Anxiety and depression are prevalent and comorbid, and transdiagnostic models highlight emotional schemas and metacognitive beliefs as relevant to emotional distress. However, little is known about their interplay within a network or whether centrality differs by symptom severity. Treatment-seeking adults (N = 1459; Mage = 34.98; 62% female) completed the LESS-II, MCQ-30, BDI, and BAI. Networks were estimated using Gaussian graphical models with EBICglasso regularization. Centrality indices were examined, and networks were compared between participants with clinically significant symptom levels (n = 797) and those without (n = 662). Loss of Control, Negative Metacognitive Beliefs about Uncontrollability and Danger, Non-Acceptance of Feelings, and Low Expression showed the highest centrality. The strongest edges linked Loss of Control with Non-Acceptance of Feelings and Duration, and Negative Metacognitive Beliefs about Uncontrollability and Danger with Need for Control. Centrality differences indicated higher strength and expected influence for Anxiety and Low Consensus in the non-clinical group, and higher strength for Negative Metacognitive Beliefs about Uncontrollability and Danger in the same group. At the edge level, several differences emerged across groups, including a stronger Anxiety-Negative Metacognitive Beliefs about Uncontrollability and Danger association in the non-clinical group and stronger Loss of Control-Non-Acceptance of Feelings and Numbness-related links in the clinical group. Emotional schemas and metacognitive beliefs are closely connected within a network of emotional distress, although longitudinal research is needed to evaluate temporal dynamics.

BACKGROUND:Irrational beliefs, considered central cognitive vulnerabilities, are strongly associated with increased distress levels, impacting a broad range of psychological and physiological responses. While the association between irrational beliefs and mental disorders is well-established, fewer studies have explored their relationship with inflammation, which represents an immune-mediated process associated with a wide range of chronic conditions. Moreover, in rheumatologic diseases, inflammatory processes represent the primary mechanism underlying the development of characteristic symptoms. This study aims to examine the correlations between distinct types of irrational beliefs and specific biomarkers of inflammatory responses associated with rheumatic diseases. METHOD:The study included 49 participants diagnosed with various rheumatic diseases. Biomarkers assessed were erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The Attitudes and Beliefs Scale-Second Edition (ABS-II) was used for measuring the levels of irrational beliefs. RESULTS:ESR showed positive correlations with awfulizing and irrational beliefs related to comfort. No significant correlations were found with CRP. CONCLUSION:Highlighting significant associations between ESR and irrational beliefs, this research underscores the relationship between psychological factors and physical health in chronic medical conditions, such as rheumatic diseases. These findings offer a basis for future studies investigating the mechanisms linking irrational beliefs and inflammatory processes, further emphasizing the clinical relevance of addressing irrational beliefs in patient care.

Introduction: This study aimed to investigate the neural correlates of adopting rational versus irrational beliefs in response to emotionally stressful scenarios, utilizing functional magnetic resonance imaging (fMRI). Grounded in Rational Emotive Behavior Therapy (REBT), we explored how endorsing rational or irrational beliefs modulates brain activity while evaluating hypothetical stressful situations. Methods: Seventy-five participants (48 females, aged 19–35) were randomly assigned to a rational or irrational belief group. Participants underwent fMRI while imagining emotionally stressful scenarios and endorsing corresponding beliefs. Results: We found that a rational way of approaching a given emotionally stressful scenario was associated with significantly higher activity in the right cuneus, superior temporal gyrus, and insula compared to the irrational thinking group. Discussions: The current result suggests that participants adopting a rational approach toward the unpleasant scenarios were able to generate better mental representations of the scenes, likely because rational thinking allows for improved regulation of the unpleasant arousal that these emotionally stressful scenarios could trigger. Interventions targeting irrational beliefs and promoting rational thinking, such as REBT, promise to improve emotional functioning and facilitate a more adaptive approach to negative scenarios.

