The contributions of affective traits and emotion regulation to internalizing disorders: Current state of the literature and measurement challenges.

“In recent years, there has been renewed attention to an enduring issue: limitations of self-report and the importance of connecting multiple levels of assessment in a single study (Haeffel & Howard, 2010; Kozak & Cuthbert, 2016; see also Nisbett & Wilson, 1977).”

“The process model (Gross, 1998, 2015) can be used to map specific strategies onto the temporal course of the emotion generation and regulation process in a way that is more contextually sensitive and incorporates emotion dynamics.”

“Ability models center around dispositional skills that are thought to facilitate adaptive emotion regulation, such as those embodied in the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004) and the Emotion Regulation Skills Questionnaire (Berking et al., 2008).”

“Broadly, emotion regulation2 refers to any attempt—even those that are implicit or habitual—to alter the course of an emotional experience, and it is one important mechanism linking affect to psychopathology (e.g., Sheppes, Suri, & Gross, 2015).”

“Similarly, positive affectivity can be decomposed into facets such as joviality, attentiveness, self-assurance, and vitality (Naragon-Gainey & Watson, in press; Stanton & Watson, 2015; Watson & Clark, 1999; Watson et al., 2015).”

“Across many theories, subjective experience is considered the core of emotion (e.g., Barrett et al., 2007; LeDoux & Hofmann, 2018; Russell & Barrett, 1999), and measurement of subjective experience by definition requires introspection that is explicitly described by the participant (i.e.,…”

“These results are generally consistent with the long-standing avoidance versus approach categories in the coping literature (e.g., Roth & Cohen, 1986), as well as the adaptive maladaptive model (e.g., Aldao et al., 2010).”

“Emotion regulation flexibility, or accurately matching one’s strategy use to the demands of the current context, is also emerging as a potentially important ability (e.g., Bonanno & Burton, 2013).”

“…negative affectivity is elevated in nearly all of the internalizing disorders, although the magnitude of the association varies by disorder, where associations are generally strongest for depression and generalized anxiety disorder (GAD; e.g., Mineka et al., 1998; Watson & NaragonGainey, 2014).”

“Affect is defined as the feeling state that is central to emotional experience, though emotions also include other loosely coupled components (e.g., facial expressions, physiological responses, behavioral tendencies; Barrett et al., 2007; Mauss, Levenson, McCarter, Wilhelm, & Gross, 2005).”

“In contrast, high levels of positive affectivity are associated with the tendency to approach potentially rewarding or enjoyable situations and engage in social interactions (Watson & Clark, 1992; Watson & Naragon-Gainey, 2014).”

“As such, trait affect alone cannot completely predict which specific disorders individuals will develop or whether they will develop a disorder at all (Nolen-Hoeksema & Watkins, 2011).”

“Regardless, when a longitudinal design is not possible, we recommend assessing the facets of trait affect or related personality traits, which allows for an empirical examination of the content that is driving observed associations (i.e., shared variance across facets vs. the unique effects of one or more facets; Orme…”

“In recent years, there has been renewed attention to an enduring issue: limitations of self-report and the importance of connecting multiple levels of assessment in a single study (Haeffel & Howard, 2010; Kozak & Cuthbert, 2016; see also Nisbett & Wilson, 1977).”

“…transdiagnostic traits include anxiety sensitivity (Naragon-Gainey, 2010), rumination (Aldao, Nolen-Hoeksema, & Schweizer, 2010; Olatunji, Naragon-Gainey, & Wolitzky-Taylor, 2013), intolerance of uncertainty (Gentes & Ruscio, 2011), and perfectionism (Limburg, Watson, Hagger, & Egan, 2017).”

“A recent approach to organizing and modeling the large array of emotion regulation strategies is to empirically identify patterns of strategy use (Lee, Witte, Weathers, & Davis, 2015; Naragon-Gainey et al., 2017; Seligowski & Orcutt, 2015).”

