strengthen an individual's commitment to an activity, providing they are self-determined. This theory therefore extends and enriches the dual motivational approach by highlighting potentially useful forms of extrinsic motivation and by emphasizing the importance of behavioral regulation. Empirical work is now needed to assess how clinicians can use self-determination theory to enhance motivation to change among patients with anorexia nervosa and encourage their adherence to care management plans.

Prevalence of Post-Traumatic Stress Disorder (PTSD) in Healthcare Workers following the First SARS-CoV Epidemic of 2003: A Systematic Review and Meta-Analysis.

The world is still in the grip of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with putative psychological consequences for healthcare workers (HCWs). Exploring the prevalence of post-traumatic stress disorder (PTSD) during the first SARS-CoV-1 epidemic in 2003 may inform us of the long-term effects of the actual pandemic, as well as putative influencing factors such as contact with the virus, time effects, or the importance of some sociodemographic data. This information may help us develop efficient preventive strategies. Therefore, we conducted a systematic review and meta-analysis on the prevalence of PTSD in HCWs following the SARS-CoV-1 in 2003. PubMed, Embase, Google Scholar, Psychinfo, and Web of Science were searched until September 2022. Random-effects meta-analyses were stratified by the time of follow-up. We included 14 studies: 4842 HCWs (32.0 years old, 84% women). The overall prevalence of PTSD was 14% (95CI 10 to 17%). The prevalence of PTSD was 16% (8 to 24%) during the epidemic, 19% (16 to 22%) within 6 months after the epidemic, and 8% (4 to 13%) more than one year after the end of the epidemic. The longest follow-up was three years after the epidemic, with 10% of HCWs with PTSD. Nevertheless, the prevalence of PTSD was significantly lower more than one year after the end of the epidemic than the first six months after the epidemic (Coefficient -10.4, 95CI -17.6 to -3.2, p = 0.007). In conclusion, the prevalence of PTSD in HCWs was high during the first epidemic of SARS-CoV in 2003 and remained high in the long term. The lessons from the SARS-CoV-1 epidemic may help prevent a wave of PTSD following the latest COVID-19 pandemic.

Validation of Visual Analogue Scales of job demand and job control at the workplace: a cross-sectional study.

OBJECTIVES: Work-related stress is a major concern. One of the best performing models is the Job Content Questionnaire (JCQ) of Karasek, assessing job demand and job control using 18 items. However, the JCQ is long and complex. Visual Analogue Scales (VASs) are easy to use and quick to implement. VASs have been validated to assess pain and occupational stress; however, VASs demand and control have not been evaluated. Therefore, we aimed to validate the use of VAS demand and control compared with the 18 items of the JCQ. DESIGN: We implemented a cross-sectional observational study, by administering a self-reported questionnaire to the users of Wittyfit software, with a second test (retest) proposed 1 week later. In addition to JCQ, VAS demand and control, we measured sociodemographic outcomes, as well as characteristics of work, sleep, well-being, stress, depression and anxiety. PARTICIPANTS: 190 volunteers French workers using WittyFit software participated in the study, and 129 completed the test-retest. RESULTS: VAS demand and VAS control correlated with the two Karasek domains from the JCQ, respectively, at 0.59 and 0.57 (p<0.001). Test-retest reliability highlighted concordance coefficients higher than 0.70. Sensitivity was higher than 70% for each VAS. External validity was acceptable. For both demand and control, VAS cut-offs were 75/100. Compared with other workers, senior executives and individuals with master's degrees had higher levels of job control but did not differ in job demand using the VAS and JCQ. CONCLUSIONS: VAS demand and VAS control are valid, quick, easy to use, and reliable tools for the assessment of job demand and job control. They can be used in daily clinical practice for primary prevention and diagnosis. However, when results are over 75 mm on VAS, we promote the use of JCQ to be more discriminant and specific to initiate action plans to help workers. TRIAL REGISTRATION NUMBER: NCT02596737.

PTSD as the second tsunami of the SARS-Cov-2 pandemic.

