The Importance of Emotional Regulation in Mental Health

Mental health is a critical component of overall well-being and exists on a continuum much like physical health. Although many ways to assess mental health exist outside of either having a disorder or not, practitioners often rely on the presence or absence of symptomatology. The assessment and promotion of emotional regulation in patients is one way to encourage individuals to engage in mental health-promoting behaviors. Specific techniques are discussed that address emotional regulation. Overall, providing patients with the tools to regulate emotional responding will likely have a direct impact on well-being as well as reduce MH symptomology.

Emotion in non-suicidal self-injury: A contradiction between global self-reports and real-time responses

<p><b>People who engage in non-suicidal self-injury (NSSI) report doing so largely to manage overwhelming emotions. Prominent theories of NSSI argue that an amplified emotional response system creates the context in which a person chooses to regulate their emotions by engaging in NSSI. In line with these theories, people who engage in NSSI consistently report greater global emotion reactivity and emotion dysregulation than do controls. These global self-reports of emotional functioning also predict the onset and cessation of NSSI, demonstrating their considerable utility in understanding the behaviour. However, global self-reports provide an overall evaluation of one’s average affective experience and so are ill-suited to isolating precise alterations in emotional responding.</b></p> <p>I first establish how best to assess NSSI (Study 1a and 1b). I then leverage experimental affective science and individual differences methodologies to test whether NSSI is characterised by a more reactive and intense emotional response to challenge, and/or whether factors that help to create, modify, and later recall the emotional response are altered in those who engage in NSSI compared with controls. Study 2 compared how young adults with a past-year history of NSSI and controls subjectively and physiologically reacted to, and recovered from, acute stress. Study 3 compared how young adults with a past-year history of NSSI and controls subjectively reacted to both explicit and more ambiguous social exclusion.</p> <p>Consistent with a wealth of research, across both Studies 2 and 3 people with a past-year history of NSSI reported considerably greater global emotion reactivity and emotion dysregulation than did controls. However, counter to predictions, both the NSSI and Control groups showed similar patterns of real-time emotional responding to both acute stress (Study 2) and social exclusion (Study 3), providing no evidence that NSSI is characterised by an amplified response to emotional challenge. In addition, we found no evidence that emotional recovery, emotion regulation strategy use, memory of emotional experience, or appraisal—all factors that shape the emotional response—operate differently in those who engage in NSSI. Focusing on how people make global self-reports, exploratory reanalysis of Study 2 and 3 suggests that people with no history of NSSI draw from their real-time experiences of acute (but not mild) emotional challenge when making judgements about their global emotion dysregulation. In contrast, people who engage in NSSI appear to rely on different channels of information when reporting their global emotion dysregulation.</p> <p>Overall, this thesis demonstrates that, despite reporting considerably poorer global emotional functioning, people who engage in NSSI show largely typical responses to real-time emotional challenges. Given that global self-reports of emotional functioning appear to be critical for understanding NSSI onset and cessation, the discrepancy between global self-reports and measures of real-time responding highlights the complexity of the relationship between emotion and NSSI. To advance our understanding of emotional responding in NSSI, research should: a) establish the conditions (if any) under which people who engage in NSSI show amplified emotional responding, and b) isolate the psychological processes that underlie the experience of poorer global emotional functioning reported by people who engage in NSSI.</p>

Emotion in non-suicidal self-injury: A contradiction between global self-reports and real-time responses

