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Clinical Psychology Review Dec 2020Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now... (Review)
Review
Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.
Topics: Humans; Stress Disorders, Post-Traumatic
PubMed: 32971312
DOI: 10.1016/j.cpr.2020.101910 -
International Journal of Environmental... Apr 2020Transdiagnostic causal variables have been identified that have allowed understanding the origin and maintenance of psychopathologies in parsimonious explanatory models...
Transdiagnostic causal variables have been identified that have allowed understanding the origin and maintenance of psychopathologies in parsimonious explanatory models of antisocial disorders. However, it is necessary to systematize the information published in the last decade. The aim of the study was to identify through a systematic review, the structural, emotional and cognitive transdiagnostic variables in antisocial disorders of adolescence and youth. Recommendations for systematic reviews and meta-extraction and analysis of information according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), the Cochrane Collaboration and Campbell were followed. We found 19 articles from 110 reviewed documents. The results indicated that at a structural level there is a general psychopathological factor (psychopathy or externalizing), non-emotional callousness and impulsivity from behavioral inhibition and activation systems, and negative affect traits as base structures. In the emotional level, the study found a risk component from emotional dysregulation and experiential avoidance. In the cognitive level, a key role of anger-rumination and violent ideation as explanatory variables of antisocial disorders. We concluded that the interaction of these identified variables makes it possible to generate an evidence-based transdiagnostic model.
Topics: Adolescent; Anger; Antisocial Personality Disorder; Child; Cognition; Emotions; Female; Humans; Male; Quality of Life; Young Adult
PubMed: 32349315
DOI: 10.3390/ijerph17093036 -
Journal of Clinical Psychology Dec 2019Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess how emotion regulation strategies reported by individuals at... (Review)
Review
OBJECTIVES
Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess how emotion regulation strategies reported by individuals at risk of mania compare with clinical and nonclinical controls.
METHODS
Search terms relating to mania risk and emotion regulation were entered into three databases. Sixteen studies were included.
RESULTS
Mania risk was typically associated with overall endorsement of emotion regulation strategies, particularly dampening, and positive and negative rumination.
CONCLUSIONS
Findings were limited by overall lack of evidence for individual strategies, lack of consideration of key mediating factors and reliance upon self-report designs.
Topics: Bipolar Disorder; Emotional Regulation; Humans; Male; Personality Inventory; Risk; Rumination, Cognitive
PubMed: 31385293
DOI: 10.1002/jclp.22841 -
Frontiers in Psychology 2019Over the past 20 years, researchers have used various methodologies to assess different forms of repetitive negative thinking (RNT) and their influence on alcohol...
Over the past 20 years, researchers have used various methodologies to assess different forms of repetitive negative thinking (RNT) and their influence on alcohol consumption. Contrasting results between clinical and general populations were observed. To summarize the current literature on RNT and alcohol use, a systematic review was conducted according to the Preferred Reporting for Systematic Review and Meta-Analysis (PRISMA) guidelines (Moher et al., 2009). Among the 27 included studies, the seven conducted among patients with alcohol use disorder (AUD) and the three focusing on other adult samples demonstrated a strong positive association between RNT and alcohol use or alcohol-related problems, regardless of the form of RNT. The results were more heterogeneous in the 17 studies conducted among adolescents and students, leading the authors to conclude that the results varied as a function of the severity of alcohol use. The results of this study suggest to focus on RNT from a transdiagnostic perspective in AUD. This processual approach may improve AUD treatment and relapse prevention. Finally, some gaps in the literature must be addressed: (1) the gender differences in the link between RNT and alcohol use and (2) the specific influence of RNT on alcohol use among young adults.
PubMed: 31333536
DOI: 10.3389/fpsyg.2019.01482 -
Harvard Review of Psychiatry 2019Emotion dysregulation is often considered a core characteristic of individuals with borderline personality disorder (BPD). With the development and strength of a... (Meta-Analysis)
Meta-Analysis
Emotion dysregulation is often considered a core characteristic of individuals with borderline personality disorder (BPD). With the development and strength of a contemporary affective-science model that encompasses both healthy emotion regulation (ER) and emotion dysregulation, this model has increasingly been used to understand the affective experiences of people with BPD. In this meta-analysis and review, we systematically review six of the most commonly studied ER strategies and determine their relative endorsement in individuals with elevated symptoms of BPD compared to individuals with low symptoms of BPD and healthy controls, as well as to individuals with other mental disorders. Results from 93 unique studies and 213 different effect-size estimates indicated that symptoms of BPD were associated with less frequent use of ER strategies that would be considered more effective at reducing negative affect (i.e., cognitive reappraisal, problem solving, and acceptance) and more frequent use of ER strategies considered less effective at reducing negative affect (i.e., suppression, rumination, and avoidance). When compared to individuals with other mental disorders, people with BPD endorsed higher rates of rumination and avoidance, and lower rates of problem solving and acceptance. We also review important contributions from studies of ER in BPD that we were unable to incorporate into our meta-analysis. We conclude by discussing how the pattern of using ER strategies in BPD contributes to emotion dysregulation and also the potential reasons for this pattern, integrating both Gross's extended process model of ER and Linehan's updated theoretical account on the development of emotion dysregulation.
