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51 to 75 of 3,214Jones BDM, Kittur ME, Mak MSB, Wang W, Zaheer J, McMain S, Husain MO, Sonley A, Gratzer D, Mulsant BH, Blumberger DM, Husain MI (2025)randomised controlled trialMEDLINE-indexed journal, not yet read by usCanadian journal of psychiatry. Revue canadienne de psychiatrie4 citations A Digital Dialectical Behaviour Therapy Intervention for Acute Suicidality in Psychiatric Inpatients: A Feasibility Randomised Controlled Study: Intervention numérique en thérapie comportementale dialectique en cas de suicidabilité aiguë de patients hospitalisés en psychiatrie : Étude de faisabilité contrôlée à répartition aléatoire.
Objective: To evaluate the feasibility and preliminary efficacy of a digital dialectical behaviour therapy (d-DBT) skills intervention in suicidal psychiatric inpatients.
Methods: A parallel arm, assessor-blinded, randomized controlled trial (RCT) was conducted to compare d-DBT to standard care among psychiatric inpatients. Participants included adults admitted for suicidality (i.e., suicidal ideation or suicide attempt). The intervention group received a d-DBT intervention encompassing 5 online modules completed over 5 to 10 days, covering mindfulness, emotion regulation, and distress tolerance skills. Participants received an initial orientation but no formal therapy sessions. Daily check-ins were available for technical-related queries. Feasibility outcomes included recruitment, adherence (≥3 modules completed), retention, and acceptability (client satisfaction questionnaire-8). Effic…
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Impact of resilience-based intervention on emotional regulation, grit and life satisfaction among female Egyptian and Saudi nursing students: A randomized controlled trial.
Aim: Evaluate and compare the impact of a resilience-based intervention on emotional regulation, grit and life satisfaction among female Egyptian and Saudi nursing students.
Background: Nursing students should experience a comprehensive learning environment since they are mind-body-spirit creatures. Therefore, nursing education should emphasize growing students' physical, social, emotional and spiritual well-being in addition to their knowledge, skills and attitudes.
Design: This study followed a parallel arm randomized controlled trial design. Study participants were randomly assigned to the intervention or control groups in a (1:1) ratio. It was conducted between January 2023 and the end of April 2023.
Method: Students were randomly allocated to the eight-week resilience intervention (n= 60) or a control (n= 60) group (half of the students in each group were from each country). The int…
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Young women's body image following upwards comparison to Instagram models: The role of physical appearance perfectionism and cognitive emotion regulation.
The present study examined whether trait physical appearance perfectionism moderates young women's body image following upwards appearance comparison to idealized body images on social media, and whether cognitive coping mediates the relationship between physical appearance perfectionism and resulting body image from social comparison processes. Female undergraduate students (N = 142) were randomly assigned to either 1) compare the size of their body parts to the body parts of attractive Instagram models, or 2) an appearance-neutral control condition. All participants completed measures of trait physical appearance perfectionism, pre and post measures of state body image, and state cognitive coping processes. Appearance comparison to the models resulted in lowered confidence and increased appearance and weight dissatisfaction. High trait physical appearance perfectionism predicted lower …
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Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder.
Background: Dialectical behaviour therapy (DBT) and mentalisation-based therapy (MBT) are both widely used evidence-based treatments for borderline personality disorder (BPD), yet a head-to-head comparison of outcomes has never been conducted. The present study therefore aimed to compare the clinical outcomes of DBT v. MBT in patients with BPD.
Methods: A non-randomised comparison of clinical outcomes in N = 90 patients with BPD receiving either DBT or MBT over a 12-month period.
Results: After adjusting for potentially confounding differences between participants, participants receiving DBT reported a significantly steeper decline over time in incidents of self-harm (adjusted IRR = 0.93, 95% CI 0.87-0.99, p = 0.02) and in emotional dysregulation (adjusted β = -1.94, 95% CI -3.37 to -0.51, p < 0.01) than participants receiving MBT. Differences in treatment dropout and use of crisis servi…
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The VLPFC versus the DLPFC in Downregulating Social Pain Using Reappraisal and Distraction Strategies.
