Abstract
Research has highlighted that emotion regulation (ER) difficulties are common in individuals with emotional disorders (ED). However, most studies were limited to non-clinical (NC) samples and focused on specific strategies to control emotions. Also, few studies investigated these difficulties “in-the-moment”. Thus, the current study aimed to investigate ER difficulties in individuals with ED that are usually neglected, such as difficulties in how they appraise their emotions (beliefs about emotions). Moreover, we examined the mediator role of irrational/dysfunctional beliefs about emotions in relation to the experience of negative meta-emotions and low perceived control of emotions. A number of 36 individuals with ED and 50 NC completed an emotion-provoking autobiographical recall task while their negative emotions, cardiac activity, beliefs about emotions, negative meta-emotions and perceived emotional control were assessed. Results indicated that compared to non-clinical controls, individuals with ED showed more irrational beliefs about emotions, more negative meta-emotions, and poorer perceived control of emotions. Also, our results showed that these irrational beliefs about emotions were further related to an increased level of negative meta-emotions and to a decreased perceived control of emotions. Finally, negative meta-emotions were differentially associated in the two groups with the control of heart rate by the two branches of the autonomous nervous system. Thus, individuals with ED may have difficulties in appraising emotions, which further expose them to maladjustment.
Similar content being viewed by others
Data Availability
Requests for data sharing should be addressed to the author.
References
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review,30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004.
Aldao, A., Sheppes, G., & Gross, J. J. (2015). Emotion regulation flexibility. Cognitive Therapy and Research,39(3), 263–278. https://doi.org/10.1007/s10608-014-9662-4.
Appelhans, B. M., & Luecken, L. J. (2006). Heart rate variability as an index of regulated emotional responding. Review of General Psychology,10(3), 229–240. https://doi.org/10.1037/1089-2680.10.3.229.
Bonanno, G. A., & Burton, C. L. (2013). Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science,8(6), 591–612. https://doi.org/10.1177/1745691613504116.
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., et al. (2011). Preliminary psychometric properties of the acceptance and action questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy,42(4), 676–688. https://doi.org/10.1016/j.beth.2011.03.007.
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology,110(4), 585–599. https://doi.org/10.1037//0021-843X.110.4.585.
Campbell-Sills, L., & Barlow, D. H. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. Handbook of emotion regulation (pp. 542–559). New York, NY: The Guilford Press.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006a). Acceptability and suppression of negative emotion in anxiety and mood disorders. Emotion Washington, DC,6(4), 587–595. https://doi.org/10.1037/1528-3542.6.4.587.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006b). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy,44(9), 1251–1263. https://doi.org/10.1016/j.brat.2005.10.001.
Cohen, A. J. (2010). Music as a source of emotion in film. Handbook of music and emotion: Theory, research, applications (pp. 879–908). New York: Oxford University Press.
Crawford, J. R., & Henry, J. D. (2004). The positive and negative affect schedule (PANAS): Construct validity, measurement properties and normative data in a large non-clinical sample. British Journal of Clinical Psychology,43(3), 245–265. https://doi.org/10.1348/0144665031752934.
David, D., & Cristea, I. (2018). The new great psychotherapy debate: Scientific integrated psychotherapy vs plurality Why cognitive-behavior therapy is the gold standard in psychotherapy and a platform for scientific integrated psychotherapy. Journal of Evidence-Based Psychotherapies,18(2), 1–17.
David, D., Szentagotai, A., Eva, K., & Macavei, B. (2005). A synopsis of rational-emotive behavior therapy (REBT); fundamental and applied research. Journal of Rational-Emotive and Cognitive-Behavior Therapy,23(3), 175–221. https://doi.org/10.1007/s10942-005-0011-0.
David, D. O., Matu, S. A., Podina, I. R., & Predatu, R. M. (2019). Future research directions for REBT. In: M. E. Bernard & W. Dryden (Eds.), Advances in REBT: Theory, practice, research, measurement, prevention and promotion (pp. 121–146). Cham: Springer. https://doi.org/10.1007/978-3-319-93118-0_6.
DiGiuseppe, R., Leaf, R., Exner, T., & Robin, M. W. (1988). The development of a measure of irrational/rational thinking. Edinburgh: In World Congress of Behavior Therapy.
Edwards, E. R., Micek, A., Mottarella, K., & Wupperman, P. (2017). Emotion ideology mediates effects of risk factors on alexithymia development. Journal of Rational-Emotive & Cognitive-Behavior Therapy,35(3), 254–277. https://doi.org/10.1007/s10942-016-0254-y.
Ellis, A. (1991). The revised ABC’s of rational-emotive therapy (RET). Journal of Rational-Emotive and Cognitive-Behavior Therapy,9(3), 139–172. https://doi.org/10.1007/BF01061227.
Field, A. (2013). Discovering statistics using IBM SPSS statistics. Thousand Oaks: SAGE.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). User’s guide for the structured clinical interview for DSM-IV axis I disorders SCID-I: Clinician version. Washington, DC: American Psychiatric Press.
