Recalled protective childhood experiences are associated with positive emotional expression in active-duty firefighters.

There is a wealth of research linking adverse childhood experiences (ACEs) with negative outcomes later in life, but less research has focused on the effects of protective childhood experiences (PCEs). PCEs have been shown broadly to promote resilience, but the precise nature of this association is not clear, particularly in studies of at-risk adults. The current investigation explored the association between recollection of early life experiences and in vivo emotional responses in at-risk adults. In 2018, 56 active-duty firefighters reported childhood experiences via a questionnaire. Using a semistructured interview, firefighters then responded to questions about recent emotionally evocative experiences (positive and negative) as a firefighter. Emotion was measured in vivo via sympathetic arousal and recorded facial expressions of emotion. Individuals who reported more PCEs expressed significantly more facial expressions of positive emotion across contexts, sr2 = .11-.14. Early childhood experiences were not significantly associated with negative facial expressions or changes in sympathetic reactivity, but ACEs were associated with tonic levels of arousal in a negative context, r = -.36. Given the adaptive role of positive emotions in adjustment to adverse events, the current investigation suggests a potential protective association between PCEs and the expression of emotion even within a high-risk context, which could help explain the resilience promoting role of PCEs.

DRD4 polymorphism associated with greater positive affect in response to negative and neutral social stimuli.

Despite the robustness of DRD4 polymorphism associations with brain-based behavioral characteristics in candidate gene research, investigations have minimally explored associations between these polymorphisms and emotional responses. In particular, the prevalent single nucleotide polymorphism (SNP) -521C/T (rs1800955) in the promoter region of DRD4 remains unexplored relative to emotions. Here, two independent samples were evaluated using different emotion elicitation tasks involving social stimuli: Study 1 (N = 120) evoked positive and negative emotional responses to validated film clips; Study 2 (N = 122) utilized Cyberball to simulate social rejection and acceptance. Across studies, C/C individuals self-reported higher mean positive affect scores using Likert scales versus T carrier individuals, selectively when presented with neutral or negative (but not positive) social stimuli. The consistent findings across these two studies supports a functional consequence of this DRD4 SNP on emotion processing during changing social contexts. Continued investigation will help clarify if a C/C genotype enhances positive emotions under negative circumstances, or if the presence of the T allele reduces positive emotions, and how rs1800955 behavioral associations might generalize across different demographics. Future studies could also reveal if this SNP interacts with other changing environmental conditions to affect emotional responses, such as social limitations during the COVID-19 pandemic.

What Drives Preventive Health Behavior During a Global Pandemic? Emotion and Worry.

BACKGROUND & PURPOSE: Primary prevention of COVID-19 has focused on encouraging compliance with specific behaviors that restrict contagion. This investigation sought to characterize engagement in these behaviors in U.S. adults early during the pandemic and to build explanatory models of the psychological processes that drive them. METHODS: US adults were recruited through Qualtrics Research Panels (N = 324; 55% female; Mage = 50.91, SD = 15.98) and completed 10 days of online reports of emotion, COVID-19 perceived susceptibility and worry, and recommended behaviors (social distancing, hand washing, etc.). Factor analysis revealed behaviors loaded on two factors suggesting distinct motivational orientations: approach and avoidance. RESULTS: Changes in approach and avoidance behaviors over the 10 days indicated large individual differences consistent with three types of participants. Discrete emotions, including fear, guilt/shame, and happiness were associated with more recommended behaviors. Fear and COVID-19 worry indirectly influenced each other to facilitate more behavioral engagement. While emotions and worry strongly predicted individual differences in behavior across the 10 days, they did not predict as well why behaviors occurred on one day versus another. CONCLUSIONS: These findings suggest how daily affective processes motivate behavior, improving the understanding of compliance and efforts to target behaviors as primary prevention of disease.

Boosting positive mood in medical and emergency personnel during the COVID-19 pandemic: preliminary evidence of efficacy, feasibility and acceptability of a novel online ambulatory intervention.

