MPA 2018

*Presentations authored/co-authored by student mentees.

Depression and Anxiety (Internalizing)
Disorders

*Falck, J., Scamaldo, K., & Yaroslavsky, I. (2018, April). Sex moderates the relationship between depression and positive affect. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction. Depression is a disorder marked by low levels of positive affect and high levels of negative affect. Both affective states are dynamitic in their temporal qualities, ranging from momentary emotions to enduring traits, and are expressed interpersonally with respect to verbal behavior. While depression is twice as common among women relative to men, relatively little is known about sex differences in the phenomenology of these depressed affects. The present study examines the relationship between depression symptoms and affect ascertained through self-report measures and in daily life.
• Methods. Community dwelling adults (N=25, 74% female, Mage= 27.84, SD = 11.17) completed measures of depression and generalized anxiety disorder symptoms, and a 7-day experience sampling protocol during which ecological momentary assessment (EMA) procedures were used to collect momentary negative affect (sad, nervous, upset, angry, frustrated, stressed affects), and positive affect (happy, excited, alert, & strong affects), and electronically activated recording (iEAR) was used to sample 30 seconds of audio every 12 minutes. Participants completed up to 35 surveys during the measurement period (98% completed all surveys) that resulted in n=646 EMA data points, and provided n=1408 audio samples where speech was present (14% of all recordings). Speech samples were transcribed and their contents analyzed with Linguistic Inquiry and Word Count to derive behavioral indices of positive and negative affect.
• Results. Depression symptoms were associated with low trait positive affect (β= -.79, p < .001) and momentary positive affect (b= -.09, p < .05), as well as with high trait negative affect (β= .75, p < .001), momentary negative affect (b= .13, p < .001), and reduced verbal utterances on behavioral indices (b= -.24, p < .05). Sex differences emerged with respect to indices of positive affect: as compared to women, men reported lower trait and momentary positive affect with increasing depression symptoms, but evidenced increased positive affect in their verbal behavior. Men and women did not differ in their self-report or verbal behavior with respect to negative affect.  
• Conclusion.  While depression risk is higher for women relative to men, our findings suggest that phenomenology of the disorder differs between the two sexes. Women generally evidenced lower levels of positive affect across the three measurement approaches, and men appeared to minimize their low hedonic levels when interacting with others. These findings suggest that self-report surveys may be preferable to extensive clinical interviews for men because men's positive speech may mask underlying depression issues.

*Jaworski, K., Oravec, K., Bolla, P., & Yaroslavsky, I. (2018, April). Parasympathetic activity and depression history predict emotion regulation outcomes. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Depression is associated with emotion regulation (ER) difficulties. Emotion regulation varies in its effectiveness: efforts are considered adaptive when they reduce sadness, and maladaptive when they maintain or increase it. While depression is associated with the use of maladaptive responses, evidence is mixed for the role of adaptive ER in depression risk. While depressed persons report difficulty deploying adaptive responses, they effectively deploy these responses in laboratory settings. These mixed findings may stem from two sources: (1) depression-prone people may default to maladaptive ER responses, thereby undermining the effectiveness of subsequent adaptive ER responses, and (2) individual differences may undermine the effectiveness of adaptive emotion regulation responses. With respect to the latter, parasympathetic nervous system (PNS) activity has been shown to predict effectiveness of adaptive ER strategies. This study examines whether the use of maladaptive ER strategies undermine adaptive ER efforts, and investigates whether PNS levels, both at rest and in response to sadness, predict the effectiveness of adaptive ER following a stressful mood induction.
• Method: Twenty-nine community-dwelling adults (N= 20 with depression histories, 59% female, Mage = 33.34, SD = 17.23) completed an experimental protocol during which negative and positive affect ratings (NA and PA) and PNS activity (indexed via Respiratory Sinus Arrhythmia, RSA) were collected as participants watched a sad film clip, and recalled neutral and stressful memories. Stressful memory recall was followed by instructed maladaptive ER (via rumination) or adaptive ER (positive autobiographical memory recall, PAM). Rumination preceded PAM for approximately half of the sample. 
• Results: Depression history predicted increased negative affect for participants who ruminated before engaging the adaptive ER response (b= 7.26, p <.01). Specifically, those without depression histories who ruminated before engaging PAM experienced fewer benefits from the ER response (b= -7.13, p < .05). PAM outcomes were unrelated to rumination among those with depression histories. Patterns of PNS activity in the form of low resting levels and strong withdrawal in response to the sad film clip predicted lowest impact of ruminative responses on PAM outcomes (b=6.19, p<.001).
• Conclusion: While PAM is an effective ER response, maladaptive ER interferes in its effectiveness for healthy individuals and those with normative RSA patterns. The insensitivity to rumination for those with depression histories and atypical RSA patterns that have previously been linked to depression and ER failure may point to a shared diathesis for depression. Clinical implications are discussed. 

