Processing negative autobiographical memories in a foreign language.

The use of a foreign language has been introduced in the clinical setting as a form of emotional distance to help deal with negative experiences. However, the evidence of foreign language reducing emotionality during processing negative events is still scarce. This study aims to test whether the description and processing of a traumatic or highly emotional event in a foreign language could modulate the strength of the connection between traumatic symptomatology and emotional reaction. For this purpose, a sample of 128 healthy participants completed a series of questionnaires via an online platform. Firstly, their levels of distress, arousal and valence were assessed in their native language. Secondly, they were assigned to either the native language or the foreign language group and described a negative childhood event in the assigned language (English or Spanish), followed by five questions for processing the event. Next, their emotionality was assessed again in their native language. Finally, a questionnaire of traumatic stress symptoms and an avoidance scale were completed. Results showed that the relationship between traumatic symptomatology and emotionality was moderated by the language of processing the negative event. Specifically, traumatic symptomatology was more strongly associated with distress and arousal change when the processing task was performed in the native language. These findings suggest the influence of a foreign language on emotional reactivity when a negative experience is processed, which could be an essential tool in the treatment of disorders related to stress and trauma.

Languages and Psychotherapy: The Effect of Foreign Language on Fear Extinction.

BACKGROUND: Using a foreign language can influence emotion modulation, but whether different psychotherapy processes would be affected by a foreign language is still unclear. The current study explored the foreign language effect on the extinction of fear. METHOD: During the conditioning phase, part of the neutral stimuli presented to the participants were associated with a threat, while they performed a countdown task in their native language. In the extinction phase, participants performed the same task either in their native/foreign language and were informed that the threat would no longer appear. We collected self-reports of fear, and pupil dilation and electrodermal activity as physiological measures of arousal. RESULTS: Extinction was successful, indicated by greater self-reported fear and pupil dilation during the threat condition compared to neutral in the conditioning phase, but no significant differences during extinction. Although the foreign language group presented higher arousal, fear extinction occurred regardless of the linguistic context. CONCLUSIONS: Fear extinction via verbal instructions is equally effective in a foreign and a native language context. These results indicate that evidence should be continue to be gathered on the role of foreign languages using basic paradigms with clinical applications.

Languages and Psychotherapy: The Effect of Foreign Language on Fear Extinction / Lenguas y Psicoterapia: El Efecto de la Lengua Extranjera en la Extinción del Miedo

Background: Using a foreign language can influence emotion modulation, but whether different psychotherapy processes would be affected by a foreign language is still unclear. The current study explored the foreign language effect on the extinction of fear. Method: During the conditioning phase, part of the neutral stimuli presented to the participants were associated with a threat, while they performed a countdown task in their native language. In the extinction phase, participants performed the same task either in their native/foreign language and were informed that the threat would no longer appear. We collected self-reports of fear, and pupil dilation and electrodermal activity as physiological measures of arousal. Results: Extinction was successful, indicated by greater self-reported fear and pupil dilation during the threat condition compared to neutral in the conditioning phase, but no significant differences during extinction. Although the foreign language group presented higher arousal, fear extinction occurred regardless of the linguistic context. Conclusions: Fear extinction via verbal instructions is equally effective in a foreign and a native language context. These results indicate that evidence should be continue to be gathered on the role of foreign languages using basic paradigms with clinical applications.(AU)

Antecedentes: Usar un idioma extranjero puede influir la modulación de las emociones, pero no está claro si su uso podría influir diferentes procesos psicoterapéuticos. Este estudio explora el efecto de la lengua extranjera en la extinción del miedo. Método: Durante el condicionamiento, parte de los estímulos presentados se asociaron a amenaza, mientras los participantes realizaban una tarea de cuenta regresiva en un contexto de lengua nativa. En la fase de extinción, se realizó la misma tarea en su lengua nativa/extranjera, y se informó de que ya no habría amenaza. Se recogieron autoinformes de miedo, así como dilatación de pupila y actividad electrodérmica como medidas fisiológicas de excitación. Resultados: La extinción fue satisfactoria, como muestran una mayor dilatación pupilar y los autoinformes de miedo al comparar las condiciones de amenaza y neutral en la fase de condicionamiento, y no encontrar diferencias significativas durante la extinción. Aunque el grupo de lengua extranjera presentó una mayor excitación, la extinción del miedo ocurre independientemente del contexto lingüístico. Conclusiones: La extinción del miedo mediante instrucciones verbales es igualmente eficaz en contexto de lengua extranjera y nativa. Estos resultados invitan a seguir reuniendo pruebas sobre el papel de las lenguas extranjeras mediante paradigmas con aplicaciones clínicas.(AU)

