Elena Constantinou

Risky and aggressive driving in young adults: Personality matters

Young, novice drivers constitute a disproportionate percentage of fatalities and injuries in road traffic accidents around the world. This study, attempts to identify motivational factors behind risky driving behavior, and examines the role of personality, especially sensation seeking, impulsivity and sensitivity to punishment/reward in predicting negative driving outcomes (accident involvement and traffic offences) among young drivers. Gender and drivers age are additional factors examined in relation to driving outcomes and personality. Adopting the contextual mediated model of traffic accident involvement (Sümer, 2003), the study is based on the theory that personality, age and gender represent distal factors that predict accident involvement indirectly through their relationship with stable tendencies towards aberrant driving behavior. Results from correlations and Structural Equation Modeling using AMOS 6 indicated that direct personality effects on driving outcomes were few, whereas personality had significant correlations with aberrant driving behavior, showing that personality is a distal but important predictor of negative driving outcomes. These high risk traits appear to be at a peak among young male drivers. Thus, personality is important in understanding aggressive and risky driving by young adults and needs to be taken into consideration in designing targeted accident prevention policies.

Do alexithymic individuals avoid their feelings? Experiential avoidance mediates the association between alexithymia, psychosomatic, and depressive symptoms in a community and a clinical sample.

OBJECTIVE Alexithymia is defined as the trait associated with difficulty in identifying and describing feelings as well as poor fantasy and imagery. While alexithymia is related to psychopathology in general, it has been associated with increased reporting of medically unexplained symptoms and depression in particular. This study attempts to assess the extent to which alexithymia represents a learned, avoidant coping strategy against unwanted emotions. In this way the study aims to identify a potential mechanism that may elucidate the relationship between alexithymia and psychological symptoms. METHOD Alexithymia is examined in two different samples, students from two universities in Cyprus and intensive outpatients/residents in an American anxiety disorder treatment program. We examine whether alexithymia predicts psychosomatic and depressive symptoms respectively through the mediating role of experiential avoidance, a coping mechanism believed to be reinforced because of the immediate relief it provides. RESULTS Experiential avoidance was found to correlate strongly with alexithymia, especially its difficulty in identifying feelings factor, while the mediation hypothesis was supported in all models tested. Furthermore, results from the clinical sample suggest that clinical improvement in depression was associated with a decrease in alexithymia, especially difficulty in identifying feelings, mediated by decreased experiential avoidance. CONCLUSIONS Alexithymia, and more specifically its difficulty in identifying feelings aspect, may be a learned behavior used to avoid unwanted emotions. This avoidant behavior may form the link between alexithymia and psychopathology. Implications for alexithymia theory and treatment are discussed.

Inducing symptoms in high symptom reporters via emotional pictures: The interactive effects of valence and arousal

OBJECTIVE Processing unpleasant emotional cues induces elevated reporting of physical symptoms, especially in people with high habitual symptom reporting. The present study examined the role of valence and arousal of emotional pictorial cues on this effect. METHODS Female participants (N=45; 21 high/24 low habitual symptom reporters) viewed six series of emotional pictures with a homogeneous affective content: low arousal/positive, high arousal/positive, low arousal/negative, high arousal/negative-disgust, high arousal/negative-threat and neutral. Heart rate (HR) and skin conductance level (SCL) were recorded during picture viewing and a symptom checklist and valence and arousal ratings were completed after each trial. RESULTS High habitual symptom reporters reported more symptoms than low habitual symptom reporters overall, but this difference was more pronounced when processing unpleasant high arousing cues. No group differences were found on physiological measures for any of the conditions, while perceived valence and arousal both moderated the relationship between habitual symptom reporting and symptom induction. CONCLUSION These findings show an interactive effect of unpleasantness and high arousal on elevated symptom reporting in high habitual symptom reporters, suggesting that different characteristics of emotional cues contribute to a somatic memory activation process leading to the experience of elevated symptoms.