Since the first cases, the coronavirus disease (COVID-19) rapidly spread around the world, with hundred-thousand cases and thousands of deaths. Post-traumatic stress disorder (PTSD) is a common consequence of major disasters. Exceptional epidemic situations also promoted PTSD in the past. Considering that humanity is undergoing the most severe pandemic since Spanish Influenza, the actual pandemic of COVID-19 is very likely to promote PTSD. Moreover, COVID-19 was renamed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). With a poor understanding of viruses and spreading mechanisms, the evocation of SARS is generating a great anxiety contributing to promote PTSD. Quarantine of infected patients evolved to quarantine of 'infected' towns or popular districts, and then of entire countries. In the families of cases, the brutal death of family members involved a spread of fear and a loss of certainty, promoting PTSD. In the context of disaster medicine with a lack of human and technical resources, healthcare workers could also develop acute stress disorders, potentially degenerating into chronic PTSD. Globally, WHO estimates 30-50% of the population affected by a disaster suffered from diverse psychological distress. PTSD individuals are more at-risk of suicidal ideation, suicide attempt, and deaths by suicide - considering that healthcare workers are already at-risk occupations. We draw attention towards PTSD as a secondary effect of the SARS-Cov-2 pandemic, both for general population, patients, and healthcare workers. Healthcare policies need to take into account preventive strategy of PTSD, and the related risk of suicide, in forthcoming months.

Exploring the Link between Work Addiction Risk and Health-Related Outcomes Using Job-Demand-Control Model.

Purpose of the study: Work addiction risk is a growing public health concern with potential deleterious health-related outcomes. Perception of work (job demands and job control) may play a major role in provoking the risk of work addiction in employees. We aimed to explore the link between work addiction risk and health-related outcomes using the framework of job-demand-control model. Methods: Data were collected from 187 out of 1580 (11.8%) French workers who agreed to participate in a cross-sectional study using the WittyFit software online platform. The self-administered questionnaires were the Job Content Questionnaire by Karasek, the Work Addiction Risk Test, the Hospital Anxiety and Depression scale and socio-demographics. Data Analysis: Statistical analyses were performed using the Stata software (version 13). Results: There were five times more workers with a high risk of work addiction among those with strong job demands than in those with low job demands (29.8% vs. 6.8%, p = 0.002). Addiction to work was not linked to job control (p = 0.77), nor with social support (p = 0.22). We demonstrated a high risk of work addiction in 2.6% of low-strain workers, in 15.0% of passive workers, in 28.9% of active workers, and in 33.3% of high-strain workers (p = 0.010). There were twice as many workers with a HAD-Depression score ≥11 compared with workers at low risk (41.5% vs. 17.7%, p = 0.009). Sleep quality was lower in workers with a high risk of work addiction compared with workers with a low risk of work addiction (44.0 ± 27.3 vs. 64.4 ± 26.8, p < 0.001). Workers with a high risk of work addiction exhibited greater stress at work (68.4 ± 23.2 vs. 47.5 ± 25.1) and lower well-being (69.7 ± 18.3 vs. 49.3 ± 23.0) compared with workers at low risk (p < 0.001). Conclusions: High job demands are strongly associated with the risk of work addiction. Work addiction risk is associated with greater depression and poor quality of sleep. Preventive strategies should benefit from identifying more vulnerable workers to work addiction risk.

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome.

