Increased Attention Regulation from Emotion Regulation Therapy for Generalized Anxiety Disorder

Renna, Megan E.; Seeley, Saren H.; Heimberg, Richard G.; Etkin, Amit; Fresco, David M.; Mennin, Douglas S.

doi:10.1007/s10608-017-9872-7

Cited by 28 publications

(26 citation statements)

References 53 publications

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“…This means that these forms could be conceived as being based on dispositional positive affect or as improving positive affect when coping with negative events. However, venting and rumination could be understood as fueled by negative affect (Aldao et al, 2010; Renna et al, 2018). …”

Section: Discussionmentioning

confidence: 99%

Examining the Structure of Negative Affect Regulation and Its Association With Hedonic and Psychological Wellbeing

et al. 2018

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The present study examines the structure of negative affect regulation strategies by confirmatory factor analysis. A total of 264 students (n = 187 women, 65 men) (M = 24 years; SD = 9.32) took part in this study. Results show a good fit indices for a three facets model: (1) modification of situation (problem-directed action, seeking emotional and instrumental social support, psychological abandonment and social isolation); (2) attentional deployment and cognitive change (distraction, acceptance, gratitude, rumination, reappraisal, spirituality, and social comparison); and (3) response modification (suppression, active and passive physiological, humor and warmth, venting, confrontation, and regulated emotional expression). The scale validity is confirmed through correlations between the expanded of Mood Affect Regulation Scale dimensions including dimensions of dispositional reappraisal and suppression, and hedonic and psychological well-being. Participants report an adaptive profile with high psychological well-being, even if they report low positive affect, suggesting a greater relevance of eudaimonic than hedonic well-being for affect regulation.

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Section: Discussionmentioning

confidence: 99%

Examining the Structure of Negative Affect Regulation and Its Association With Hedonic and Psychological Wellbeing

et al. 2018

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“…Using this formulation of distress disorders as a conceptual model, Mennin and Fresco developed emotion regulation therapy (ERT), a theoretically-derived, mechanism focused treatment that integrates findings from affect science with principles from cognitive behavioral therapy (i.e., CBT; see Mennin et al, 2013) to target and normalize these neurobehavioral deficits (Fresco et al, 2013; Mennin and Fresco, 2015; Mennin et al, 2018; Renna et al, 2018b). ERT targets three hypothesized mechanisms: (1) motivational mechanisms, the functional purpose and inclinations of emotional response tendencies; (2) regulatory mechanisms, the ability to alter emotional responses both at less elaborative/attentional levels and more verbally elaborative and effortful levels including the ability to decenter (i.e., the meta-cognitive ability to observe items that arise in the mind with distance and perspective; present sample; Fresco et al, 2007; Bernstein et al, 2015) and reappraise (i.e., reinterpreting the meaning to change emotional trajectory; Ochsner and Gross, 2005); and (3) contextual learning, the use of flexible and adaptive behavioral repertoires, Using a motivational framework (i.e., identifying reward- and risk-based impulses), ERT instructs patients to engage in mindful emotion regulation skills to counteract negative self-referential processing (e.g., worry, rumination, and self-criticism) in service of pursuing intrinsically rewarding and goal-directed actions in their lives.…”

Section: Introductionmentioning

confidence: 99%

Changes in Functional Connectivity Following Treatment With Emotion Regulation Therapy

Scult

Fresco

Gunning

et al. 2019

Front. Behav. Neurosci.

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Emotion regulation therapy (ERT) is an efficacious treatment for distress disorders (i.e., depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals with distress disorders exhibit disruptions in two corresponding brain networks including the salience network (SN) reflecting emotion/motivation and the default mode network (DMN) reflecting self-referentiality. Using resting-state functional connectivity (rsFC) analyses, seeded with primary regions in each of these networks, we investigated whether ERT was associated with theoretically consistent changes across nodes of these networks and whether these changes related to improvements in clinical outcomes. This study examined 21 generalized anxiety disorder (GAD) patients [with and without major depressive disorder (MDD)] drawn from a larger intervention trial (Renna et al., 2018a), who completed resting state fMRI scans before and after receiving 16 sessions of ERT. We utilized seed-based connectivity analysis with seeds in the posterior cingulate cortex (PCC), right anterior insula, and right posterior insula, to investigate whether ERT was associated with changes in connectivity of nodes of the DMN and SN networks to regions across the brain. Findings revealed statistically significant treatment linked changes in both the DMN and SN network nodes, and these changes were associated with clinical improvement corresponding to medium effect sizes. The results are discussed in light of a nuanced understanding of the role of connectivity changes in GAD and MDD, and begin to provide neural network support for the hypothesized treatment model predicated by ERT.

