Emotion differentiation (ED), the extent to which same-valenced emotions are experienced as distinct, is considered a valuable ability in various contexts owing to the essential affect-related ...information it provides. This information can help individuals understand and regulate their emotional and motivational states. In this study, we sought to examine the extent to which ED can be beneficial in psychotherapy context and specifically for predicting treatment response. Thirty-two prospective patients with mood and anxiety disorders completed four daily assessments of negative and positive emotions for 30 days before receiving cognitive-behavioral treatment. Depression, stress, and anxiety symptoms severity were assessed pre- and post-treatment using self-reports and clinical interviews. We conducted a series of hierarchical regression models in which symptoms change scores were predicted by ED while adjusting for the mean and variability. We found that negative ED was associated with greater self-reported treatment response (except for anxiety) when negative emotional variability (EV) was included in the models. Probing negative ED and EV’s interactive effects suggested that negative ED was associated with greater treatment response (except for anxiety) for individuals with lower EV levels. Results were obtained while controlling for mean negative affect. Our findings suggest that negative ED can benefit psychotherapy patients whose negative emotions are relatively less variable. We discuss the meaning of suppression and interactive effects between affect dynamics and consider possible clinical implications.
To analyze the perception of gynecologic examination from the patients' point of view.
This anonymous electronic cross-sectional survey aimed to evaluate the subjective experiences of women during ...gynecologic examinations (levels of pain, embarrassment and trauma), the manner the examination was conducted, and women's suggestions for improving their experience.
Overall, 6,508 women answered the survey. The examination was considered an embarrassing event by 47%, painful by 35% and traumatic by 19%. Importantly, only 43% of the respondents stated they would notify the gynecologist in case of physical discomfort or pain during the examination. The quality of physician-to-patient communication was rated as the most important aspect of gynecologic examination, and showed a significant association with the general quality of the experience (levels of pain, embarrassment, and trauma). Matters relating to women's privacy during gynecologic examination were also considered important. An option for a companion was rated as important by 64% of the respondents. Significant differences with large effect-sizes were found between the respondents' preferences and their reports of the observed situation.
The findings highlight the need for establishing guidelines for gynecologic examinations, according to a patient-centered care approach. This study constitutes a first discourse on the subject of gynecologic examinations in Israel in order to provide an overview and initial insights, serving as a starting point for further specific and more in-depth research.
Emotion differentiation, the extent to which same-valenced emotions are experienced as distinct, has been found to be associated with various positive outcomes. However, little is known about its ...role in relational contexts. The present work examines couples in the transition to parenthood, a particularly emotionally demanding period, and explores the associations between emotion differentiation and both concurrent (3-month post-partum) and prospective (6-month post-partum) relationship quality adjusting for pre-partum relationship quality. Both negative emotion differentiation (NED) and positive emotion differentiation (PED) were computed from daily affect ratings completed over 21 days by both partners in 88 couples. They were then examined as predictors of relationship quality (relationship satisfaction and perceived partner responsiveness) using actor–partner interdependence models. NED was found to be concurrently associated with elevated perceived partner responsiveness for one’s self and for one’s partner, and with elevated relationship satisfaction when the partner’s NED was low. Positive emotion differentiation was found to be concurrently associated with relationship satisfaction for one’s self and one’s partner. Prospectively, partner NED and partner PED were associated with greater relationship satisfaction. The findings suggest that NED may function as a compensatory or shared dyadic resource, and that PED, whose effects in previous studies have been mixed, may also be constructive. Individuals undergoing emotionally demanding periods (such as the transition to parenthood) may benefit from developing more nuanced emotional experiences.
We sought to explore the daily association between shame and self-criticism, and the extent to which this association varies as a function of social anxiety symptoms. Fifty-nine undergraduate ...students completed a measure of social anxiety symptoms at a baseline meeting and then completed measures of shame experienced during significant social interactions and self-criticism following those interactions twice daily for 10 days. Social anxiety symptoms predicted more shame during daily social interactions and more self-criticism following them. Additionally, shame predicted subsequent self-criticism. This relationship was moderated by levels of social anxiety symptoms, such that those with higher levels of social anxiety symptoms exhibited high levels of self-criticism following daily social interactions characterized by both high and low shame, whereas those with lower levels of social anxiety symptoms showed high levels of self-criticism only after interactions with high levels of shame. These findings are consistent with the notion that self-criticism may serve as a regulatory coping method when experiencing shame, and that social anxiety difficulties are related to an inflexibly high level of self-criticism.
