Emotion regulation and tic disorders in children.

Tic disorders (TD) are developmental neuropsychiatric conditions often accompanied by comorbid conditions, and psychosocial hardships for child and family. The etiology of tics is unknown, and is complex and multifactorial. Stress is known to aggravate tic expression as well as associated comorbidities. Consequently, this study focused on possible connections between stress, emotion regulation, tic expression, and related psychopathology. Sixty consecutive admissions were assessed for perceived stress, emotional dysregulation, severity of obsessions and compulsions, anxiety, depression, attention deficit disorder, and tic expression at a TD clinic, in a university affiliated pediatric hospital. The results indicated that stress and emotion dysregulation were significantly related to both tic expression and severity of comorbidities. We discuss the role of emotion regulation dimensions regarding TD and related psychopathology as well as the mediating role of emotion regulation, and how they may contribute to the development of improved therapies for children with TD.

The long-term impact of tissue injury on pain processing and modulation: a study on ex-prisoners of war who underwent torture.

BACKGROUND: Tissue injury may, in some instances, induce chronic pain lasting for decades. Torture survivors suffer from high rates of chronic pain and hypersensitivity in the previously injured regions. Whether torture survivors display generalized alterations in pain perception and modulation, and whether such alterations underlie their chronic pain is unknown. We aimed at exploring the long-term alterations in pain perception and modulation in torture survivors. METHODS: In order to address these questions, a systematic quantitative somatosensory evaluation was performed in individuals (n = 60) who suffer from chronic pain, and who, decades previously, were tortured, resulting in substantial tissue damage. These individuals were compared with age- and sex-matched individuals (n = 44) of similar background. Testing included the measurement of pain threshold and pain tolerance, perceived suprathreshold stimuli, conditioned pain modulation (CPM) and temporal summation of pain (TSP) in intact body regions. RESULTS: Chronic pain was found highly prevalent (86.6%) among torture survivors, who exhibited higher suprathreshold pain ratings (p < 0.05), poorer CPM (p < 0.0001) and stronger TSP (p < 0.0001) than controls. Significant differences in CPM and TSP were also found between torture survivors and controls with chronic pain. Chronic pain intensity among torture survivors correlated negatively with the magnitude of CPM (r = -0.47, p < 0.01). CONCLUSIONS: Torture appears to induce generalized dysfunctional pain modulation that may underlie the intense chronic pain experienced by torture survivors decades after torture. The results may be generalized to instances where chronic pain exists for decades after severe injury in non-tortured populations and emphasize the importance of preventive care.

Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder.

BACKGROUND: Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. METHOD: The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. RESULTS: Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. CONCLUSIONS: The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.

An existentialist view on mortality salience effects: personal hardiness, death-thought accessibility, and cultural worldview defence.

Two studies examined the possible moderating role of hardiness on reactions to mortality salience inductions. A sample of 240 Israeli undergraduate students completed a hardiness scale, were exposed to a mortality salience or control induction, and then either rated the severity and punishment of 10 social transgressions (Study 1, N = 120) or performed a word-stem completion task, which tapped the accessibility of death-related thoughts (Study 2, N = 120). Results indicated that a mortality salience induction led to more severe judgments of social transgressions as well as to more severe punishments than a control induction only among participants scoring low in the hardiness scale. However, a mortality salience induction led to a higher cognitive accessibility of death-related thoughts than a control condition regardless of participants' hardiness scores. The discussion emphasizes the importance of considering inner resources when examining reactions to mortality reminders.

The affective component of the secure base schema: affective priming with representations of attachment security.

Using an affective priming procedure (S. T. Murphy & R. B. Zajonc, 1993), 7 studies examined the effects of the contextual activation of representations of attachment security (secure base schema) on the evaluation of neutral stimuli under either neutral or stressful contexts. In all the studies, participants also reported on their attachment style. Results indicated that the subliminal priming of secure base representations led to more positive affective reactions to neutral stimuli than did the subliminal priming of neutral or no pictures under both neutral and stressful contexts. Although the subliminal priming of positively valued, attachment-unrelated representations heightened positive evaluations under neutral contexts, it failed to elicit positive affect under stressful contexts. The results also revealed interesting effects of attachment style. The discussion focuses on the affective component of the secure base schema.

