A processing model of emotion regulation (PMER) was investigated by assessing the attachment system and the two types of emotion regulation strategies (adaptive and maladaptive) in undergraduate students (N = 307) at Georgia State University. The analysis of the data revealed an interesting set of findings: (a) attachment anxiety was a stronger indicator of whether people use adaptive or maladaptive emotion regulation strategies than was attachment avoidance; (b) self efficacy, and not cognitive inability to suppress unwanted thoughts, partially mediated the relationship between attachment anxiety and adaptive emotion regulation strategies; and (c) cognitive inability to suppress unwanted thoughts, and not self efficacy beliefs, partially mediated the relationship between attachment anxiety and maladaptive emotion regulation strategies. Overall, the findings provided substantial support for the PMER, and also have important implications for clinical interventions aimed at effective emotion regulation.

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<p> Background: There is strong evidence to suggest that emotional distress, particularly depression, is common in patients with heart failure (HF). Caregivers of patients with HF play a pivotal role in improving HF patient outcomes; however, these caregivers are at risk for caregiver burden and emotional distress. Objectives: The objectives of this study were to explore potential relationships among patient and caregiver emotional status, uncertainty and caregiver appraisal. For the purposes of this study, emotional distress is defined as the presence of symptoms of anxiety or depression. Methods: Using a longitudinal exploratory design, 48 HF patient-caregiver pairs were recruited. Patients and caregivers completed the Hospital Anxiety and Depression Scale, Mishel Uncertainty in Illness Scale (MUIS) and caregivers also completed the Caregiver Reaction Assessment at baseline, 2 months and 4 months. Results: Patients had advanced HF symptoms and were older than caregivers (mean age 72.6 years, 54% male versus mean age 58.4 years, 54% female). The majority of caregivers were spouses (58%) but many were adult children (42%). There were significant relationships between: a) HF patient and caregiver uncertainty, and b) caregiver emotional distress and caregiver burden. There were no significant relationships between: a) patient and caregiver symptoms of anxiety and depression, b) emotional distress and uncertainty, or c) patient emotional distress and caregiver burden. Over time, there was a trend for a decrease in: a) patient symptoms of depression, b) caregiver symptoms of anxiety, and c) patient and caregiver uncertainty. Conclusions: Contrary to findings in other studies, there was no significant relationship between symptoms of anxiety and depression in patients and their primary caregivers. There was no relationship between emotional distress and uncertainty; however, this is one of the first studies using the MUIS in HF patients and caregivers and further research with this tool is needed. Finally, this study supports findings from other studies suggesting a strong relationship between caregiver emotional distress and caregiver burden. </p> / Thesis / Doctor of Philosophy (PhD)

Within the last few decades, public opinion has greatly shaped the justice system to prevent "slippery slopes". This is most evident in the common law doctrine that restricts an alleged victim for recovering damages of emotional distress without notable physical manifestation in the eyes of a layperson—The Impact Doctrine. However, emotional distress is manifested in many psychological illnesses that do not require physical injury that are recognized as legitimate in psychology. This research explores the history of the rule and how it is inconsistent with not only areas of science; but also, other areas of the law. The purpose of this thesis is to explore alternatives to The Impact Doctrine. Through analysis of American common law, Florida common law, and British common law, it can be concluded that the British have found the best alternative to the rule that helps prevent "slippery slopes", while also bridging the gap between science and the law. By analyzing the LGBT (Lesbian, Gay, Bisexual, and Transgender) community and Civil Rights Actions, the LGBT community may bring a suit for emotional distress based upon a Civil Rights action.

The main purpose of this study was to determine the impact of depression and anxiety on mortality, CHD incidence, and quality-of-life in patients hospitalised for an acute myocardial infarction (MI). Questionnaires, including the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory were completed during hospitalisation by 288 MI patients, and four months and 12 months after discharge among survivors. Quality-of-life was assessed at both follow-up points using the Dartmouth COOP charts. Twenty-five (8.7%) patients died, 22 of cardiac causes, during the four month follow-up. Six further fatalities occurred between four and 12 months following MI. Symptoms of depression and anxiety did not predict either cardiac or all-cause mortality, or CHD incidence at either follow-up point. Indices of disease severity predicted both four month and 12 month mortality and CHD incidence. In a subset of seven patients who died prior to discharge, depressive symptoms did predict mortality, but the association did not withstand correction for severity of infarction. Multiple regression analyses revealed that baseline depression and state anxiety, as well as severity of infarction, predicted both four and 12 month quality-of-life. In addition, partner status and living alone also predicted four and 12 month quality-of-life, respectively. Attendance at rehabilitation was positively associated with quality-of-life at both four and 12 months, and negatively associated with 12 month CHD morbidity. In conclusion, depression and anxiety were not significant predictors of mortality, or CHD incidence, during the first year following MI but they were predictive of four and 12 month quality-of-life among survivors.