* Bolla, P., Basting, E., Oravec, K., & Yaroslavsky, I. (2018, April). Depressive symptoms maintain state rumination but not thought suppression. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Depression is a disorder marked by emotion regulation deficits. In particular, the frequent use of ER responses that paradoxically maintain or exacerbate distress (maladaptive ER) has received increased attention as a mechanism for depression risk. Rumination and emotional suppression are two maladaptive ER responses that have been strongly linked to dysphoric affects, depression symptoms, and risk for depressive episodes. However, most studies that examine the relationship between these ER responses and depression outcomes employ self-report methods, or instruct participants to engage in these responses. Therefore, it remains unclear how spontaneous use of these responses affects mood that is linked to depression. Further, most laboratory studies that examine the effects of rumination and suppression on emotional states measure immediate affective outcomes only; thus, the chronicity of spontaneous rumination and suppression following distress, and their consequences on affect, are not known. The current study sought to examine the link between depressive symptoms and spontaneous rumination and suppression following a sad mood induction task and subsequent rest periods.
• Method: Thirty-six community dwelling adults (Females=63%; Mage= 34.08 SD= 16.62) completed a measure of depressive symptoms (Center for Epidemiologic Studies Depression Scale), watched a sad film clip (21 Grams), then rested for a one-minute period. Participants rated their level of sadness and spontaneous uses of rumination and suppression immediately following the film clip and rest period. 
• Results: Repeated measures analyses revealed significant effects of depression symptoms for rumination, (F(1, 64)=7.40, p < .01.) Planned contrasts revealed that elevated depression symptoms predicted low rumination levels immediately following the sad film clip (b= -.11, p< .05), but elevated and maintained rumination levels over the subsequent one minute rest period (b=.10, p< .05). Depression symptoms also predicted spontaneous use of suppression following the sad film (b=.06, p<.05). Independent of depression symptoms, spontaneous rumination following the sad film clip and at the one minute rest period predicted and maintained concurrent feelings of sadness (b= .20 -.42, ps< .05). Suppression was unrelated to affective outcomes. 
• Conclusion: Results demonstrate that those with elevated depressive symptoms engage in a pattern of spontaneous suppression followed immediately by rumination; this increase in rumination results in increased negative affect over time. These findings suggest that maladaptive ER responses may lead to other maladaptive responses, and in turn, provide worse mood outcomes. This is clinically relevant, as it reinforces common intervention strategies that encourage healthy expression of emotion rather than suppression. 

*Szewcyk, T., Bolla, P., & Yaroslavsky, I. (2018, April). Depression and generalized anxiety disorder comorbidity effects on savoring. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Depression and Generalized Anxiety Disorder (GAD) are highly impairing disorders that are fairly common. Both disorders evidence reduced capacity to implement effect emotion regulation (ER) and experience positive emotions such as positive affect (Eisner, Johnson, & Carver, 2009). One potential mechanism for these deficits may be the limited capacity of individuals with either disorder to actively access positive affect, which underlies many adaptive ER responses. However, the literature has yet to examine the relationship between the reduced capacity to savor positive emotions in these disorders and subsequent ER outcomes. The present study aims to bridge this gap by examining the interplay of depression and GAD in the savoring of positive emotions and the subsequent effects of such savoring on ER effectiveness in a laboratory setting.
• Method: Community-dwelling adults (N=87; Female=57; Age M=31.23, SD=12.83) completed measures of depression (Center for Epidemiologic Studies Depression Scale), worry (Penn State Worry Questionnaire), and hedonic savoring (Snaith Hamilton Pleasure Scale). They were then induced into negative mood states by watching a sad film clip (My Girl), that were followed by one of two instructed adaptive ER conditions, an attention-refocusing task that involved viewing a kaleidoscope video (N=43) or a savoring two pieces of chocolate (N=44), and a 120-second rest interval.  Happiness ratings were collected following mood induction, ER procedures, and rest period.
• Results: Instructed ER robustly increased feelings of happiness following the sad film clip, with greater benefits reaped by those in the savoring condition relative to those who refocused their attention, F (1, 75) = 7.08, p = .01, but influence the degree to which happiness was sustained across the resting period. While depression uniquely predicted deficits in hedonic savoring independent of worry (β = -.72, p b = -.05). Interestingly, worry also was linked to slower declines in happiness for those with elevated depression symptoms across the resting period (b = -.03, p = .001).
• Conclusion: These findings suggest that worry dampens hedonic experiences in the presence of depression, which paradoxically reduce ER gains and maintain their affective outcomes. This effect is consistent with a literature linking GAD to blunted affective reactivity across the valence spectrum, and suggests that worry are a "double-edged sword" for ER outcomes. Clinical implications are discussed.

* Bolla, P., Basting, E., Oravec, K., & Yaroslavsky, I. (2018, April). State rumination maintains distress in daily life only for trait. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Rumination has been identified as a maladaptive emotion regulation response that is a transdiagnostic risk factor for various disorders (Ebner-Priemer & Trull, 2009). Rumination can reflect dispositional tendencies to moodily about one's emotional states, or spontaneous cognitive responses in response to life event stressors (state). Both state and trait rumination are linked to increased distress in response to stressors across laboratory studies and daily life (Ciesla & Roberts, 2007; Moberly & Watkins, 2008; Papageorgiou & Wells, 2004; Ebner-Priemer & Trull, 2009). However, there is a lack of literature regarding the link between rumination observed in the laboratory setting and its effect in everyday life. The present study examined the effects of spontaneous ER ascertained in the laboratory on affective outcomes in the daily lives of adults with and without histories of depressive disorders.
• Method: Twenty-eight (63% Females) community dwelling adults completed a measure of trait rumination (Rumination Response Scale) and spontaneous ruminative responses following a negative mood induction via a sad film clip (21 Grams), and a 7-day Ecological Momentary Assessment protocol. During this protocol, current and hourly peak negative affect (NA) (sad, nervous, upset, angry, frustrated, stressed affects) was collected 5 times daily.
• Results: Dispositional rumination and high average levels of NA predicted slow recovery in transient NA levels across peak and current assessment time, b=.07 and b=.50, respectively (ps<.001 ). Tendencies to ruminate after the sad film clip were associated with faster reductions in NA levels across the peak and current assessments time points (b=-.20, p<.01). However, this effect was moderated by a three-way interaction with trait rumination and participants' average levels of NA across the measurement period (b=.003, p<.01). Specifically, the use of spontaneous ruminative responses following the film clip predicted faster recovery from peak levels of NA among those with low dispositional ruminative tendencies when they experienced high average levels of NA.
• Conclusion: Our findings suggest that state rumination predicts more enduring distress as a function of an individual's disposition to ruminate and average distress in daily life. This suggests that maladaptive nature of ruminating on ones emotions is contextual. This finding is consistent with results showing that rumination can be adaptive in the form of reflection as opposed to maladaptive in the form of brooding. Clinical implications are discussed. 