We propose a transdiagnostic approach that centers on modes, state-like manifestations of personality that function as cohesive organizational units. Modes are characterized by specific profiles of ...affects, behaviors, cognitions, and desires that tend to be coactivated. Each mode is typically experienced as having its own distinct experiential and agentic qualities. A mode-based approach to psychopathology builds on recent analytic and methodological developments which demonstrate the value of modeling personality states dynamically, as well as on longstanding theoretical and empirical traditions that highlight the pragmatic clinical utility of such conceptualizations. We seek to illustrate how the conceptualization of psychopathology in terms of modes and their dynamic interrelations holds considerable transdiagnostic promise. As background, we review both theory and research from philosophical accounts of selfhood, developmental psychology, social and personality psychology, and diverse psychotherapy models that lay the foundation for this mode-based approach to psychopathology. We elaborate on this foundation and (in Section 1 of our online supplemental materials) provide examples of the approach's explicit or implicit relevance to several classes of psychopathology, including dissociative, trauma-related, mood, anxiety, obsessional, substance, psychotic, and personality disorders. After addressing the clinical utility of mode-based conceptualizations, we lay out a research blueprint for assessing and modeling modes, and (in Section 2 of the online supplemental materials) present a broader research agenda highlighting intriguing empirical questions regarding modes in psychopathology. We conclude by noting that the time seems ripe for modes to be (re-)introduced as an organizing construct for understanding psychopathology and personality.
General Scientific Summary
We put forward the notion of "modes"-cohesive, experientially distinct, state-like manifestation of personality characterized by specific profiles of affects, behaviors, cognitions, and desires-that can serve as an organizing framework for psychopathology. We review long-standing theoretical and empirical traditions which lay the foundation for this concept, as well as recent analytic and methodological developments which allow us to draft a blueprint for assessing and modeling such modes.
Therapists' ability to accurately assess their clients' emotions is a critical clinical skill across various therapeutic approaches. However, little is understood about the contexts that facilitate ...or interfere with the effects of this accuracy on therapeutic outcomes. This study investigated the relationship between therapists' empathic accuracy (EA) concerning their clients' emotions and session outcomes, and whether this relationship is moderated by the therapists' use of different intervention types. A sample of 81 clients treated by 50 therapists in a university setting was used for the study. Following each session, clients rated the emotions they experienced during the session, as well as the quality of the session, while therapists rated their perception of their clients' emotions. Findings revealed that therapists' EA for negative emotions (but not positive ones) positively correlated with higher client evaluations of the session. Furthermore, the frequency of exploratory interventions (but not directive ones) moderated this relationship. The results highlight that merely being empathically accurate in assessing clients' negative emotions may not be sufficient; therapists who employ an exploratory approach while being empathically accurate can better facilitate emotional processing, potentially leading to improved outcomes.
Public Significance Statement
This study highlights that therapists who employ an exploratory approach while being empathically accurate in assessing clients' negative emotions may achieve enhanced therapy outcomes.
Empathic accuracy (EA; Ickes & Hodges, 2013) is the extent to which people accurately perceive their peers' thoughts, feelings, and other inner mental states. EA has particularly interested ...researchers in the context of romantic couples. Reviews of the literature suggest a possible link between romantic partners' EA and their relationship satisfaction (Ickes & Simpson, 2001; Sillars & Scott, 1983). To assess the magnitude of this association and examine possible moderators, we performed a meta-analytic review of 21 studies (total N = 2,739 participants) that examined the association between EA and satisfaction. We limited our review to studies measuring EA using the dyadic interaction paradigm (Ickes, Stinson, Bissonnette, & Garcia, 1990). We found a small but significant association between the two (r = .134, p < .05). Subsequent moderation analyses demonstrated that EA for negative emotions (one's accuracy when assessing a partner's negative emotions) was more closely related to satisfaction (r = .171, p < .05) than EA for positive ones (r = .068, p > .1). The association was also stronger in relationships of moderate length, suggesting that EA may be more meaningful when relationships are consolidating but before they become stable. Gender and procedural variations on the dyadic interaction paradigm did not moderate the association, and there was no difference depending on whether the association was between EA and perceivers' or targets' satisfaction (i.e., actor or partner effects). We discuss the implications of these findings and offer recommendations for future EA studies.
