Charles L. Burton

Regulatory Flexibility An Individual Differences Perspective on Coping and Emotion Regulation

People respond to stressful events in different ways, depending on the event and on the regulatory strategies they choose. Coping and emotion regulation theorists have proposed dynamic models in which these two factors, the person and the situation, interact over time to inform adaptation. In practice, however, researchers have tended to assume that particular regulatory strategies are consistently beneficial or maladaptive. We label this assumption the fallacy of uniform efficacy and contrast it with findings from a number of related literatures that have suggested the emergence of a broader but as yet poorly defined construct that we refer to as regulatory flexibility. In this review, we articulate this broader construct and define both its features and limitations. Specifically, we propose a heuristic individual differences framework and review research on three sequential components of flexibility for which propensities and abilities vary: sensitivity to context, availability of a diverse repertoire of regulatory strategies, and responsiveness to feedback. We consider the methodological limitations of research on each component, review questions that future research on flexibility might address, and consider how the components might relate to each other and to broader conceptualizations about stability and change across persons and situations.

COPING FLEXIBILITY AND COMPLICATED GRIEF: A COMPARISON OF AMERICAN AND CHINESE SAMPLES

The ability to process a death and the ability to remain optimistic and look beyond the loss are both thought to be effective means of coping with loss and other aversive events. Recently, these seemingly contrary dimensions have been integrated into the idea of coping flexibility.

Treatment type and demographic characteristics as predictors for cancer adjustment: Prospective trajectories of depressive symptoms in a population sample.

OBJECTIVE Prospectively identifying individuals at heightened risk for depression can alleviate the disease burden of distal physical and mental health consequences after cancer onset. Our objective was to identify heterogeneous trajectories of adjustment in cancer patients, using treatment-type as a predictor. METHODS Participants were followed for 6 years within the Health and Retirement Study (HRS), a prospective population-based cohort study. The sample consisted of 1,294 middle-aged participants who were assessed once before and 3 time points after their report of an initial cancer diagnosis. In addition to self-reported depressive symptoms, subjects indicated receipt of surgical, radiological, or chemical interventions as part of their usual oncological care. RESULTS Four symptom trajectories were identified with Latent Growth Mixture Modeling: an increasing depression (10.5%), chronic depression (8.0%), depressed-improved (7.8%), and stable-low depression (73.7%). A conditional model using participants with available predictor data (n = 545) showed individuals in the emerging depression class were significantly more likely to have received chemo/medication therapy when compared with the remitting depression, stable-low, and chronic depression classes. Participants in the chronic and depressed-improved classes generally had worse baseline health, and the depressed-improved were also younger in age. CONCLUSION Patients who exhibited increasing depressive symptoms had a greater probability of receiving chemo/medication therapy than any other adjustment trajectory group, although the majority of chemotherapy patients did not exhibit depressive symptom changes. These data underscore the diversity of ways that patients adjust to cancer, and suggest cancer treatment, baseline health, and age may influence long-term patterns of psychological adjustment.

Familial social support predicts a reduced cortisol response to stress in sexual minority young adults

Social support has been repeatedly associated with mental and physical health outcomes, with hypothalamic-pituitary-adrenocortical (HPA) axis activity posited as a potential mechanism. The influence of social bonds appears particularly important in the face of stigma-related stress; however, there is a dearth of research examining social support and HPA axis response among members of a stigmatized group. To address this gap in the literature, we tested in a sample of 70 lesbian, gay, and bisexual (LGB) young adults whether family support or peer support differentially predict cortisol reactivity in response to a laboratory stressor, the Trier Social Stress Test. While greater levels of family support were associated with reduced cortisol reactivity, neither peer support nor overall support satisfaction was associated with cortisol response. These findings suggest that the association between social support and neuroendocrine functioning differs according to the source of support among members of one stigmatized group.

The Burden of Stigma on Health and Well-Being: A Taxonomy of Concealment, Course, Disruptiveness, Aesthetics, Origin, and Peril Across 93 Stigmas:

Most individuals are stigmatized at some point. However, research often examines stigmas separately, thus underestimating the overall impact of stigma and precluding comparisons across stigmatized identities and conditions. In their classic text, Social Stigma: The Psychology of Marked Relationships, Edward Jones and colleagues laid the groundwork for unifying the study of different stigmas by considering the shared dimensional features of stigmas: aesthetics, concealability, course, disruptiveness, origin, peril. Despite the prominence of this framework, no study has documented the extent to which stigmas differ along these dimensions, and the implications of this variation for health and well-being. We reinvigorated this framework to spur a comprehensive account of stigma’s impact by classifying 93 stigmas along these dimensions. With the input of expert and general public raters, we then located these stigmas in a six-dimensional space and created discrete clusters organized around these dimensions. Next, we linked this taxonomy to health and stigma-related mechanisms. This quantitative taxonomy offers parsimonious insights into the relationship among the numerous qualities of numerous stigmas and health.

Depression and Substance Use: Towards the Development of an Emotion Regulation Model of Stigma Coping

ABSTRACT The comorbidity between depression and substance use problems is well-documented, yet little research has investigated how stigma associated with ones depression might relate to alcohol and drug use. The current study examined the association between depression-related stigma and substance use coping and considered the role of emotion dysregulation (i.e., difficulty in monitoring, evaluating, and modulating ones emotional reactions) as a mechanism underlying this association. A sample of individuals who self-identified as having current or remitted depression (N = 218) completed self-report measures of depression-related stigma, emotion dysregulation, and tendency to rely on alcohol or drugs to cope with psychological distress. Depression-related stigma was positively associated with emotion dysregulation, which was in turn associated with a greater tendency to engage in substance use coping. These findings provide initial support for the role of stigma as a contributor to maladaptive coping responses, such as substance use, among people living with depression. Further, they underscored the potential utility of targeting emotion dysregulation in stigma coping and substance abuse prevention intervention efforts.

Does Getting Stigma Under the Skin Make It Thinner? Emotion Regulation as a Stress-Contingent Mediator of Stigma and Mental Health:

Emotion regulation deficits may link stigma to poor mental health, yet authors of existing studies have relied on self-reported stigma and have not considered contextual factors. In the present research, we examined associations among cultural stigma (i.e., objective devaluation of one’s stigmatized status), emotion regulation deficits, and poor mental health. In Study 1, we created an index of cultural stigma by asking members of the general public and stigma experts to indicate desired social distance toward 93 stigmatized attributes. In Study 2, emotion regulation deficits mediated the association between cultural stigma and adverse mental health outcomes, including depressive symptoms and alcohol use problems, among individuals endorsing diverse stigmatized identities. The indirect effect of cultural stigma, via emotion regulation, on these outcomes was stronger among those reporting more life stress. These findings highlight the adverse impact of cultural stigma on mental health and its role in potentiating stigmatized individuals’ susceptibility to general life stress.