*Ghose, S., Petrochic, K., & Yaroslavsky, I. (2018, April). Health-related quality of life, emotion regulation, and inflammatory bowel disease. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Inflammatory Bowel Disease (IBD) is a term that encapsulates gastrointestinal diseases that are chronic, pervasive, and have the potential to adversely impact individual functioning across several life domains (social, biological, occupational). Health related quality of life (HRQOL) pertains to an individual's perception of their disease-related day-to-day functioning in the social, biological, and occupational life domains. Those who view their levels of functioning as impaired by their IBD have an increased risk to experience worsened disease severity. It is important to identify tools that individuals, despite level of daily functioning, can utilize in order to decrease or maintain their disease statuses. Emotion Regulation (ER) may be one such tool that an individual can utilize to ameliorate distress and potentially buffer the potentially harmful effects of perceived HRQOL on IBD severity. The present study investigates the relationships between perceived HRQOL, ER, and self-reported IBD severity.
• Methods: Participants were 30 adults (90.6% female, M_age= 43, SD= 13.27) recruited nationally via ResearchMatch who completed measures of health related functioning (Shortened Inflammatory Bowel Disease Questionnaire), Emotion Regulation Strategy Utilization (Feelings and Me), and IBD symptom severity (Harvey Bradshaw Index) as part of their involvement in a larger study on IBD and emotion regulation.
• Results: While maladaptive ER was unrelated to disease severity, adaptive ER evidenced significantly lowered disease severity (B=-.25, p=.005).  It was further evidenced that as perceived HRQOL improved, disease severity significantly decreased (B=-.54, p=.001). Most notably, adaptive ER surfaced as a moderator in the relationship between HRQOL and disease severity (B=.04, p<.05).
• Conclusion: These findings support the use of ER as a tool for individuals with IBD to use to decrease or maintain disease severity. More importantly, this study points to the potential for ER to be considered not only effective in decreasing disease severity, but a tool with utility independent of individual characteristics. Clarifying such modifiable tools to decrease symptom expression in those with IBD could inform future research on the implications of adaptive ER not only for IBD, but for other chronic diseases as well.

*Ghose, S., Petrochic, K., & Yaroslavsky, I. (2018, April). The effect of emotion Health-related quality of life, emotion regulation, and inflammatory bowel disease. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: It is readily established that individuals with Inflammatory Bowel Disease (IBD) experience internalizing conditions, such as depression and anxiety, at significantly higher rates than controls (Irvine, 2004). In fact, disease expression/symptoms is associated with increased experience of depression and vice versa (Danesh et. al, 2015). Emotion regulation (ER) is a self-regulatory tool that individuals can utilize in response to disease-related stressors, such as IBD flares, or periods of active symptom expression. ER can be adaptive, helpful in ameliorating distress, or maladaptive, helpful in the short term but causing potentially harmful health related consequences in the long term (Gross 1998, 2002). Individuals with IBD have been shown to utilize maladaptive ER strategies at a significantly high rate (Danesh et. al, 2015). Depression levels can be inflated both during times of active disease expression and in response to maladaptive ER strategy utilization. As this is the case, the present study investigates the relationships between disease severity, ER, and depression levels among individuals with IBD.
• Methods: Participants were 30 adults (90.6% female, M_age= 43, SD= 13.27) recruited nationally via ResearchMatch who completed measures of depression (CES-D), Emotion Regulation Strategy Utilization (Feelings and Me), and IBD symptom severity (Harvey Bradshaw Index) as part of their involvement in a study on IBD and emotion regulation. Age was utilized as a covariate in multiple hierarchical regression analysis, conducted via SPSS version 24.
• Results: While adaptive ER was unrelated to depression levels, it was evidenced that increased disease severity significantly indicated an increase in depression levels (B=1.13, p<.05). Further, when maladaptive ER was added to the multiple regression model in Block II, it was discovered that the relationship between disease severity and depression levels was no longer significant, providing for a total mediation by maladaptive ER specifically (B=.997, p<.05).
• Conclusion: These findings support the adverse effects that maladaptive ER strategy utilization can have on an individual's depression levels regardless of disease severity. As individuals with IBD are indeed reported to engage in higher levels of maladaptive ER than controls, these findings further indicate the utility of increased psychoeducation on coping skills within this population. In fact, as maladaptive ER was shown to be associated with increased depression levels despite IBD severity, there is a chance that this research can inform further investigation into the relationship between maladaptive ER and depression in individuals with other chronic diseases..

*Bush, A., Scamaldo, K., & Yaroslavsky, I. (2018, April). Emotion regulation mediates the effects of abuse on stress-depression dynamics. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction:  Many studies show that sexual and physical abuse during early development is a risk factor for a number of adjustment problems in adulthood, including depression. Such abuse has been shown to increase sensitivity to life event stress, whereby those with abuse histories experience the adverse emotional effects of stressors more keenly than their non-abused peers.  Therefore, abuse may reflect a diathesis by which stress increases depression risk. A growing body of work also suggests that abuse may be linked to emotion regulation (ER) deficits in the form of reduced access to adaptive responses that downregulate distress (adaptive ER), and overabundant repertoires of responses that exacerbate it (maladaptive ER). In turn, ER deficits have been shown to exacerbate the effects of stress on affective outcomes. However, it remains unclear whether ER deficits are one mechanism by which those with abuse histories experience more adverse effects of stress than their peers. The present study examines these associations in a sample of adults with various histories of physical and sexual abuse.   We hypothesized that ER deficits in the form of low adaptive ER repertoires and high maladaptive ER repertoires will mediate the iatrogenic effect of abuse histories on the association between stress and depression symptoms.  
• Methods: Participants were 151 undergraduate students and community dwelling adults (65.6% female, M_age 26.88, SD = 11.545) who completed ER, perceived stress, and depression measures, as well as a psychosocial interview during which physical and sexual abuse histories were ascertained.
• Results:  Abuse histories moderated the effect of stress on depression (b=2.91, p<.05): stress predicted depression severity at higher levels for those with abuse histories. This effect was mediated by maladaptive ER whereby abuse histories were associated with higher levels of maladaptive ER (b=5.31, p<.01), which, in turn, exacerbated the adverse effects of stress (b=5.66, p <.05).  While abuse predicted lower levels of adaptive ER, adaptive ER was unrelated to the experience of stress.
• Discussion: Our findings suggest that maladaptive ER is a key mechanism by which abuse histories exude their adverse effects. Implications of these findings include that the presence of maladaptive ER responses should be assessed as part of early prevention efforts among those with abuse histories, and that reducing maladaptive ER repertoires should be considered a key target of treatment.  Notably, our findings also suggest that adaptive ER repertoires may be less important treatment targets than maladaptive ER responses for those with abuse histories. 