When we are accurate regarding our partners' negative moods, are we seen as more responsive (and do we see them as such) as a function of the presence/absence of conflict? In 2 daily diary studies, ...empathic accuracy (EA) was assessed by comparing targets' daily negative moods with perceivers' inferences of these moods. We hypothesized that conflict will be associated with reductions in perceived partner responsiveness (PPR) for both parties; that on no-conflict days, EA will be positively associated with both parties' PPR; that on conflict days, this positive association will be stronger for targets but will become negative for perceivers; and that regardless of conflict, overestimation (vs. underestimation) of negative moods will be tied with higher PPR for targets but with lower PPR for perceivers. Thirty-six (Sample 1) and 77 (Sample 2) committed couples completed daily diaries (for 21 or 35 days, respectively). We utilized multilevel polynomial regression with response surface analyses, a sophisticated approach for studying multisource data of this sort (Edwards & Parry, 1993). Results partially supported our hypotheses: conflict was tied to reduced PPR; on no-conflict days, EA was not consistently predictive of target or perceiver PPR; on conflict days, EA predicted increased target PPR but decreased perceiver PPR; finally, overestimation predicted increased target PPR on no-conflict days and decreased perceiver PPR regardless of conflict. These results highlight the double-edged effects of EA on conflict days, and the importance of investigating dyadic EA in a context-sensitive approach.
Shared experience - i.e. commonality in inner states such as feelings, beliefs, or concerns - plays an important role in establishing and maintaining close relationships. Emotional Similarity (ES) ...can be thought of as one type of shared experience, but the exact role it plays in our responses to specific contexts (objects, events, circumstances) is not well understood. We sought to examine the day-level context-dependent roles of romantic partners' ES. We hypothesised that relational events (i.e. conflict and sexual activity) occurring on days with high ES would be more consequential. Two samples (N = 44, N = 80) of committed couples completed daily diaries for three and five weeks, respectively. Each evening, partners reported their currently-felt moods, relationship quality, and the occurrence of conflict and/or sex in the preceding 24 h. ES was operationalised as the profile similarity between the partners' moods on each day. Generally, ES moderated the associations between conflict or sex and relational outcomes: on days marked by greater ES, conflict and sex had stronger negative/positive outcomes, respectively. These findings highlight the importance of considering ES on a momentary basis and suggest that it may function as an amplifier of charged relational events.
Objective: Therapists' empathic accuracy (EA) toward their clients' fluctuating emotions is a crucial clinical skill that underlies many therapeutic interventions. In contrast to the subjective ...components of empathy, limited empirical work has addressed EA or its effect on the outcomes of psychotherapy. Here, we differentiate between the components of EA (tracking accuracy, directional discrepancy) as well as the valence of the target emotions (positive vs. negative). We also investigated the relative contribution of cognitive and emotional processes to therapists' EA and examined the associations between EA and treatment outcomes. Method: The sample comprised 93 clients treated by 62 therapists in a university setting. Prior to each session, clients self-reported their symptoms. Following each session, clients rated their positive (PE) and negative (NE) emotions during the session and therapists rated their own emotions, as well as their assessment of their clients' emotions. Results: Therapists accurately tracked their clients' PE and NE and were more accurate for NE. Therapists tended to overestimate their clients' NE and underestimate their clients' PE. Therapists' emotions were associated with their clients' emotions (real similarity). Therapists' emotions were also associated with their assessments of their clients' emotions (assumed similarity). Therapists' own emotions partially mediated the association between clients' emotions and therapists' assessments. Therapists' inaccuracy in assessing their clients' PE was associated with higher reported symptoms in the next session. Conclusion: These findings help provide a better understanding of the specific characteristics associated with more EA and underscore the importance of EA in facilitating clients' emotional well-being.
What is the public health significance of this article?
The current findings highlight the importance of therapists' empathic accuracy regarding their clients' emotions. The findings advance the idea that both cognitive and emotional empathy contribute to therapists' ability to correctly assess their clients' emotions. The results point to the risk on the part of therapists to neglect clients' positive emotions and stress the importance of attending to these emotions.
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