Emotion-related impulsivity across transdiagnostic dimensions of psychopathology.

OBJECTIVE: Several dimensions have received attention for their potential role in explaining shared variance in transdiagnostic symptoms of psychopathology. We hypothesized emotion-related impulsivity, the trait-like tendency toward difficulty restraining responses to emotion, would relate to symptoms of psychopathology, with two separable dimensions of emotion-related impulsivity relating distinctly to internalizing and externalizing symptoms. METHOD: Across two studies, we tested hypotheses using structural equation models of emotion-related impulsivity and multiple indicators of internalizing, externalizing, and thought symptoms. RESULTS: In Study 1 (658 undergraduates), emotion-related impulsivity was highly correlated with the general psychopathology (p) factor. In study 2 (421 Mechanical Turk participants), models did not support a general p factor; however, we replicated the hypothesized associations of emotion-related impulsivity dimensions with internalizing and externalizing factors. Across both studies, forms of emotion-related impulsivity uniquely and differentially related to internalizing and externalizing symptoms. CONCLUSIONS: Findings indicate emotion-related impulsivity may help explain transdiagnostic dimensions of psychopathology, such as the p factor.

Who disengages from emotion and when? An EMA study of how urgency and distress intolerance relate to daily emotion regulation.

Overreliance on disengagement emotion regulation strategies (e.g., emotion avoidance, emotion suppression) has been shown to relate to poor clinical outcomes. Two traits characterized by difficulties in goal-directed responses to emotion-urgency and distress intolerance-may help explain who is likely to disengage from emotion and when. These traits are associated with diverse forms of psychopathology and greater reliance on disengagement strategies. Gaps remain about how these traits relate to emotion regulation in daily life. The present study uses ecological momentary assessment (EMA) to determine the associations of urgency and distress intolerance with momentary high arousal negative affect and momentary attempts to regulate negative emotions. Participants (N = 101) were college students who endorsed at least weekly behaviors often characterized by emotion dysregulation (e.g., self-harm, binging/purging, alcohol/drug use). Participants completed trait measures at baseline and EMA surveys of momentary affect and emotion regulation, six times daily for 4 days. Results indicated that at certain levels, urgency and distress intolerance moderated the relationship between high arousal negative affect and disengagement from emotion: low urgency scores related to relatively greater disengagement from emotion following reported high arousal negative affect, whereas high distress intolerance scores related to relatively greater disengagement following high arousal negative affect. Findings support the role of both urgency and distress intolerance in the relationship between high arousal negative affect and disengagement, which implicates the utility of clinical interventions that focus on emotion regulation, especially during high arousal states. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotion-related impulsivity and risky decision-making: A systematic review and meta-regression.

Emotion-related impulsivity, the trait-like tendency toward regrettable behavior during states of high emotion, is a robust predictor of internalizing and externalizing psychopathology. Despite substantial evidence that emotion-related impulsivity is important transdiagnostically, relatively little is known about its cognitive correlates. This systematic review and meta-regression investigates one such candidate, risky decision-making. We analyzed 195 effect sizes from 51 studies of 14,957 total participants, including 105 newly calculated effect sizes that were not reported in the original publications. The meta-regression demonstrated evidence for a small, positive relationship of emotion-related impulsivity with behavioral indices of risky decision-making (ß = 0.086). Effects generalized across sample age, gender, Positive versus Negative Urgency, and clinical versus nonclinical samples. The average effect size varied by task type, with stronger effects for the Iowa Gambling Task and Delay Discounting Task. Experimental arousal manipulation was nearly a significant moderator, with stress and pharmacological manipulations yielding significant effect sizes. Analyses indicated that publication bias did not skew the current findings. Notwithstanding limitations, the data suggest that risky decision-making is a cognitive domain that relates to emotion-related impulsivity. We conclude with recommendations regarding the specific types of tasks and arousal inductions that will best capture emotion-related impulsivity in future experimental research.

Guidelines to Address Barriers in Clinical Training for Trainees with Sensory Disabilities.