Insomnia Severity Index (ISI) is one of the most widely used screening instruments for chronic insomnia, yet limitations in prior studies leave aspects of its psychometric properties incomplete. This study aimed to validate the ISI and investigate its screening utility in a clinical and nonclinical Romanian sample (N = 326; Mage = 25.84). Results indicate good internal consistency (αT1 = .84, αT2 = .86) and good test-rest reliability (r = .82). ISI significantly correlates with depression (r = .69), anxiety (r = .52), self-esteem (r = -.42), and quality of sleep (r = .75), supporting its concurrent and convergent validity. Regression analyses confirm its predictive validity, based on neurologists' (β = .39) and clinicians' (β = .43) diagnostic ratings of chronic insomnia. A cutoff score of 13 is optimal for a good balance between sensitivity (.79) and specificity (.68). Confirmatory factor analysis supports a two-factor model. Moreover, measurement invariance analyses show that ISI functions equivalently across the clinical and nonclinical groups. Overall, ISI scores provide reliable and valid information for screening chronic insomnia in patients with or without other psychiatric and/or medical conditions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

IntroductionPrevious research highlighted the importance of investigating distinct protective factors that predict the experience of positive emotions during stressful situations, such as the COVID-19 pandemic. In this longitudinal study, we specifically focused on positive expectancies towards the future (optimism, response expectancy, and response hope) in relation to the experience of positive emotions during the COVID-19 pandemic. Our primary objectives were to identify the best predictors for experiencing short-term and long-term positive emotions and investigate their interrelationships.MethodsData from 271 participants (average age = 29.2 years, 84.7% female) were analyzed using four cross-lagged models.ResultsResults showed that response expectancy was the best predictor for experiencing positive emotions in the short term, while optimism was the best predictor for experiencing positive emotions in the long term. Additionally, through further exploratory analysis, multiple bidirectional relationships were identified between positive expectancies and positive emotions.DiscussionOur results highlight the significant role played by positive expectancies in predicting the experience of positive emotions. Specifically, dispositional optimism emerged as a stronger predictor of longer-term positive emotions, whereas response expectancy proved to be a better predictor of shorter-term positive emotions. Thus, interventions targeting positive expectancies have the potential to enhance emotional functioning in individuals during challenging situations like the COVID-19 pandemic. Response expectancy positively predicts positive emotions in the short term.Optimism positively predicts positive emotions in the long term.Response expectancy positively predicts optimism in the short and long term.Response expectancy positively predicts response hope in the short term.Response hope negatively predicts optimism in the short and long term.Positive emotions positively predict positive expectancies (response expectancy, response hope, and optimism) on short term.The discrepancy score negatively predicts positive emotions in the short term.The discrepancy score negatively predicts optimism in the short and long term.

IntroductionThis randomized controlled trial aimed to address a knowledge gap concerning the mechanisms responsible for the efficacy of gratitude interventions. Specifically, we investigated how various response expectancies (positive, ambiguous + negative, and no expectancy) impact the efficacy of the “counting blessings” intervention in influencing positive and negative emotions. Additionally, the study explores how optimism levels (high, medium, low) interact with these expectancies to influence intervention efficacy.MethodA total of 529 adult volunteers were recruited through social media and randomly assigned to one of three experimental conditions, Positive Condition (PC), Ambiguous + Negative Condition (ANC), No Expectancy Condition (NEC), using a Random Sequence Generator. Of these, 142 participants completed the seven-day counting blessings intervention, and 111 participated in a follow-up assessment 1 month later. Missing data were addressed using multiple imputation. The main outcomes were changes in positive and negative emotions, with moderation analysis assessing the interaction between optimism levels and response expectancies. The study adhered to the CONSORT guidelines.ResultsWhile no significant interaction was found between experimental conditions and time regarding emotional outcomes (p ˃ 0.05), moderation analysis revealed differential interactions between optimism levels and expectancies, particularly influencing positive emotions (p < 0.009). For participants with low optimism, positive emotions significantly increased from post-intervention to follow-up in the PC (t = −2.42, p < 0.016) and from pre-intervention to post-intervention in the ANC (t = 2.41, p < 0.018). Participants with medium optimism experienced an increase in positive emotions across all conditions from pre-intervention to follow-up and from post-intervention to follow-up (ps < 0.05). High optimism participants showed an increase in positive emotions from pre-intervention to follow-up and post-intervention to follow-up in the PC (t = 2.09, p < 0.038 and t = 3.06, p < 0.003) and NEC c (t = −2.76, p < 0.006 and t = 2.74, p < 0.007).ConclusionOur findings emphasize the effectiveness of a brief gratitude journal and underscore the nuanced role of response expectancy, especially in interaction with the initial level of optimism, in enhancing positive emotions. These results hold significance for both theoretical understanding and clinical applications.