OBJECTIVES: The aim of this project was to test the efficacy of a brief and novel online ambulatory intervention aimed at supporting psychological health and well-being for medical personnel and first responders during the COVID-19 pandemic. METHODS: Interested participants, n=28, actively employed as medical personnel, support staff and emergency responders, in the Midwestern USA in May-June of 2020, provided informed consent and were randomised to complete either low-dose or high-dose intervention, one time daily for 1 week via smartphone application. Each daily intervention included expressive writing, adaptive emotion regulation activity and (one vs two) positive emotion-generation activities, lasting 3-6 min a day. Ratings of negative and positive emotion were provided before and after each activity daily. Analyses tested compliance, acceptability, as well as efficacy at increasing positive emotion and decreasing negative emotion with each use and across time. RESULTS: The results indicated a 13% increase in positive emotion, t(25)=2.01, p=0.056; and decrease in negative emotion by 44%, t(25)=-4.00, p=0.001 across both doses. However, there was a clear advantage for individuals in the high-dose condition as daily boosts in positive emotion were significantly greater (an additional 9.4%) B=0.47, p=0.018. Overall, compliance was good. Acceptability ratings were good for those who completed the follow-up assessment. CONCLUSION: Front-line personnel, including medical staff and emergency responders, are experiencing unprecedented psychological stress during the COVID-19 pandemic. This investigation suggests both feasibility and efficacy for a brief, daily, ambulatory intervention which could provide essential psychological support to individuals at risk in the workplace.

A film set for the elicitation of emotion in research: A comprehensive catalog derived from four decades of investigation.

Emotions are highly influential to many psychological processes. Indeed, research employing emotional stimuli is rapidly escalating across the field of psychology. However, challenges remain regarding discrete evocation of frequently co-elicited emotions such as amusement and happiness, or anger and disgust. Further, as much contemporary work in emotion employs college students, we sought to additionally evaluate the efficacy of film clips to discretely elicit these more challenging emotions in a young adult population using an online medium. The internet is an important tool for investigating responses to emotional stimuli, but validations of emotionally evocative film clips across laboratory and web-based settings are limited in the literature. An additional obstacle is identifying stimuli amidst the numerous film clip validation studies. During our investigation, we recognized the lack of a categorical database to facilitate rapid identification of useful film clips for individual researchers' unique investigations. Consequently, here we also sought to produce the first compilation of such stimuli into an accessible and comprehensive catalog. We based our catalog upon prior work as well as our own, and identified 24 articles and 295 film clips from four decades of research. We present information on the validation of these clips in addition to our own research validating six clips using online administration settings. The results of our search in the literature and our own study are presented in tables designed to facilitate and improve a selection of highly valid film stimuli for future research.

Negative affect differentiation and adherence during treatment for thalassemia.

BACKGROUND: Although research has demonstrated the detrimental effects of excessive negative affect on treatment adherence and morbidity in chronic illness, rarely have researchers investigated the benefits of awareness of negative emotional experiences during treatment. PURPOSE: In this investigation, we examined the association of negative affect differentiation (the ability to report negative emotional experiences as separate and distinct from each other,) to treatment adherence in adult patients with the congenital blood disorder thalassemia. METHOD: Negative affect differentiation was assessed during a 12-16-week treatment-based diary and adherence was operationalized as attendance at routine screenings over 12 months. Participants were adult patients (n = 32; age M = 31.63, SD = 7.72; 72 % female) with transfusion-dependent thalassemia in treatment in a large metropolitan hospital in the Northeastern USA. RESULTS: The results indicate that negative affect differentiation is significantly associated with greater adherence to treatment, even when controlling for disease burden and level of psychological distress. CONCLUSION: Although preliminary, this investigation suggests that differentiated processing of negative emotional experiences during illness can lead to adaptive treatment-related behavior. As such, it may present a new avenue for research and intervention targeting the improvement of adherence during treatment for chronic illness.

Is disgust more resistant to extinction than fear? A meta-analytic review of laboratory paradigms.

Disgust can be acquired via evaluative conditioning; a process by which a neutral stimulus (conditioned stimulus; CS) comes to be evaluated as disgusting due to its pairing with an inherently disgusting stimulus (unconditioned stimulus; US). Research has shown that conditioned disgust responses are resistant to extinction which may have implications for disorders (i.e., contamination-based obsessive-compulsive disorder, specific phobias, and post-traumatic stress disorder) in which heightened disgust has been implicated. Importantly, extinction is the primary mechanism by which exposure therapies are thought to achieve symptom reduction for these disorders. Exposure therapies were originally modeled on fear extinction, whereas disgust extinction was largely overlooked until recently. Accordingly, differences in the degree to which learned disgust and fear can be attenuated via extinction learning remains unclear. The present investigation was a meta-analysis directly comparing the degree of extinction of conditioned disgust (n = 14) and conditioned fear (n = 14) in laboratory paradigms. Extinction was operationalized as the standardized mean difference (SMD) in evaluative ratings between the CS+ (the CS paired with the US) and CS- (the unpaired CS) after extinction training. Results of a subgroup analysis indicated that disgust (SMD = 0.52) was significantly more resistant to extinction than fear (SMD = 0.37). Additionally, a series of meta-regression analyses indicated that extinction was not influenced by important study characteristics (e.g., sex, age, number of conditioning and extinction trials). The findings suggest that extinction-based approaches may be less effective at attenuating learned disgust and research is needed to better optimize treatments for disgust-related disorders.