Attachment theory and intergroup bias: evidence that priming the secure base schema attenuates negative reactions to out-groups.

Five studies examined the effects of priming the secure base schema on intergroup bias. In addition, Studies 1-2 examined the effects of dispositional attachment style, Studies 2-5 examined a mood interpretation, Study 3 examined the mediating role of threat appraisal, and Studies 4-5 examined the effects of secure base priming while inducing a threat to self-esteem or cultural worldview. Secure base priming led to less negative evaluative reactions toward out-groups than positive affect and neutral control conditions. In addition, whereas the effects of secure base priming did not depend on attachment style and were not explained by mood induction, they were mediated by threat appraisal and occurred even when self-esteem or cultural worldview was threatened. The discussion emphasizes the relevance of attachment theory for understanding intergroup attitudes.

Attachment theory and reactions to others' needs:' evidence that activation of the sense of attachment security promotes empathic responses.

Five studies examined the effects of chronic and contextual activation of attachment security on reactions to others' needs. The sense of attachment security was contextually primed by asking participants to recollect personal memories, read a story, or look at a picture of supportive others or by subliminally exposing them to proximity-related words. This condition was compared against the priming of neutral themes, positive affect, or attachment-insecurity schemas. Then reports of empathy and personal distress or the accessibility of empathy and personal-distress memories were assessed. Attachment-security priming strengthened empathic reactions and inhibited personal distress. Self-reports of attachment anxiety and avoidance were inversely related to empathy, and attachment anxiety was positively related to personal distress. The discussion emphasizes the relevance of attachment theory for explaining reactions to others' needs.

Exploring individual differences in reactions to mortality salience: does attachment style regulate terror management mechanisms?

Five studies examined the contribution of attachment style to mortality salience effects. In Study 1, mortality salience led to more severe judgments of transgressions only among anxious-ambivalent and avoidant persons but not among secure persons. In addition, whereas anxious-ambivalent persons showed immediate and delayed increases in severity judgments, avoidant persons showed this response only after a delay period. In Study 2, anxious-ambivalent persons showed immediate and delayed increases in death-thought accessibility after death reminders. Avoidant and secure persons showed this effect only after a delay period. Study 3 revealed that worldview defense in response to mortality salience reduced death-thought accessibility only among avoidant persons. Studies 4-5 revealed that mortality salience led to an increase in the sense of symbolic immortality as well as in the desire of intimacy only among secure persons, but not among avoidant and anxious-ambivalent persons.

Stress and accessibility of proximity-related thoughts: exploring the normative and intraindividual components of attachment theory.

Three studies examine the effects of stress on the accessibility of proximity-related thoughts. In all the studies, participants reported on their attachment style, and the accessibility of proximity themes and worries in a lexical decision task was assessed upon the priming of a stress or neutral word. In Study 2, the primed stress word was semantically related to attachment themes. In Study 3, lexical decisions were made under low or high cognitive load conditions. Overall, the priming of a stress word led to increased accessibility of proximity themes, regardless of attachment style. Anxious-ambivalent people also showed high accessibility to proximity themes and worries in both neutral and stress contexts. In most conditions, avoidant persons' reactions were similar to those of secure persons. However, they showed no accessibility to proximity worries even after the priming of a semantically related word and reacted with high accessibility to these worries upon the addition of cognitive load.

Does a threat appeal moderate reckless driving? A terror management theory perspective.

A series of two studies examined the effects of threat appeals on reckless driving from a terror management theory perspective. In both studies, all the participants (N = 109) reported on the relevance of driving to their self-esteem, and, then, half of them were exposed to a road trauma film and the remaining to a neutral film. In Study 1, the dependent variable was the self-report of intentions to drive recklessly in hypothetical scenarios. In Study 2, the dependent variable was actual behavior (driving speed) in a driving simulator. Findings indicated that a road trauma film led to less reported intentions of reckless driving, but to higher driving speed than a neutral film. These effects were only found among participants who perceived driving as relevant to their self-esteem. The discussion emphasized the self-enhancing mechanisms proposed by the terror management theory.

