Preclinical Alzheimer’s disease (AD) is associated with distressing neuropsychiatric symptoms (NPSs) that may accelerate progression toward dementia. Existing approaches probe the symptom-level domain-general or domain-specific neural correlates of NPSs. However, the field lacks process-oriented models of symptom emergence for targeted treatment. We propose one pathway for symptom emergence involving the disruption of emotion regulation (ER) systems by early AD pathology. AD pathology in the ventral anterior cingulate cortex-ventromedial prefrontal cortex disrupts model-free ER that modulates negative valuations using experience-dependent reinforcement learning (e.g., fear extinction), leading to increased negative valuations and negative affect. We further propose that model-based ER competes for overtaxed executive resources and is less successful in preclinical AD, particularly in demanding real-world contexts. These changes lead to a shift toward negative affect, leading to divergent trajectories of NPSs depending on critical moderators. We discuss implications for intervention to improve NPSs and potentially slow dementia progression.

Introduction Mental health conditions are prevalent during adolescence, but access to early evidence-based treatments remains limited. Scalable, online, theory-based transdiagnostic interventions delivered in primary care have the potential to reduce this treatment gap, but the effectiveness remains unknown. The objective is to investigate whether an online transdiagnostic emotion regulation treatment for adolescents with mental health conditions is superior to an active control treatment. Methods and analysis This single-blind, randomised clinical superiority trial will evaluate the effectiveness and cost-effectiveness of an online transdiagnostic emotion regulation treatment for adolescents with mental health conditions within primary care in Sweden. We aim to include 388 participants (adolescents aged 12–17 years with mental health conditions and their parents), recruited through primary care and self-referral. Patients will be randomised to either an online transdiagnostic emotion regulation treatment or an active control treatment. Participants will receive 6 weeks of therapist-guided online transdiagnostic emotion regulation treatment or an active control treatment consisting of 6 weeks of online supportive treatment. Parents will participate in parallel with their adolescents in both conditions and will receive an online parent course. The primary outcome, assessed by blinded assessors, will be clinical global symptom severity measured with the Clinical Global Impressions-Severity scale. Treatment effectiveness will be evaluated through blinded assessment and self-assessment at primary endpoint (immediately after treatment) and 3 months after treatment. In addition, a health economic evaluation will be conducted. The study will be undertaken between October 2023 and July 2026. Ethics and dissemination The study has obtained ethical approval from the Swedish Ethical Review Authority. Findings will be disseminated in peer-reviewed publications and presented at scientific conferences. Trial registration number NCT06067165 .

Regret is a counterfactual emotion that arises when one judges that an outcome would have been better if one had acted differently. Classic accounts distinguish between commission regret (regretting an action) and omission regret (regretting an inaction). Here, we re-examine this distinction through the lens of attention and counterfactual salience. We find that externally highlighting subsets of options reliably increased omission and commission regret even after action. Increasing the size of the salient set attenuated regret intensity. When participants actively constructed their own consideration sets, the same patterns emerged. These findings suggest that commission--omission asymmetries may depend less on action versus inaction per se, and more on how attention shapes the space of salient counterfactuals, with implications for when regret might support adaptive learning or disrupt it.

Severe worry is a transdiagnostic syndrome associated with significant morbidity in older adults. In this study, we aim to infer worry-related mental states though brain activity timeseries. We acquired fMRI on two cohorts (N=116 and N=88), using an in-scanner worry induction and reappraisal task. We trained a recurrent long short-term memory (LSTM) neural network, using the first cohort as the train/validation and the second cohort as an independent test set. We predicted worry induction, reappraisal, and neutral states (area under the curve 0.89, 0.77, 0.91 for the test set and 0.78, 0.63, 0.81 for the independent set). The model was most accurate when participants reported high worry during the induction state. Dorsal attention network, and networks seeded on the anterior hippocampus, and supplementary motor area were most important for predicting worry states. The LSTM approach may have critical translational implications for identifying and treating severe worry in older adults.