Effects of a brief online emotion word learning task on negative emotion differentiation, emotional self-efficacy, and prospective distress: Preliminary findings.

BACKGROUND: Disruptions in emotion processing are common across psychological disorders. Research suggests that emotion differentiation (ED; specificity in language used to characterize one's emotional experience) and emotional self-efficacy (ESE; perceived ability to understand and manage one's emotions) are important transdiagnostic factors associated with various psychological benefits. Whether ED and ESE can be improved in adults remains largely unclear. METHODS: Using a longitudinal prospective design, we tested a brief online training targeting emotion word knowledge (vs. a control condition) to see if it improved negative ED (NED) and ESE in a college sample. Moreover, we tested if changes in NED or ESE mediated the effects of the training on levels of psychological distress one week and two-months post-intervention. RESULTS: Findings provided partial support for our hypotheses. Individuals whose ESE increased post-intervention reported lower levels of distress two months later. Moreover, exploratory analyses revealed those who demonstrated greater training engagement experienced increases in NED that in turn predicted lower distress one-week post-intervention. However, there were no direct effects of intervention group on NED or ESE and distress. CONCLUSIONS: These findings highlight the potential of a remotely-administered emotion-language intervention to influence key dimensions of emotion processing and suggest avenues for further refinement. Both NED and ESE may be malleable for some, and that enhancements in ESE may produce long-term psychological benefits.

What drives preventative health behaviors one year into a pandemic? A replication and extension.

Objective: There is continued interest in understanding what leads people to engage in CDC-recommended COVID-19 prevention behaviors. We tested whether fear and COVID-19 worry would replicate as the primary drivers of six CDC recommended prevention behaviors. Methods and Measures: We recruited 741 adult participants during the second major peak of the COVID-19 pandemic in the United States (early 2021). Using very similar methods to the original study, participants completed a 10-day daily diary. Mixed effects models identified the strongest predictors of each individual prevention behavior as well as approach and avoidance behavior clusters. Results: At the between-person level, COVID-19 worry, COVID-19 perceived susceptibility, fear, and positive emotions all had positive zero-order associations with the prevention behaviors. However, with all predictors in the same model together, primarily COVID-19 worry remained significant for both the individual behaviors and behavior clusters. At the within-person level, only fear related to assessing oneself for COVID-19 and approach behaviors on the same day, but not the next day. Mediational analyses suggested COVID-19 worry, but not COVID-19 susceptibility, mediated the links between fear and approach/avoidance behaviors. Conclusion: Findings replicated worry about yourself or a loved one getting COVID-19 as the strongest predictor of prevention behaviors.

Can the positive buffer the negative? Testing the impact of protective childhood experiences on adjustment in adults following trauma exposure.

BACKGROUND: It is unclear if protective childhood experiences (PCEs), like emotional support and economic stability, exert influence on adulthood adjustment. Prior research suggests PCEs can promote childhood resilience through increased social connection. In contrast, research has demonstrated potential life-long negative impacts of adverse childhood experiences (ACEs) on psychological health. This study examined the role of PCEs and ACEs in psychological symptoms following potentially traumatic events (PTE) in adults. METHODS: Participants (N = 128) were adults admitted to two Level 1 Trauma Centers following violence, motor-vehicle crashes, or other accidents. Participants reported childhood experiences and completed assessments of depression, PTSD, and social support at one, four, and nine months post-PTE. RESULTS: Structural Equation Modeling was used to simultaneously model PCEs and ACEs as predictors of psychological symptoms over time, with potential mediation through social support. PCEs overall did not directly affect psychological symptoms nor indirectly through social support. However, the emotional support component of PCEs had an indirect effect on psychological symptoms at baseline through social support. ACEs predicted greater psychological symptoms at baseline and over time. CONCLUSION: PCEs consisting of childhood emotional support indirectly promote adjustment in adults after PTEs through initial social support, while ACEs exert direct effects on psychological symptoms.

