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Research themes

Emotion and Psychopathology

Several authors consider that the construct emotional regulation has the potential of unifying diverse symptom presentations and maladaptive behaviours. Linehan has offered a very comprehensive work incorporating emotional regulation in a clinical disorder. Linehan and colleagues postulate that emotional dysregulation (i.e., failure of emotional regulation) constitutes the main aetiological factor and the crucial point of intervention for borderline personality disorder. More recently, emotional dysregulation has been incorporated in models of bipolar disorders and major depressive disorder. Moreover, many of the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders include disturbances in regulatory processes. Emotion regulation involves any extrinsic and intrinsic process aimed at monitoring, evaluating, and modifying emotional reactions; especially their intensive and temporal features to bring about one’s goals, and includes both voluntary regulatory processes and automatic processes. We are very interested in finding out more precisely the role of emotion regulation in the aetiology and/or maintenance of psychological disorders.

Emotion regulation

One of the main themes researched in the Psychopathology Research Group (PRG) is Emotion Regulation (ER) in psychopathology. How people regulate their emotions (or don’t) is increasingly postulated to play a role in the gestation and/or maintenance of psychopathology. Emotions (e.g., sadness) are different to moods (e.g., depression) and we (and a few research centres around the world) think how people regulate their emotions tends to predict the course of their psychological difficulties, and this is worth exploring. Therapy normally focuses on the role of medication (i.e., psychotropics); cognitions (thoughts, beliefs, core beliefs, etc.); behaviours; and social support. All these aspects appear to be crucial, but as common knowledge attests, much work needs to be done before we can say we have created the ideal intervention. ER appears a relatively new aspect that could be considered a target of intervention in the therapeutic equation. This is now formally acknowledged in the study of borderline personality disorder, but there is a strong movement today to expand this to all psychopathological presentations. Therefore, ER becomes a transdiagnostic theme whose precise nature, course, and potential therapeutic target represent a fascinating challenge.

Transdiagnostic Issues

A transdiagnostic approach in clinical psychology involves emphasising the commonalities across multiple diagnoses rather than the differences. From this perspective, we study clients’ ability to identify and challenge a variety of problematic cognitions and behaviours which may elicit the same emotional response (e.g., anxiety) to different stimuli (e.g social situations, needles, heights, work performance, etc.) as well as different emotional responses to the same stimuli (e.g. anxiety and depression). There is strong empirical evidence to support that commonalities across mental disorders are greater than differences and thus transdiagnostic treatment would be at least equally as effective to diagnostic specific approaches.

Bipolar Disorder

Bipolar disorder (BD) is a chronic psychiatric condition characterised by manic, depressive and mixed states. In spite of significant advances in its treatment, the course of BD is typically characterised by high rates of relapse and hospitalisation. For example, a seminal longitudinal study found that 37% of patients taking mood-stabilizing medications relapsed within one year, 60% in two years, and 73% in five or more years. Moreover, psychosocial functioning and quality of life often remain impaired between mood episodes. The burden on individuals, their families and health care systems is therefore significant. Several factors are recognised as triggering mood episodes including psychosocial challenges and their emotional consequences. Surprisingly, there is little research on the emotional strategies that people with BD use to deal with psychosocial challenges. We are trying to characterize the emotion regulation style in people with BD and thus help in the prevention of such high rate of relapse. Additionally, we want to help in profiling the neuropsychological functioning in people with BD. We were very pleased when ECU awarded us the Early Career Research Grant (2011), to fund a project titled ‘Do neuropsychological variables predict recovery from Bipolar Disorder episodes? There is some controversy as to the precise nature of executive functioning in BD with a significant number of papers reporting intact executive functioning in BD whilst in remission (i.e., not manic nor depressed) whilst others reporting the opposite. A lot of work needs to be done in this area.

Theory of Mind

Theory of mind (ToM) refers to the ability to understand and attribute mental states to others, including thoughts, beliefs, feelings, desires and intentions. The terminology describing ToM is broad, and the concept has also been referred to as mentalising, social intelligence, mind-reading, and perspective-taking. With intact ToM, we recognise others’ perspectives as separate from our own. Research has found some weaknesses in ToM in a few psychological diagnoses. We want to be able to characterise ToM functioning in depression, bipolar, and other conditions as well as examine whether ToM processing depends on modality (e.g., visually or orally presented stimuli).

Psychophysiology and emotions in psychopathology

The PRG makes an excellent fit with, and use of, the new Psychophysiology Laboratory offered by the School of Arts and Humanities. The addition of objective psychophysiological measurements provides important information to enhance current research investigations, and to improve the competitiveness of the research group for external funding applications. Some of the current projects include heart rate and electrodermal activity in response to emotional stimuli in both healthy control (HC) participants and those with Bipolar Disorders. Another project looks into the potential differences between HC and people with depression whilst exposed to Theory of Mind (ToM) tasks (crudely put ToM refers to the ability to understand that others have beliefs, emotions and intentions). Another project looks at the belief that people with Borderline Personality Disorder have a more pronounced reactivity to emotional reactivity (biosocial model). We are also interested in the difference between self-reported objective psychophysiological measures in response to emotional stimuli.

Alexithymia in psychopathology

Alexithymia literally means “no words for emotions” and it is a phenomenon widely studied in the psychosomatic domain. However, the phenomenon is also studied in acquired brain injury and has been increasingly been examined in more traditional psychiatric conditions. We are curious about the role of Alexithymia, as measured by the Toronto Alexithymia Scale (TAS), in the course of recovery. In other words, could the TAS predict recovery from psychiatric conditions after intervention? Common sense would dictate that being good at identifying and describing your emotions would act as a facilitating variable in recovery. Would this apply to depression, anxiety and/or bipolar disorders? These are some of the questions we are interested in.

Mindfulness

One of the issues in psychopathology is that patients tend to engage with their emotions automatically (particularly if they are negative). Cognitive behaviour therapy (CBT) operates under the assumption that if we can modify the most damaging unhelpful thinking tendencies, this would necessarily lead to a healthier way of experiencing emotions. In a way, CBT is an indirect way of emotion regulation. However, Mindfulness appears to be a more direct regulatory strategy. There are numerous ways of defining Mindfulness but psychologists appear to favour the one offered by Kabat-Zinn, 1994, p.4) “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally”. Mindfulness has been a relatively unfamiliar concept in much of western cultures and it is strongly associated with Buddhism. However, recently many scholars suggest that mindfulness practice may be beneficial to many people suffering psychological difficulties. Current empirical literature, based on training mindfulness skills is quite supportive of this proposition but more research is needed. This represents an exciting additional approach to help people to alleviate their suffering stemming from psychological complications. We have a couple of stimulating projects currently taking place and are very interested in continuing this line of research.

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