"It's ok that I feel like this": a qualitative study of adolescents' and parents' experiences of facilitators, mechanisms of change and outcomes in a joint emotion regulation group skills training.

BACKGROUND: Emotion regulation difficulties underlie several psychiatric conditions, and treatments that focus on improving emotion regulation can have an effect on a broad range of symptoms. However, participants' in-depth experiences of participating in emotion regulation treatments have not been much studied. In this qualitative study, we investigated participants' experiences of a joint emotion regulation group skills training in a child and adolescent psychiatric outpatient setting. METHODS: Twenty-one participants (10 adolescents and 11 parents) were interviewed about their experiences after they had participated in a seven-session transdiagnostic emotion regulation skills training for adolescents and parents. The aim of the skills training was to decrease emotion regulation difficulties, increase emotional awareness, reduce psychiatric symptoms, and enhance quality of life. The skills training consisted of psychoeducation about emotions and skills for regulating emotions. The interviews were transcribed and analysed using reflexive thematic analysis. RESULTS: The analysis resulted in three overarching themes: Parent - Child processes, Individual processes, and Group processes. The result showed that participants considered an improved parent-child relationship to be the main outcome. Increased knowledge, emotion regulation skills and behavioural change were conceptualised as both mechanisms of change and outcomes. The group format, and the fact that parents and adolescents participated together, were seen as facilitators. Furthermore, the participants experienced targeting emotions in skills training as meaningful and helpful. CONCLUSION: The results highlight the potential benefits of providing emotion regulation skills training for adolescents and parents together in a group format to improve the parent-child relationship and enable the opportunity to learn skills.

Nonprescription drug-related problems and pharmacy interventions.

OBJECTIVE: To document the number and types of drug-related problems (DRPs) identified in customers purchasing nonprescription products in Swedish pharmacies; describe the distribution of DRPs by customer's gender, age, underlying ailment, and class of drug; determine whether problems are identified to the same extent in pharmacies with staffed nonprescription self-service departments as in pharmacies with over-the-counter sales; and document the number and types of pharmacy interventions to prevent or resolve DRPs, including reasons for drug switches and referrals to physicians. METHODS: A computerized instrument for documentation of DRPs and pharmacy interventions was developed. The study was conducted in 45 volunteer pharmacies in Sweden during 10 weeks in late 1999. RESULTS: A total of 1,425 problems and 2,040 interventions were recorded by 308 pharmacy practitioners. Relatively fewer DRPs were documented in pharmacies with self-service departments. The most common DRPs were uncertainty about the indication for the drug (33.5%) and therapy failure (19.5%). Dyspepsia was the most frequently specified symptom (11.4%). Consumers of dermatologic products had significantly higher rates of problems than expected in relation to sales volume. The most common ways of responding to a problem were with consumer drug counseling (61.1%), switching of drugs (43.9%), and referral to a physician (27.5%). CONCLUSIONS: The study has demonstrated a need for more professional attention and intervention by pharmacy staff to prevent and rectify DRPs in nonprescription consumers. It seems especially important to make sure that consumers receive the appropriate drugs for their current ailments.

Unconscious facial reactions to emotional facial expressions.

Studies reveal that when people are exposed to emotional facial expressions, they spontaneously react with distinct facial electromyographic (EMG) reactions in emotion-relevant facial muscles. These reactions reflect, in part, a tendency to mimic the facial stimuli. We investigated whether corresponding facial reactions can be elicited when people are unconsciously exposed to happy and angry facial expressions. Through use of the backward-masking technique, the subjects were prevented from consciously perceiving 30-ms exposures of happy, neutral, and angry target faces, which immediately were followed and masked by neutral faces. Despite the fact that exposure to happy and angry faces was unconscious, the subjects reacted with distinct facial muscle reactions that corresponded to the happy and angry stimulus faces. Our results show that both positive and negative emotional reactions can be unconsciously evoked, and particularly that important aspects of emotional face-to-face communication can occur on an unconscious level.

Rapid facial reactions to emotional facial expressions.

This study explored how rapidly emotion specific facial muscle reactions were elicited when subjects were exposed to pictures of angry and happy facial expressions. In three separate experiments, it was found that distinctive facial electromyographic reactions, i.e., greater Zygomaticus major muscle activity in response to happy than to angry stimuli and greater Corrugator supercilii muscle activity in response to angry stimuli, were detectable after only 300-400 ms of exposure. These findings demonstrate that facial reactions are quickly elicited, indicating that expressive emotional reactions can be very rapidly manifested and are perhaps controlled by fast operating facial affect programs.