Using Artificial Intelligence to Enhance Ongoing Psychological Interventions for Emotional Problems in Real- or Close to Real-Time: A Systematic Review.

Emotional disorders are the most common mental disorders globally. Psychological treatments have been found to be useful for a significant number of cases, but up to 40% of patients do not respond to psychotherapy as expected. Artificial intelligence (AI) methods might enhance psychotherapy by providing therapists and patients with real- or close to real-time recommendations according to the patient's response to treatment. The goal of this investigation is to systematically review the evidence on the use of AI-based methods to enhance outcomes in psychological interventions in real-time or close to real-time. The search included studies indexed in the electronic databases Scopus, Pubmed, Web of Science, and Cochrane Library. The terms used for the electronic search included variations of the words "psychotherapy", "artificial intelligence", and "emotional disorders". From the 85 full texts assessed, only 10 studies met our eligibility criteria. In these, the most frequently used AI technique was conversational AI agents, which are chatbots based on software that can be accessed online with a computer or a smartphone. Overall, the reviewed investigations indicated significant positive consequences of using AI to enhance psychotherapy and reduce clinical symptomatology. Additionally, most studies reported high satisfaction, engagement, and retention rates when implementing AI to enhance psychotherapy in real- or close to real-time. Despite the potential of AI to make interventions more flexible and tailored to patients' needs, more methodologically robust studies are needed.

Cognitive reappraisal is not always successful during pain anticipation: Stimulus-focused and goal-based reappraisal effects on self-reports and peripheral psychophysiology.

The present study aims at comparing the effects of two subtypes of cognitive reappraisal (i.e., stimulus-focused vs. goal-based reappraisal) to reduce anticipatory anxiety of pain. Affective ratings, startle reflex, and autonomic measures (electrodermal and heart rate changes) were used as a measure of emotion regulation success. A total of 86 undergraduate students completed an anticipatory task in which they had to regulate their negative emotions or react naturally when faced with the possibility of receiving a painful thermal stimulus. Participants were randomly assigned to two experimental groups to compare the stimulus-focused and goal-based strategies explored here. Our results revealed enhanced self-reported anxiety, electrodermal activity and eyeblink response when participants tried to voluntarily down-regulate their negative emotions, compared to the control instruction. Differences between both cognitive reappraisal groups were not found. These unexpected findings suggest that brief reappraisal instructions may not necessarily be favorable for regulating emotions during anticipation of aversive events. Moreover, these results are further explained in terms of the pain expectation, the painful stimuli modality, and emotion regulation instructions.

Emotion regulation and peripheral psychophysiological correlates in the management of induced pain: A systematic review.

Cognitive reappraisal and acceptance strategies have been shown to be effective in reducing pain experience and increasing pain tolerance. However, no systematic reviews have focused on the relationship between the use of these two strategies and peripheral physiological correlates when pain is experimentally induced. This systematic review aims to summarize the existing literature that explores the relationship between emotion regulation strategies (i.e., cognitive reappraisal and acceptance) and peripheral correlates of the autonomic nervous system and facial electromyography, such as affect-modulated responses and corrugator activity, on laboratory tasks where pain is induced. The systematic review identifies nine experimental studies that meet our inclusion criteria, none of which compare these strategies. Although cognitive reappraisal and acceptance strategies appear to be associated with decreased psychological responses, mixed results were found for the effects of the use of both strategies on all the physiological correlates. These inconsistencies between the studies might be explained by the high methodological heterogeneity in the task designs, as well as a lack of consistency between the instructions used in the different studies for cognitive reappraisal, acceptance, and the control conditions.

