Depression self-labeling in U.S. college students: Associations with perceived control and coping strategies.

BACKGROUND: Research on mental illness labeling has demonstrated that self-labeling (identifying with a mental illness label, e.g., "I have depression") is associated with internalized stigma, maladaptive responses to that stigma, and lower quality of life. However, research has not yet examined the link between self-labeling and how individuals cope with emotional distress. It is important to understand this relationship because adaptive and maladaptive methods of coping can lead to positive and negative mental illness outcomes. METHODS: This cross-sectional study examined the link between depression self-labeling, depression symptoms, and three constructs related to depression self-management (perceived control over depression, cognitive emotion regulation strategies, and help-seeking beliefs) in a large (N = 1423) sample of U.S. college students. RESULTS: Approximately one-fifth of students (22.2 %) self-labeled as having depression, while 39.0 % were estimated to meet diagnostic criteria for MDD. After controlling for depression symptom severity, self-labeling was associated with lower levels of perceived control over depression (p = .002), more catastrophizing (p = .013), less perspective taking, refocusing, reappraisal, and planning (ps < 0.05), and more positive help-seeking attitudes towards medication (p < .001) but not therapy. LIMITATIONS: Results are non-causal and may not generalize to non-college populations. CONCLUSIONS: Self-labeling may inform how individuals cope with emotional distress, with the potential for positive and negative effects on clinical outcomes. This is consistent with well-established research on self-labeling with regards to stigma, but extends this research in important new directions.

The mindful gaze: trait mindful people under an instructed emotion regulation goal selectively attend to positive stimuli.

Trait mindfulness confers emotional benefits and encourages skillful emotion regulation, in part because it helps people more deliberately attend to internal experiences and external surroundings. Such heightened attentional control might help skillfully deploy one's attention towards certain kinds of stimuli, which may in turn help regulate emotions, but this remains unknown. Testing how trait mindful people deploy attention when regulating their emotions could help uncover the specific mechanisms of mindfulness that confer its emotional benefits. The present study aimed to determine whether high trait mindfulness is associated with sustained attention biases to (i.e. longer gaze at) emotional scenes, when all participants are given the emotion regulation goal of staying in a positive mood. To measure this, we used eye tracking to assess selective attention to positive, neutral, and negative photographs. Higher trait mindfulness was associated with both a stronger attention bias for positive (vs. neutral and vs. negative) images, as well as greater success staying in a positive mood during viewing. Surprisingly, this attention bias towards the positive images did not mediate the relationship between mindfulness and maintenance of positive mood. Future work should compare visual attention to other emotion regulation strategies that may maximise positive affect for mindful people.

How does emotion regulation change during psychotherapy? A daily diary study of adults in a transdiagnostic partial hospitalization program.

OBJECTIVE: Improvement in emotion regulation is a proposed transdiagnostic mechanism of change. However, treatment research is limited by disorder-specific investigations that assess a narrow number of emotion regulation strategies. Moreover, most assess pre-to-post-treatment change without examining short-term changes throughout psychotherapy that might influence treatment response. METHOD: To address these gaps, this study uses daily diary methodology to examine trajectories of change in use of six emotion regulation strategies during partial hospitalization psychiatric treatment. Treatment was rooted in cognitive behavioral principles and included skills adapted from empirically supported cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) manuals. Participants were adults (N = 364; Mage = 34.6 years; 60% female; 85% non-Hispanic White) with various profiles of mood, anxiety, and obsessive-compulsive disorders who completed symptom measures at baseline and discharge and daily measures of emotion regulation. RESULTS: In the first 7 treatment days, patients increased use of engagement strategies (reappraisal, acceptance) and decreased use of disengagement (expressive suppression) and cognitive perseveration (experiential avoidance, rumination) strategies. Day-to-day trajectories found that decreased use of experiential avoidance predicted next-day changes in distraction and suppression use. In predicting treatment outcomes, steeper rates of decreased suppression use predicted reductions in anxiety, depression, and general psychopathology symptoms; similar patterns were observed for decreased rumination and experiential avoidance use and increased reappraisal use. CONCLUSION: Results add to a growing literature on the value of intentional, constructive engagement with emotional experiences as a mechanism of psychological health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Lay perspectives on emotion: past, present, and future research directions.

Empirical research has demonstrated that individuals vary widely in how they view their emotions. We call the viewpoints that individuals have towards their emotions emotion perspectives. While many subdisciplines of psychology, such as social psychology and clinical psychology, have studied this topic, research thus far can be siloed, despite overlap in terms and constructs. The goal of the current special issue and this introduction is to describe the state of research on emotion perspectives, highlight common themes in streams of emotion perspective research, and present future directions for investigation. The first portion of this introduction to the special issue provides a basic review of emotion perspective research, spotlighting topics such as emotion beliefs, emotion mindsets, lay theories of emotion, and attitudes toward emotion. The second portion of the introduction presents themes that cut across papers in the special issue, with a discussion of future research directions throughout. The goal of this introduction and special issue is to serve as a guide for greater integration in emotion perspective research and to provide a roadmap for emotion perspective research moving forward.