Personality or pathology? Predictors of early substance use in first-year college students.

OBJECTIVE: The aim of the current study was to examine the dual role of personality and psychopathology in predicting substance use among first-year students. PARTICIPANTS: 103 first-semester undergraduate students were recruited via the university subject pool. METHODS: Participants completed personality questionnaires, structured clinical interviews, followed by the completion of diary entries each week reporting on substance use throughout their first semester. RESULTS: Results indicated that a past diagnosis of an affective (mood/anxiety/stress) disorder was the most significant predictor of substance use. Personality and current psychopathology had no association to substance use. CONCLUSION: This finding is consistent with developmental models of substance use relating to emotion-related disease and suggests that greater nuance is needed in understanding substance use risk in college students.

Emotional complexity under high stress: Do protective associations for risk behaviors persist even during a pandemic?

Risk behaviors like substance use and binge eating are often used to cope with negative emotions. Engagement in these behaviors has been exacerbated by the COVID-19 pandemic. Past research suggests that complex emotion conceptualizations captured as emotion differentiation (ability to discriminate between emotional states) and polarity (ability to integrate positive and negative features of emotional experience) may be protective. We examined associations of mean affect intensity, emotion differentiation, and emotion polarity with frequency of daily substance use and binge eating across 10 days in a demographically diverse sample of U.S. adults (N = 353) recruited between March 24 and April 9, 2020, when stay-at-home orders were initiated. Owing to the nested data structure and excessive zero values, analyses were conducted using multilevel zero-inflated negative binomial regression. Consistent with past research, negative affect was positively associated with frequency of substance use and binge eating. Importantly, results indicated that negative emotion differentiation was protective, predicting greater likelihood of not using substances and binge eating at all across the sampling period. These effects remained even after controlling for mean affect intensity, emotion polarity, and positive emotion differentiation. Neither positive emotion differentiation nor emotion polarity were significantly associated with either behavior. Our results suggest that greater complexity in conceptualization of negative emotions facilitates some protection against risk behaviors such as substance use and binge eating, even during periods of high environmental stress. These findings have important implications for optimizing interventions to reduce engagement in risk behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Number lines can be more effective at facilitating adults' performance on health-related ratio problems than risk ladders and icon arrays.

Visual displays, such as icon arrays and risk ladders, are often used to communicate numerical health information. Number lines improve reasoning with rational numbers but are seldom used in health contexts. College students solved ratio problems related to COVID-19 (e.g., number of deaths and number of cases) in one of four randomly assigned conditions: icon arrays, risk ladders, number lines, or no accompanying visual display. As predicted, number lines facilitated performance on these problems-the number line condition outperformed the other visual display conditions, which did not perform any better than the no visual display condition. In addition, higher performance on the health-related ratio problems was associated with higher COVID-19 worry for oneself and others, higher perceptions of COVID-19 severity, and higher endorsement of intentions to engage in preventive health behaviors, even when controlling for baseline math skills. These findings have important implications for effectively presenting health statistics. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotion differentiation and behavioral dysregulation in clinical and nonclinical samples: A meta-analysis.

Behavioral dysregulation that may manifest as the use of maladaptive behaviors aimed at regulating or avoiding distress, despite potential negative health consequences, is central to the development and maintenance of common psychological disorders. However, less is known about factors that may influence the engagement of these maladaptive behaviors. Recent research suggests that negative emotion differentiation (NED) may be important. The present investigation was a meta-analysis examining the relationship between NED and maladaptive behaviors ranging from binge drinking and nonsuicidal self-injury to treatment noncompliance, in clinical and nonclinical samples across 17 included studies obtained via electronic literature searches. Despite between-study methodological heterogeneity, our results indicated that NED was negatively associated with the enactment of maladaptive behaviors (r = -.15). Additionally, no significant differences in effect sizes were observed between clinical (n = 7; r = -.15) and nonclinical (n = 10; r = -.16) samples. Critically, the relationship between NED and maladaptive behaviors remained significant even after controlling for negative affect (NA; n = 11; r = -.09). This association also did not depend on levels of NA. Overall, our findings suggest that NED is generally associated with reduced engagement of maladaptive behaviors, regardless of diagnostic status and NA, and have important clinical implications for understanding and treating psychological disorders involving behavioral dysregulation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does past military experience impact fear reactivity in active-duty firefighters? Well, it is complicated.

