Linguistic measures of psychological distance track symptom levels and treatment outcomes in a large set of psychotherapy transcripts

Using language to distance oneself from negative stimuli (e.g., by reducing use of the word “I” and present-tense verbs) is associated with effective emotion regulation. Given that internalizing disorders like anxiety and depression are characterized by maladaptive emotion regulation, stronger linguistic distance may be both a diagnostic marker of lower internalizing symptoms and a prognostic indicator of treatment progress. Here, we tested these hypotheses in a large corpus of naturalistic psychotherapeutic exchanges between clients and their therapists (> 1.2 million messages from 6,229 clients). In both exploratory (N=3,729) and validation (N=2,500) datasets, we found that clients’ internalizing symptoms decreased over therapy, that client linguistic distance increased over therapy, and that internalizing symptoms tracked fluctuations in linguistic distance both within- and between-individuals. In other words, clients shifted from discussing themselves and the present moment to discussing other people and timepoints over treatment, and this was related to symptom improvements. However, effect sizes for linguistic results were small, and we failed to find consistent evidence that linguistic distance statistically mediated changes in symptoms over time. Treatment efficacy also was related to therapist linguistic distance in some—but not all—analyses, suggesting that changing therapist language could improve outcomes. Finally, clustering analyses revealed that data-driven groups of clients defined based solely on their linguistic distance differed in both their symptom severity and treatment outcomes. Together, these findings provide replicable evidence that linguistic distance is a marker of internalizing symptom severity and treatment progress in real-world therapeutic interactions.

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Betrayal vs. nonbetrayal trauma: Examining the different effects of social support and emotion regulation on PTSD symptom severity.

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0000983 ◽

2020 ◽

Author(s):

Nora K. Kline ◽

Kathleen M. Palm Reed

Keyword(s):

Social Support ◽

Emotion Regulation ◽

Symptom Severity ◽

Ptsd Symptom ◽

Ptsd Symptom Severity

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Intimate Partner Violence and Posttraumatic Stress Symptoms: Indirect Effects Through Negative and Positive Emotion Dysregulation

Journal of Interpersonal Violence ◽

10.1177/08862605211006371 ◽

2021 ◽

pp. 088626052110063

Author(s):

Lauren E. Simpson ◽

Alexa M. Raudales ◽

Miranda E. Reyes ◽

Tami P. Sullivan ◽

Nicole H. Weiss

Keyword(s):

Intimate Partner Violence ◽

Emotion Regulation ◽

Posttraumatic Stress ◽

Symptom Severity ◽

Partner Violence ◽

Emotion Dysregulation ◽

Positive Emotion ◽

Intimate Partner ◽

Difficulties In Emotion Regulation

Women who experience intimate partner violence (IPV) are at heightened risk for developing posttraumatic stress (PTS). Emotion dysregulation has been linked to both IPV and PTS, separately, however, unknown is the role of emotion dysregulation in the relation of IPV to PTS among women who experience IPV. Moreover, existing investigations in this area have been limited in their focus on negative emotion dysregulation. Extending prior research, this study investigated whether physical, sexual, and psychological IPV were indirectly associated with PTS symptom severity through negative and positive emotion dysregulation. Participants were 354 women who reported a history of IPV recruited from Amazon’s MTurk platform ( Mage = 36.52, 79.9% white). Participants completed self-report measures assessing physical (Conflict Tactics Scale), sexual (Sexual Experiences Scale), and psychological (Psychological Maltreatment of Women) IPV; negative (Difficulties in Emotion Regulation Scale) and positive (Difficulties in Emotion Regulation Scale-Positive) emotion dysregulation; and PTS symptom severity (PTSD Checklist for DSM-5) via an online survey. Pearson’s correlation coefficients examined intercorrelations among the primary study variables. Indirect effect analyses were conducted to determine if negative and positive emotion dysregulation explained the relations between physical, sexual, and psychological IPV and PTS symptom severity. Physical, sexual, and psychological IPV were significantly positively associated with both negative and positive emotion dysregulation as well as PTS symptom severity, with the exception that psychological IPV was not significantly associated with positive emotion dysregulation. Moreover, negative and positive emotion dysregulation accounted for the relationships between all three IPV types and PTS symptom severity, with the exception of positive emotion dysregulation and psychological IPV. Our findings provide support for the potential underlying role of both negative and positive emotion dysregulation in the associations of IPV types to PTS symptom severity. Negative and positive emotion dysregulation may be important factors to integrate into interventions for PTS among women who experience IPV.

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The Multilevel Structure of Daily Emotion-Regulation-Strategy Use: An Examination of Within- and Between-Person Associations in Naturalistic Settings

Clinical Psychological Science ◽

10.1177/2167702618807408 ◽

2018 ◽

Vol 7 (2) ◽

pp. 321-339 ◽

Cited By ~ 9

Author(s):

Tierney P. McMahon ◽

Kristin Naragon-Gainey

Keyword(s):

Emotion Regulation ◽

Emotional Expression ◽

Experiential Avoidance ◽

Internalizing Symptoms ◽

Clinical Sample ◽

Strategy Use ◽

Expressive Suppression ◽

Student Sample ◽

Attentional Shift ◽

Exploratory Factor Analyses

Existing structural analyses of emotion-regulation (ER) strategies have relied on retrospective, dispositional assessments, ignoring the within-person structure (i.e., intraindividual strategy groupings based on momentary covariances) and variability in strategy use across time and contexts. We conducted multilevel exploratory factor analyses on self-reported daily use of 11 strategies (i.e., acceptance, behavioral avoidance, distraction, experiential avoidance, expressive suppression, procrastination, reappraisal, reflection, rumination, savoring, social support) in clinical ( N = 129) and student ( N = 109) samples with intensive longitudinal designs. At the between-person level, two factors—Engagement and Avoidance—emerged in both samples. A different structure was found at the within-person level, with four factors in the student sample (i.e., Attentional Shift, Acceptance, Avoidance, Emotional Expression) and three in the clinical sample (i.e., Attentional Shift, Avoidance, Emotional Expression). The validity of these factors was examined via their associations with daily internalizing symptoms and affect. Implications for naturalistic ER strategy use and clinical assessment/intervention are discussed.

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Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Veterans With Posttraumatic Stress Disorder: A Pilot Study

Behavior Modification ◽

10.1177/0145445517724539 ◽

2017 ◽

Vol 42 (2) ◽

pp. 210-230 ◽

Cited By ~ 7

Author(s):

Ruth L. Varkovitzky ◽

Andrew M. Sherrill ◽

Greg M. Reger

Keyword(s):

Posttraumatic Stress Disorder ◽

Emotion Regulation ◽

Depressive Symptoms ◽

Pilot Study ◽

Posttraumatic Stress ◽

Emotional Disorders ◽

Symptom Severity ◽

Stress Disorder ◽

Transdiagnostic Treatment ◽

Unified Protocol

Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire–9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.

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Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial

10.31219/osf.io/4se5m ◽

2017 ◽

Author(s):

Emily K Lindsay ◽

Shinzen Young ◽

Joshua M Smyth ◽

Kirk Warren Brown ◽

J. David Creswell

Keyword(s):

Blood Pressure ◽

Emotion Regulation ◽

Social Stress ◽

Stress Reactivity ◽

Controlled Trial ◽

Stress Test ◽

Mindfulness Training ◽

Trier Social Stress Test ◽

Present Moment ◽

Regulation Mechanism

Objective: Mindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects. Method: In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor+Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age = 32 years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test. Results: As predicted, Monitor+Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress.Conclusions: This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.

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