Disability is an important facet of diversity. Although diversity in clinical training in health service psychology has improved considerably, training often neglects accessibility and inclusion for individuals with sensory disabilities. The limited research to date documents that trainees with sensory disabilities (TSD) report extensive barriers and are consistently under-represented in clinical settings. Further, few resources have been developed to guide accommodating TSD in clinical training. Accordingly, our goals in this article are two-fold: (1) to highlight the barriers in clinical training faced by TSD and (2) to provide recommendations for trainees, supervisors, clinical leadership, and directors of clinical training to improve accessibility and inclusion for TSD. We offer vignettes to illustrate barriers faced by TSD and suggest guidelines to improve access for TSD.

Momentary Emotion Goals and Spontaneous Emotion Regulation in Daily Life: An Ecological Momentary Assessment Study of Desire for High Versus Low Arousal Positive Emotion.

Recent research has highlighted that emotion regulation strategy use varies both between and within people, and specific individual and contextual differences shape strategy use. Further, use of specific emotion regulation strategies relates to a wide array of differential outcomes, including mental health and behavior. Emotion goals (desire for a given emotion state) are thought to play a particularly important role in shaping people's use of emotion regulation strategies; yet, surprisingly little is known about whether and how momentary emotion goals predict spontaneous strategy use in daily life. In the present investigation, we examined whether ideal desire for high versus low arousal positive affect was associated with subsequent use of specific emotion regulation strategies. Undergraduate participants (final N = 101) completed ecological momentary assessments (final ks = 1,932 for contemporaneous analyses, 1,386 for time-lagged analyses) of their momentary experienced affect, momentary desire for high versus low arousal positive affect, and emotion regulation. Desire for higher arousal predicted greater use of three disengagement strategies: distraction, expressive suppression, and experiential suppression. None of these strategies, though, were associated with sustained enhancement of high arousal (or low arousal) positive affect. These findings point to a possible disconnect between the strategies that people tend to use when they want to feel more arousal and the affective outcomes associated with use of those strategies.

Emotion-related impulsivity: Testing a model of arousal effects on cognitive control.

The trait-based tendency to respond rashly to emotions is robustly tied to many forms of psychopathology and poor behavioural outcomes, including aggression and suicidality. Researchers have found associations between response inhibition and emotion-related impulsivity; however, effect sizes are often small. Because emotion-related impulsivity emerges in the context of heightened positive and negative emotions, arousal is a candidate trigger of impulsivity. The goals of the present study were to (1) replicate the association between emotion-related impulsivity and response inhibition, and (2) test whether emotion-related impulsivity is associated with arousal-induced decays in response inhibition performance. Participants (N = 55) completed a self-report measure of emotion-related impulsivity, and then completed a computer-based response inhibition task (the antisaccade task, in which participants must make a rapid saccadic eye movement away from a cue rather than toward it) before and after a well-validated stress induction (the Trier Social Stress Test). Psychophysiological indices of arousal were measured throughout the session. Findings provide partial support for the association between emotion-related impulsivity and pre-stress response inhibition. Contrary to hypotheses, emotion-related impulsivity did not interact with arousal to predict post-stress response inhibition performance after controlling for pre-stress response inhibition performance. Future research is needed to consider clinical samples and to assess whether emotion-related impulsivity is related to deficits in other facets of cognitive control and decision-making.

Emotion-related impulsivity predicts increased anxiety and depression during the COVID-19 pandemic.

INTRODUCTION: Emotion-related impulsivity, defined by poor constraint in the face of emotion, is related to internalizing symptoms, cross-sectionally and longitudinally. Internalizing symptoms, though, are profoundly tied to stress reactivity, and little is known about how emotion-related impulsivity relates to stress reactivity. METHOD: Taking advantage of a sample that had completed measures of depression, anxiety, suicidal ideation, and two forms of emotion-related impulsivity before the pandemic, we asked participants to complete three weekly follow-up internalizing assessments early in the pandemic. RESULTS: Among the 150 participants, pre-pandemic emotion-related impulsivity scores predicted higher depression, anxiety, general distress, and suicidal ideation during the COVID-19 pandemic. Controlling for pre-pandemic scores, one form of emotion-related impulsivity (Feelings Trigger Action) predicted increased anxiety and general distress. We also examined how pre-pandemic emotion-related impulsivity was moderated by weekly COVID-related stress. One form of emotion-related impulsivity (Pervasive Influence of Feelings) predicted internalizing symptoms at low stress levels, and a different form (Feelings Trigger Action) predicted internalizing symptoms at higher stress levels. LIMITATIONS: Limitations include the small sample size, the absence of repeat measures of impulsivity, the attrition of individuals with more internalizing symptoms, and the reliance on self-rated measures. CONCLUSIONS: Forms of emotion-related impulsivity predict increases in anxiety and distress over time, but the interactions with stress levels appear to vary. Emotion-related impulsivity can be addressed with accessible intervention tools, suggesting the promise of broader screening for those at risk for internalizing symptoms during periods of high stress.