The association between parental reports of attachment style and family dynamics, and offspring's reports of adult attachment style.

This research assessed the association between parents' reports of attachment styles and their perceptions of family environment, on the one hand, and offspring's reports of adult attachment styles, on the other. The sample included 98 Israeli young adults who completed the adult attachment style scale, and their mothers and fathers who completed this scale, as well as FACES III, and the conflict and expressiveness subscales of the Family Environment Scale. Findings revealed associations between parents' and offspring's reports of attachment styles, which were qualified by gender matching. They also indicated independent and differential contributions of the examined dimensions of perceived family environment to offspring's attachment styles. The discussion attempts to integrate attachment theory with a family system perspective.

Adult attachment style and the perception of others: the role of projective mechanisms.

In 3 reported studies the authors examined attachment-style differences in the perception of others and the hypothesis that projective mechanisms underlie these differences. In these studies, participants reported on their attachment style and generated actual-self-traits and unwanted-self-traits. Then, a 2nd session was conducted, in which impression formation about new persons (Study 1), the ease of retrieval of memories about known persons (Study 2), or memory inferences about learned features of fictional persons (Study 3) were assessed. Findings indicate that whereas anxious-ambivalent persons' impression formation, memory retrieval, and inferences about others reflected the projection of their actual-self-traits, avoidant persons' responses reflected the projection of their unwanted-self-traits. Findings are discussed in terms of the regulatory goals and strategies that characterize the mental representations of each attachment style.

The subjective experience of problem irresolvability and suicidal behavior: dynamics and measurement.

This article presents the dynamics and measurement of a relatively unstudied concept in children's and adolescents' suicidal behavior: the subjective experience of problem irresolvability (SEPI). This concept relates to the youngsters' sense of lack of control due to being pressured to resolve irresolvable problems within the family circle. The first study describes the construction and factor analysis of the SEPI scale as well as its relationship to suicidal tendencies, perceived parental care, and self-esteem. The second study presents a repeated factor analysis and the association between the SEPI scale and suicidal tendencies, hopelessness, depression, anxiety, and commitment to parents. The results suggest that the scale has a 4-factor structure with sound psychometric properties that distinguish successfully between suicidal adolescents on the one hand, and psychiatric and normal adolescents on the other. The SEPI was also found to be associated with the various studied variables.

The association between spouses' self-reports of attachment styles and representations of family dynamics.

The current research assesses the association between spouses' self-reports of attachment style and their perceptions of family dynamics. The sample included 93 Israeli married couples with young children. Both husbands and wives completed the adult attachment style scale and the perceived and ideal versions of FACES III. Findings showed that spouses whose self-reports endorsed the secure style perceived relatively high levels of family cohesion and adaptability; persons who endorsed the anxious-ambivalent style reported high levels of family cohesion but low levels of adaptability; and persons who endorsed the avoidant style reported relatively low levels of both family dimensions. In addition, significant associations were found between reports of attachment styles, on the one hand, and ideal representations of family dynamics, the marital partner's representations of family dynamics, and spouses' discrepancies in these representations, on the other. Findings are discussed in terms of attachment theory.

The impact of mortality salience on reckless driving: a test of terror management mechanisms.

A series of 4 studies, based on terror management theory (TMT), examined the effects of mortality salience on risk taking while driving. In all the studies, participants (N = 603) reported on the relevance of driving to their self-esteem. Then half of them were exposed to various mortality salience inductions, and the remaining to a control condition. The dependent measures were either self-reported behavioral intentions of risky driving or driving speed in a car simulator. In Study 4, half of the participants in each condition received positive feedback about their quality of driving. Findings showed that mortality salience inductions led to more risky driving than the control condition only among individuals who perceived driving as relevant to their self-esteem. The introduction of positive feedback about driving eliminated this effect. The results were discussed in light of the self-enhancing mechanisms proposed by TMT.