OBJECTIVE: A significant proportion of military veterans successfully transition out of the military into civilian careers as first responders, such as firefighters. Like military service, being a firefighter is a high-risk profession involving exposure to aversive environments. Thus, it is possible that military experience might serve to buffer or exacerbate risk for negative psychological outcomes in firefighters. However, both occupations are associated with increased risk for psychopathology, such as PTSD, and little research has examined the effect of military service on processes that underlie stress in veterans serving as active-duty firefighters. The current study explores whether military service confers an adaptive advantage or an additional risk. METHOD: Using a case-control design, we examined differences in fear reactivity through electrodermal activity (EDA) and recording of fearful facial expressions, between 32 firefighters with and 32 firefighters without military veteran status (MVS; all men). Participants completed a semistructured, emotionally evocative interview with multiple contexts eliciting varying levels of emotion. RESULTS: MVS firefighters had relatively elevated EDA across contexts. However, lower baseline levels indicated calmer resting state in MVS firefighters. There was greater incidence of lifetime PTSD in MVS compared with non-MVS firefighters (40.6% vs. 15.6%). Overall, firefighters with past PTSD had less EDA reactivity. Finally, number of military deployments was associated with higher fear expressions throughout the interview. CONCLUSIONS: These findings highlight the need to consider interactions between military experience and psychiatric history in future investigations examining risk and resilience in first responders. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-care behaviors and affect during the early stages of the COVID-19 pandemic.

OBJECTIVE: Self-care behaviors aimed at maintaining physical and mental health are often recommended during stressful contexts. We tested emotional predictors of self-care behaviors (healthy eating, exercise, engaging in a hobby, relaxation/meditation, time spent with a supportive person, talking online with friends/family) during the COVID-19 pandemic and their emotional consequences. We hypothesized a reciprocal within-person process whereby positive affect increases self-care behaviors (Hypothesis 1) and self-care behaviors increase positive affect while decreasing negative affect (Hypothesis 2). METHOD: A 10-day daily diary was completed by 289 adult participants in the United States during spring 2020 when counties in 40 out of 50 states had some form of stay-at-home orders. RESULTS: Lagged analyses for Hypothesis 1 suggested that positive affect did not significantly predict residualized change in self-care behaviors; however, more intense negative affect predicted increased self-care behaviors from one day to the next. Concurrent analyses for Hypothesis 2 indicated most self-care behaviors were associated with more positive affect and some with less negative affect on the same day. Lagged analyses for Hypothesis 2 indicated that self-care behaviors largely did not predict residualized change in positive or negative affect from one day to the next. At the between-person level, people who experienced more positive affect engaged in more self-care behaviors across the sampling period. CONCLUSION: Self-care behaviors continue to have mental health benefits during stressful environments such as the COVID-19 pandemic and stay-at-home orders. Negative affect can play an adaptive role during times of stress by facilitating self-care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Were there losses in social support during the pandemic? Testing the impact of COVID-19 on psychological adjustment to trauma in United States adults.

Introduction: Social support is a key protective factor in the psychological adjustment of individuals to traumatic events. However, since March 2020, extant research has revealed evidence of increased loneliness, social isolation, and disconnection, likely due to COVID-19 pandemic-related recommendations that restricted day-to-day contact with others. Methods: In this investigation, we applied a case-control design to test the direct impacts of the pandemic on social support in United States adults recovering from a significant injury caused by PTSD-qualifying, traumatic events (e.g., motor vehicle crashes, violence, etc.). We compared individuals who experienced trauma during the pandemic, the "cases" recruited and evaluated between December 2020 to April 2022, to trauma-exposed "controls," recruited and evaluated pre-pandemic, from August 2018 through March 9, 2020 (prior to changes in public health recommendations in the region). Cohorts were matched on key demographics (age, sex, education, race/ethnicity, income) and injury severity variables. We tested to see if there were differences in reported social support over the first 5 months of adjustment, considering variable operationalizations of social support from social network size to social constraints in disclosure. Next, we tested to see if the protective role of social support in psychological adjustment to trauma was moderated by cohort status to determine if the impacts of the pandemic extended to changes in the process of adjustment. Results: The results of our analyses suggested that there were no significant cohort differences, meaning that whether prior to or during the pandemic, individuals reported similar levels of social support that were generally protective, and similar levels of psychological symptoms. However, there was some evidence of moderation by cohort status when examining the process of adjustment. Specifically, when examining symptoms of post-traumatic stress over time, individuals adjusting to traumatic events during COVID-19 received less benefit from social support. Discussion: Although negative mental health implications of the pandemic are increasingly evident, it has not been clear how the pandemic impacted normative psychological adjustment processes. These results are one of the first direct tests of the impact of COVID-19 on longitudinal adjustment to trauma and suggest some minimal impacts.