People appraise situations in different ways, giving rise to affective responses that can be modified through reappraisal. It is not clear, however, whether effective reappraisal involves tailoring appraisals to situational demands—thereby expanding the number of appraisal profiles—or reusing particularly helpful appraisals across situations, thereby reducing the number of appraisal profiles. To address this question, we examined whether successful reappraisal relates to an expansion or a reduction in appraisal variability. In an online experiment (Sample A, N = 158) and a laboratory replication with facial electromyographic measurement (Sample B, N = 70), participants viewed and reappraised affective pictures and rated their subjective affect and appraisals along the dimensions of relevance, congruence, accountability, certainty, and controllability. We found that appraisal variability decreased during reappraisal, as indicated by a higher Gini index, and that the greater this reduction, the greater the reappraisal success, reflected in increased positive affect and decreased negative affect. Together, these results suggest that successful reappraisal involves a narrowing of appraisal profiles. This challenges the assumption that greater variability is always advantageous and highlights the need to better understand the mechanisms underlying this effect. Moreover, the findings underscore the value of examining discrete appraisal profiles and their variability for better understanding the cognitive mechanisms of reappraisal.

LGBTQ+ youth commonly have unmet mental health needs and are at elevated risk for self-harm, yet many face persistent institutional barriers to accessing support. One impactful way to reduce risk and promote wellbeing is by supporting emotion regulation; that is, the process by which individuals can influence which emotions they feel, when they feel them and how they experience or express these emotions. This universal, modifiable process is widely considered a key transdiagnostic target for mental ill-health prevention and intervention efforts. We conducted a randomized controlled trial using Purrble, a socially assistive robot designed to provide in-the-moment emotion regulation support through intuitive tactile interaction. Between 12 January and 1 September 2024, 153 LGBTQ+ youth with self-harm ideation were randomized 1:1 to receive Purrble and safety planning (Purrble + SP) or safety planning alone (SP-Only), stratified by gender identity (50.3% transgender/gender diverse). Data were collected over 13 weeks, with data collection closing on 22 October 2024. The primary outcome was perceived emotion regulation difficulties at follow-up, adjusted for baseline, gender identity and age. Participants allocated to the Purrble intervention reported fewer emotion regulation difficulties at follow-up than those allocated to safety planning alone (adjusted mean difference: -3.04; 95% confidence interval (CI): -4.92 to -1.16; P = 0.002; partial η2 = 0.07). For secondary outcomes, participants in the Purrble intervention also reported significantly lower symptoms of anxiety and depression, but no significant main effect was observed for self-harm. No serious Purrble-related adverse events were observed. Purrble may offer a scalable intervention to complement existing therapeutic approaches to support LGBTQ+ youth to enhance their emotion regulation. ClinicalTrials.gov: NCT06025942 .

Background: Successful emotion regulation is a critical component of psychological health. One of the most effective emotion regulation strategies, “cognitive reappraisal”, consists of adjusting the way a situation is perceived to alter its emotional response. Extant literature suggests that cognitive reappraisal is not only effective for reducing negative affect in subclinical populations but is also a component of clinical interventions like cognitive-behavioral therapies. Nonetheless, concerns have been raised about the efficacy of cognitive reappraisal in situations of high distress. We tested whether general emotional distress symptom severity and pre-emotion regulation distress moderates the efficacy of cognitive reappraisal (vs. expressive writing) in predicting post-regulation distress. Methods: We recruited a sample of adults (N=2,449), representative of the U.S. on age, sex assigned at birth, and race-ethnicity. After describing a recently upsetting event, participants were randomized to reappraisal or expressive writing conditions. Distress symptoms were measured with the K6 and pre- and post-regulation distress were measured with a 100-point visual analogue scale. Results: Higher levels of both pre-regulation distress and general emotional distress were positively associated with higher levels of post-emotion regulation distress. However, there was no interaction with condition and either distress variable in predicting post-regulation distress. Conclusion: Despite a large and representative sample, we did not find that cognitive reappraisal is less effective than a comparator when distress is elevated. These findings suggest that cognitive reappraisal may be efficacious even at heightened levels of distress.