Emotion malleability beliefs influence emotion regulation and emotion recovery among individuals with depressive symptoms.

Despite the centrality of emotion regulation in psychiatric disorders such as depression, there is a lack of experimental studies examining the psychological factors that influence emotion regulation in individuals with depressive symptoms. Participants with current depressive symptoms were randomly assigned to an experimental manipulation promoting more malleable emotion beliefs or the control condition. Participants underwent a negative emotion induction and reported on their affect and emotion regulation during the induction. Individuals who received the experimental manipulation reported greater cognitive reappraisal and greater emotion recovery. Experimental manipulations that can enhance emotion regulation and emotion recovery possess significant promise as a preliminary step in developing brief interventions that can overcome formal barriers to care.

Tobacco Use Predicts Treatment Dropout and Outcome in an Acute, Transdiagnostic Psychiatric Treatment Setting.

Tobacco use is consistently associated with greater levels of depression and anxiety, broadly, and preliminary evidence suggests that current tobacco use is a significant predictor of dropout from psychiatric treatment. The current study extends past work to examine the impact of tobacco use on treatment dropout and outcomes in an acute psychiatric treatment setting. Upon intake to a partial hospitalization program (PHP), patients completed a battery of measures assessing sociodemographic characteristics, current tobacco use, depression and generalized anxiety, and substance use. Patients at the PHP also completed measures assessing levels of depression and generalized anxiety again upon discharge from the program. In line with hypotheses, current tobacco use was a significant predictor of dropout from treatment at the PHP. Importantly, this relationship remained significant when statistically controlling for demographic variables and psychiatric and substance use severity (such as number of previous inpatient psychiatric hospitalizations and degree of alcohol or drug problems). Results from the current study indicate that tobacco use is a significant risk factor for treatment dropout. Further research is needed to replicate these findings and to determine the mechanism underlying this link between tobacco use and treatment dropout for people receiving intensive psychiatric care.

Emotion Beliefs, Emotion Regulation, and Emotional Experiences in Daily Life.

One potential factor that could influence how individuals with at least moderate symptoms of depression cope with upsetting events in their daily lives is the beliefs that these individuals hold about whether emotions are malleable or fixed. The current study adopted an experience sampling approach to examine how the beliefs about emotion's malleability related to daily positive and negative affect and daily emotion regulation efforts among individuals with at least moderate symptoms of depression (N = 84). Results demonstrated that individuals having at least moderate symptoms of depression who held more malleable beliefs about emotions reported decreased negative affect both overall during the day and specifically in response to daily upsetting events. Additionally, these individuals who held more malleable beliefs about their emotions also reported more daily use of cognitive reappraisal to regulate their emotions in response to upsetting daily events. Results from the current study extend previous work examining the relationship between emotion malleability beliefs, emotional experiences, and emotion regulation to examine these relationships in people who are moderately depressed as they navigate the emotional landscape of their daily lives.

Dampening of Positive Affect Predicts Substance Use During Partial Hospitalization.

BACKGROUND: Elevated positive affect is associated with craving for substances of abuse, yet little is known about regulation of positive emotion in substance use disorders. This study tested if the emotion regulation strategy of dampening (deliberately down-regulating positive affect) contributes to substance use outcomes in a transdiagnostic sample. METHODS: Participants (N = 120) were adults endorsing risky substance use, recruited from an acute psychiatric treatment program that requires abstinence during treatment. Craving and dampening were assessed at admission. RESULTS: A logistic regression to evaluate likelihood of substance use during treatment yielded a significant interaction between dampening and frequency of substance use in the previous month: odds of use during treatment were higher among those with heavier pre-treatment use, but only at high levels of dampening. CONCLUSIONS: This study provides preliminary evidence that dampening increases risk for substance use among those with high levels of pre-treatment substance use. Findings are limited by the use of a general psychiatric sample, which did not include individuals seeking treatment for substance use disorders; future studies are needed to replicate this effect in individuals with substance use disorders. Results point to the need for interventions to enhance healthy regulation of positive affect in substance-using populations.

Emotion malleability beliefs and coping with the college transition.

First-year students navigating the transition to undergraduate life experience an increase in psychopathology, yet some students thrive while others struggle. The current study examined whether first-year students' beliefs about emotion's malleability predicted emotion regulation and mental health during this critical period. First-year college students completed a battery of self-report questionnaires at the beginning and end of the fall semester. Students who held more malleable views of emotion at the semester's onset reported more of a decrease in depression, more of an increase in the use of cognitive reappraisal, and decreased reliance on rumination as emotion regulation strategies during the fall semester. As hypothesized, emotion regulation played a significant role linking emotion malleability beliefs to depression. Students' beliefs that emotions were more malleable at the beginning of the semester predicted less depression at the end of the semester through greater use of cognitive reappraisal and less use of rumination. These results suggest that emotion malleability beliefs are systematically related to emotion regulation and mental health adjustment during this stressful transition and could be targets for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Pain catastrophizing and distress intolerance: prediction of pain and emotional stress reactivity.