Feel to Heal: Negative Emotion Differentiation Promotes Medication Adherence in Multiple Sclerosis.

Multiple Sclerosis (MS) is a debilitating chronic autoimmune disease of the central nervous system that results in lower quality of life. Medication adherence is important for reducing relapse, disease progression, and MS-related symptoms, particularly during the early stages of MS. However, adherence may be impacted by negative emotional states. Therefore, it is important to identify protective factors. Past research suggests that the ability to discriminate between negative emotional states, also known as negative emotion differentiation (NED), may be protective against enactment of maladaptive risk-related behaviors. However, less is known as to how NED may promote adaptive health behaviors such as medication adherence. Utilizing weekly diaries, we investigated whether NED moderates the association between negative affect and medication adherence rates across 58 weeks among patients (n = 27) newly diagnosed with MS (following McDonald criteria). Results revealed that NED significantly moderated the relationship between negative affect and medication adherence. Specifically, greater negative affect was associated with lower adherence only for individuals reporting low NED. However, this link disappeared for those reporting moderate to high NED. Building upon past research, our findings suggest that NED may promote adaptive health behaviors and have important clinical implications for the treatment and management of chronic illness.

Predicting negative affect variability and spontaneous emotion regulation: Can working memory span tasks estimate emotion regulatory capacity?

[Correction Notice: An Erratum for this article was reported online in Emotion on Jan 7 2021 (see record 2021-06077-001). In the article, in the Results and Discussion sections for Study 2 and in Table 6, it was stated that RSPAN scores predicted spontaneous down-regulation of negative affect from one diary signal to the next. However, because RSPAN scores are a person-level variable, it is an error to describe the results in that way. RSPAN scores cannot predict variability within person (i.e., signal to signal) but rather predict variability between person (i.e., person to person). Hence, a corrected interpretation would be to state that the RSPAN predicted levels of negative affect across the experience sampling diary, even when considering trait and state levels of affect and variability in daily stress. The analysis remains correct and the findings remain meaningful.] We tested the association of 2 versions of the Reading Span Task of working memory capacity, a conventional neutral version (RSPAN-N) and an adapted task with incidental negative content (RSPAN-E), for predicting objective indicators (behavioral displays; autonomic activation) of negative emotion regulation during a laboratory provocation, as well as reported negative emotion in daily life experience sampling. Across 2 samples, both tasks demonstrated utility as estimates of spontaneous negative emotion regulation capacity, predicting down-regulation of negative emotion in daily life and during a lab challenge. In addition, scores from both tasks appear to be independent of self-reported distress, a confound often present in studies of emotion regulation. There was some incremental evidence that the RSPAN-E may have advantages over the RSPAN-N for predicting some indices of emotion processing. Together these findings provide further evidence for the role of working memory (among other executive-control abilities) in emotion regulatory processing and suggest that RSPAN tasks may have considerable potential as tools in research on emotion processing and emotion regulation in psychological health and adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Micro Versus Macro Processes: How specific stress exposure impacts sleep, affect, and risk-related behavior on the path to disease in high-risk adults.

BACKGROUND: The stress-to-disease association has been well-accepted for some time. However, the understanding of how stress exposure contributes to psychological disease progression remains unclear. OBJECTIVE: To test the real-time impact of variable stress exposure on risk-related clinical phenomena and affective disease progression in a high-risk sample of active-duty firefighters. METHODS: Participants completed weekly diaries reporting stressful event exposure, affect, sleep, and risk-related and healthy behaviors over six-months and were evaluated for lifetime and current psychiatric disease using clinical interviews before and after the sampling period. RESULTS: Stress exposure impacted clinical phenomena in differing ways. Major personal events and day-to-day hassles predicted health-impairing shifts in sleep and behavior that were associated with increases in symptoms and psychological distress over the 6-month period. In contrast, highly aversive incidents predicted greater adaptive behaviors that were uniquely predictive of symptom decreases over the six-month period. CONCLUSION: These findings shed new light on stress-to-disease processes, demonstrating how variable stress exposure influences critical shifts in behavior and sleep, contributing to psychological adjustment of firefighters over time. These data suggest practical ways to monitor risk in high-risk samples (e.g., monitoring sleep latency) and offer avenues for further explication of disease processes in real time.