Emotion processing deficits in alexithymia and response to a depth of processing intervention

Findings on alexithymic emotion difficulties have been inconsistent. We examined potential differences between alexithymic and control participants in general arousal, reactivity, facial and subjective expression, emotion labeling, and covariation between emotion response systems. A depth of processing intervention was introduced. Fifty-four participants (27 alexithymic), selected using the Toronto Alexithymia Scale-20, completed an imagery experiment (imagining joy, fear and neutral scripts), under instructions for shallow or deep emotion processing. Heart rate, skin conductance, facial electromyography and startle reflex were recorded along with subjective ratings. Results indicated hypo-reactivity to emotion among high alexithymic individuals, smaller and slower startle responses, and low covariation between physiology and self-report. No deficits in facial expression, labeling and emotion ratings were identified. Deep processing was associated with increased physiological reactivity and lower perceived dominance and arousal in high alexithymia. Findings suggest a tendency for avoidance of intense, unpleasant emotions and less defensive action preparation in alexithymia.

Can words heal? Using affect labeling to reduce the effects of unpleasant cues on symptom reporting

Processing unpleasant affective cues induces elevated momentary symptom reports, especially in persons with high levels of symptom reporting in daily life. The present study aimed to examine whether applying an emotion regulation strategy, i.e. affect labeling, can inhibit these emotion influences on symptom reporting. Student participants (N = 61) with varying levels of habitual symptom reporting completed six picture viewing trials of homogeneous valence (three pleasant, three unpleasant) under three conditions: merely viewing, emotional labeling, or content (non-emotional) labeling. Affect ratings and symptom reports were collected after each trial. Participants completed a motor inhibition task and self-control questionnaires as indices of their inhibitory capacities. Heart rate variability was also measured. Labeling, either emotional or non-emotional, significantly reduced experienced affect, as well as the elevated symptoms reports observed after unpleasant picture viewing. These labeling effects became more pronounced with increasing levels of habitual symptom reporting, suggesting a moderating role of the latter variable, but did not correlate with any index of general inhibitory capacity. Our findings suggest that using an emotion regulation strategy, such as labeling emotional stimuli, can reverse the effects of unpleasant stimuli on symptom reporting and that such strategies can be especially beneficial for individuals suffering from medically unexplained physical symptoms.

Healing Words: Using Affect Labeling to Reduce the Effects of Unpleasant Cues on Symptom Reporting in IBS Patients

PurposeThe present study aimed to induce elevated symptom reports through the presentation of unpleasant cues in patients with irritable bowel syndrome (IBS) and examine whether applying an emotion regulation technique (affect labeling) can reduce symptom reporting in patients.MethodsPatients diagnosed with IBS (N = 29) and healthy controls (N = 26) were presented with six picture series (three pleasant, three unpleasant) under three within-subject conditions: merely viewing, emotional labeling, or content (non-emotional) labeling. Each picture viewing trial was followed by affect ratings and a symptom checklist, consisting of general arousal and IBS-specific symptoms.ResultsViewing unpleasant pictures led to overall increased symptom reports, both for arousal and gastrointestinal symptoms, in both groups. Labeling the pictures did not reduce these effects significantly, although a trend toward less arousal symptoms after unpleasant cues emerged in the patient group only, especially during emotional labeling.ConclusionsCurrent findings indicate that the mere presentation of unpleasant cues can induce elevated symptom reports in IBS patients. The results of the labeling manipulation provide modest support for the effectiveness of emotion regulation strategies in reversing these effects of unpleasant cues in patients suffering from functional syndromes. Methodological issues that may have confounded present results are discussed.

