Ihno A. Lee

Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder.

UNLABELLED Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety. CLINICALTRIALSGOV IDENTIFIER NCT00380731; http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1.

Maladaptive Behavior in Autism Spectrum Disorder: The Role of Emotion Experience and Emotion Regulation

AbstractMaladaptive behavior is common in Autism Spectrum Disorder (ASD). However, the factors that give rise to maladaptive behavior in this context are not well understood. The present study examined the role of emotion experience and emotion regulation in maladaptive behavior in individuals with ASD and typically developing (TD) participants. Thirty-one individuals with ASD and 28 TD participants and their parents completed questionnaires assessing emotion experience, regulation, and maladaptive behavior. Compared to TD participants, individuals with ASD used cognitive reappraisal less frequently, which was associated with increased negative emotion experience, which in turn was related to greater levels of maladaptive behavior. By decreasing negative emotions, treatments targeting adaptive emotion regulation may therefore reduce maladaptive behaviors in individuals with ASD.

A wandering mind is a less caring mind: Daily experience sampling during compassion meditation training

Mind wandering, or the tendency for attention to drift to task-irrelevant thoughts, has been associated with worse intra- and inter-personal functioning. Utilizing daily experience sampling with 51 adults during 9-weeks of a compassion meditation program, we examined effects on mind wandering (to neutral, pleasant, and unpleasant topics) and caring behaviors for oneself and others. Results indicated that compassion meditation decreased mind wandering to neutral topics and increased caring behaviors towards oneself. When collapsing across topics, mind wandering did not serve as an intermediary between the frequency of compassion meditation practice and caring behaviors, though mind wandering to pleasant and unpleasant topics was linked to both variables. A path analysis revealed that greater frequency of compassion meditation practice was related to reductions in mind wandering to unpleasant topics and increases in mind wandering to pleasant topics, both of which were related to increases in caring behaviors for oneself and others.

Fluid cognitive ability is a resource for successful emotion regulation in older and younger adults

The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER) framework suggests that (1) emotion regulation (ER) strategies require resources and that (2) higher levels of relevant resources may increase ER success. In the current experiment, we tested the specific hypothesis that individual differences in one internal class of resources, namely cognitive ability, would contribute to greater success using cognitive reappraisal (CR), a form of ER in which one reinterprets the meaning of emotion-eliciting situations. To test this hypothesis, 60 participants (30 younger and 30 older adults) completed standardized neuropsychological tests that assess fluid and crystallized cognitive ability, as well as a CR task in which participants reinterpreted the meaning of sad pictures in order to alter (increase or decrease) their emotions. In a control condition, they viewed the pictures without trying to change how they felt. Throughout the task, we indexed subjective emotional experience (self-reported ratings of emotional intensity), expressive behavior (corrugator muscle activity), and autonomic physiology (heart rate and electrodermal activity) as measures of emotional responding. Multilevel models were constructed to explain within-subjects variation in emotional responding as a function of ER contrasts comparing increase or decrease conditions with the view control condition and between-subjects variation as a function of cognitive ability and/or age group (older, younger). As predicted, higher fluid cognitive ability—indexed by perceptual reasoning, processing speed, and working memory—was associated with greater success using reappraisal to alter emotional responding. Reappraisal success did not vary as a function of crystallized cognitive ability or age group. Collectively, our results provide support for a key tenet of the SOC-ER framework that higher levels of relevant resources may confer greater success at emotion regulation.

Emotion regulation strategy selection in daily life: The role of social context and goals

Recent studies have begun to document the diversity of ways people regulate their emotions. However, one unanswered question is why people regulate their emotions as they do in everyday life. In the present research, we examined how social context and goals influence strategy selection in daily high points and low points. As expected, suppression was particularly tied to social features of context: it was used more when others were present, especially non-close partners, and when people had instrumental goals, especially more interpersonal ones (e.g., avoid conflict). Distraction and reappraisal were used more when regulating for hedonic reasons (e.g., to feel better), but these strategies were also linked to certain instrumental goals (e.g., getting work done). When contra-hedonic regulation occurred, it primarily took the form of dampening positive emotion during high points. Suppression was more likely to be used for contra-hedonic regulation, whereas reappraisal and distraction were used more for pro-hedonic regulation. Overall, these findings highlight the social nature of emotion regulation and underscore the importance of examining regulation in both positive and negative contexts.