The dorsolateral prefrontal cortex (DLPFC) and ventrolateral PFC (VLPFC) are both crucial structures involved in voluntary emotional regulation. However, it remains unclear whether the functions of these two cortical regions that are involved in emotional regulation, which are usually active in non-social situations, could be generalized to the regulation of social pain as well. This study employed transcranial magnetic stimulation (TMS) to examine the causal relationship between the DLPFC/VLPFC and the emotional regulation of social pain via distraction and reappraisal. Ninety human participants (45 males and 45 females) initially underwent either active (DLPFC/VLPFC, n = 30/30) or sham (vertex, n = 30) TMS sessions. Participants were then instructed to use both distraction and reappraisal strategies to downregulate any negative emotions evoked by social exclusion pictures. Convergent r…
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Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?
Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination parti…
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Neuroimaging cognitive reappraisal in clinical populations to define neural targets for enhancing emotion regulation. A systematic review.
Reduced capacity to cognitively regulate emotional responses is a common impairment across major neuropsychiatric disorders. Brain systems supporting one such strategy, cognitive reappraisal of emotion, have been investigated extensively in the healthy population, a research focus that has led to influential meta-analyses and literature reviews. However, the emerging literature on neural substrates underlying cognitive reappraisal in clinical populations is yet to be systematically reviewed. Therefore, the goal of the current review was to summarize the literature on cognitive reappraisal and highlight common and distinct neural correlates of impaired emotion regulation in clinical populations. We performed a two-stage systematic literature search, selecting 32 studies on cognitive reappraisal in individuals with mood disorders (n=12), anxiety disorders (n=14), addiction (n=2), schizophr…
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Emotion regulation model in binge eating disorder and obesity--a systematic review.
Deficits in emotion regulation processes are a common and widely used explanation for the development and maintenance of binge eating disorder (BED). It is assumed that BED patients - as they have difficulty regulating their negative emotions - use binge eating to cope with these emotions and to find relief. However, the number of experimental studies investigating this assumption is scarce and the differentiation of obese individuals with and without BED regarding the emotion regulation model is not verified. We reviewed literature for experimental studies investigating the emotion regulation model in obese patients (OB) with and without BED. Our search resulted in 18 experimental studies examining the triggering effect of negative emotions for binge eating or its effects on subsequent relief. We found evidence indicating that negative emotion serves as a trigger for binge eating in the…
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Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial.
The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8 treatment modules) addresses topics such as pain education,…
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Burke JD, Loeber R (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of abnormal child psychology22 citations Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.
Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress…
matched on Emotions (mesh), Adaptation, Psychological (mesh), emotion regulation (text)
Alexithymia, emotional dysregulation, and recovery from alcoholism: therapeutic response to assessment of mood.
This study is a secondary analysis of a randomized controlled trial that tested the effects of a gratitude intervention on well-being in a sample of individuals in outpatient treatment for alcohol use disorder (AUD). Follow-up qualitative interviews unexpectedly revealed that participants found the Positive and Negative Affect Schedule (PANAS) to be helpful to their recovery in the ways that it asked them to identify and rate their emotions. Participant statements were purposively sampled and analyzed using grounded theory methods to produce a conceptual framework illustrating the process of mood identification and its sequelae. Evidence of existing alexithymia and emotional dysregulation, dominance of negative mood, and increasing ability to identify, accept, and regulate mood as part of recovery was found. Findings suggest that emotion regulation is a compelling topic for those in reco…
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A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for bulimia nervosa.
Background: The purpose of this investigation was to compare a new psychotherapy for bulimia nervosa (BN), integrative cognitive-affective therapy (ICAT), with an established treatment, 'enhanced' cognitive-behavioral therapy (CBT-E).
Method: Eighty adults with symptoms of BN were randomized to ICAT or CBT-E for 21 sessions over 19 weeks. Bulimic symptoms, measured by the Eating Disorder Examination (EDE), were assessed at baseline, at the end of treatment (EOT) and at the 4-month follow-up. Treatment outcome, measured by binge eating frequency, purging frequency, global eating disorder severity, emotion regulation, self-oriented cognition, depression, anxiety and self-esteem, was determined using generalized estimating equations (GEEs), logistic regression and a general linear model (intent-to-treat).
Results: Both treatments were associated with significant improvement in bulimic sympt…
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Kemeny ME, Foltz C, Cavanagh JF, Cullen M, Giese-Davis J, Jennings P, Rosenberg EL, Gillath O, Shaver PR, Wallace BA, Ekman P (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usEmotion (Washington, D.C.)100 citations Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses.