*Rupani, N., Ghose, S., & Yaroslavsky, I. (2018, April). The relationship between emotion regulation, trait anxiety, and IBD severity. Poster presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: According to current literature, many patients with IBD, or inflammatory bowel disease, experience comorbid psychological disorders, particularly depression and anxiety (Kurina, Goldacre, Yeates, & Gill, 2001; Kovacs & Kovacs, 2007) . Some studies suggest that anxiety disorders may be risk factors for IBD, and might exacerbate the condition (Bannaga & Selinger, 2015; Sareen, Cox, Clara, & Asmundson, 2005). Emotion regulation (ER) reflects processes that modify the experience of distress, and constitutes responses that effectively reach the desired goal (adaptive) or paradoxically maintain or exacerbate distress (maladaptive). However, the effects of ER may be influenced by emotional states, whereby high levels of distress may reduce the effectiveness of adaptive responses, and potentiate the effects of maladaptive responses. Trait anxiety reflects stable individual tendencies to attend to and experience anxious emotions that engender distress. The current study examined the effect of adaptive and maladaptive ER on IBD severity, and the moderating role of trait anxiety on these associations.  
• Methods: Participants were 26 adults (92.3% female, Mage = 42.65, SD = 13.39) who completed surveys regarding their maladaptive and adaptive emotion regulation mechanisms (Feelings and Me), anxiety-related cognitions and tendencies (State-Trait Anxiety Inventory), and the extent of their disease activity (Harvey Bradshaw Index, or HBI). These surveys were part of a larger study examining emotion regulation in the context of IBD.
• Results: Hierarchical linear regressions revealed that IBD severity was associated with low adaptive emotion regulation (B = -0.29, p < 0.01), but was otherwise not related to trait anxiety or maladaptive emotion regulation repertoires. Anxiety did not moderate the effects of adaptive or maladaptive emotion regulation responses on IBD severity.
• Conclusion: These findings seem to indicate that adaptive emotion regulation can be an important tool in reducing the severity of symptoms in patients with IBD, regardless of their preexisting levels of trait anxiety. An interesting finding was that maladaptive emotion regulation did not affect disease activity; this could potentially be because any comorbid psychological disorders may be confounding factors when determining the specific impact of maladaptive emotion regulation on disease activity. The implications of this suggest that improving adaptive emotion regulation might decrease overall disease activity.

Borderline Personality Disorder

*Napolitano, S., Scamaldo, K., & Yaroslavsky, I. (2018, April). Impaired attentional processes predict current depressive symptomology. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Problem: Major Depressive Disorder (MDD) is a highly debilitating mental health condition with biological, psychological, and physiological substrates. Contemporary models of depression point to impaired disengagement from negative stimuli as one mechanism by which MDD risk increases. One physiological mechanism for attentional "switching" may be respiratory sinus arrhythmia (RSA), a parasympathetic marker of stress responses. However, the relationship between attentional deficits, parasympathetic reactivity, and depressive symptoms remains unclear. Specifically, while the literature posits that the relationship between cognitive and behavioral indices of attention and MDD may be physiologically mediated, the directionality and depth of these relationships have yet to be established. The present study examined self-report, cognitive, and experimental behavioral indices of attention as they relate to current depressive symptoms via PNS activity.
• Procedure: Community dwelling adults (N=46, 56% female, Mage=26.37, SD = 11.86, current cMDD= 5, rMDD=18, HC=19) completed a measure of dispositional rumination (Ruminative Response Scale-Brooding Subscale), an attention task where they were asked to engage and disengage attention from emotional-neutral face pairs (happy and sad expressions), and an experimental protocol during which they were induced into a negative mood by watching a sad film clip. Affect ratings (on a 10-pt Likert scale ranging from very upset to very happy) were collected at baseline and following mood induction. Measures of PNS reactivity were indexed via RSA at baseline (bRSA) and change after sad film (dRSA).
• Results: Generalized linear models revealed that both history of depression (b=-4.46, p< .001) and dRSA³ (b=-1.35, p< .001) predicted lower levels of brooding rumination, whereby low levels of bRSA predicted significantly more brooding relative to moderate bRSA levels. Surprisingly, high bRSA predicted significantly lower brooding after the sad film. Next, lower bRSA predicted slower disengagement from sad faces (b=28.15, p< .05), while disengagement from sad faces (b=.05, p< .001) and depression history (b=10.90, p< .01) predicted higher current depression symptoms. Above and beyond depression history, levels of brooding (b=1.10, p<.05) predicted current depression symptoms.
• Conclusions:  Results suggest that a history of depression predicts greater levels of brooding rumination and higher levels of current depression symptoms. Furthermore, resting RSA and RSA reactivity appear to predict longer engagement with sad stimuli. Together, this impaired disengagement from negative stimuli predicts higher current depressive symptoms, above and beyond depression history. These findings further support the integrative role of cognitive, physiological, and behavioral indices in predicting depressive symptomology.