“T hi s ar tic le is in te nd ed so le ly fo r th e pe rs on al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. and it is not substantially related to most other types of anxiety (Mineka et al., 1998; Watson & Naragon-Gainey, 2010, 2014).”

“Ability models center around dispositional skills that are thought to facilitate adaptive emotion regulation, such as those embodied in the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004) and the Emotion Regulation Skills Questionnaire (Berking et al., 2008).”

“…(negatively) related to symptoms among those who also use maladaptive strategies, suggesting that adaptive strategy use can help reduce the negative consequences of maladaptive strategies (Aldao, Jazaieri, Goldin, & Gross, 2014; Aldao & Nolen-Hoeksema, 2012; McMahon & Naragon-Gainey, 2018).”

“Whereas positive affectivity is elevated among individuals with bipolar disorder (Gruber, 2011; Stanton & Watson, 2015; Watson et al., 2012), it is inversely associated with depression and social anxiety,”

“Furthermore, in studies that accounted for comorbidity, clinical traits were still significantly associated with symptoms, indicating that the observed transdiagnostic associations were not solely due to comorbidity (Naragon-Gainey, 2010; Olatunji et al., 2013).”

“T hi s ar tic le is in te nd ed so le ly fo r th e pe rs on al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. and it is not substantially related to most other types of anxiety (Mineka et al., 1998; Watson & Naragon-Gainey, 2010, 2014).”

“This overlap has led some researchers to question the utility of affectivity and related traits as risk factors for internalizing symptoms, suggesting that if associations primarily reflect shared content, they are tautological and noninformative (e.g., Ormel et al., 2004).”

“Furthermore, one fundamental goal of psychopathology research is to understand— and when there is extensive suffering, to alter—the subjective human experience of emotion (LeDoux & Hofmann, 2018).”

“…clarify the specific components that drive associations, because this will allow for more precise conclusions about why and how affect contributes to symptoms and which types of affective experiences are most important for psychological wellbeing (Ormel et al., 2013; Watson & Naragon-Gainey, 2014).”

“Of importance, this is not just a cross-sectional phenomenon, because these traits prospectively predict changes in depressive and anxiety symptoms over months or years (for meta-analyses of longitudinal studies, see Jeronimus, Kotov, Riese, & Ormel, 2016; Khazanov & Ruscio, 2016).”

“However, we argue that just as self-report should not be mindlessly utilized, neither should it automatically or unilaterally be dismissed as inferior to other approaches (Haeffel & Howard, 2010).”

“…negative emotions, accessing emotion regulation strategies) mediated the associations of a variety of risk or protective factors with depression (Boden & Thompson, 2015; Vine & Aldao, 2014) and with several types of anxiety symptoms (O’Connor, Staiger, Kambouropoulos, & Smillie, 2014; Tull,…”

“…(such as avoidance, rumination, thought suppression, and expressive suppression), they also had higher levels of internalizing symptoms at that time or shortly after (Kashdan et al., 2014; Li, Starr, & Hershenberg, 2017; McMahon & Naragon-Gainey, in press; Short, Boffa, Clancy, & Schmidt, 2018).”

“…emotion regulation strategies) mediated the associations of a variety of risk or protective factors with depression (Boden & Thompson, 2015; Vine & Aldao, 2014) and with several types of anxiety symptoms (O’Connor, Staiger, Kambouropoulos, & Smillie, 2014; Tull, Berghoff, Wheeless, Cohen,…”

“Although the sadness facet uniquely contributes to the prediction of depression, and the anxiety facet uniquely contributes to the prediction of generalized anxiety in some studies (Naragon-Gainey & Watson, 2014, 2018; Uliaszek et al., 2009; Zinbarg et al., 2016), this is likely due in part to overlapping content betw…”

“…disorders in clinical and nonclinical samples (Mahaffey et al., 2016), particularly for anxiety sensitivity (e.g., Naragon-Gainey & Watson, 2018; Norr et al., 2013; Paulus et al., 2015; Zinbarg et al., 2016) and intoler- ance of uncertainty (e.g., Brown & Naragon-Gainey, 2013; Norr et al.,…”

“Whereas positive affectivity is elevated among individuals with bipolar disorder (Gruber, 2011; Stanton & Watson, 2015; Watson et al., 2012), it is inversely associated with depression and social anxiety,”

“, 2016) and intolerance of uncertainty (e.g., Brown & Naragon-Gainey, 2013; Norr et al., 2013; Paulus et al., 2015).”