Alexithymia is an important risk factor for psychopathology. However, it is not yet clear why. Here, we examine alexithymia's relationship with both ill-being and well-being outcomes and test whether emotion regulation patterns are a key mechanism explaining these links. Based on contemporary affective science frameworks, we predicted that people high (vs. low) in alexithymia would more frequently use maladaptive emotion regulation strategies that involve disengaging from negative emotions and less frequently use adaptive strategies that involve engaging with negative emotions. We also predicted that emotion regulation strategy choice should, in turn, statistically mediate relationships between alexithymia and ill- and well-being. We conducted two cross-sectional survey studies with mediation modeling, one exploratory (N = 427) and one preregistered (N = 600). In both studies, results indicated that (a) alexithymia is associated with higher ill-being and lower well-being, (b) alexithymia is associated with greater use of maladaptive disengagement emotion regulation strategies and less use of adaptive engagement strategies, and (c) the relationships between alexithymia and ill- and well-being outcomes are statistically partially explained by this profile of emotion regulation. Conceptually, these findings are well aligned with the attention-appraisal model of alexithymia and process model of emotion regulation, empirically supporting the claim that interactions between alexithymia and emotion regulation have important implications for people's ill-being and well-being. Clinically, these findings highlight the importance of targeting both alexithymia and emotion regulation patterns in treatment to help facilitate desirable affective outcomes. Our findings suggest that such work may help reduce ill-being and enhance well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Emotion regulation and memory control are indispensable for well-being, yet their interplay remains poorly understood. In this preregistered electroencephalogram (EEG) study, we investigated how emotion regulation influences the subsequent control of negative memories. Participants learned object-aversive scene pairings and were then instructed to either naturally watch or actively reappraise the aversive scenes. They subsequently completed an EEG-based Think/No-Think (TNT) task, where they either retrieved or suppressed the retrieval of aversive scenes in response to Think or No-Think object cues while reporting any intrusions they experienced. Different from our initial hypothesis, preregistered analyses showed that during retrieval suppression, reappraised memories were associated with larger centro-parietal P300 than watched scenes. Consistently, in the post-TNT recall test, participants recalled more details and reported lower negative emotions related to these reappraised scenes than the watched scenes. These results suggest that cognitive reappraisal may preserve the episodic content of negative memories while lessening their emotional impact during recall. This finding holds significant clinical potential, as it could enable individuals to retain valuable information from adverse experiences without being overwhelmed by distress. Additionally, it may help address reduced memory specificity in affective disorders, offering a promising avenue for therapeutic intervention.

Difficulties with emotion regulation (ER) have widely been associated with the development and persistence of poor mental health, such as depression, anxiety, self-harmful thoughts, behaviours, and suicide attempts. Despite the importance of ER as a transdiagnostic risk factor, few interventions directly target ER. The impact of one such intervention, Purrble (a socially assistive robot), was recently evaluated when compared to treatment-as-usual within a randomised controlled trial (RCT) with sexual orientation and gender identity minorities (LGBTQ+) youth who had self-harm experiences (Williams et al., 2026). However, while RCTs are well suited to evaluating effectiveness, they offer limited insight into how participants engage with, integrate, and perceive the value of interventions, like Purrble, in their everyday lives. Consequently, complementary qualitative process evaluation is needed to fully understand participants’ experiences and contextualise trial outcomes. Process evaluation interviews were used to explore and understand the engagement with and integration of the Purrble intervention, considering its perceived influence on ER, mental health, and self-harm experiences. Following their participation in the Purrble RCT, 40 LGBTQ+ young people (16-25 years) with current self-harm ideation took part in this qualitative process evaluation using semi-structured online interviews. Interviews explored participant expectations of the RCT and Purrble; engagement and appropriation of Purrble; and perceived impact to mental health and self-harm. Thematic analysis was used to develop a thematic framework. Four overarching themes were developed from the data. The first theme describes how participants used Purrble to ground themselves and manage distress, often preventing escalation to self-harm thoughts or behaviours. The second theme captures how Purrble was perceived as a companion or source of comfort, supporting self-soothing and self-care. The third theme highlights the role of accessibility and proximity, how the availability and location of Purrble during moments of distress influenced its perceived usefulness. The final theme examines circumstances in which participants chose not to engage with Purrble, offering insights into barriers to use and individual differences in engagement. This process evaluation demonstrates how Purrble can be a helpful intervention for those LGBTQ+ young people with experience of self-harm thoughts and behaviours. This evaluation also clarifies when Purrble may not be helpful. These qualitative findings offer important insights supporting the quantitative results of the related RCT.