Ford, B. Q., & Gross, J. J. (2018). Emotion regulation: Why beliefs matter. Canadian Psychology/Psychologie Canadienne,59(1), 1–14. https://doi.org/10.1037/cap0000142.
Friedman, B. H. (2007). An autonomic flexibility–neurovisceral integration model of anxiety and cardiac vagal tone. Biological Psychology,74(2), 185–199. https://doi.org/10.1016/j.biopsycho.2005.08.009.
Geisler, F. C. M., Vennewald, N., Kubiak, T., & Weber, H. (2010). The impact of heart rate variability on subjective well-being is mediated by emotion regulation. Personality and Individual Differences,49(7), 723–728. https://doi.org/10.1016/j.paid.2010.06.015.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment,26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94.
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology,2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271.
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology,85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy,44(1), 1–25. https://doi.org/10.1016/j.brat.2005.06.006.
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: Understanding and treating human suffering. New York: Guilford.
Hofmann, S. G., Sawyer, A. T., Fang, A., & Asnaani, A. (2012). Emotion dysregulation model of mood and anxiety disorders. Depression and Anxiety,29(5), 409–416. https://doi.org/10.1002/da.21888.
Kashdan, T. B., Barrett, L. F., & McKnight, P. E. (2015). Unpacking emotion differentiation: Transforming unpleasant experience by perceiving distinctions in negativity. Current Directions in Psychological Science,24(1), 10–16. https://doi.org/10.1177/0963721414550708.
Kashdan, T. B., Farmer, A. S., Adams, L. M., Ferssizidis, P., McKnight, P. E., & Nezlek, J. B. (2013). Distinguishing healthy adults from people with social anxiety disorder: Evidence for the value of experiential avoidance and positive emotions in everyday social interactions. Journal of Abnormal Psychology,122(3), 645–655. https://doi.org/10.1037/a0032733.
Kemp, A. H., Quintana, D. S., Gray, M. A., Felmingham, K. L., Brown, K., & Gatt, J. M. (2010). Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis. Biological Psychiatry,67(11), 1067–1074. https://doi.org/10.1016/j.biopsych.2009.12.012.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., et al. (2003). The epidemiology of major depressive disorder: Results from the national comorbidity survey replication (NCS-R). JAMA,289(23), 3095–3105. https://doi.org/10.1001/jama.289.23.3095.
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H.-U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research,21(3), 169–184. https://doi.org/10.1002/mpr.1359.
Kneeland, E. T., Dovidio, J. F., Joormann, J., & Clark, M. S. (2016). Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science. Clinical Psychology Review,45, 81–88. https://doi.org/10.1016/j.cpr.2016.03.008.
Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review. Biological Psychology,84(3), 394–421. https://doi.org/10.1016/j.biopsycho.2010.03.010.
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry,32(4), 345–359. https://doi.org/10.1016/j.genhosppsych.2010.03.006.
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine,146(5), 317. https://doi.org/10.7326/0003-4819-146-5-200703060-00004.
Lavender, J. M., Tull, M. T., DiLillo, D., Messman-Moore, T., & Gratz, K. L. (2017). Development and validation of a state-based measure of emotion dysregulation: The state difficulties in emotion regulation scale (S-DERS). Assessment,24(2), 197–209. https://doi.org/10.1177/1073191115601218.
Leahy, R. L. (2002). A model of emotional schemas. Cognitive and Behavioral Practice,9(3), 177–190. https://doi.org/10.1016/S1077-7229(02)80048-7.
Leahy, R. L., Tirch, D. D., & Melwani, P. S. (2012). Processes underlying depression: Risk aversion, emotional schemas, and psychological flexibility. International Journal of Cognitive Therapy,5(4), 362–379. https://doi.org/10.1521/ijct.2012.5.4.362.
Leahy, R. L., Wupperman, P., Edwards, E., Shivaji, S., & Molina, N. (2019). Metacognition and emotional schemas: Effects on depression and anxiety. International Journal of Cognitive Therapy,12(1), 25–37. https://doi.org/10.1007/s41811-018-0035-8.
Levenson, R. W. (2003). Blood, sweat, and fears. Annals of the New York Academy of Sciences,1000(1), 348–366. https://doi.org/10.1196/annals.1280.016.
Lobbestael, J., Leurgans, M., & Arntz, A. (2011). Inter-rater reliability of the structured clinical interview for DSM-IV axis I disorders (SCID I) and axis II disorders (SCID II). Clinical Psychology & Psychotherapy,18(1), 75–79. https://doi.org/10.1002/cpp.693.
Maffei, A., & Angrilli, A. (2019). Spontaneous blink rate as an index of attention and emotion during film clips viewing. Physiology & Behavior,204, 256–263. https://doi.org/10.1016/j.physbeh.2019.02.037.
Manser, R., Cooper, M., & Trefusis, J. (2012). Beliefs about emotions as a metacognitive construct: Initial development of a self-report questionnaire measure and preliminary investigation in relation to emotion regulation. Clinical Psychology & Psychotherapy,19(3), 235–246. https://doi.org/10.1002/cpp.745.