White matter structure in the uncinate fasciculus: Implications for socio-affective deficits in Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) have social and communication deficits and difficulties regulating emotions. The brain bases of these socio-affective deficits are not yet clear, but one candidate is structural connectivity in the left uncinate fasciculus, which connects limbic temporal and frontal areas thought to be involved in socio-affective processing. In this study, we assessed white matter structure in the left and right uncinate fasciculus in 18 high-functioning individuals with ASD and 18 group-matched typically developing (TD) controls using Diffusion Tensor Imaging. To test specificity of the associations, we also examined the association between both uncinate fasciculi and restricted and repetitive behaviors. Compared to TD individuals, individuals with ASD had significantly lower fractional anisotropy (FA) in the left and right uncinate. Group status significantly moderated the association between left uncinate and socio-affective deficits, indicating that within the ASD group, FA was associated with socio-affective deficits: Individuals with ASD with lower FA in the left uncinate had significantly more social and emotion regulation deficits. There was no association with restricted and repetitive behaviors. This study provides evidence that the left uncinate may play a critical role in socio-affective skills in individuals with ASD.

Decreases in the proportion of bullying victims in the classroom: Effects on the adjustment of remaining victims

Sharing a classroom environment with other victimized peers has been shown to mitigate the adverse effects of peer victimization on children’s social and psychological adjustment. By extension, this study hypothesized that classroom reductions in the proportion of victims would be harmful for children who remain victimized. Data were collected at the end of 2 subsequent school years from 4,466 fourth- to sixth-graders (mean age = 11 years), as part of the implementation of the Finnish anti-bullying program KiVa (an acronym for Kiusaamista Vastaan, “against bullying”). Multiple regression analyses were conducted on a subsample of 170 stable victims (children reporting being victimized at least 2–3 times a month at both time points) to test whether a decrease in the proportion of victims in their classrooms had an effect on their adjustment at Time 2. Stable victims felt more depressed, more socially anxious and were less liked at Time 2 in classrooms where the proportion of victims had decreased in 1 year compared to stable victims in classrooms where it had increased or remained the same. These effects were not moderated by the intervention status of the classroom. Paradoxically, an improved social environment can be detrimental for some children. These findings point to the necessity to maintain anti-bullying intervention efforts especially when successful.

Anxiety trajectories in response to a speech task in social anxiety disorder: Evidence from a randomized controlled trial of CBT ☆

The subjective experience of anxiety plays a central role in cognitive behavioral models of social anxiety disorder (SAD). However, much remains to be learned about the temporal dynamics of anxiety elicited by feared social situations. The aims of the current study were: (1) to compare anxiety trajectories during a speech task in individuals with SAD (n=135) versus healthy controls (HCs; n=47), and (2) to compare the effects of CBT on anxiety trajectories with a waitlist control condition. SAD was associated with higher levels of anxiety and greater increases in anticipatory anxiety compared to HCs, but not differential change in anxiety from pre- to post-speech. CBT was associated with decreases in anxiety from pre- to post-speech but not with changes in absolute levels of anticipatory anxiety or rates of change in anxiety during anticipation. The findings suggest that anticipatory experiences should be further incorporated into exposures.

Pre-treatment social anxiety severity moderates the impact of mindfulness-based stress reduction and aerobic exercise.

UNLABELLED We examined whether social anxiety severity at pre-treatment would moderate the impact of mindfulness-based stress reduction (MBSR) or aerobic exercise (AE) for generalized social anxiety disorder. MBSR and AE produced equivalent reductions in weekly social anxiety symptoms. Improvements were moderated by pre-treatment social anxiety severity. PRACTITIONER POINTS Mindfulness-based stress reduction (MBSR) and aerobic exercise (AE) are effective in reducing symptoms of social anxiety. Pre-treatment social anxiety severity can be used to inform treatment recommendations. Both MBSR and AE produced equivalent reductions in weekly levels of social anxiety symptoms. MBSR appears to be most effective for patients with lower pre-treatment social anxiety symptom severity. AE appears to be most effective for patients with higher pre-treatment social anxiety symptom severity.

Emotion regulation choice in an evaluative context: the moderating role of self-esteem

ABSTRACT Evaluative contexts can be stressful, but relatively little is known about how different individuals who vary in responses to self-evaluation make emotion regulatory choices to cope in these situations. To address this gap, participants who vary in self-esteem gave an impromptu speech, rated how they perceived they had performed on multiple evaluative dimensions, and subsequently chose between disengaging attention from emotional processing (distraction) and engaging with emotional processing via changing its meaning (reappraisal), while waiting to receive feedback regarding these evaluative dimensions. According to our framework, distraction can offer stronger short-term relief than reappraisal, but, distraction is costly in the long run relative to reappraisal because it does not allow learning from evaluative feedback. We predicted and found that participants with lower (but not higher) self-esteem react defensively to threat of failure by seeking short-term relief via distraction over the long-term benefit of reappraisal, as perceived failure increases. Implications for the understanding of emotion regulation and self-esteem are discussed.