Topics: Borderline Personality Disorder; Emotional Regulation; Humans
PubMed: 31219881
DOI: 10.1097/HRP.0000000000000212 -
European Journal of Psychotraumatology 2019: Violent loss (i.e. loss through homicide, suicide, or accident) is associated with high levels of prolonged grief disorder (PGD). : The current meta-analysis aims at... (Review)
Review
: Violent loss (i.e. loss through homicide, suicide, or accident) is associated with high levels of prolonged grief disorder (PGD). : The current meta-analysis aims at identifying correlates of PGD in adults exposed to violent loss. : We conducted a systematic literature search in PsycINFO, PsycARTICLES, PubMed, Web of Science, and Scopus. We used the Pearson correlation coefficient as an effect size measure and a random effects model was applied to calculate effect sizes. : Thirty-seven eligible studies published between 2003 and 2017 (= 5911) revealed 29 potential correlates. Most studies used a cross-sectional design. Analyses revealed large significant effect sizes for comorbid psychopathology (= .50-.59), suicidality (= .41, 95% confidence interval [CI] [.30; .52]), and rumination (= .42, 95% CI [.31; .52]), while medium effect sizes were found for exposure to traumatic events and factors concerning the relationship to the deceased. Small effect sizes emerged for sociodemographic characteristics, multiple loss, physical symptoms, and religious beliefs. Ten variables did not show a significant association with PGD. Heterogeneity and a small number of studies assessing certain correlates were observed. : The associations with psychological disorders may indicate shared mechanisms of psychopathology. Moreover, we recommend that clinicians carefully assess suicidal ideation among individuals with PGD who have been exposed to violent loss. Further research is warranted using longitudinal study designs with large sample sizes to understand the relevance of these factors for the development of PGD.
PubMed: 30949303
DOI: 10.1080/20008198.2019.1583524 -
Journal of Affective Disorders Mar 2019Depression can be debilitating, as well as a risk factor for self-harm and suicide. Social rank theory (SRT) suggests depression stems from feelings of defeat and...
BACKGROUND
Depression can be debilitating, as well as a risk factor for self-harm and suicide. Social rank theory (SRT) suggests depression stems from feelings of defeat and entrapment that ensue from experiencing oneself to be of lower rank than others. This study aims to review the literature investigating the relationship between self-perceptions of social rank and depressive symptoms or suicidal ideation/behaviour.
METHODS
A keyword search of three psychological and medical databases was completed (Psychinfo, Medline, Web of Knowledge). Studies were quality assessed using established criteria.
RESULTS
An initial 1290 records were identified. After application of inclusion and exclusion criteria, 70 remained measuring depressive symptoms (n = 68), self-harm (n = 3) and suicidal ideation (n = 3). The main measures assessing social rank were the social comparison scale (SCS; n = 32) and subjective social status (SSS, n = 32), with six additional papers including another measure of social rank. In univariate analyses, as perceptions of social rank decreased, depressive symptoms (and suicidal ideation/self-harm) increased. Multivariate analyses indicated that social rank may act as a psychosocial mechanism to explain the relationship between social factors (in particular socio-economic status) and depressive symptoms. Additionally, psychological variables, such as rumination or self-esteem, may mediate or moderate the relationship between social rank and depressive or suicidal symptoms.
LIMITATIONS
Study quality was variable and 89% of studies were cross-sectional.
CONCLUSIONS
Although more prospective research is required, this review highlights the importance of understanding an individual's perception of their social position compared to others as it may lead to an enhanced understanding of the aetiology of depressive disorders.
Topics: Adult; Depression; Depressive Disorder; Emotions; Female; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Self Concept; Self-Injurious Behavior; Social Theory; Suicidal Ideation
PubMed: 30594043
DOI: 10.1016/j.jad.2018.12.045 -
Journal of Affective Disorders Mar 2019Theoretical frameworks emphasise associations between interpretations and responses to affect and bipolar disorder (BD). This review (PROSPERO CRD42016043801)...
Theoretical frameworks emphasise associations between interpretations and responses to affect and bipolar disorder (BD). This review (PROSPERO CRD42016043801) investigated which emotion regulation (ER) strategies have been applied to BD, are elevated in BD compared to clinical and non-clinical controls, and are associated with clinical and functional outcomes in BD METHODS: Search terms relating to emotion regulation, coping and bipolar disorder were entered into Embase, MedLine and PsycInfo. Quantitative studies investigating relationships between ER strategies and BD were eligible for this narrative synthesis RESULTS: A large volume of research (n = 47) investigated specific ER strategies in BD. Maladaptive strategies such as rumination and dampening were elevated in BD compared to controls and these particular strategies had a detrimental impact on outcomes such as mood symptoms. BD had a similar profile of ER strategies to unipolar depression, but there was limited comparison to other clinical groups. People with BD did not generally have deficits in using adaptive strategies, as evidenced by comparisons with controls and experimental studies LIMITATIONS: Methodological heterogeneity and a lack of ecologically valid ER assessments CONCLUSIONS: Empirical literature is critiqued in line with contemporary theories of BD and of emotion regulation more generally, in order to inform future research recommendations. This includes investigation of the importance of context in the impact of ER strategies, and discrepancies between trait and state use of ER strategies, particularly through experience sampling.