Cross-national research on self-objectification remains notably limited. The present study investigated the associations between self-objectification, body surveillance, and body shame among women in Belgium (N = 239), the United Kingdom (N = 213), and the United States of America (N = 159) in Study 1, and in Belgium (N = 209), Israel (N = 299), and Thailand (N = 230) in Study 2. In Study 1, employing the Likert version of the Self-Objectification Questionnaire (LSOQ), we demonstrated that self-objectification indirectly predicts body shame through body surveillance in the case of Belgian, UK, and US women. In Study 2, we successfully replicated these indirect effects among Belgian, Israeli, and Thai women. This research stands as one of the first empirical, cross-national investigations of the improved self-objectification scale, evidencing the robust association between self-objectification, body surveillance, and body shame across countries.

Abstract Introduction Previous work suggests that ruminative thoughts, even when not sleep-related, are associated with more severe insomnia symptoms. However, few studies have examined whether interventions that target insomnia may also improve rumination over time. It remains untested whether improvements in insomnia severity resulting from CBTI are driving improvements in rumination. Likewise, it is unknown whether the link between higher rumination and insomnia is present at all assessed timepoints. Here we conducted a secondary analysis of a previous single-arm mechanistic CBTI trial (NCT04424407) to test the hypotheses that (1) CBTI would be associated with improvements in rumination, (2) improvements in rumination would be associated with improvements in insomnia, and (3) that these associations would persist after treatment. Methods Fifty individuals (age mean+/-SD = 40.36+/-10.95 years; 64% female; 48 completers), with co-occurring insomnia and depressive symptoms completed the insomnia severity index (ISI) and Ruminative Responses Scale-Short (RRS) before and after receiving 6-sessions of CBTI. Linear mixed effects models tested the impact of CBTI on rumination, longitudinal associations between ISI and RRS, and whether treatment moderated these associations. Linear regression tested associations between symptoms changes. Age and sex were included as covariates in all models. Results CBTI was associated with an improvement in rumination (b=-2.65, p=0.002) following treatment. Improvements in insomnia symptoms were not associated with changes in rumination (b=-0.04, p=0.85). Rumination and insomnia were not associated with each other overtime (b=0.05, p=0.74). Moderation analyses revealed that the associations were not different across timepoints (b=0.03, p=0.90): ISI and RRS were not associated at baseline nor post-treatment (|b’s|< 0.07, p’s>0.70). Conclusion CBTI was associated with improvement in rumination at post-treatment. However, counter to our hypotheses, insomnia and rumination symptoms were not associated. Limited variability in insomnia and rumination scores in our sample may be occluding our expected effects (i.e. all participants had insomnia/depression at study entry). These findings indicate that improvements in rumination following CBTI may not be due to changes in insomnia itself. Future studies should examine whether subcomponents of rumination, mood variability, or broader sleep health shape these relationships. Support (if any) R61MH120245 and R33MH120245