Contemplative practices are believed to alleviate psychological problems, cultivate prosocial behavior and promote self-awareness. In addition, psychological science has developed tools and models for understanding the mind and promoting well-being. Additional effort is needed to combine frameworks and techniques from these traditions to improve emotional experience and socioemotional behavior. An 8-week intensive (42 hr) meditation/emotion regulation training intervention was designed by experts in contemplative traditions and emotion science to reduce "destructive enactment of emotions" and enhance prosocial responses. Participants were 82 healthy female schoolteachers who were randomly assigned to a training group or a wait-list control group, and assessed preassessment, postassessment, and 5 months after training completion. Assessments included self-reports and experimental tasks to…
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Aldao A, Mennin DS (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehaviour research and therapy50 citations Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.
Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or …
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Promoting adaptive emotion regulation and coping in adolescence: a school-based programme.
Particularly in adolescence, fostering adaptive emotion regulation is an important aim in health promotion. Expressive writing in combination with psycho-education on emotion regulation seems especially appropriate to serve this aim. In this study, school classes were randomly assigned either to a prevention (N = 208) or to a non-treatment control group (N = 151). The prevention group showed significant improvements regarding negative affect, grades, and days absent compared to the control-group. A combination of expressive writing with elements of psycho-education of emotion regulation might be an effective preventive tool, as it seems to improve psychosocial adjustment by establishing functional emotion regulation strategies.
matched on Emotions (mesh), Adaptation, Psychological (mesh), emotion regulation (text)
Oxytocin buffers cortisol responses to stress in individuals with impaired emotion regulation abilities.
Oxytocin facilitates stress regulation but little is known about individual differences in this effect. The present study investigates whether the effect of intranasal oxytocin on stress-contingent cortisol release differs between individuals with high vs. low emotional regulation abilities (ERA). In a double-blind study thirty-six healthy male students with either high or low ERA were randomly assigned to receive intranasally 24 IU oxytocin or placebo. Cortisol was measured at several times before and after a social stressor (public speaking). Individuals with impaired ERA showed a reduced cortisol response to stress after oxytocin but an increased cortisol response after placebo application. The results suggest that healthy individuals with low ERA benefit from intranasal oxytocin application. Neurobiological mechanisms potentially underlying the link between oxytocin, cortsiol and ERA…
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Suveg C, Sood E, Comer JS, Kendall PC (2009)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 5352 citations Changes in emotion regulation following cognitive-behavioral therapy for anxious youth.
This study examined emotion-related functioning following cognitive-behavioral therapy (CBT) with 37 youth with anxiety disorders (22 boys, 15 girls) ranging in age from 7 to 15 with a principal diagnosis of generalized anxiety disorder (n = 27), separation anxiety disorder (n = 12), and/or social phobia (n = 13). Treated youth exhibited a reduction in anxiety and increased anxiety self-efficacy and emotional awareness at posttreatment. Treated youth also demonstrated improved coping and less emotional dysregulation with worry but not with anger or sadness. The results suggest that the gains made in worry regulation do not generalize to other emotions that are not specifically targeted within the CBT protocol.
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Arch JJ, Craske MG (2006)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehaviour research and therapy347 citations Mechanisms of mindfulness: emotion regulation following a focused breathing induction.
The current study investigated whether a 15 min recorded focused breathing induction in a normal, primarily undergraduate population would decrease the intensity and negativity of emotional responses to affectively valenced picture slides and increase willingness to remain in contact with aversive picture slides. The effects of the focused breathing induction were compared with the effects of 15 min recorded inductions of unfocused attention and worrying. The focused breathing group maintained consistent, moderately positive responses to the neutral slides before and after the induction, whereas the unfocused attention and worry groups responded significantly more negatively to the neutral slides after the induction than before it. The focusing breathing group also reported lower negative affect and overall emotional volatility in response to the post-induction slides than the worry grou…
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The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis.
Background: Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association.
Objective: To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics.
Methods: We searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings.
Results: After screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There wa…
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A meta-review of stress, coping and interventions in dementia and dementia caregiving.
Background: There has been a substantial number of systematic reviews of stress, coping and interventions for people with dementia and their caregivers. This paper provides a meta-review of this literature 1988-2014.
Method: A meta-review was carried out of systematic reviews of stress, coping and interventions for people with dementia and their caregivers, using SCOPUS, Google Scholar and CINAHL Plus databases and manual searches.
