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Emotional eating is a common behavioral phenomenon that involves eating in response to emotional impulses rather than physical hunger and is believed to be a form of affect regulation (Ball and Lee, 2002). While emotional eating occurs within the symptomatology of eating disorders it also occurs independently (Benett, Greene, and Schwartz-Barcott, 2012). Further, a pattern of emotional eating can lead to weight gain and the development of eating disorders (Grant and Boersma, 2005). Currently, research is limited in terms of smart practice treatment recommendations for emotional eating. In order to address this gap in research, the Delphi method was utilized in order to gain consensus from a panel of nine experts regarding treatment recommendation specific to emotional eating. These panelists identified 47 treatment interventions that will be discussed. / Master of Science

Traumatiska upplevelser som inte bearbetas kan ge somatiska symtom, i en del fall som uttryck för dissociation, så kallade somatoforma dissociationer. Patienter med dessa symtom söker sig till sjukvården där bristande kunskap om symtom på trauma kan fördröja adekvat behandling. Studiens syfte är undersöka traumainriktade terapeuters erfarenheter av arbete med patienter som har somatoforma dissociationer. Frågeställningarna är: Vilka upplevelser har psykoterapeuter av affektreglering och allians med traumatiserade patienter? Vilka symtom i form av somatoforma dissociationer ses hos patienterna? Hur kan man fånga upp traumarelaterad problematik inom sjukvården? Metoden är en kvalitativ undersökning i form av intervjuer med fem legitimerade psykoterapeuter som arbetar på traumamottagningar. Resultatet visar att somatiska symtom är vanliga hos traumatiserade patienter och att en del av symtomen kan betraktas vara somatoforma dissociationer. De somatiska symtomen kan ses som ett uttryck för obearbetade affekter och affektreglering är en väg till minskning av symtomen. I psykoterapin är tilliten en viktig del i alliansen. Slutsatser som kan dras är att somatoforma dissociationer kan behöva lyftas fram för att tydliggöra de somatiska uttryckens koppling till trauma. Inom sjukvården är det av vikt med ökad kunskap kring trauma så att patienten även får hjälp till affektreglering genom terapi och inte endast t ex fortsatt medicinsk behandling för somatiska och psykiska symtom. / Experiences of trauma that not are taken care of may give somatic symptoms, in some cases as signs of dissociation, so called somatoform dissociations. Patients with these symptoms search for help in the medical care where insufficient knowledge of trauma symptoms can delay adequate treatment. The aim of this study is to investigate therapists’ experiences of therapy with traumatized patients that have somatoform dissociations. The questions to be asked are: Which experiences do psychotherapists have of affect regulation and alliance with traumatized patients? Which symptoms do patients have that can be seen as somatoform dissociations? How can you be aware of trauma related problems in the medical care? The method is a qualitative approach based on interviews of five legitimated psychotherapists working with traumatized patients. The result shows that somatic symptoms are common in traumatized patients and that some symptoms can be seen as somatoform dissociations. The somatic symptoms can be seen as signs of unprocessed affects and affect regulation is a way to reduce the symptoms. In psychotherapy faith is an important part of the alliance. Derived conclusions are that somatoform dissociations need to be highlighted so that the link between somatic symptoms and dissociation can be clarified. In the medical care the knowledge of trauma is essential so that the patient also gets help with affect regulation and not only further medical treatment of somatic and psychological symptoms.

Expressive Writing (EW) involves asking participants to write emotionally about stressful life events and has been associated with improvements in psychological and physical health. The purpose of the current study was to extend previous work by examining the moderating and mediating role of emotion regulation within the EW intervention. Sixty participants who had experienced a traumatic event were recruited from the community and were assigned to an EW or control writing condition. Measures assessing emotion regulation and indices of psychological and physical health were administered at baseline and one month follow-up to determine changes in symptomatology. In comparison to control writing, EW led to significant improvements in depression, emotional clarity, and to a lesser degree emotional awareness. Although no other group differences were found, all participants demonstrated significant improvements in their symptoms of posttraumatic stress, reported physical health, overall emotion regulation abilities, their ability to accept their emotions, engage in goal directed behaviour when distressed, and access emotion regulation strategies they perceive as effective. No support was found for our moderation hypothesis. However, a significant moderation was discovered revealing that difficulties engaging in goal directed behaviour when distressed moderated improvements in posttraumatic stress symptoms. Specifically, control participants with this emotion regulation deficit demonstrated significantly poorer outcomes than control participants without this deficit; in comparison to the EW group participants who improved similarly on posttraumatic stress symptoms regardless of their level of difficulties at baseline engaging in goal directed behavour when distressed. Additionally, baseline emotion regulation abilities predicted improvements on psychological health (but not physical health) outcome measures for both groups. No support was found for our mediation hypothesis. Exploratory analyses revealed that the EW group demonstrated greater emotional arousal in response to their writing in sessions 1 and 2, but that by session 3 their arousal had significantly decreased and was equivalent to that of the control group, which showed no changes in arousal across sessions. No support was found for the moderating or mediating influence of arousal on outcome. Results will be discussed within a model of emotional expression and emotion regulation and compared to the existing EW literature.