Covariate effects of resting heart rate variability on affective ratings and startle reflex during cognitive reappraisal of negative emotions.

Heart Rate Variability (HRV) has been widely studied in laboratory settings due to its clinical implications, primarily as a potential biomarker of emotion regulation (ER). Studies have reported that individuals with higher resting HRV show more distinct startle reflexes to negative stimuli as compared to those with lower HRV. These responses have been associated with better defense system function when managing the context demands. There is, however, a lack of empirical evidence on the association between resting HRV and eyeblinks during laboratory tasks using instructed ER. This study explored the influence of tonic HRV on voluntary cognitive reappraisal through subjective and startle responses measured during an independent ER task. In total, 122 healthy participants completed a task consisting of attempts to upregulate, downregulate, or react naturally to emotions prompted by unpleasant pictures. Tonic HRV was measured for 5 minutes before the experiment began. Current results did not support the idea that self-reported and eyeblink responses were influenced by resting HRV. These findings suggest that, irrespective of resting HRV, individuals may benefit from strategies such as reappraisal that are useful for managing negative emotions. Experimental studies should further explore the role of individual differences when using ER strategies during laboratory tasks.

Cognitive reappraisal during unpleasant picture processing: Subjective self-report and peripheral physiology.

Increased attention among the research community in exploring underlying mechanisms of emotion regulation has prompted a growth of experimental works in this field. Empirical studies have mainly focused on self-reports, brain imaging, and electrophysiological measures, with only a few works exploring peripheral physiology. Additionally, most of such studies have not considered the specific stimuli content, even though prior literature has shown relevant differences in psychophysiological and subjective responses depending on picture categories. The current study assessed several peripheral correlates (startle amplitude, electrodermal changes, heart rate) of emotion regulation processes in a sample of 122 healthy participants. The task consisted of voluntary reappraisal of negative emotions prompted by unpleasant pictures (threat to others and victims), compared to a nonregulation control condition (looking at exemplars of the same categories and household objects). Results showed an effect of emotion regulation instructions in all psychophysiological and subjective measures. In peripheral physiology, greater responses were observed specifically when increasing negative emotions, concurring with previous research. Regarding specific content, our findings evidence a similar emotion regulation pattern, independently of the unpleasant category, suggesting a plausible effect of cognitive variables (such as cognitive effort) during voluntary reappraisal for both categories.

Improving chronic pain management with eHealth and mHealth: study protocol for a randomised controlled trial.

INTRODUCTION: Chronic pain has become a matter of public health concern due to its high prevalence and because public costs associated with treatment and disability increase each year. Research suggests that limitations in the traditional assessment of chronic pain patients limit the effectiveness of current medical treatments. The use of technology might serve change patient traditional monitoring into ecological momentary assessments, which might be visualised by physicians live. This study describes a randomised control trial designed to test the utility of a technology-based solution for pain telemonitoring consisting of a smartphone app for patients and a web application for physicians. The goal of this study will be to explore whether this combination of eHealth and mHealth improves the effectiveness of existing pain treatments. METHODS AND ANALYSIS: Participants will be 250 patients randomly assigned to one of these two conditions: treatment-as-usual (TAU) and TAU +app+ web. All participants will receive the usual treatment for their pain. Only the TAU +app+ web group use Pain Monitor app, which generates alarms that are sent to the physicians in the face of previously established undesired events. Physicians will be able to monitor app reports using a web application, which might result in an adjustment of treatment. We anticipate that the use of Pain Monitor plus the therapist web will result in a reduction of pain intensity and side effects of the medication. Improvements on secondary outcomes, namely fatigue, mood, pain interference, rescue medication use and quality of life, are also expected. Mixed repeated-measure multivariate analyses of variances will be conducted to investigate whether there are differences between preassessment and postassessment scores as a function of the experimental condition. ETHICS AND DISSEMINATION: Ethical approval from the Hospital General Universitari de Castellon was obtained. The findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03606265.