Mennin, D. S., & Fresco, D. M. (2010). Emotion regulation as an integrative framework for understanding and treating psychopathology. Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment (pp. 356–379). New York: Guilford Press.
Naragon-Gainey, K. (2010). Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychological Bulletin,136(1), 128–150. https://doi.org/10.1037/a0018055.
Schwartz, A. R., Gerin, W., Davidson, K. W., Pickering, T. G., Brosschot, J. F., Thayer, J. F., et al. (2003). Toward a causal model of cardiovascular responses to stress and the development of cardiovascular disease. Psychosomatic Medicine,65(1), 22. https://doi.org/10.1097/01.PSY.0000046075.79922.61.
Silberstein, L. R., Tirch, D., Leahy, R. L., & McGinn, L. (2012). Mindfulness, psychological flexibility and emotional schemas. International Journal of Cognitive Therapy,5(4), 406–419. https://doi.org/10.1521/ijct.2012.5.4.406.
Smidt, K. E., & Suvak, M. K. (2015). A brief, but nuanced, review of emotional granularity and emotion differentiation research. Current Opinion in Psychology,3, 48–51. https://doi.org/10.1016/j.copsyc.2015.02.007.
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine,166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092.
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. JAMA,282(18), 1737–1744. https://doi.org/10.1001/jama.282.18.1737.
Spokas, M., Luterek, J. A., & Heimberg, R. G. (2009). Social anxiety and emotional suppression: The mediating role of beliefs. Journal of Behavior Therapy and Experimental Psychiatry,40(2), 283–291. https://doi.org/10.1016/j.jbtep.2008.12.004.
Tarvainen, M. P., Niskanen, J.-P., Lipponen, J. A., Ranta-aho, P. O., & Karjalainen, P. A. (2014). Kubios HRV—Heart rate variability analysis software. Computer Methods and Programs in Biomedicine,113(1), 210–220. https://doi.org/10.1016/j.cmpb.2013.07.024.
Thayer, J. F., Åhs, F., Fredrikson, M., Sollers, J. J., & Wager, T. D. (2012). A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neuroscience & Biobehavioral Reviews,36(2), 747–756. https://doi.org/10.1016/j.neubiorev.2011.11.009.
Tirch, D. D., Leahy, R. L., Silberstein, L. R., & Melwani, P. S. (2012). Emotional schemas, psychological flexibility, and anxiety: The role of flexible response patterns to anxious arousal. International Journal of Cognitive Therapy,5(4), 380–391. https://doi.org/10.1521/ijct.2012.5.4.380.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology,54(6), 1063–1070. https://doi.org/10.1037//0022-3514.54.6.1063.
Werner, K., & Gross, J. J. (2010). Emotion regulation and psychopathology: A conceptual framework. Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment (pp. 13–37). New York: The Guilford Press.
Westphal, M., Leahy, R. L., Pala, A. N., & Wupperman, P. (2016). Self-compassion and emotional invalidation mediate the effects of parental indifference on psychopathology. Psychiatry Research,242, 186–191. https://doi.org/10.1016/j.psychres.2016.05.040.
Williams, D. P., Cash, C., Rankin, C., Bernardi, A., Koenig, J., & Thayer, J. F. (2015). Resting heart rate variability predicts self-reported difficulties in emotion regulation: A focus on different facets of emotion regulation. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2015.00261.
Yoon, S., Dang, V., Mertz, J., & Rottenberg, J. (2018). Are attitudes towards emotions associated with depression? A conceptual and meta-analytic review. Journal of Affective Disorders,232, 329–340. https://doi.org/10.1016/j.jad.2018.02.009.
Zhang, X., Yu, H. W., & Barrett, L. F. (2014). How does this make you feel? A comparison of four affect induction procedures. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2014.00689.
Zvolensky, M. J., Vujanovic, A. A., Bernstein, A., & Leyro, T. (2010). Distress tolerance: Theory, measurement, and relations to psychopathology. Current Directions in Psychological Science,19(6), 406–410. https://doi.org/10.1177/0963721410388642.
Acknowledgements
The authors would like to thank every research assistant involved in conducting the experiment. AM is funded by a fellowship within the scope of a grant from MIUR-Ministero dell’Istruzione, dell’Università e della Ricerca (grant “Dipartimenti di Eccellenza” DM 11/05/2017 n.262) to the Department of General Psychology, University of Padova.
Author information
Authors and Affiliations
Contributions
All authors contributed substantially to this paper. Study conception and design: RP, DD. Data Acquisition and analysis: RP, DD, AM. Interpretation of data and manuscript drafting: RP, DD, AM.
Corresponding author
Ethics declarations
Conflict of interest
Răzvan Predatu, Daniel David and Antonio Maffei declare that they have no conflict of interest.
Ethical Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Animal Rights
No animal studies were carried out by the authors for this article.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Predatu, R., David, D.O. & Maffei, A. Beliefs About Emotions, Negative Meta-emotions, and Perceived Emotional Control During an Emotionally Salient Situation in Individuals with Emotional Disorders. Cogn Ther Res 44, 287–299 (2020). https://doi.org/10.1007/s10608-019-10064-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-019-10064-5