The aim of the current study was to investigate whether the experience of insomnia symptoms per se and symptoms of insomnia due to stress are associated with an increased brain response to the presentation of emotional faces. In addition, we also examined whether the effect of these sleep difficulties on emotional reactivity at the brain level depends on the experience of emotion regulation (ER) difficulties. The current sample consisted of 37 individuals (20 females, 17 males) selected from a larger group of 120 respondents who completed a survey about sleep problems and ER difficulties. Our results indicate that the tendency to experience stress-related insomnia symptoms but not insomnia symptoms per se modulates brain responses to emotional facial expressions, especially in areas of the parietal cortex, insula, and surrounding opercular voxels. Furthermore, difficulties in ER might play an important role, as the effect of stress-related insomnia symptoms on most of these brain regions disappears when controlling for difficulties in ER. However, an effect in the insula was maintained during the presentation of angry faces, suggesting that stress-related insomnia symptoms may increase the brain response to anger in the insula relatively independent from difficulties in ER. These findings suggest that individuals affected by stress-related insomnia symptoms show an enhanced brain response when presented with emotional stimuli (either positive or negative) in brain areas associated with hyperarousal, which could represent a possible ER deficit in these individuals. Thus, interventions that focus on targeting ER difficulties might be effective in reducing the hyperarousal state in individuals affected by stress-related insomnia symptoms.

Background: Emotional disorders are the most prevalent mental health conditions affecting children and adolescents. Thus, it becomes essential to develop and test early intervention strategies that are accessible and attractive as therapeutic strategies and can effectively improve youth's emotional and psychobiological reactivity to distress. Methods: A randomized control trial compared the prevention effects of a newly-developed therapeutic game based on Rational Emotive Behavior Education, REThink, to those of a standard, face-to-face group Rational Emotive Behavior Education (REBE) and those of a waitlist. Out of 142 healthy children and adolescents who completed the intervention stage, 137 completed follow-up assessment measuring subjective anxiety and biological stress reactivity in an impromptu speech task. Results: No differences were found between groups at follow-up in terms of subjective state anxiety variations between baseline, anticipation, speech and recovery. In terms of the psychobiological index, results showed an increase in left asymmetry for the REThink group at post-test and follow-up compared to pre-intervention levels. The same trend was found for the WL group, but not for the REBE group. Conclusions: Preliminary results suggest that decreases in the biological reactivity can be maintained in the long run following a therapeutic video game for children and adolescents. Future research needs to clarify the adequate usage of the therapeutic videogames to bring significant improvements in the psychobiological functioning of the youths.

Although evidence-based interventions exist, estimates suggest that about 60% percent of children and adolescents with mental health disorders do not receive the treatment they need. In this context, one expanding strategy for increasing access to mental health care for children and adolescents is the use therapeutic, or serious, games. REThink is one such therapeutic game, developed to offer a CBT-based prevention that was documented in a controlled trial to develop psychological resilience in children and adolescents, aged between 10 and 16, helping them learn healthy strategies for coping with dysfunctional negative emotions such as anxiety, anger and depression. This study aims to test the effectiveness of the REThink therapeutic online video game in promoting emotional health in children and adolescents in a pilot study. Participants (N = 31), aged between 10 and 16 years, were recruited on a volunteer basis from a school. Emotional problems, irrational beliefs, negative automatic thoughts, rational beliefs, and problem solving abilities were assessed pre- and post-using the therapeutic game. We also measured participants' satisfaction with the game. Results obtained show improvements in terms of emotional problems of the youths, their irrational beliefs, negative automatic thoughts and high levels of intervention satisfaction. of this study are in support of the previous findings suggesting that the REThink online game can be a valuable tool for large-scale mental health efforts aimed at the prevention of emotional disorders in children and adolescents, in accordance with evidence-based prevention protocols.