Alexithymia is usually described by three main dimensions difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). The most commonly used questionnaire investigating alexithymia, the Toronto Alexithymia Scale (TAS-20), supports this three-factor structure. One important assumption is that alexithymia severity is associated to vulnerability to somatic diseases, among them gastrointestinal disorders. However, the association between alexithymia and gastrointestinal disorders is not systematic, thus questioning the role of alexithymia as a vulnerability factor for those illnesses. A recent factor analysis suggested another four-factor structure for the TAS-20: difficulties in awareness of feelings (DAF), difficulties in interoceptive abilities (DIA), externally oriented thinking (EOT), and poor affective sharing (PAS). We assume that DIA and DAF might be more relevant to investigate the association between alexithymia and gastrointestinal disorders. The rationale is that DIA and DAF reflect impairments in emotion regulation that could contribute to an inappropriate autonomic and HPA axis homeostasis in irritable bowel syndrome (IBS), ulcerative colitis (UC), or Crohn's disease (CD). The aim of this study was to investigate whether DIA and DAF are associated with the presence of IBS, UC or CD, while checking for anxiety, depression, parasympathetic (vagus nerve) activity and cortisol levels. We recruited control participants (n=26), and patients in remission who were diagnosed with IBS (n=24), UC (n=18), or CD (n=21). Participants completed questionnaires to assess anxiety, depression, and alexithymia. A blood sample and an electrocardiogram were used to measure the level of cortisol and parasympathetic activity, respectively. Logistic regressions with the four-factor structure of the TAS-20 revealed that DIA was a significant predictor of IBS (W(1)=6.27, p=.01). Conversely, DIA and DAF were not significant predictors in CD and UC patients. However, low cortisol level was a significant predictor of UC (W(1)=4.67, p=.035). Additional logistic regressions based on the original 3-factor structure of TAS-20 (DIF, DDF, and EOT) showed that only DDF was a significant predictor of CD [W(1)=6.16, p < .001]. The present study suggests that DIA is an important dimension for assessing potential risk for gastrointestinal diseases, in particular for IBS.

Importance of considering interoceptive abilities in alexithymia assessment.

BACKGROUND: Recent studies have shown that people with high alexithymia scores have decreased interoceptive abilities, which can be associated with psychological and physical disorders. Early assessments of the alexithymia trait included the evaluation of these abilities through the dimension measuring the difficulty in identifying and distinguishing between feelings and bodily sensations (the 26-item Toronto Alexithymia Scale; TAS-26). The revised version of the TAS, the TAS-20, contains a three-factor solution that does not involve a dimension assessing interoceptive abilities. However, the three items allowing the evaluation of these abilities are still present in the TAS-20. In this context, we hypothesized that the 3 items which assess interoceptive abilities in the TAS-20 should constitute an independent factor. In addition to exploring the internal structure of the TAS-20, we examined its external validity by assessing the relationships between the new factors and self-reported measures of personality trait and psychological and physical health. METHOD: Two online studies (N = 253 and N = 287) were performed. The participants completed the TAS-20 and a set of psychological questionnaires (e.g., anxiety, depression) and health questions (e.g., "Do you suffer from a somatic disorder?"). The structure of the TAS-20 was examined using exploratory factor analysis (EFA), followed by an investigation of the relationships between the resulting new factors and other psychological and health data using regressions. In both studies, EFA revealed a new structure of the questionnaire consisting of four dimensions: (1) difficulty in the awareness of feelings, (2) externally oriented thinking, (3) difficulty in interoceptive abilities, and (4) poor affective sharing. The first factor was positively associated with all self-reported psychological and personality trait measures while the third factor was associated more with somatic disorders and medication intake. RESULTS: Our results suggest the presence of a new latent factor in the assessment of alexithymia that reflects interoceptive abilities specifically related to health and personality trait outcomes. In accordance with the results and the literature, it seems important to include an assessment of interoceptive abilities when considering the evaluation of alexithymia. The next step would be to develop a valid measure of these abilities.

Introduction and validation of the Natural Disasters Picture System (NDPS).

Given the growing demand for studies dealing with natural disasters, the research fields of emotion and social cognition require validated picture stimuli of natural hazards. Such material is essential for studying perceptual processes and behaviors of exposed individuals, and it could find practical applications, such as the improvement of communication strategies during crises. We present the Natural Disasters Picture System (NDPS), a database of pictures of natural hazards, with an emphasis on volcanic threats, and their impact on the environment and humans. We first describe in detail the picture selection and database creation. We then report the validation procedure. One hundred twenty participants rated the pictures on the basis of four dimensions: valence, arousal, dominance and certainty. For each picture, we ultimately determined the best-fitting emotion on the basis of its dimensional pattern. The Hierarchical Ascendant Classification, which yielded 4 clusters subdivided into 9 classes, indicated a highly consistent and distinctive classification of the pictures. Overall, 90% of the pictures elicited negative emotions (fear or sadness), and the other 10% induced neutral to positive emotions (e.g., aesthetic emotions). The NDPS offers a new tool for studying natural events and disasters in the field of affective and cognitive sciences, which will benefit from scientific research and its practical applications. The NDPS is unrestrictedly accessible for researchers.