Topics: Adaptation, Psychological; Affect; Bipolar Disorder; Catastrophization; Depressive Disorder, Major; Ecological Momentary Assessment; Emotions; Humans; Impulsive Behavior; Risk-Taking; Rumination, Cognitive
PubMed: 30590289
DOI: 10.1016/j.jad.2018.12.026 -
Occupational and Environmental Medicine Dec 2018Post-traumatic growth is defined as positive psychological, social or spiritual growth after a trauma.
BACKGROUND
Post-traumatic growth is defined as positive psychological, social or spiritual growth after a trauma.
OBJECTIVES
This systematic review aimed to identify studies that quantitatively measured post-traumatic growth among (ex-) military personnel, to determine whether there is evidence of growth in this context and whether such growth is associated with any sociodemographic, military, trauma or mental health factors.
DATA SOURCES
The electronic databases PsycInfo, OVIDmedline and Embase were searched for studies published between 2001 and 2017.
STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS
Papers were retained if they involved military or ex-military personnel, where some had been deployed to Iraq or Afghanistan.
STUDY APPRAISAL
Quality assessment was conducted on all studies.
RESULTS
21 studies were retained. The Post-Traumatic Growth Inventory was employed by 14 studies: means ranged from 32.60 (standard deviation = 14.88) to 59.07 (23.48). The Post-Traumatic Growth Inventory Short Form was used by five studies: means ranged from 17.11 (14.88) to 20.40 (11.88). These values suggest moderate growth. Higher levels of social support, spirituality and rumination and minority ethnicity were most frequently associated with more post-traumatic growth.
LIMITATIONS
The involved studies may lack generalisability and methodological quality.
CONCLUSIONS
Overall, this paper confirms that negative reactions to trauma, particularly post-traumatic stress disorder, are not the only possible outcomes for service personnel, as moderate post-traumatic growth can also be observed.
IMPLICATIONS OF KEY FINDINGS
Interventions aimed at helping current and former armed forces personnel to identify and promote post-traumatic growth post-conflict may be beneficial for their well-being.
Topics: Humans; Military Personnel; Risk Factors; Stress Disorders, Post-Traumatic; Veterans; Warfare; Wounds and Injuries
PubMed: 30377257
DOI: 10.1136/oemed-2018-105166 -
Frontiers in Psychology 2018Major Depressive Disorder (MDD) is a highly prevalent, recurrent, and potentially chronic disorder. Identifying risk factors and underlying mechanisms to inform...
Major Depressive Disorder (MDD) is a highly prevalent, recurrent, and potentially chronic disorder. Identifying risk factors and underlying mechanisms to inform preventive and therapeutic interventions is therefore imperative. Emotion regulation is a proposed factor in the development and maintenance of MDD. The aim of the present review was to summarize and synthesize research on self-reported emotion regulation strategy use and emotion regulation abilities in adults diagnosed with current and remitted MDD. Seventy-two eligible studies were retrieved from databases through a systematic literature search. Group differences between individuals with current MDD, remitted MDD, and healthy controls were calculated using meta-analytic procedures. Meta-regression analyses investigated potential moderator effects on emotion regulation difficulties. Results indicated that individuals with current MDD report higher maladaptive emotion regulation strategy use for avoidance (Hedges' = 1.3), rumination ( = 2.1), and suppression ( = 1.1) compared to healthy controls. Also, they reported lower adaptive emotion regulation strategy use for acceptance ( = -1.0), problem solving ( = -1.0), and reappraisal ( = -0.7). Individuals with current MDD reported limited general emotion regulation abilities, indicated by higher alexithymia ( = 1.45), lower emotional awareness ( = -0.95), emotional clarity ( = -1.50) and emotional tolerance ( = -1.89). Similar results were found in individuals with remitted MDD for avoidance ( = 1.0), rumination ( = 1.1), suppression ( = 0.6), and general emotion regulation abilities. However, no difference was found between individuals with remitted MDD and healthy controls for adaptive emotion regulation strategies. Meta-regression analyses suggest that age of illness onset, comorbid anxiety and duration of remission influence emotion regulation. The present review and meta-analysis indicates that individuals with current and remitted MDD have difficulties with emotion regulation compared to individuals who have never been depressed. Although depressive symptoms improve, emotion regulation difficulties may continue, and could be a contributing factor to relapse. Our findings inform future research on emotion regulation and psychotherapeutic interventions.
PubMed: 29867700
DOI: 10.3389/fpsyg.2018.00756