<p><b>People who engage in non-suicidal self-injury (NSSI) report doing so largely to manage overwhelming emotions. Prominent theories of NSSI argue that an amplified emotional response system creates the context in which a person chooses to regulate their emotions by engaging in NSSI. In line with these theories, people who engage in NSSI consistently report greater global emotion reactivity and emotion dysregulation than do controls. These global self-reports of emotional functioning also predict the onset and cessation of NSSI, demonstrating their considerable utility in understanding the behaviour. However, global self-reports provide an overall evaluation of one’s average affective experience and so are ill-suited to isolating precise alterations in emotional responding.</b></p> <p>I first establish how best to assess NSSI (Study 1a and 1b). I then leverage experimental affective science and individual differences methodologies to test whether NSSI is characterised by a more reactive and intense emotional response to challenge, and/or whether factors that help to create, modify, and later recall the emotional response are altered in those who engage in NSSI compared with controls. Study 2 compared how young adults with a past-year history of NSSI and controls subjectively and physiologically reacted to, and recovered from, acute stress. Study 3 compared how young adults with a past-year history of NSSI and controls subjectively reacted to both explicit and more ambiguous social exclusion.</p> <p>Consistent with a wealth of research, across both Studies 2 and 3 people with a past-year history of NSSI reported considerably greater global emotion reactivity and emotion dysregulation than did controls. However, counter to predictions, both the NSSI and Control groups showed similar patterns of real-time emotional responding to both acute stress (Study 2) and social exclusion (Study 3), providing no evidence that NSSI is characterised by an amplified response to emotional challenge. In addition, we found no evidence that emotional recovery, emotion regulation strategy use, memory of emotional experience, or appraisal—all factors that shape the emotional response—operate differently in those who engage in NSSI. Focusing on how people make global self-reports, exploratory reanalysis of Study 2 and 3 suggests that people with no history of NSSI draw from their real-time experiences of acute (but not mild) emotional challenge when making judgements about their global emotion dysregulation. In contrast, people who engage in NSSI appear to rely on different channels of information when reporting their global emotion dysregulation.</p> <p>Overall, this thesis demonstrates that, despite reporting considerably poorer global emotional functioning, people who engage in NSSI show largely typical responses to real-time emotional challenges. Given that global self-reports of emotional functioning appear to be critical for understanding NSSI onset and cessation, the discrepancy between global self-reports and measures of real-time responding highlights the complexity of the relationship between emotion and NSSI. To advance our understanding of emotional responding in NSSI, research should: a) establish the conditions (if any) under which people who engage in NSSI show amplified emotional responding, and b) isolate the psychological processes that underlie the experience of poorer global emotional functioning reported by people who engage in NSSI.</p>

The Temporal Dynamics of Spontaneous Emotional Brain States and Their Implications for Mental Health

Temporal processes play an important role in elaborating and regulating emotional responding during routine mind wandering. However, it is unknown whether the human brain reliably transitions among multiple emotional states at rest and how psychopathology alters these affect dynamics. Here, we combined pattern classification and stochastic process modeling to investigate the chronometry of spontaneous brain activity indicative of six emotions (anger, contentment, fear, happiness, sadness, and surprise) and a neutral state. We modeled the dynamic emergence of these brain states during resting-state fMRI and validated the results across two population cohorts—the Duke Neurogenetics Study and the Nathan Kline Institute Rockland Sample. Our findings indicate that intrinsic emotional brain dynamics are effectively characterized as a discrete-time Markov process, with affective states organized around a neutral hub. The centrality of this network hub is disrupted in individuals with psychopathology, whose brain state transitions exhibit greater inertia and less frequent resetting from emotional to neutral states. These results yield novel insights into how the brain signals spontaneous emotions and how alterations in their temporal dynamics contribute to compromised mental health.

Heightened facial muscle reactivity in preadolescent girls with pathological anxiety

Anticipatory anxiety and heightened responses to uncertainty are central features of anxiety disorders (ADs). We examined facial emotional responding in a sample of preadolescent girls with a range of anxiety symptoms: no/low anxiety (controls) to subthreshold anxiety (subthreshold-AD) to DSM-5 diagnoses of separation, social, and/or generalized ADs. Using a threat anticipation paradigm, we assessed how variations in image valence (negative vs. neutral) and image anticipation (uncertain vs. certain timing) impacted activity of the corrugator supercilii, a forehead muscle implicated in the ‘frown’ response that modulates to emotional stimuli (negative>neutral). Average corrugator magnitude and corrugator time-course were compared between groups. Findings demonstrate greater corrugator activity during anticipation and viewing of negative stimuli, with overall increased corrugator reactivity in subthreshold-AD and AD girls. Time-course analyses revealed anxiety-related sustained corrugator activity during uncertain anticipation of negative images. Results extend the physiological characterization of childhood pathological anxiety, highlighting the impact of subthreshold-AD symptoms.