Influence of uncertainty on framed decision-making with moral dilemma.

In cases of impending natural disasters, most events are uncertain and emotionally relevant, both critical factors for decision-making. Moreover, for exposed individuals, the sensitivity to the framing of the consequences (gain or loss) and the moral judgments they have to perform (e.g., evacuate or help an injured person) constitute two central effects that have never been examined in the same context of decision-making. In a framed decision-making task with moral dilemma, we investigated whether uncertainty (i.e., unpredictably of events) and a threatening context would influence the framing effect (actions framed in loss are avoided in comparison to the ones framed in gain) and the personal intention effect (unintentional actions are more morally acceptable in comparison to intentional actions) on the perceived moral acceptability of taking action. Considering the impact of uncertainty and fear on the processes underlying these effects, we assumed that these emotions would lead to the negation of the two effects. Our results indicate that the exposure to uncertain events leads to the negation of the framing effect, but does not influence the moral acceptability and the effect of personal intention. We discuss our results in the light of dual-process models (i.e. systematic vs. heuristic), appraisal theories, and neurocognitive aspects. These elements highlight the importance of providing solutions to cope with uncertainty, both for scientists and local populations exposed to natural hazards.

Work Addiction Test Questionnaire to Assess Workaholism: Validation of French Version.

BACKGROUND: Work addiction is a significant public health problem with a growing prevalence. The Work Addiction Risk Test (WART) is the gold standard questionnaire to detect workaholism. OBJECTIVE: The main objective of this study was to validate the French version of the WART. METHODS: Questionnaires were proposed to voluntary French workers using the WittyFit software. There were no exclusion criteria. The questionnaire was administered anonymously for initial validity testing and readministered one week later for test-retest reliability. We also assessed the workers' sociodemographic characteristics, as well as other measurements for external validity, such as stress, well-being, and coaddictions to tobacco, alcohol, and cannabis. Several psychometric properties of the French-WART were explored: acceptability, reliability (internal consistency [Cronbach alpha coefficient] and reproducibility [Lin concordance coefficient]), construct validity (correlation coefficients and principal component analysis), and external validity (correlation coefficients). RESULTS: Among the 1580 workers using WittyFit, 187 (11.83%) agreed to complete the WART questionnaire. Of those, 128 completed the test-retest survey (68.4%). Acceptability found that all respondents had fully completed the questionnaire, with few floor or ceiling effects. Reliability was very good with a Cronbach alpha coefficient at .90 (internal consistency) and Lin concordance coefficient at .90 (95% CI .87-.94] with a difference on the retest of .04 (SD 4.9) (95% CI -9.6 to 9.7) (reproducibility). We identified three main dimensions (construct validity). Relationships between WART and stress and well-being confirmed its external validity. CONCLUSIONS: The French version of the WART is a valid and reliable instrument to assess work addiction with satisfactory psychometric properties. Used in occupational medicine, this tool would allow the diagnosis of work addiction and can be easily implemented in current practice.

Relationship between vagal tone, cortisol, TNF-alpha, epinephrine and negative affects in Crohn's disease and irritable bowel syndrome.