Expressive Writing (EW) involves asking participants to write emotionally about stressful life events and has been associated with improvements in psychological and physical health. The purpose of the current study was to extend previous work by examining the moderating and mediating role of emotion regulation within the EW intervention. Sixty participants who had experienced a traumatic event were recruited from the community and were assigned to an EW or control writing condition. Measures assessing emotion regulation and indices of psychological and physical health were administered at baseline and one month follow-up to determine changes in symptomatology. In comparison to control writing, EW led to significant improvements in depression, emotional clarity, and to a lesser degree emotional awareness. Although no other group differences were found, all participants demonstrated significant improvements in their symptoms of posttraumatic stress, reported physical health, overall emotion regulation abilities, their ability to accept their emotions, engage in goal directed behaviour when distressed, and access emotion regulation strategies they perceive as effective. No support was found for our moderation hypothesis. However, a significant moderation was discovered revealing that difficulties engaging in goal directed behaviour when distressed moderated improvements in posttraumatic stress symptoms. Specifically, control participants with this emotion regulation deficit demonstrated significantly poorer outcomes than control participants without this deficit; in comparison to the EW group participants who improved similarly on posttraumatic stress symptoms regardless of their level of difficulties at baseline engaging in goal directed behavour when distressed. Additionally, baseline emotion regulation abilities predicted improvements on psychological health (but not physical health) outcome measures for both groups. No support was found for our mediation hypothesis. Exploratory analyses revealed that the EW group demonstrated greater emotional arousal in response to their writing in sessions 1 and 2, but that by session 3 their arousal had significantly decreased and was equivalent to that of the control group, which showed no changes in arousal across sessions. No support was found for the moderating or mediating influence of arousal on outcome. Results will be discussed within a model of emotional expression and emotion regulation and compared to the existing EW literature.

Research has suggested that affective states have critical effects on various cognitive processes and performance. Evidence from driving studies has also emphasized the importance of driver situation awareness (Endsley, 1995b) for driving performance and safety. However, to date, no research has investigated the relationship between affective effects and driver situation awareness. Two studies examined the relationship between a driver's affective states and situation awareness. In Experiment 1, 30 undergraduates drove in a simulator after either anger or neutral affect induction. Results suggested that an induced angry state can degrade driver situation awareness and driving performance more than the neutral state. Interestingly, the angry state did not influence participants' perceived workload. Experiment 2 explored the possibilities of using an "attention deployment" emotion regulation strategy as an intervention for mitigating angry effects on driving, via an adaptive speech-based system. 60 undergraduates drove the same scenario as in Experiment 1 after affect induction with different intervention conditions: anger with no sound; anger with the ER system: directive/ command style emotion regulation messages; anger with the SA system: suggestive/ notification style situation awareness prompts; or neutral with no sound. Results showed that both speech-based systems can not only enhance driver situation awareness and driving performance, but also reduce the anger level and perceived workload. Participants rated the ER system as more effective, but they rated the SA system as less annoying and less authoritative than the ER system. Based on the results of Experiment 2, regression models were constructed between a driver's affective states and driving performance, being mediated by situation awareness (full mediation for speeding and partial mediation for collision). These results allow researchers to construct a more detailed driver behavior model by showing how an affective state can influence driver situation awareness and performance. The practical implications of this research include the use of situation awareness prompts as a possible strategy for mitigating affective effects, for the design of an affect detection and mitigation system for drivers.