<p>Breast cancer is the most common type of cancer among women in the United States. Despite more women undergoing treatment and increased survival rates, many women continue to suffer from emotional distress and physical symptoms associated with treatments for breast cancer (e.g., surgery). To date, there has been limited research investigating the efficacy of psychosocial interventions for breast cancer patients during the surgical time frame. This randomized controlled pilot study examined the effect of a lovingkindness meditation intervention on key psychological and physical outcomes surrounding breast surgery. Sixty women undergoing surgery were randomly assigned to one of three treatment conditions at breast biopsy: 1) lovingkindness meditation, 2) music, 3) standard care. Assessments of emotional distress, physical symptoms, and positive psychosocial resources occurred prior to patients' biopsy, following their biopsy, one week after receipt of their biopsy results, and one week following breast surgery. Multilevel model analyses demonstrated that lovingkindness meditation significantly improved anxiety, pain, self-compassion, emotional suppression, mindfulness, social isolation, and heart rate levels over time compared to control conditions. These results support the efficacy of a brief lovingkindness meditation intervention for breast cancer patients during the surgical time frame. The implications of these findings on future research, theory, and policy are discussed.</p> / Dissertation

The primary aim of this thesis was to increase healthcare professionals’ understanding surrounding the emotional distress of paediatric oncology patients prior to reaching five-year survivorship status, to inform resource allocation and evidence-based clinical interventions. Paper 1 systematically reviewed the extant literature that has assessed the emotional distress severity of paediatric oncology patients who had not yet reached five-year survivorship status. Contradictory findings were evident from the 21 studies reviewed. These inconsistencies in findings were discussed in relation to methodological limitations present within the studies and the heterogeneous oncology and control groups studied. The review concluded that further multiple-centre studies, using appropriate self-report and parent-proxy standardised measures, and larger, representative samples comprising patients with CNS and non-CNS malignancies at differing points in their treatment journeys, are needed to identify demographic, illness and treatment variables that leave paediatric oncology patients vulnerable to emotional distress. The empirical paper presented in Paper 2 utilised a rigorous methodology to address this need, and additionally explored modifiable psychological risk factors for emotional distress in this population. 74 paediatric oncology patients (aged 12-18 years), who were within five years of treatment completion, completed self-report measures of emotional distress, self-concept and health related quality of life (HRQOL), whilst their parents provided background information regarding patients’ demographics, diagnoses and treatment protocols. 72 parents also provided ratings surrounding patients’ self-concepts and HRQOL. The mean emotional distress rating indicated that the sample was clinically distressed. Demographic, illness and treatment factors explained little variance in emotional distress, whilst global self-concept, global-generic and cancer-specific HRQOL were significant predictors. Provisional analyses indicated that experiencing pain, illness-related worries, communication difficulties and negative self-views in relation to maths abilities, parent relations and opposite-sex peer relations were specific risk factors in the sample studied. Patient- and parent-reports of patients’ self-concepts and HRQOL were highly consistent. These findings suggest that paediatric oncology patients would benefit from frequent routine screening for emotional distress to allow early identification and intervention. Furthermore, prevention-oriented interventions surrounding emotional distress, and indirect interventions targeting global self-concept and HRQOL could be beneficial. Paper 3 critically appraises the systematic review and empirical paper in terms of their methodologies and clinical contexts. It is acknowledged that some of the results are preliminary in nature and need replicating in larger samples. Nevertheless, this research was successful in exploring demographic, illness, treatment and psychological risk factors for emotional distress for paediatric oncology patients prior to reaching five-year survivorship status, providing guidance for future clinical interventions, and making suggestions for future studies, in terms of their aims and methodologies.

The present study investigated whether the presentation of severe psychological injury increased the perceived likelihood of sexual harassment and more plaintiff-friendly verdicts in a hostile environment sexual harassment claim. Four hundred thirty-two participants were presented with a case summary divided into five paragraphs. Within the fifth paragraph, participants were informed that the plaintiff suffered from different severity levels of psychological injury. Gender was monitored to ensure a proportional amount of males and females in each condition. Results indicated that the presentation of psychological injury in any form increased the likelihood of perceived sexual harassment and verdicts for the plaintiff. Participants believed that garden-variety injuries (i.e., embarrassment, humiliation) were more likely to occur from sexual harassment, and had a greater impact on their perceptions and liability determinations. These results suggest that participants may use the presentation of psychological injury as a heuristic that when present, favors the plaintiff. / Department of Psychological Science

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