Introduction: First episode-psychosis (FEP) represents a stressful/traumatic event for patients. To our knowledge, no study to date has investigated thought suppression involved in FEP in a Romanian population. Our objective was to investigate thought suppression occurring during FEP within primary psychotic disorders (PPD) and substance/medication induced psychotic disorders (SMIPD). Further, we examined the relationship between thought suppression and negative automatic thoughts within PPD and SMIPD. Methods: The study included 30 participants (17 females) with PPD and 25 participants (10 females) with SMIPD. Psychological scales were administered to assess psychotic symptoms and negative automatic thoughts, along a psychiatric clinical interview and a biochemical drug test. Results: Participants in the PPD group reported higher thought suppression compared to SMIPD group. For the PPD group, results showed a positive correlation between thought suppression and automatic thoughts. For the SMIPD group, results also showed a positive correlation between thought suppression and automatic thoughts. Conclusions: Patients with PPD rely more on thought suppression, as opposed to SMIPD patients. Thought suppression may be viewed as an unhealthy reaction to FEP, which is associated with the experience of negative automatic thoughts and might be especially problematic in patients with PPD. Cognitive behavioral therapy is recommended to decrease thought suppression and improve patients’ functioning.

BACKGROUND AND OBJECTIVES:Recent approaches suggest that emotion regulation (ER) abilities represent potential predictors of emotional response among youths navigating stressful situations. To test this, we investigated whether ER abilities predicted the subjective and physiological emotional response experienced by youths during a stressful situation.DESIGN:A cross-sectional design was employed.METHOD:One hundred and thirty-four youths completed measures of ER abilities (emotional awareness, anxiety sensitivity, emotional control) and were asked to deliver a speech while their anxiety, positive emotions, heart rate, and alpha asymmetry were collected at four time points: baseline, anticipation, speech, and post-recovery.RESULTS:Pearson r correlations showed that poor emotional control and awareness, as well as high anxiety sensitivity were related to greater anxiety and lower positive emotions experienced during the speech. Hierarchical multiple regressions also revealed that emotional control and emotional awareness predicted greater speech anxiety and lower positive emotions. Moreover, anxiety sensitivity was related to and predicted an increased heart rate experienced during speech.CONCLUSIONS:Findings suggest that difficulties in emotional awareness, anxiety sensitivity, and emotional control predict the emotional response experienced by youths during a stressful situation. Interventions delivered by clinicians/teachers that target ER difficulties may be effective in improving emotional functioning when navigating stressful situations.

The current study investigated the effects of an integrative CBT/REBT intervention on anxiety symptoms, negative emotions, irrational beliefs (IBs) and emotional stability in a sample of anxious medical students. In addition, we examined the role of IBs as a predictor of changes in anxiety symptoms, negative emotions, and emotional stability during the CBT/REBT intervention. A number of 60 medical students with moderate and high anxiety were included in the current study. Anxiety symptoms, negative emotions, IBs, and emotional stability were assessed pre- and post-intervention. Results revealed significant decreases in anxiety symptoms, negative emotions, and IBs after the intervention, as well as a significant increase in emotional stability. Also, when changes in specific IBs were simultaneously examined in relation to changes in anxiety symptoms, negative emotions, and emotional stability, the changes in Low Frustration Tolerance (LFT) were the only significant predictor of changes in emotional stability. Otherwise, only overall changes in IBs were significant predictors of changes in anxiety and negative emotions. Thus, current results indicate that CBT/REBT can be successfully applied to anxious medical students demonstrating beneficial effects on emotional and personality functioning by targeting IBs in general, and LFT in particular.