Research Doctorate - Doctor of Philosophy (Clinical Psychology) / Overgeneral autobiographical memory is thought to be a clinically meaningful phenomenon which is related to affect regulation, problem solving ability, and treatment outcome in clinical populations (see J. M. G. Williams et al., 2007, for review). Individuals with Borderline Personality Disorder (BPD) are thought to be particularly prone to developing an overgeneral style of memory due to their temperamental difficulties in controlling affect (J. M. G. Williams, 1996). However, research in this population has so far yielded inconsistent findings. In a series of three studies, this thesis addresses the question whether overgeneral memory is associated with BPD, as well as exploring the relationship between memory specificity, affect regulation, problem solving ability, and response to treatment in this population. Findings indicate that individuals with BPD display reduced autobiographical specificity relative to controls, however, this appears to be a reflection of differences in cognitive ability as IQ and education mediated the association between specificity and diagnosis. Reduced specificity was not associated with Borderline traits in a non-clinical sample. Results failed to confirm the hypothesis that autobiographical memory specificity would be related to affect regulation in individuals with BPD, although there was some indication that memory specificity is associated with reduced rates of deliberate self-harm. Specificity was related to problem solving performance in individuals with BPD, although this relationship did not extend to self-reported problem solving ability. Memory specificity also appeared to change significantly over the course of treatment in a year-long Dialectical Behavior Therapy program, however, there was little indication that change in memory specificity was associated with the observed improvement in symptomatology, affect regulation or problem solving ability. Lastly, an experimental study with university students found no relationship between memory specificity and affect dysregulation, although low specific students reported greater reductions in positive affect following a negative event than individuals with a specific style of autobiographical recall. The assimilation model is considered as a framework for conceptualising these results.

Qigong is a Chinese mind-body therapy that aims to, through the use of movements, relaxed breathing and relaxation/meditation, create a healthy flow of life force, qi, in the body, and consequently improve health. A growing number of Qigong studies report beneficial effects on health and well-being. However, little attention has fo-cused on the acute affective responses that accompany single sessions of Qigong ex-ercise. The aim of the present thesis was therefore to study affective reactions to Qigong exercise. In Study I, the effects of Qigong exercise on mood and anxiety were compared to a control group. Results showed partial support for the superiority of Qigong exercise compared to controls. In Study II, different lengths of session time were compared, resulting in similar affective benefits for the 30 and 60-minute ses-sions. In Study III, affective responses were also assessed during the session, using mean scores and individual responses. Results showed an increase toward greater Activated and Deactivated Pleasantness during the session, with the greatest changes at the end of the bout. The majority of individuals reported increased Pleasantness during the Qigong session. Expectations of positive outcomes were significantly as-sociated with only few affective responses. Responses to open-ended questions of af-fective experiences displayed affective reactions mostly toward greater Deactivated Pleasantness. This thesis contributes to a greater understanding of the limited area of Qigong-related affective responses. For the exercisers, Qigong is associated with a greater momentary emotional state. However, due to the highly select group of regu-lar Qigong exercisers, generalizing the results outside the sample population is lim-ited. Theories on active mechanisms in the Qigong-affect relationship, and results from studies of affective responses to similar activities, suggest that other groups of people would also benefit affectively from Qigong exercise. Given the many benefits of positive affect, Qigong exercise may also pose great promises for the enhancement of other areas related to health and well-being. This calls for additional studies.

The opponent process theory of emotion [Solomon, R.L., and Corbit, J.D. (1974). An opponent-process theory of motivation: I. Temporal dynamics of affect. Psychological Review, 81, 119-143.] predicts a temporary reversal of emotional valence during the recovery from emotional stimulation. We hypothesized that this affective contrast would be apparent in asymmetrical activity patterns in the frontal lobes, and would be more apparent for left frontally active individuals. The present study tested this prediction by examining EEG asymmetries during and after blocked presentations of aversive pictures selected from the International Affective Picture System (IAPS). 12 neutral images, 12 aversive images, and 24 neutral images were presented in blocks. Participants who were right frontally active at baseline did not show changes in EEG asymmetry while viewing aversive slides or after cessation. Participants left frontally active at baseline, however, exhibited greater relative left frontal activity after aversive stimulation than before stimulation. Asymmetrical activity patterns in the frontal lobes may relate to affect regulatory processes, including contrasting opponent after-reactions to aversive stimuli.

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