*Scamaldo, K., Napolitano, S., & Yaroslavsky, I. (2018, April). Negative and Positive Affectivity Distinguishes Depression from Borderline Personality Disorder. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Problem: Depression and Borderline Personality Disorder (BPD) are highly comorbid, with as many as 38% of individuals with BPD reporting symptoms of depression or a depressive episode, and as many as 48% of people with depression reporting a diagnosis of BPD. These high rates of co-occurrence may illustrate a shared dispositional vulnerability in the form of high negative affectivity. However, the role of positive affectivity, which has traditionally been viewed as depression-specific risk factor, is not known. The present study aimed to test whether low positive affectivity reflects a specific risk factor for depression among individuals at low and elevated levels of BPD features. We examined the unique effects of depression and BPD across dispositional, state, and reactivity indices of positive (PA) and negative affect (NA) to accommodate the tendency for those with BPD to over-report their symptoms and distress levels on retrospective measures. 
• Procedure: Eighty-three (N=83) community dwelling adults (67% female, Mage=31.01, SD=12.99) completed measures of BPD (Personality Assessment Inventory-Borderline Subscale), depression (Center for Epidemiological Studies Depression Scale), dispositional PA and NA (Positive Affect and Negative Affect Schedule), and affect ratings of PA and NA at baseline and in response to two film clips that engendered sadness ("The Champ") and happiness ("Wall-E"). Reactivity in each affect domain reflects the difference between post-film and baseline levels.
• Results: Multivariate and repeated measures analyses suggested that independent of BPD symptoms, depression symptoms were associated with higher levels of NA and lower levels of PA across dispositional (bNA=.28, bPA=-.41, ps<.001) and state measures (bNA=.08, bPA=-.06, p < .05), while BPD was uniquely linked to elevated dispositional NA (b= .30, p <.001). Interestingly, while both depression levels and BPD symptoms predicted attenuated affect reactivity to the sad film clip, these results fell below significance levels when symptoms of both disorders were examined simultaneously.
• Conclusions: Results suggest that positive affectivity may the key to differentiate depression from BPD. At trait levels, depressive symptoms are related to blunted positive affect and enhanced negative affect, where BPD symptoms are related to only elevated negative affect. Relatedly, state affect ratings remain stable when depressive symptoms are present, but not when BPD symptoms are present. These findings are significant because they suggest that blunted positive affect is stable across trait and state measures and is likely domain-specific to depression.

*Scamaldo, K., Napolitano, S., & Yaroslavsky, I. (2018, April). Borderline Personality Disorder Symptoms Uniquely Predict Substance Use in Daily Life. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Problem: Borderline personality disorder is characterized by enduring negative affective states, and a tendency to engage in risky behaviors like substance use. Research suggests that those with BPD are more likely to experience substance abuse than  individuals without a personality disorder. While there are many plausible reasons why BPD is tied to substance use, one explanation may be that those with BPD use substances at higher rates in effort to regulate their distress. Recent findings suggest that a subset of substance abusers use drugs as a means of regulating their emotions. However, the role of substance use as an ER response among those with BPD has been studied using cross-sectional and retrospective self-report methods. Therefore, it remains unclear whether those with BPD are more likely to use substances when distressed in their daily lives. The present study explores whether symptoms BPD features predict daily life substance use during times of distress, and whether this relationship is influenced by distress levels. 
• Procedure: Community dwelling adults (N=74, 67% female, Mage= 28.82, SD = 10.95) completed a measure of BPD (Personality Assessment Inventory-Borderline Personality Disorder subscale) and coping strategies (Brief COPE—Substance Use), throughout a 7-day ecological momentary assessment protocol. During this time, hourly peak NA (sad, upset, angry, frustrated, stressed affects) and emotion regulation response (alcohol and drug use) to distress were measured 5 times daily. Substance use (tobacco, drugs, and alcohol) was recorded on 77 occasions of the 1167 measured observations. Peak NA was person mean centered, thereby accounting for momentary affective fluctuations over the measurement period.
• Results: Independent of age and sex, BPD symptoms significantly predicted substance use as a dispositional coping strategy (B=.41, p<.001). BPD symptoms also predicted a greater likelihood to engage in substance use to resolve peak negative affect in daily life (OR=1.05, p<.001) and moderated the effect of increased negative affect relative to participants' average levels over the measurement period (b=.002, p<.01). Substance use among those with high BPD symptoms was unaffected by momentary changes in their NA levels (OR=.99) as compared to those with low BPD symptoms for whom increasing distress reduced their risk for substance use (OR=.94).
• Conclusions: These findings suggest that those with elevated BPD symptoms are at risk for engaging in substance use during times of distress, even when their distress levels are relatively low. Intervention efforts should consider targeting substance use as a main area of treatment for those with elevated BPD symptoms. 

*Napolitano, S., Scamaldo, K., & Yaroslavsky, I. (2018, April). Borderline personality disorder predicts impaired emotion regulation in daily life. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Problem: Borderline Personality Disorder (BPD) is characterized by emotion regulation (ER) difficulties wherein these individuals engage in ineffective ER responses (maladaptive ER) and experience difficulty deploying strategies that resolve their negative mood states in the short- and long-term. However, most work that examines ER deficits in BPD has relied on cross-sectional or retrospective self-report methods. Therefore, it remains unclear whether BPD is associated with the selection of maladaptive ER responses, the insufficient use of adaptive ER responses, or the failure of adaptive responses to resolve distress. The present study aims to elucidate the relationship between BPD and the selection and consequence of ER deployment in the daily lives of participants with elevated BPD features.
• Procedure: Community dwelling adults (N=79, 65% female, Mage=30.78, SD=1.44) completed a measure of BPD (Personality Assessment Inventory-Borderline) and a 7-day Ecological Momentary Assessment protocol. During this protocol, current and hourly peak NA (sad, nervous, upset, angry, frustrated, stressed affects) was collected 5 times daily, along with the use of adaptive (reappraisal, problem-solving, distraction, and interpersonal interaction) and maladaptive (rumination and suppression) ER strategies during peak NA. Mixed-effects models were used to examine the probability of deploying given ER responses as a function of BPD features, with affective outcomes measured by sustained NA across peak and current periods.
• Results: Our results showed that elevated BPD features were associated with a lower use of problem solving during times of peak distress (OR=.97, p<.05). Interestingly, those with elevated BPD were less likely to ruminate when experiencing increased momentary NA relative to their average weekly NA levels (OR=.92) relative to those with low BPD features (OR=.87). Regarding affective outcomes, those with elevated BPD features benefited less when deploying problem solving responses (b=.02, p<.05) and experienced more enduring NA when deploying rumination (b=.05, p<.05) as compared to those with low BPD features.
• Conclusions: Findings indicate that individuals with BPD symptoms may face difficulty in utilizing ER strategies to lower feelings of distress. Specifically, when individuals attempt to use a more adaptive strategy, like problem solving, the outcome may be sustained negative affect. Moreover, the effect of rumination appears to be particularly potent in this population, whereby these individuals may not choose to ruminate more, but if they do, they feel much worse for a greater length of time. These findings are clinically relevant as they illustrate that maladaptive strategies are particularly pernicious and adaptive strategies may not be as helpful as expected.