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“…Using this formulation of distress disorders as a conceptual model, Mennin and Fresco developed emotion regulation therapy (ERT), a theoretically-derived, mechanism focused treatment that integrates findings from affect science with principles from cognitive behavioral therapy (i.e., CBT; see to target and normalize these neurobehavioral deficits (Fresco et al, 2013;Mennin et al, 2018;Renna et al, 2018b). ERT targets three hypothesized mechanisms: (1) motivational mechanisms, the functional purpose and inclinations of emotional response tendencies; (2) regulatory mechanisms, the ability to alter emotional responses both at less elaborative/attentional levels and more verbally elaborative and effortful levels including the ability to decenter (i.e., the meta-cognitive ability to observe items that arise in the mind with distance and perspective; present sample; Fresco et al, 2007;Bernstein et al, 2015) and reappraise (i.e., reinterpreting the meaning to change emotional trajectory; Ochsner and Gross, 2005); and (3) contextual learning, the use of flexible and adaptive behavioral repertoires, Using a motivational framework (i.e., identifying reward-and risk-based impulses), ERT instructs patients to engage in mindful emotion regulation skills to counteract negative self-referential processing (e.g., worry, rumination, and self-criticism) in service of pursuing intrinsically rewarding and goal-directed actions in their lives.…”

Section: Introductionmentioning

confidence: 99%

“…The gains were maintained in post-treatment assessments 3-and 9-months following the end of treatment. In a secondary analysis of these trial data, Renna et al (2018b) examined ERT-linked changes in behavioral tasks of flexible and sustained attention. Findings indicated that improvements in a specific form of attentional flexibility, conflict adaptation, predicted increases in mindful observing abilities whereas gains in sustained attention were related to mindful nonreactivity, clinical improvement, and decreased functional impairment.…”

Section: Introductionmentioning

confidence: 99%

Changes in Functional Connectivity following Treatment with Emotion Regulation Therapy

Scult¹,

Fresco²,

Gunning³

et al. 2019

Preprint

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Emotion Regulation Therapy (ERT) is an efficacious treatment for distress disorders (i.e. depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals with distress disorders exhibit disruptions in two corresponding brain networks including the salience network (i.e., “SN”) reflecting emotion/motivation and the default mode network (i.e., “DMN”) reflecting self-referentiality. Using resting-state functional connectivity analyses, seeded with primary regions in each of these networks, we investigated whether ERT was associated with theoretically consistent changes across nodes of these networks and whether these changes related to improvements in clinical outcomes. This study examined 21 generalized anxiety disorder (GAD) patients (with and without major depressive disorder (MDD)) drawn from a larger intervention trial (Renna et al., 2018), who completed resting state fMRI scans before and after receiving 16 sessions of ERT. We utilized seed-based connectivity analysis with seeds in the PCC, right anterior insula, and right posterior insula, to investigate whether ERT was associated with changes in connectivity of nodes of the DMN and SN networks with changes across the brain. Findings revealed statistically significant treatment linked changes in both the DMN and SN network nodes, and these changes were associated with clinical improvement corresponding to medium effect sizes. The results are discussed in light of a nuanced understanding of the role of connectivity changes in GAD and MDD, and begin to provide neural network support for the hypothesized treatment model predicated by ERT.

show abstract

Increased Attention Regulation from Emotion Regulation Therapy for Generalized Anxiety Disorder

Cited by 28 publications

References 53 publications

Examining the Structure of Negative Affect Regulation and Its Association With Hedonic and Psychological Wellbeing

Examining the Structure of Negative Affect Regulation and Its Association With Hedonic and Psychological Wellbeing

Changes in Functional Connectivity Following Treatment With Emotion Regulation Therapy

Changes in Functional Connectivity following Treatment with Emotion Regulation Therapy

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