Exposure to stress is associated with poor outcomes in people with chronic pain. Dispositional variables, such as pain catastrophizing and distress intolerance, may impact reactivity to stressors. Importantly, these variables can be modified with treatment. The aim of this study was to investigate whether pain catastrophizing and distress intolerance were associated with tolerance of a pain stressor or a psychosocial stressor, and heightened negative affect following these stressors. A sample of 50 adults with chronic pain completed self-report measures and pain and psychosocial stress inductions. Results indicated that pain catastrophizing was associated with heightened anxiety during pain induction. Distress intolerance was associated with negative affect following a psychosocial stressor, and with poorer tolerance of the psychosocial stressor. Pain catastrophizing and distress intolerance are related factors, however, they exhibit distinct associations with amplification of pain and psychosocial stress reactivity. These variables may be important treatment targets in people with chronic pain.

Associations between pain catastrophizing and clinical characteristics in adults with substance use disorders and co-occurring chronic pain.

Background: Pain catastrophizing refers to the tendency to interpret pain as harmful, intolerable, or uncontrollable. Greater pain catastrophizing is associated with more pain-related negative phenomena, such as pain reactivity, pain disability, and emotional distress related to pain. Several studies of patients seeking chronic pain treatment have identified an association between pain catastrophizing and misuse of opioids and alcohol; however, it is unknown whether this association would be similarly present in patients with chronic pain seeking substance use disorder treatment. Objectives: The current study examined whether pain catastrophizing is associated with worse pain-related outcomes and psychological functioning in individuals receiving inpatient substance use disorder treatment who endorsed current chronic pain. Methods: In a series of regression models, we tested the associations between pain catastrophizing and functioning, specifically pain interference, craving, anxiety, and days of mood difficulties in a cross-sectional sample of patients seeking substance use disorder treatment with co-occurring chronic pain (N = 244, 67.6% female). Results: Greater pain catastrophizing was associated with more pain interference, higher levels of craving, more anxiety symptoms and more days of mood difficulties, adjusted for demographic characteristics and pain severity. Conclusion: In patients with comorbid substance use disorder and chronic pain, pain catastrophizing may offer a potential therapeutic target to improve substance use treatment outcomes.

Affective vulnerability in substance use disorders.

Substances of abuse are characterized by their rewarding effects and engagement of reward pathways in the brain. However, these substances also provide rapid relief of negative affect, and thus are highly negatively reinforcing. Accordingly, negative affectivity and other affective vulnerabilities (factors related to the experience of affect) are strongly linked to problematic substance use and substance use disorders. In this review, we provide a critical overview of the literature on affective vulnerabilities in substance use disorders. We discuss how both the experience of affect (e.g. negative affectivity, stress reactivity) and the interpretation of affect (e.g. distress intolerance, anxiety sensitivity) are pertinent to the development, maintenance, and treatment of substance use disorders.

Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science.

Beliefs that individuals hold about whether emotions are malleable or fixed, also referred to as emotion malleability beliefs, may play a crucial role in individuals' emotional experiences and their engagement in changing their emotions. The current review integrates affective science and clinical science perspectives to provide a comprehensive review of how emotion malleability beliefs relate to emotionality, emotion regulation, and specific clinical disorders and treatment. Specifically, we discuss how holding more malleable views of emotion could be associated with more active emotion regulation efforts, greater motivation to engage in active regulatory efforts, more effort expended regulating emotions, and lower levels of pathological distress. In addition, we explain how extending emotion malleability beliefs into the clinical domain can complement and extend current conceptualizations of major depressive disorder, social anxiety disorder, and generalized anxiety disorder. This may prove important given the increasingly central role emotion dysregulation has been given in conceptualization and intervention for these psychiatric conditions. Additionally, discussion focuses on how emotion beliefs could be more explicitly addressed in existing cognitive therapies. Promising future directions for research are identified throughout the review.

Psychiatric disorder-weight associations and the moderating effect of sex in an outpatient psychiatric sample.

BACKGROUND: Few studies have examined the association between weight and psychiatric disorders in psychiatric treatment samples, and no known studies in treatment samples have examined potential moderators of the psychiatric illness-weight relationship. The aim of the present study is to examine if weight is associated with specific mood and anxiety disorders in a psychiatric treatment-seeking sample, and if a person's sex moderate any of these associations. Greater knowledge of particular subgroups experiencing psychiatric illness-obesity comorbidity could aid in better providing personalized treatment. METHODS: Participants (N = 3,585) were administered a semi-structured diagnostic interview at initial presentation for treatment. Hierarchical logistic regression analyses examined simple effects of body mass index (BMI) and sex on current mood and anxiety disorders and the moderating effects of sex. RESULTS: We did not find simple effects between BMI and mood/anxiety disorders after controlling for demographic variables. Female sex moderated a relationship between BMI and social anxiety disorder (SAD) only. CONCLUSIONS: Findings suggest that the presence of SAD in psychiatric patients is associated with a higher BMI only for females, yet this was not the case for the presence of other mood and anxiety disorders. Further research examining the relationship between SAD, weight, and sex is warranted.