*Tokar, T., Oravec, K., Bolla, P., & Yaroslavsky, I. (2018, April). A pupilometry study of stress reactivity and borderline personality disorder. Poster presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Borderline Personality Disorder (BPD) is characterized by unstable mood states, chaotic interpersonal relationships, and behavioral dysregulation in the form of self-injurious acts that results in notable functional impairment (APA, 2013). Emotion dysregulation, marked by strong shifts in emotional states away from baseline levels across subjective and physiological substrates, is believed to reflect one mechanism in the relationship between BPD and functional impairment (Terzi et al., 2017). However, it remains unclear whether emotion dysregulation represents a general tendency to experience both positive and negative emotions keenly, or to specifically be sensitized to negative mood states. Indeed, those with elevated BPD symptoms report reacting strongly to both positively and negatively valanced stimuli, and to be apprehensive about feeling strong emotions (Pfaltz et al., 2015).  The present study examines whether BPD symptoms are linked to SNS hyper-arousal, measured via pupillometry, while participants recalled positive (happy memory) and negative life events (stressful memory).
• Methods: Community-dwelling adults (N=22, 27% male, M age = 37.95 , SD = 15.25) completed clinical and life event stress interviews, questionnaire batteries, and an experimental protocol during which their pupil dilation was measured. During the structured clinical interview (SCID) participants identified neutral, stressful, and positive events that they clearly remembered and that occurred during the 3 months prior to their participation in this study. Participants were presented with event-specific cues and recalled details of these events while their pupil sizes were measured. Dilation measurement was captured using the Tobii X3-120 eye tracking system, pupil metrics reflect the maximum pupil size in millimeters during the first 15 seconds of neutral, stressful, and happy memory recall. 
• Results: BPD symptoms predicted a trend for different pupil dilation levels across the three memory tasks, F (2, 40) = 3.09, p = .056. Planned contrasts revealed that elevated BPD symptoms predicted increased pupil dilation in response to the stressful memory, F(1, 20) = 6.11, p < .05, but not the positive memory, F(1, 20) = 1.41, p = .25.
• Conclusion: These results suggest that emotion dysregulation among those with elevated BPD symptoms is specific to negative emotional states, rather than a general tendency to experience emotions strongly.  Thus, BPD may not be a disorder of emotion dysregulation per se, but a condition marked by dysregulation of the negative information/valence system. While BPD is associated with a general fear of emotional experiences, therapeutic goals may best be served by focusing specifically on negative emotions.  

*Oravec, K., Napolitano, S., Tokar, Z., & Yaroslavsky, I. (2018, April). Rumination predicts distress via borderline personality disorder in daily life. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Borderline Personality Disorder (BPD) is linked to protracted negative affect, which may be explained, in part, by emotion regulation responses that maintaining negative information in conscious awareness. Rumination is one process that maintains such information through moody pondering about one's sadness (depressive rumination) and about interpersonal sleights (anger rumination) that is associated with elevated BPD features. A growing literature suggests that rumination is linked to difficulties disengaging from negative information, although much of this work is theoretical. Further, it remains unclear whether the relationship between attention disengagement and rumination varies as a function of rumination's content, as sadness is an emotion that is linked to avoidance motivations, while anger is associated with approach motivations.  The present study examined the relationship between the capacity to behaviorally disengage from negative stimuli, dispositional anger and depressive rumination, and distress in daily lives of those with various levels of BPD symptoms. 
• Method: Community dwelling adults (N=33, 70% female, Mage=32, SD=15.75) completed measures of trait depressive and anger rumination (Ruminative Response Scale & Anger Rumination Scale), an attention disengagement task that involved participants viewing and shifting between pairs of neutral and negatively valanced faces. Participants then completed a seven-day ecological momentary assessment protocol (EMA) during which momentary and peak-hourly negative affect ratings (that included sad, upset, nervous, angry, frustrated, and stress affects) were ascertained up to 5 times daily.
• Results: Elevated BPD symptoms were linked to faster attentional shifts away from the negatively valanced faces at a trend level (b=-1.44, p = .09), and predicted high levels of trait anger (b=.51, p < .01) and depressive rumination (b=.59, p< .01). Depressive rumination then, in turn, predicted more enduring negative affect in participants daily lives (b=.07, p < .05). Longer disengaging times from negative information also predicted protracted negative affect (b=.009, p < .05).
• Conclusion: Our results suggest that difficulty disengaging from negative information and depressive rumination, rather than anger rumination, maintained distress for those with elevated BPD features. These findings implicate that dysregulated attention processes, particularly those linked to sadness, are key mechanisms in emotional disturbances experienced by those with BPD.   