Adult attachment style and affect regulation: strategic variations in self-appraisals.

Four studies examined the link between adult attachment style and strategic variations in self-appraisals. Whereas secure persons held a stable positive self-view, Studies 1-2 showed that avoidant persons showed a positive self-view and anxious-ambivalent persons a negative self-view, which were strengthened by distress arousal and weakened by factors that inhibit the activation of regulatory mechanisms. Studies 3-4 indicated that insecure persons' self-views varied in accordance with specific attachment-related concerns and needs. Avoidant persons' positive self-view was related to their attempts to validate their sense of self-reliance, and anxious-ambivalent persons' negative self-view was related to their attempts to win others' compassion and affection. Results are discussed in terms of attachment-related strategies of affect regulation.

Adult attachment style and affect regulation: strategic variations in subjective self-other similarity.

Six studies examined the link between adult attachment style and subjective self-other similarity. In Studies 1-3, data were collected on representations of self-other similarity in the realms of traits and opinions. Studies 4-5 examined the effects of affective inductions on the link between attachment and self-other similarity. Study 6 examined the cognitive maneuvers people differing in attachment style use for changing self-other similarity upon distress arousal. Whereas avoidant persons underestimated self-other similarity and anxious-ambivalent persons overestimated it, secure persons provided more accurate similarity scores. These differences were exacerbated by negative affect and mitigated by positive affect. Insecure persons' distortions resulted from transformations they made in representations of the self and others. Results are discussed in terms of attachment theory.

The contribution of adult attachment style to the adjustment to infertility.

This study examines the contribution of adult attachment style to the adjustment to infertility. Both husbands and wives of 80 infertile couples undergoing medical treatment completed the Attachment Style Scale, the Mental Health Inventory and the Dyadic Adjustment Scale. One year later, data were collected on whether women became pregnant. Diagnosis of male infertility was significantly more distressing than diagnosis of female infertility. Significant differences were found among attachment groups: secure persons, either men or women, reported more well-being, less distress and more dyadic adjustment than avoidant and anxious-ambivalent persons. Partners of secure persons also reported significantly higher levels of well-being and dyadic adjustment and significantly lower levels of distress than partners of anxious-ambivalent persons. However, these effects of attachment style were significant mainly when male infertility was diagnosed. Husbands' secure attachment made a significant positive contribution to pregnancy likelihood and this effect was mediated by adjustment measures. Results are discussed in terms of attachment theory.

Self-representation of suicidal adolescents.

This study focused on the self-representations of suicidal adolescent. Twenty-six Israeli suicidal inpatients, 24 nonsuicidal inpatients, and 24 control participants completed scales on suicidal tendencies, the hedonic value of self-representations, the complexity (differentiation, integration) of these self-representations, and the discrepancies among self domains (actual, ideal, ought). Suicidal adolescents showed more negative self-representations, a less differentiated and less integrated organization of self-attributes, and more discrepancies between the 3 assessed domains of the self than did control participants. In addition, compared with psychiatric nonsuicidal participants, suicidal adolescents showed a less complex organization of self-attributes and a higher discrepancy between ideal self and ought self. Results were discussed in terms of the vulnerable self of suicidal adolescents, characterized by uneven processing of positive and negative information, confusion, and simplicity.

Learned helplessness and the occurrence of depressive-like and paranoid-like responses: the role of attentional focus.

Five experiments were performed to examine different manifestations of depressive- and paranoid-like responses after failure in unsolvable problems. Participants were exposed to no feedback, "universal" failures, or "personal" failures while their attention was focused on either themselves or the experimenter. Then, depressive and paranoid-related states of mind, interfering thoughts, self-schemata, others-schemata, and autobiographical memories were measured. Findings indicated that when attention was focused on the self, personal failure was effective in producing depressive-like reactions. When attention was focused on the threatening agent (experimenter), participants reacted to the exposure to personal failure with paranoid-like responses. Universal failure failed to produce either depressive- or paranoid-like reactions. The discussion focuses on the association between personal learned helplessness and psychopathology and on the role of attentional focus.