Reactions to Laboratory-Based Trauma Research in a Sample of Incarcerated Women

An evidence-based approach to research ethics is critical to ethical research but little is known about how trauma survivors—especially those from vulnerable populations—respond to laboratory-based trauma research. One hundred four incarcerated women ( N = 64 rape survivors) reported their traumatic life experiences, listened to and responded to an audio recording of a dating interaction that culminates in a completed rape, and then reported their responses to their participation. Compared to the control group ( N = 40), rape survivors ( N = 64) had more posttraumatic stress disorder symptoms and these symptoms were associated with more emotional responding. Both groups showed a positive benefit–cost ratio with regard to their participation did not differ on their overall reactions to research participation. These findings suggest that laboratory-based trauma research methods are associated with consistently positive experiences, which can help inform researchers and institutional review boards about the risks and benefits of such research.

Emotional Responding and Adversity

The experience of emotions is a ubiquitous human experience, as is the experience of adversity. In the aftermath of an adverse life event, a variety of emotional experiences can occur. This chapter reviews the relationship between emotional responding and adversity within the science of emotion and resilience. Current literature on possible emotional responses to adversity are reviewed, including literature on both resilience and psychopathology. Multiple trajectories following the experience of various types of potentially traumatic events are outlined, including predictors for each of these trajectories. In addition, forms of psychopathology in emotional responding after adversity are discussed, including posttraumatic stress disorder, prolonged grief disorder, adjustment disorders, and other mental health conditions. Information regarding risk and resilience factors for each disorder are discussed, and evidence regarding treatment is briefly summarized.

Negative Overgeneralization is Associated with Anxiety and Mechanisms of Pattern Completion in Peripubertal Youth

This study examines neural mechanisms of negative overgeneralization, the increased likelihood of generalizing negative information, in peri-puberty. Theories suggest that weak pattern separation (overlapping representations are made distinct, indexed by DG/CA3 hippocampal subfield activation) underlies negative overgeneralization. We alternatively propose that neuro-maturational changes that favor pattern completion (cues reinstate stored representations, indexed by CA1 activation) are modulated by circuitry involved in emotional responding (amygdala, medial prefrontal cortices [mPFC]) to drive negative overgeneralization. Youth (N=34, 9-14 years) recruited from community and clinic settings participated in an emotional mnemonic similarity task while undergoing MRI. At Study, participants indicated the valence of images; at Test, participants made recognition memory judgments. Critical lure stimuli, that were similar to images at Study, were presented at Test, and errors (“false alarms”) to negative relative to neutral stimuli reflected negative overgeneralization. Negative overgeneralization was related to greater and more similar patterns of activation in CA1 and both dorsal and ventral mPFC for negative relative to neutral stimuli. At Study, amygdala exhibited greater functional coupling with CA1 and dorsal mPFC during negative items that were later generalized. Negative overgeneralization is rooted in amygdala and mPFC modulation at encoding and pattern completion at retrieval.

Effort beats effectiveness in emotion regulation choice: Differences between suppression and distancing in subjective and physiological measures

Emotion regulation (ER) can be implemented by different strategies which differ in their capacity to alter emotional responding. What all strategies have in common is that cognitive control must be exercised in order to implement them. The aim of the present preregistered study was to investigate whether the two ER strategies expressive suppression and distancing require different amounts of cognitive effort and whether effort is associated with personality traits. Effort was assessed subjectively via ratings and objectively via pupillometry and heart period. In two studies, N = 110 and N = 52 healthy adults conducted an ER paradigm. Participants used suppression and distancing during inspection of positive and negative pictures. They also had the choice to reapply either of the strategies at the end of the paradigm. Although distancing was more effective in downregulation of subjective arousal (Study 1: p &lt; .001, ηp² = .20; Study 2: p &lt; .001, ηp² = .207), about two thirds reapplied suppression, because it was perceived as less effortful. Effort was rated significantly lower for suppression compared to distancing (Study 1: p = .042, ηp² = .04; Study 2: p = .002, ηp² = .13). However, differences in effort were not reflected in pupillary data or heart period. Broad and narrow personality traits were neither associated with the preferred strategy, nor with subjective or physiological effort measures. Findings suggest that people tend to use the ER strategy that is perceived as less effortful, even though it might not be the most effective strategy.