“…than was typical for them, the association of negative events and depressive symptoms that day was stronger, and on occasions when participants engaged in more dampening than usual, the association between positive events and decreased depressive symptoms that day was weakened (Li et al., 2017).”

“…and nonclinical samples (Mahaffey et al., 2016), particularly for anxiety sensitivity (e.g., Naragon-Gainey & Watson, 2018; Norr et al., 2013; Paulus et al., 2015; Zinbarg et al., 2016) and intoler- ance of uncertainty (e.g., Brown & Naragon-Gainey, 2013; Norr et al., 2013; Paulus et al., 2015).”

“In fact, statistically removing transient variance in trait affect ratings over time (which includes influences due to current mood state) increased the associations of negative and positive affect with internalizing symptoms in a clinical sample (Naragon-Gainey et al., 2013).”

“Although the sadness facet uniquely contributes to the prediction of depression, and the anxiety facet uniquely contributes to the prediction of generalized anxiety in some studies (Naragon-Gainey & Watson, 2014, 2018; Uliaszek et al., 2009; Zinbarg et al., 2016), this is likely due in part to overlapping content betw…”

“Two studies found that a variety of clinical traits were largely indistinguishable from neuroticism (Mahaffey, Watson, Clark, & Kotov, 2016; Naragon-Gainey & Watson, 2018) and that they were most closely related to the anxiety facet specifically (Naragon-Gainey & Watson, 2018).”

“…with other levels of analysis (e.g., genes, psychophysiology, neurological circuits, cognitive measures, behavioral outcomes) to combine complementary sources of information and yield a more complete picture of affective experience (see, e.g., Stange et al., 2017, and Tull et al., 2018).”

“…contributes to the prediction of depression, and the anxiety facet uniquely contributes to the prediction of generalized anxiety in some studies (Naragon-Gainey & Watson, 2014, 2018; Uliaszek et al., 2009; Zinbarg et al., 2016), this is likely due in part to overlapping content between the…”

“…(negatively) related to symptoms among those who also use maladaptive strategies, suggesting that adaptive strategy use can help reduce the negative consequences of maladaptive strategies (Aldao, Jazaieri, Goldin, & Gross, 2014; Aldao & Nolen-Hoeksema, 2012; McMahon & Naragon-Gainey, 2018).”

“Nonetheless, there is some evidence for their incremental validity— beyond affectivity and personality traits—when predicting mood and anxiety disorders in clinical and nonclinical samples (Mahaffey et al., 2016), particularly for anxiety sensitivity (e.”

“A recent approach to organizing and modeling the large array of emotion regulation strategies is to empirically identify patterns of strategy use (Lee, Witte, Weathers, & Davis, 2015; Naragon-Gainey et al., 2017; Seligowski & Orcutt, 2015).”

“These effects were both within-person (when individuals had more momentary clarity than they typically do, this predicted fewer symptoms on the next occasion) and betweenperson (people who had greater clarity overall had fewer symptoms overall; Park & Naragon-Gainey, 2018).”

“One study found a replicable twofactor structure across numerous faceted measures of positive affectivity, consisting of joviality (i.e., joyfulness, feeling energetic, attentiveness) and experience-seeking (i.e., experience-seeking, self-assurance; Stanton & Watson, 2015).”

“Similarly, positive affectivity can be decomposed into facets such as joviality, attentiveness, self-assurance, and vitality (Naragon-Gainey & Watson, in press; Stanton & Watson, 2015; Watson & Clark, 1999; Watson et al., 2015).”