Breath holding duration as a measure of distress tolerance: examining its relation to measures of executive control

Recent research considers distress (in)tolerance as an essential component in the development of various forms of psychopathology. A behavioral task frequently used to assess distress tolerance is the breath holding task. Although breath holding time (BHT) has been associated with behavioral outcomes related to inhibitory control (e.g., smoking cessation), the relationship among breath holding and direct measures of executive control has not yet been thoroughly examined. The present study aims to assess (a) the BHT-tasks test-retest reliability in a 1-year follow-up and (b) the relationship between a series of executive function tasks and breath holding duration. One hundred and thirteen students completed an initial BHT assessment, 58 of which also completed a series of executive function tasks [the Wisconsin Card Sorting Test (WCST), the Parametric Go/No-Go task and the N-back memory updating task]. A subsample of these students (N = 34) repeated the breath holding task in a second session 1 year later. Test-retest reliability of the BHT-task over a 1-year period was high (r = 0.67, p < 0.001), but none of the executive function tasks was significantly associated with BHT. The rather moderate levels of unpleasantness induced by breath holding in our sample may suggest that other processes (physiological, motivational) besides distress tolerance influence BHT. Overall, the current findings do not support the assumption of active inhibitory control in the BHT-task in a healthy sample. Our findings suggest that individual differences (e.g., in interoceptive or anxiety sensitivity) should be taken into account when examining the validity of BHT as a measure of distress tolerance.

Emotion dysregulation in alexithymia: Startle reactivity to fearful affective imagery and its relation to heart rate variability

Alexithymia is associated with deficiencies in recognizing and expressing emotions and impaired emotion regulation, though few studies have verified the latter assertion using objective measures. This study examined startle reflex modulation by fearful imagery and its associations with heart rate variability in alexithymia. Fifty-four adults (27 alexithymic) imagined previously normed fear scripts. Startle responses were assessed during baseline, first exposure, and reexposure. During first exposure, participants, in separate trials, engaged in either shallow or deep emotion processing, giving emphasis on descriptive or affective aspects of imagery, respectively. Resting heart rate variability was assessed during 2 min of rest prior to the experiment, with high alexithymic participants demonstrating significantly higher LF/HF (low frequency/high frequency) ratio than controls. Deep processing was associated with nonsignificantly larger and faster startle responses at first exposure for alexithymic participants. Lower LF/HF ratio, reflecting higher parasympathetic cardiac activity, predicted greater startle amplitude habituation for alexithymia but lower habituation for controls. Results suggest that, when exposed to prolonged threat, alexithymics may adjust poorly, showing a smaller initial defensive response but slower habituation. This pattern seems related to their low emotion regulation ability as indexed by heart rate variability.

Modeling Data Access Legislation with Gorgias

This paper uses argumentation as the basis for modeling and implementing the relevant legislation of an EU country relating to medical data access. Users can consult a web application for determining their allowed level of access to a patient’s medical record and are offered an explanation based on the relevant legislation. The system can also advise a user on what additional information is required for a higher access level. The system is currently in the process of an extensive evaluation through a pilot trial with a special focus group of medical professionals. The development methodology that we have used is generally applicable to any other similar cases of decision making based on legislative regulations. The main advantage of using argumentation is the ability to explain the solutions drawn and the high modularity of software facilitating the extension and adaptation of the system when new relevant legislation becomes available.

Psychophysiological and self-reported reactivity associated with social anxiety and public speaking fear symptoms: Effects of fear versus distress

This study examines psychophysiological and subjective reactivity to anxiety-provoking situations in relation to social anxiety and public speaking fear. We hypothesized that social anxiety symptoms would be associated with similar reactivity across types of imaginary anxiety scenes and not specifically to social anxiety-related scenes. This would be attributed to co-existing depression symptoms. Public speaking fear was expected to be associated with more circumscribed reactivity to survival-threat scenes, due to its association with fearfulness. Community participants imagined standardized anxiety situations, including social anxiety and animal fear scenes, while their physiological reactivity and self-reported emotions were assessed. Findings supported that social anxiety was associated with undifferentiated physiological reactivity across anxiety-provoking situations, except with regards to skin conductance level, which was higher during social anxiety imagery. Public speaking fear was associated with increased reactivity to animal phobia and panic scenes. Covariance analyses indicated that the lack of response specificity associated with social anxiety could be attributed to depression levels, while the specificity associated with public speaking fear could be explained by fearfulness. Findings highlight the need to assess not only primary anxiety symptoms but also depression and fearfulness, which likely predict discrepant reactions of individuals to anxiogenic situations.