Crohn's disease (CD) and irritable bowel syndrome (IBS) involve brain-gut dysfunctions where vagus nerve is an important component. The aim of this work was to study the association between vagal tone and markers of stress and inflammation in patients with CD or IBS compared to healthy subjects (controls). The study was performed in 73 subjects (26 controls, 21 CD in remission and 26 IBS patients). The day prior to the experiment, salivary cortisol was measured at 8:00 AM and 10:00 PM. The day of the experiment, subjects completed questionnaires for anxiety (STAI) and depressive symptoms (CES-D). After 30 min of rest, ECG was recorded for heart rate variability (HRV) analysis. Plasma cortisol, epinephrine, norepinephrine, TNF-alpha and IL-6 were measured in blood samples taken at the end of ECG recording. Compared with controls, CD and IBS patients had higher scores of state-anxiety and depressive symptomatology. A subgroup classification based on HRV-normalized high frequency band (HFnu) as a marker of vagal tone, showed that control subjects with high vagal tone had significantly lower evening salivary cortisol levels than subjects with low vagal tone. Such an effect was not observed in CD and IBS patients. Moreover, an inverse association (r =  -0.48; p<0.05) was observed between the vagal tone and TNF-alpha level in CD patients exclusively. In contrast, in IBS patients, vagal tone was inversely correlated with plasma epinephrine (r =  -0.39; p<0.05). No relationship was observed between vagal tone and IL-6, norepinephrine or negative affects (anxiety and depressive symptomatology) in any group. In conclusion, these data argue for an imbalance between the hypothalamus-pituitary-adrenal axis and the vagal tone in CD and IBS patients. Furthermore, they highlight the specific homeostatic link between vagal tone and TNF-alpha in CD and epinephrine in IBS and argue for the relevance of vagus nerve reinforcement interventions in those diseases.

Dopamine replacement therapy and deep brain stimulation of the subthalamic nuclei induce modulation of emotional processes at different spatial frequencies in Parkinson's disease.

BACKGROUND: Deep brain stimulation of the subthalamic nuclei (STN-DBS) is an effective treatment for the most severe forms of Parkinson's disease (PD) and is intended to suppress these patients' motor symptoms. However, be it in association with Dopamine Replacement Therapy (DRT) or not, STN-DBS may in some cases induce addictive or emotional disorders. OBJECTIVE: In the current study, we suggest that PD patients suffer from emotional deficits that have not been revealed in previous studies because in those experiments the stimuli were displayed for a time long enough to allow patients to have recourse to perceptual strategies in order to recognize the emotional facial expressions (EFE). METHODS: The aim of the current article is to demonstrate the existence of emotional disorders in PD by using a rapid presentation of the visual stimuli (200-ms display time) which curtails their perceptual analysis, and to determine whether STN-DBS, either associated or not associated with DRT, has an impact on the recognition of emotions. RESULTS: The results show that EFE recognition performance depends on both STN-DBS ('on' vs. 'off') and medication ('on' vs. 'off'), but also that these variables have an interactive influence on EFE recognition performance. Moreover, we also reveal how these EFE impairments depend on different spatial frequencies perceptual channels (related to different cortical vs. subcortical neural structures). CONCLUSIONS: The effect of PD without therapy seems to be particularly acute for LSF emotional faces, possibly due to a subcortical dysfunction. However, our results indicate that the joint action of STN-DBS and DRT could also disrupt recognition of emotional expressions at the level of occipito-temporal cortical areas (processing HSF visual information) inducing broad global impairment of EFE at the level of HSF visual channels.

The combined effect of subthalamic nuclei deep brain stimulation and L-dopa increases emotion recognition in Parkinson's disease.