*Oravec, K., Tokar, Z., Bolla, P., & Yaroslavsky, I. (2018, April). Impaired disengagement predicts emotion dysreguation in borderline personality disorder in daily life. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Borderline Personality Disorder (BPD) is characterized by emotion dysregulation in the form of strong emotional reactions that are slow to return to baseline levels. Theory and empirical evidence point to autonomic nervous system processes, particularly those of the sympathetic branch, are involved in emotion dysregulation. However, the mechanism by which sympathetic activity is associated with emotion dysregulation is not known. Inflexible attention may be one means by which sympathetic hyper-arousal leads to emotion dysregulated. Indeed, empirical works tie sympathetic activity to attention processes, although this association has yet to be studies among those with BPD features. Further, studies that examine SNS activity in BPD often employ negative mood induction procedures using stimuli that are not personally-meaningful, thereby attenuating the expected physiological responses. The present study examined whether sympathetic hyper arousal and attention inflexibility mediate the effects of BPD symptom on emotion dysregulation in the form of negative affectivity in response to an autobiographical interpersonal stressor.
• Method: Community dwelling adults (N=37, 62% female, Mage=34.11, SD=16.39) completed clinical and life event stress interviews, measures of BPD symptoms, and an experimental protocol that induced negative mood by recalling neutral and stressful autobiographical memories. Participants also completed a visual attention-switching task that involved flexibly allocating attention towards and away neutral and negative valanced faces. Sympathetic arousal was indexed via changes in maximum pupillary responses while recalling the neutral and stressful autobiographical memory. 
• Results: Elevated BPD symptoms predicted a strong sympathetic response as indexed via increased maximum pupil dilation in response to the stressful memory (b=0.01, p < .05). Further, an elevated pupillary response evidenced a curvilinear relationship with attention flexibility (b= 42.16, p < .01) and distress following the stressful autobiographical memory task (b=9.63, p <.05): low and high pupillary responses were associated with longer disengagement times from sad to neutral faces, as well as high levels of distress following the stressful memory recall procedure.
• Conclusion: Our findings highlight the role the sympathetic nervous system in attention processes and emotion dysregulation among those with elevated BPD symptoms. These findings are significant because they point to optimal physiological arousal as key state that is impaired in BPD. The downstream effects of aberrant sympathetic arousal on key processes that support emotion regulation suggests that future studies should consider physiological dysregulation as a mechanism of BPD risk. 

Cultural Differences in Emotion Depression and Anxiety (Internalizing) Disorders

*Lee, N. H., Agarwal, A., & Yaroslavsky, I. (2018, April). Self compassion, emotion dysregulation, and depression among Southeast Asian and American.  Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Dysregulated emotional states are a known risk factor for depressive disorders. Such difficulties manifest as failures to maintain goal-directed behaviors, poor impulse control, emotional non-acceptance, and failure to deploy emotion regulation responses that are appropriate to context when faced with dysphoric affect. A growing literature shows that self-compassion is a strong protective factor for depression, which may act by reducing emotion dysregulation. Self-compassion is an emotion regulation process of mindfully accepting one-self by reducing self-criticism and examining one's experience from a broader perspective. The values behind self-compassion are based on Southeast Asian cultural teachings, and are the norm, unlike Western culture. A small but growing body of work suggest that self-compassion outcomes may differ across those of Southeast Asian and US backgrounds, given that self-criticism is a key factor among those who lack self-compassion. In Asian cultures, it is well-accepted cultural norm that self-criticism is an opportunity for social self-improvement to work harmoniously in social-settings. However, the effect of cultural background on the relationship between self-compassion, emotion dysregulation, and depression remains largely unknown. The current study tested whether the relationship between self-compassion, difficulties in emotion regulation and depression differ between Southeast Asian and Caucasian backgrounds.
• Procedure: Participants (N= 267 students; n= 177 Caucasian; 71% female, Mage = 21.40 years, SD = 5.07) were presented with a letter of consent and completed a series of questionnaires that included those measuring self-compassion (Self-Compassion Scale, SCS), depression (Center for Epidemiologic Studies Depression Scale, CESD), and emotion dysregulation (Difficulties in Emotion Regulation Scale, DERS).
• Results: Self-compassion and race explained a significant amount of variance in depression, F(2, 271)=44.72, p < 0.001, R2 =0.24), whereby those of Southeast Asian background reported higher levels of depression symptoms (β = 0.12, p < 0.05), and self-compassion predicted low levels of depression (β = -0.49, p < 0.001). Importantly, low self-compassion levels predicted higher depression symptoms among Southeast Asians relative to their Caucaisan peers (β = -0.23, p < 0.05). While self-compassion predicted emotion dysregulation (β = -0.63, p < 0.001), which in turn predicted depression symptoms (β = 0.49, p < .001), culture did not moderate either association. 
• Conclusions: The strong adverse effects of low self-compassion levels for those of Southeast Asian backgrounds suggests that diverging from one's culture-based emotion regulation norms may be a pernicious risk factor for depression. Notably, emotion dysregulation appears to be a common pathway for elevated depression risk across cultures. Limitations and future research directions will be discussed.