A baseline is necessary to define biological reactivity in psychophysiological research. However, the conceptualization and implementation of baseline measurements are often underdescribed and weakly justified. This poses a problem because poor baseline decisions have the potential to introduce noise, reduce comparability across studies, and bias interpretations of data. In this article, we focus on laboratory studies using cardiovascular measures to examine how baselines are described and used in affective psychophysiology. To describe heterogeneity in baseline procedures, Study 1 reviewed 310 psychophysiological studies and coded baseline activities, durations, analyzed intervals, and theoretical justifications. To examine within-baseline stabilization, Study 2 analyzed the POPANE dataset to assess minute-by-minute changes in cardiovascular activity in 1,010 participants during a standard 5-minute baseline. To test whether these patterns replicated and whether baseline estimates differed across sessions, Study 3 analyzed the CEPAV dataset in 300 participants across two separate laboratory visits. Finally, to assess generalizability across a larger and more heterogeneous sample, Study 4 replicated these analyses using compiled laboratory data from 2,395 participants. Across studies, results indicate that baseline procedures vary considerably, are often insufficiently reported, and may meaningfully impact the interpretation of cardiovascular data. Although different cardiovascular indices may stabilize differently during a 5-minute baseline, findings suggest that this procedure is a reasonable, pragmatic choice and that separate-session baselines should not be assumed to be superior. More broadly, findings highlight the need for stronger justification, standardization, and reporting of baseline procedures in psychophysiological research.

BackgroundIndividuals vary in their tendency to interpret emotionally ambiguous stimuli as relatively more positive or negative, a trait-like difference known as “valence bias.” To date, research on valence bias has relied upon two-alternative forced-choice (2AFC) valence decisions that conflate the presence of positivity with the absence of negativity, and vice versa. This is problematic because more frequent negative judgments of ambiguous stimuli (i.e., a more negative valence bias) could represent true negative appraisals of those stimuli, or a difficulty in identifying a positive appraisal.MethodsIn two preregistered studies, participants completed a standard 2AFC valence bias task (n = 100 and n = 508 in the respective studies) and provided separate positive and negative unipolar ratings of the same stimuli.ResultsThe 2AFC valence bias task captured independent effects of both positivity and negativity. Individuals with a more negative valence bias showed high endorsement of negativity and low endorsement of positivity; those with a more positive bias showed the opposite pattern. Individuals with a more positive valence bias also exhibited a stronger relationship between positive unipolar ratings and 2AFC categorization than individuals with a more negative valence bias, suggesting a greater sensitivity to positive appraisals. These results replicated in Study 2 in a larger, more diverse sample using unique stimulus sets.DiscussionDespite individual differences as a function of valence bias, ambiguous stimuli were endorsed as both positive and negative on unipolar scales, refuting claims that they might be “valence-free.” Collectively, these results demonstrated that multiple appraisals of ambiguity are recognized and weighted based on individual bias in valence processing during affective decision-making.

Adolescence is a period of biopsychosocial change, where some youth thrive while others develop stress-related difficulties, making it crucial to understand the processes that may contribute to poor mental health. This study examined adolescents’ emotion regulation (ER) repertoires and their associations with indicators of mental health, using data pooled across three waves of ecological momentary assessment (EMA), each spaced six months apart. The final sample included 292 adolescents (Mage = 12.55 years, SDage = 0.46; 41.48

Resting-state functional connectivity (rsFC) has shown widespread changes in intrinsic functional brain networks in individuals with chronic low back pain (CLBP). However, less is known about rsFC between task-evoked brain networks (i.e., networks formed by regions that are activated to tasks) implicated in cognitive reappraisal and attention regulation in this population. This cross-sectional study analyzed resting-state fMRI and behavioral data from a separate pain regulation task in 184 individuals with CLBP to investigate whether rsFC among ROIs defined from task-based meta-analyses of cognitive reappraisal and attention regulation networks was associated with pain regulation success. We hypothesized that increased rsFC within and between task-based networks would be associated with greater pain regulation success, and that trait cognitive reappraisal and mindfulness would mediate these relationships. Results indicated that increased rsFC between ROIs in the task-based cognitive reappraisal network, including the left ventrolateral prefrontal cortex (vlPFC) and left middle temporal gyrus (MTG), was associated with reduced pain regulation success using either cognitive reappraisal or attention regulation. Conversely, increased rsFC between ROIs in the task-based cognitive reappraisal network left vlFPC and attention regulation network right middle frontal gyrus (MFG) was associated with increased pain regulation success using attention regulation. Examining the relationship between rsFC and self-reported measures of pain, cognition, and emotion, we found that increased rsFC between the task-based cognitive reappraisal network left MTG and attention regulation network right inferior frontal gyrus (IFG) was associated with increased self-reported cognitive distortions. In contrast, increased rsFC between the task-based attention regulation network bilateral vlPFC and left posterior cingulate cortex (PCC) was associated with more habitual use of cognitive reappraisal, lower pain catastrophizing, and lower depression. In a formal mediation analysis, neither trait cognitive reappraisal nor trait mindfulness mediated the relationship between rsFC and pain regulation success. Together, our findings suggest that rsFC between brain regions in task-based cognitive reappraisal and attention regulation networks is related to behavioral outcomes in a separate evoked pain regulation task and may underlie cognition and emotion regulation success in individuals with CLBP.