Deep brain stimulation of the subthalamic nucleus (DBS) is a widely used surgical technique to suppress motor symptoms in Parkinson's disease (PD), and as such improves patients' quality of life. However, DBS may produce emotional disorders such as a reduced ability to recognize emotional facial expressions (EFE). Previous studies have not considered the fact that DBS and l-dopa medication can have differential, common, or complementary consequences on EFE processing. A thorough way of investigating the effect of DBS and l-dopa medication in greater detail is to compare patients' performances after surgery, with the two therapies either being administered ('on') or not administered ('off'). We therefore used a four-condition (l-dopa 'on'/DBS 'on', l-dopa 'on'/DBS 'off', l-dopa 'off'/DBS 'on', and l-dopa 'off'/DBS 'off') EFE recognition paradigm and compared implanted PD patients to healthy controls. The results confirmed those of previous studies, yielding a significant impairment in the detection of some facial expressions relative to controls. Disgust recognition was impaired when patients were 'off' l-dopa and 'on' DBS, and fear recognition impaired when 'off' of both therapies. More interestingly, the combined effect of both DBS and l-dopa administration seems much more beneficial for EFE recognition than the separate administration of each individual therapy. We discuss the implications of these findings in the light of the inverted U curve function that describes the differential effects of dopamine level on the right orbitofrontal cortex (OFC). We propose that, while l-dopa could "overdose" in dopamine the ventral stream of the OFC, DBS would compensate for this over-activation by decreasing OFC activity, thereby restoring the necessary OFC-amygdala interaction. Another finding is that, when collapsing over all treatment conditions, PD patients recognized more neutral faces than the matched controls, a result that concurs with embodiment theories.

Embodiment of emotion concepts.

Theories of embodied cognition hold that higher cognitive processes operate on perceptual symbols and that concept use involves partial reactivations of the sensory-motor states that occur during experience with the world. On this view, the processing of emotion knowledge involves a (partial) reexperience of an emotion, but only when access to the sensory basis of emotion knowledge is required by the task. In 2 experiments, participants judged emotional and neutral concepts corresponding to concrete objects (Experiment 1) and abstract states (Experiment 2) while facial electromyographic activity was recorded from the cheek, brow, eye, and nose regions. Results of both studies show embodiment of specific emotions in an emotion-focused but not a perceptual-focused processing task on the same words. A follow up in Experiment 3, which blocked selective facial expressions, suggests a causal, rather than simply a correlational, role for embodiment in emotion word processing. Experiment 4, using a property generation task, provided support for the conclusion that emotions embodied in conceptual tasks are context-dependent situated simulations rather than associated emotional reactions. Implications for theories of embodied simulation and for emotion theories are discussed.

Imitation of in-group versus out-group members' facial expressions of anger: a test with a time perception task.

This research investigated the automatic imitation of facial expressions of anger by in-group and out-group members, using a temporal estimation task. Individuals typically overestimate duration represented by angry faces, probably due to increases in arousal (Droit-Volet, Brunot, & Niedenthal, 2004). Overestimation is not observed when imitation of the facial expressions is inhibited, suggesting that embodied simulation mediates the changes in arousal (Effron, Niedenthal, Gil, & Droit-Volet, 2006). This method thus provides an implicit measure of imitation and was used to test the hypothesis that individuals imitate in-group, but not out-group members' facial expressions of emotion. In separate studies Chinese and French Caucasian participants were presented with short (400 ms) and long (1600 ms) standard durations in a temporal bisection task. They then categorized standard and intermediate durations, represented by angry and neutral faces, in terms of similarity to the short and long standard durations. Half of the face stimuli were Chinese, and half Caucasian. Results revealed a bias in the temporal perception of emotion for the Caucasian participants when they were presented with Caucasian facial expressions and not Chinese ones. In contrast, this bias in time perception was observed when Chinese individuals imitated faces of both in- and out-group members. The results of the Chinese participants are interpreted in terms of familiarity with and motivations to understand the emotional expressions of members of a host culture.

Beliefs about power and its relation to emotional experience: a comparison of Japan, France, Germany, and the United States.

This research examined the concept of power in Japan, France, Germany, and the United States, as well as beliefs about the emotions persons in power tend to elicit in others and about powerful people's regulation (specifically, inhibition) of certain emotions. Definitions of power were assessed by examining the importance of two main components: control over self versus other and freedom of action vis-à-vis social norms. Beliefs about both positive (pride, admiration) and negative (jealousy, contempt) emotions were measured. Analyses revealed that the concept of power differed across countries and that the definitions of power as well as country of origin significantly predicted beliefs about the emotions that are elicited in others by powerful people and also the regulation of expression of emotion by powerful people.