*Lee, N. H., Agarwal, A., & Yaroslavsky, I. (2018, April). Relationship between attachment style and depression in South Asian and American. Paper presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction:  Attachment styles develop during childhood and reflect working models of oneself in relation to others. Secure and insecure attachment styles are commonly studies forms of attachment; secure attachment reflects a healthy working model of interpersonal relationships, while insecure attachment is characterized by fear of rejection (anxious attachment) or the discomfort with emotional closeness (avoidant attachment). Anxious and avoidant attachment styles are associated with unhealthy relationships and are risk factors for depression. As the US becomes increasingly diverse, there is increased interest in the impact of culture on these two styles. Much of the work on culture and attachment styles has focused on individuals of South Asian backgrounds, with evidence pointing to elevated levels of anxious and avoidant attachment styles among members of this group relative to their Western peers. However, there is evidence that these styles are culturally normative, as "helicopter parenting" is common in families from South Asian cultures, and is associated with the development of insecure attachment. If insecure attachment is a normative style among those of South Asian backgrounds, its adverse effects on depression may not hold for this cultural group. Therefore, we examined whether the relationship between anxious and avoidant attachment styles and depression differs across those of South Asian and Western backgrounds.
• Procedure:  One-hundred and ninety-two college participants (n=41 South Asian, M age= 21.79, SD= 5.13, 85% female) were presented with a letter of consent and completed a series of questionnaires that included measures of attachment style (Relationship Scale Questionnaire, RSQ) and depression symptoms (Center for Epidemiological Studies Depression Scale, CES-D).
• Results:  Those of South Asian backgrounds did not differ significantly in their levels of depression nor their attachments styles. However, when examined together, having a South Asian background (β= .19, p < .05), anxious attachment (β = .51, p < .001) and avoidant attachment (β = .22, p < .05) predicted elevated depression symptoms. Importantly, cultural moderated the effect of anxious attachment (β = .14, p = .06) on depression. Specifically, those of South Asian background experienced higher levels of depression as a function of anxious attachment relative to their Caucasian peers.
• Conclusions: While our findings imply that anxious attachment is a risk factor for depression among those of South Asian backgrounds, this effect was found among those residing outside of their culture of origin. Future works should consider cultural background along with current cultural context when examining attachment style and depression risk.

*Agarwal, A., Lee, N. H., & Yaroslavsky, I. (2018, April). Attachment style predicting depression in South East Asians and Caucasians. Poster presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Attachment style is idea of developing relationships and attachments to other people. Evidence has proven that the type of attachment style, particularly insecure, leads to depression. The amount of insecure attachment style, however, differs based on individualistic or collectivistic cultures. Individualistic cultures such as Western maintain a secure attachment style by focusing on independency while collectivistic cultures such as Eastern end up relying on insecure attachment style due to the lack of independency. Literature review explains that insecure attachment style is linked to an increase in depression but little research has been observed across ethnic groups to explain the relationship between attachment and depression among people of Eastern backgrounds. Our research will focus on anxious and avoidant attachment styles, two types of insecure attachment on Eastern cultural groups, specifically South East Asian. We examine that among South East Asian individuals, depression rate will be higher than among Caucasian individuals due to their lack of secure attachment style.
• Procedure: One-hundred and ninety two college participants (n= 98 Caucasian) were recruited from Houston, Texas. The participants (M age= 21.33, SD= 4.83)  were presented with an informed consent and completed online questionnaires about attachment styles.The participants completed the Relationship Scale Questionnaire (RSQ) and a measure for depression, Center for Epidemiological Studies Depression Scale (CES-D). We defined South East Asian culture in this study as all the individuals belonging to the Chinese, Vietnamese, and Japanese race.
• Results: The results indicated that anxious attachment style, avoidant attachment style, and race combined were significant predicators for depression, F(5, 192)=16.84, p< .001. The variance for all these variables together was 30%. Individually, anxious attachment (β= .51, p< .001) and avoidant attachment (β= .22, p< .001) were significant predicators for depression. Race was unrelated to both attachment styles and depression symptoms.  
• Conclusion: The study found that South East Asians exhibited higher levels of depression than Caucasians when it came to high and low levels of anxious attachment style.This indicates that at high and low levels of anxious attachment, South East Asians are less protected against depression than Caucasians. Depression is also higher for South East Asians at high and low levels of avoidance as compared to Caucasians. Again, indicating that South East Asian are much less protected against depression than Caucasians when it comes to avoidance attachment style.

*Agarwal, A., Lee, N. H., & Yaroslavsky, I. (2018, April). Self compassion, emotion dysregulation, and depression among South Asians. Poster presented at the 90th annual meeting of the Midwestern Psychological Association, Chicago, IL.

• Introduction: Self-compassion (SC) reflects the tendency to treat oneself with kindness and acceptance when facing difficulties. Increasing evidence shows that SC protects against depression and may have emotion regulation (ER) benefits in the form of reduced difficulty engaging in goal-directed behaviors, less impulsive behavior, greater emotional clarity, and perceived ER effectiveness. This is important as ER difficulties are a well-known risk-factor for depression.Recent evidence suggests that SC is impacted by culture, whereby those of Indian (South Asian) backgrounds evidence lower SC levels than their Western peers. However, it is unknown whether the relationship between SC, emotion regulation difficulties and depression vary as a function of culture. Clarify the role of culture in these relationships is important as the US is becoming more diverse, particularly with those hailing from South Asian backgrounds. We examine whether culture, defined as identifying as South Asian versus Caucasian, moderates the relationships between the SC, emotion regulation deficits, and depression symptoms.
• Procedure: One hundred and twenty seven students (n=114 Caucasian, 77% female, M age= 22.09 years, SD= 5.46) were presented with a letter of consent and completed a series of questionnaires that included measures of self-compassion (Self-Compassion Scale), emotion regulation difficulties (Difficulties in Emotion Regulation Scale), and depression symptoms (Center for Epidemiological Studies Depression Scale, CES-D).
• Results: Analyses revealed that sex, age, self-compassion, and race explained a significant amount of variance in emotion regulation difficulties, F(4,122)= 33.32, p< 0.001, R-squared = .52, Self-compassion  = -0.69, p< 0.001, race  = 0.13, p< 0.05. These variables also accounted for a significant amount of variance in depression symptoms, F(4,109)= 5.49, p< 0.001, although self-compassion was the sole predictor to reach a level of significance ( = -0.38, p< 0.001). Importantly, emotion regulation difficulties significantly mediated the effects of SC on depression symptoms (  = 0.67, p< 0.001). However, culture did not moderate the effects of self-compassion on either for difficulties in emotion regulation or depression.
• Conclusion: Culture did not moderate the effects of self-compassion on difficulties in emotion regulation or depression. This suggest that self-compassion is a protective factor for those of South Asian and Caucasian backgrounds. Therefore, efforts to increase self-compassion within therapeutic settings may prove effective in reducing depression risk for those of varied cultural backgrounds.