Disability self-worth relates to lower anxiety and depression in people with visual impairment.

OBJECTIVE: Visual impairment (VI) has been associated with depression and anxiety. Although researchers have identified several relevant individual differences associated with risk for depression and anxiety, researchers have not considered the role of personal disability identity (PDI) in depression and anxiety for people with VI. The purpose of this study is to examine the association between two aspects of PDI, perceived self-worth and personal meaning, and depression and anxiety among people with VI. METHOD: Hierarchical linear regressions assessed the relative contribution of PDI and disability characteristics to anxiety and depression in an international sample of adults with VI (N = 390). RESULTS: Lower disability self-worth, but not lower personal meaning, was significantly associated with higher depression and anxiety, explaining more variance than demographic or disability-related factors. CONCLUSION: By introducing disability self-worth as a correlate of depression and anxiety in VI, study findings suggest that considering and cultivating PDI for people with VI may be useful for improving clinical outcomes.

Maladaptive behavior and affect regulation: A functionalist perspective.

Clinical science has benefited tremendously from taking seriously the proposition that putatively maladaptive behaviors serve psychological functions, prominently among these affect regulation (AR). These functionalist accounts have not only advanced basic clinical science, but also formed the bedrock for the development of effective treatments. Drawing heavily on reinforcement learning theory, we aim to elucidate functional relationships between maladaptive behavior and AR. Specifically, we take the view that maladaptive behaviors are frequently motivated and reinforced by hedonic AR functions (i.e., decreasing negative affect and increasing positive affect) but are also susceptible to becoming stimulus-bound habits. We review empirical evidence related to one such behavior, nonsuicidal self-injury. We close with a brief reflection on future directions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Immune response to stress induction as a predictor of cognitive-behavioral therapy outcomes in adolescent mood disorders: A pilot study.

Cognitive-behavioral therapy (CBT) alleviates symptoms of depression in youth with bipolar disorder (BD) and major depressive disorder (MDD). Empirical research has linked inflammatory markers to depressive symptoms and acute psychosocial stress; however, a gap remains as to whether immune response to stress may serve as a putative mechanism of treatment. This preliminary pilot study determined the modest feasibility of assessing psychobiological response to stress as a predictor of CBT outcomes for youth with mood disorders. We evaluated whether participation in a 10-session group-CBT intervention for mood disorders altered inflammatory response to a laboratory psychosocial stress induction and if this alteration in immune stress responsivity was related to a decrease in depressive symptoms. Thirty-four youth (age M = 15.03, SD = 1.91) diagnosed with BD or MDD participated in a 10-session CBT group and pre- and post-group assessments; twenty-eight participants who completed the group had usable cytokine data. Pre- and post-group assessments included stress induction with the Trier Social Stress Test (TSST) during which inflammatory cytokines were measured at baseline (time 0) and after the TSST at 30, 60, and 90 min. Results suggest it is modestly feasible to measure immune response to stress alongside CBT treatment for adolescent mood disorders. Our findings were mixed; across seven cytokines, hierarchical linear models indicated two cytokines, IL6 and IL12, were sensitive to acute laboratory stress. We also found significant correlations between life stress, inflammation, and depression both pre- and post- CBT group. Inflammation pre-group, as measured by IL12 and IL1 ß predicted depressive symptoms following treatment. Although we did not find significant within-subject reductions in inflammation, chronic stress predicted changes in IL ß, signaling the central role of chronic stress. This study offers preliminary evidence that immune responsivity to stress induction could serve as a mechanism of treatment for mood disorders in youth, indicating a potential marker for more personalized model of healthcare.