“…with other levels of analysis (e.g., genes, psychophysiology, neurological circuits, cognitive measures, behavioral outcomes) to combine complementary sources of information and yield a more complete picture of affective experience (see, e.g., Stange et al., 2017, and Tull et al., 2018).”

“With longitudinal data, a viable approach may be to statistically control for baseline symptoms when predicting subsequent symptoms from trait affect, though this decision should be grounded in whether it clarifies one’s specific research question (Riese et al., 2016).”

“A second possibility is that the constructs assessed in this study—and clinical psychology intervention research more broadly—have shown considerable overlap, both conceptually and statistically [74,75], and may not reflect entirely distinct constructs.”

“, fear, sadness, anger, and guilt), to withdraw from potentially risky situations, and to react intensely to stress (Naragon-Gainey et al., 2018).”

“Emotion regulation difficulties are believed to play a key role in the development of disorders that are characterised by excessive negative affect, such as depression and generalised anxiety disorder (Naragon-Gainey et al., 2018), and have been identified as an important target for interventions aimed at promoting th…”

“…of ER strategies depends on the external and internal context in which individuals respond to emotional experiences (e.g., Bonanno et al., 2020; Naragon-Gainey et al., 2018) but also compelling evidence that contextual factors to better delineate the complex process of ER should be taken into…”

“…Emotionality (N/NE) and Extraversion/Positive Emotionality (E/PE)—have attracted the most theoretical attention and show the most robust empirical links in cross-sectional and longitudinal studies with internalizing symptoms (Clark, 2005; Kotov et al., 2010; Naragon-Gainey et al., 2018).”

“Internalizing correlates with a broad range of clinical and personality trait dimensions that reflect dysfunctional, high negative, and/or low positive, affect (Naragon-Gainey et al., 2018; Sellbom et al., 2008).”

“…research should extend these daily linkages toward an ecological momentary assessment space to gain moment-to-moment precision of associations between affect and RTI, increase ecological validity, and decrease likelihood of response biases from retrospective recall (Naragon-Gainey et al., 2018).”

“Though previous literature has emphasised the role of emotion regulation in internalising disorders (Zeman et al., 2002; Kim-Spoon et al., 2012; Naragon-Gainey et al., 2018), this study has not found such association.”

“A synthesis of the existing literature suggests that adaptive strategies for emotion regulation act as a protective factor against internalizing disorders such as anxiety and depression (Aldao and Nolen-Hoeksema, 2010; Naragon-Gainey et al., 2018).”

“…using the RewP to understand neurobiological mechanisms underlying depressive symptoms and disorders (Proudfit, 2015) and research on trait-like vulnerabilities that predict broad patterns of internalizing psychopathology (Conway et al., 2016; Klein et al., 2011; Naragon-Gainey et al., 2018 ).”

“High emotion sensitivity, negative beliefs about emotions, and difficulties regulating strong emotions confer risk for emotional disorders (Naragon-Gainey et al., 2018).”

“…with elevated depressive symptoms may have comparatively poor emotion regulation capabilities (Kim-Spoon et al., 2013; Lougheed & Hollenstein, 2012; Naragon-Gainey et al., 2018) and were at particular risk for fluctuations in internalizing symptoms over the first year of the COVID-19 pandemic.”

“This fi nding is consistent with research demonstrating that effective emotion regulation reduces the risk for internalizing problems [45]; further, it suggests that fathers ’ abilities to employ regulatory strategies in response to stressors in a fl exible and nonjudgmental manner may be…”

“51,52 It is noteworthy that negative emotions are directly associated low social support/positive affect, which in turn may spread and be linked to social withdrawal.”

“Negative affectivity has been found to positively predict emotional and behavioral problems, including internalizing and externalizing problems (Naragon-Gainey et al., 2018; Nigg, 2006; Stanton & Watson, 2014).”

“…whether life satisfaction moderates the relationships between internalizing symptoms and dif - ferent facets of neuroticism, such as anxiety, sadness, and stress vulnerability (e.g., Naragon-Gainey & Watson, 2018), which is a promising avenue for future studies (e.g., Naragon-Gainey et al., 2018).”