Results: The meta-review identified 45 systematic reviews, of which 15 were meta-analyses. Thirty one reviews addressed the effects of interventions and 14 addressed the results of correlational studies of factors associated with stress and coping. Of the 31 systematic reviews dealing with intervention studies, 22 focused on caregivers, 6 focused on people with dementia and 3 addressed both groups. Overall, benefits in terms of psychological measures of mental…
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The Relationship Between Self-Compassion and Well-Being: A Meta-Analysis.
Background: Self-compassion describes a positive and caring attitude of a person toward her- or himself in the face of failures and individual shortcomings. As a result of this caring attitude, individuals high in self-compassion are assumed to experience higher individual well-being. The present meta-analysis examines the relationship between self-compassion and different forms of well-being.
Method: The authors combined k = 79 samples, with an overall sample size of N = 16,416, and analyzed the central tendencies of effect sizes (Pearson correlation coefficients) with a random-effect model.
Results: We found an overall magnitude of the relationship between self-compassion and well-being of r = .47. The relationship was stronger for cognitive and psychological well-being compared to affective well-being. Sample characteristics and self-esteem were tested as potential moderators. In addi…
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Kalisch R (2009)meta-analysisMEDLINE-indexed journal, not yet read by usNeuroscience and biobehavioral reviews260 citations The functional neuroanatomy of reappraisal: time matters.
Humans can regulate their emotional states through a number of effortful cognitive strategies, a type of adaptive behavior not found in animals. The best studied strategy is reappraisal which consists in deliberately changing the emotional interpretation of a stimulus. Reappraisal modulates both subjective and physiological emotional response components and has long-term effects on well-being and mental health. Over the past few years, a rapidly growing neuroimaging literature has attempted to characterize the neural mechanisms that mediate reappraisal, but results have so far been relatively inconsistent. This article provides an overview of the current state of the field and presents a first formal quantitative meta-analysis of neuroimaging findings. It introduces a new model of the cognitive processes underlying reappraisal which builds on a conceptualization of reappraisal as a tempo…
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Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis.
The authors investigated the effect of chronic exercise on feelings of energy and fatigue using meta-analytic techniques. Chronic exercise increased feelings of energy and lessened feelings of fatigue compared with control conditions by a mean effect delta of 0.37. The effect varied according to the presence or absence of a placebo control or whether chronic exercise was completed alone or in combination with an additional therapy. Investigations that used a placebo control and examined chronic exercise alone found no effect of chronic exercise on feelings of energy and fatigue. Certain placebo controls may increase feelings of energy and lessen feelings of fatigue when used with older adults or people with psychological distress. The results highlight the need for research identifying the most useful control conditions for accurately interpreting mental health outcome data obtained in c…
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Experiential Avoidance in Advanced Cancer: a Mixed-Methods Systematic Review.
Background: People with advanced cancer experience psychological distress due to physical symptoms, functional decline, and a limited prognosis. Difficult thoughts, feelings, and emotions may exacerbate distress and lead to avoidance of these experiences which is sometimes referred to as experiential avoidance (EA). Advanced cancer patients may be more likely to engage in EA especially when no obvious solutions to their problems exist. This study aims to examine the terms used to describe EA, the processes that might indicate EA, associations between EA and psychological distress, and to understand why individuals might engage in EA.
Methods: A mixed-methods review. Literature search of Medline, Embase, Psych INFO, and CINAHL 1980-October 2019.
Inclusion: adults ≥ 18 years; advanced cancer not amenable to cure.
Exclusion: no measures of EA or psychological distress. Risk of bias and stud…
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Coping, Cognitive Emotion Regulation, and Burnout in Long-Term Care Nursing Staff: A Preliminary Study.
Direct care workers (e.g., certified nursing assistants [CNAs]) employed in long-term care (LTC) are particularly vulnerable to the experience of burnout, yet they have received relatively less research attention compared to Licensed Practical Nurses and Registered Nurses. Within the burnout literature, evidence suggests that the deployment of certain coping strategies influences levels of burnout. The current study examined the extent to which coping (e.g., problem-focused, emotion-focused, and dysfunctional coping) and cognitive emotion regulation strategies (e.g., positive reappraisal) predicted burnout after controlling for covariates (age, sleep duration). Fifty-six CNAs were surveyed at four skilled nursing facilities in the United States. Dysfunctional coping was significantly associated with emotional exhaustion and depersonalization. Among cognitive emotion regulation strategies…
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