Do LLMs have emotions? A recent paper from Anthropic reports finding internal representations of emotion concepts in Claude Sonnet 4.5, concluding that the LLM has 'functional emotions.' We evaluate this claim against what is known about how emotions actually function in biological systems. We argue that emotions serve two core functions: the context-sensitive interpretation of situations, and the reorganization of processing across multiple systems in response to those interpretations. The Anthropic findings offer partial support for the first function, though the consistent, discrete emotional representations identified in Claude sit uneasily with affective neuroscience findings that human emotion is characterized by variable rather than uniform neural signatures. On the second function, the evidence is mixed: Claude's representations modulate output without producing the dynamic reorganization of attention, decision speed, and motivational state that defines emotion in biological systems. We close by proposing what it would take for an LLM to have emotions.

Effective emotion regulation plays a critical role in mental health. Identifying factors that contribute to this ability could have clinical relevance. Two candidate factors are emotion recognition and emotional awareness. Specifically, if one does not recognize emotions in the self or others-and does not have a fine-grained understanding (trait awareness) of those emotions-it may be difficult to identify effective regulation strategies. Here, we tested whether individual differences in awareness moderate the association between recognition and regulation. Two independent samples of participants (Sample 1: N = 375, 72.8% female, 63.2% White [collected between 2018 and 2020]; Sample 2: N = 196, 67.3% female, 63.8% White [collected between 2020 and 2021]) completed a battery of commonly used self-report and performance-based (PB) measures of each construct. Self-report measures showed the expected pattern of significant positive associations; however, correlations between self-report and PB measures were largely absent. In both samples, two self-reported aspects of emotional awareness-greater emotion vocabulary and a better understanding of how emotions relate to bodily sensations-were significant moderators. In particular, they each strengthened the link between better self-focused emotion recognition (interoception, internal attention) and greater tendencies to use mindfulness-based regulation strategies. Novel positive associations were also observed between PB measures of each construct (e.g., tests of emotion recognition in faces/voices, emotion concept knowledge, and choice of regulation responses within hypothetical scenarios). However, hypothesized moderation patterns in PB measures could not be replicated. These results highlight new pathways and specific measurement approaches that might be utilized in future studies aiming to improve mental health and well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BACKGROUND:Across diverse populations, there is growing evidence that emotion regulation is central to healthy adaptation. Much is known about emotion regulation processes in typically developing populations, but comparatively very little is known about how these processes unfold in individuals with intellectual disability. METHODS:This integrative review advances understanding of emotion regulation in intellectual disability within a clinical framework. We first synthesize research on affective and behavioral functioning across the heterogeneous intellectual disability population. We then apply the process model of emotion regulation to examine how differences in cognition, language, and executive functioning shape regulation capacities. Particular attention is given to the distinction between self-focused strategies used by individuals to regulate their own emotions, and other-focused, interpersonal strategies (i.e. caregiver-mediated support), which may play a particularly critical role for individuals with intellectual disability across the lifespan. Finally, we discuss implications for clinical practice, including interventions for promoting healthy emotion regulation in intellectual disability within the process model framework and recommendations for family-centered approaches. CONCLUSIONS:By integrating empirical evidence with a widely used theoretical model, this review establishes a foundation for conceptualizing emotion regulation in intellectual disability and for improving interventions that support emotional well-being in this underserved population.