Unpacking Emotion Inflexibility and Prospective Prediction of Affective Disease

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PROJECT ABSTRACT/SUMMARY The prevalence of psychiatric disorders has reached nearly epidemic proportions. Rates of common affective diseases (unipolar depression, anxiety and stress disorders) are high across the lifespan and these diseases place a tremendous social and economic burden on the individual and society. Clear evidence indicates that most affective disorders emerge at the intersection of pre-existing vulnerability and significant, highly stressful, life-events. However, current models of emotion-related risk do not adequately account for this confluence of biological, historical, and situational factors. In this investigation, we build upon our prior work demonstrating broad associations between flexible emotion processing and psychological health and adjustment, and in-flexible emotion and psychological risk and affective disease. Specifically, we will recruit 400 adults in hospital following a potentially traumatic event (e.g., accident, violence, fire, etc.) in order to model the influence of early emotion processing on trajectories of adjustment. We focus our investigation on the super-ordinate construct of Emotion flexibility (EF) which encompasses the ability to generate or up-regulate emotions, as well as to shift or down-regulate emotions according to needs and/or environmental demands. EF is well-suited to inform models of emotion-related risk and adjustment as it characterizes an optimal balance of two biologically-based, constituent dimensions: “bottom-up” threat-related processing and “top-down” cognitive control increasingly recognized as central to all emotion processing. We propose rigorous methods to assess EF and related processing in-vivo in lab and via experience sampling. Moreover, we will follow participants to 18 months post event so as to effectively model the association between emotion processing and trajectories of adjustment, while also considering established influences such as physical health status, psychiatric history, childhood maltreatment, daily stress/hassles, and social support. In particular, we will incorporate recent developments in advanced statistical modelling to better characterize the complex and interactive influence of historical and contemporary factors on moment-level emotion processing, EF and adjustment. Broadly, this project is in line with the most recent NIMH strategic plan and will contribute to more complex models of the most common affective diseases, including facilitating the charting of illness trajectories to help determine when, where, and how to intervene. Moreover, this research will directly examine how variation in key systems can influence emotion-processing and adjustment to aversive life events, fitting complex influences more directly into models of risk for the most common and burdensome affective diseases.