The current study aimed at investigating the effect of endorsing different beliefs about emotions (BAEs) on the emotional response and perceived control of emotions. Two hundred and fourteen individuals were randomly assigned to one of four groups. One group was instructed to endorse irrational BAEs, one rational BAEs, one to approach emotions with acceptance, and a control group received no specific instructions. Participants further watched an emotion-provoking film and applied the instructions assigned to their group while their negative emotions, skin conductance, respiratory rate, heart rate, negative meta-emotions, and perceived emotional control were assessed. Results showed that after the film clip, individuals endorsing irrational and rational BAEs showed significant decreases in negative emotions compared to the control group. However, individuals endorsing irrational BAEs reported more negative meta-emotions and poorer perceived emotional control. Further, after a recovery period, only individuals endorsing rational BAEs and those endorsing an acceptance-based approach showed significant decreases in negative emotions. No between-groups differences were observed on physiological measures. Thus, current results show that how individuals evaluate their emotions has important consequences for emotional functioning and instructing them to endorse rational BAEs might be beneficial when encountering emotional situations.

Research has highlighted that emotion regulation (ER) difficulties are common in individuals with emotional disorders (ED). However, most studies were limited to non-clinical (NC) samples and focused on specific strategies to control emotions. Also, few studies investigated these difficulties "in-the-moment". Thus, the current study aimed to investigate ER difficulties in individuals with ED that are usually neglected, such as difficulties in how they appraise their emotions (beliefs about emotions). Moreover, we examined the mediator role of irrational/dysfunctional beliefs about emotions in relation to the experience of negative meta-emotions and low perceived control of emotions. A number of 36 individuals with ED and 50 NC completed an emotion-provoking autobiographical recall task while their negative emotions, cardiac activity, beliefs about emotions, negative meta-emotions and perceived emotional control were assessed. Results indicated that compared to non-clinical controls, individuals with ED showed more irrational beliefs about emotions, more negative meta-emotions, and poorer perceived control of emotions. Also, our results showed that these irrational beliefs about emotions were further related to an increased level of negative meta-emotions and to a decreased perceived control of emotions. Finally, negative meta-emotions were differentially associated in the two groups with the control of heart rate by the two branches of the autonomous nervous system. Thus, individuals with ED may have difficulties in appraising emotions, which further expose them to maladjustment.

Introduction: Children and adolescents' ability to effectively identify and understand emotions is an important aspect of development that has been linked to a variety of beneficial outcomes (e.g., better mental health, social skills and academic performance; Sprung, Miinch, Harris, Ebesutani, & Hofmann, 2015). According to the binary model of distress (David, Montgomery, Macavei, & Bovbjerg, 2005), stemming from the Rational-Emotive Behavior Therapy/Coaching (REBT/ REBC; Ellis, 1962) theory, there are functional and dysfunctional emotions, the latter ones being maladaptive. The REThink platform aims at using online gaming for coaching emotion regulation in children and adolescents based on these principles. Objective: We conducted a pilot study to investigate if the Feeling Better mini video game, part of the REThink therapeutic online platform as a resource activity, can be a useful tool in coaching the distinction between functional and dysfunctional emotions in children and adolescents in the therapeutic video game environment. Method: The online game was delivered to a sample of 22 children and adolescents, aged between 10 to16 years. Emotion understanding was indexed by the amount of acquired points for correctly collecting functional emotions. Results: The Feeling Better game was found to be a useful tool in improving in-game emotional understanding, children and adolescents indicating a significant increase in their ability to correctly identify and collect functional emotions after three trials of playing. Conclusions: Using therapeutic video games may be a useful tool for coaching emotion regulation skills in children and adolescents. Finally, satisfaction with and advantages for the use of online video games in coaching emotional skills are discussed.

Children and adolescents' ability to effectively understand their own emotions is an important aspect of their development, related with a variety of beneficial outcomes (e.g. better mental health, social skills, and academic performance). Although there are effective programs for developing emotional skills of young people, their implementation is a challenge and the access to them is reduced. We designed and developed a therapeutic online video game - REThink - that aims to coach children and adolescents' emotion regulation abilities. This paper describes the development of cartoon based stimulus emotional set, with high quality and drawn character images of children and adolescents' emotional expressions, in order to be integrated in the REThink online therapeutic game. The set includes 87 characters depicting various emotions (13 emotions). The sample consisted of 21 healthy children and adolescents, aged between 10 to 16 years. After the presentation of each stimulus, participants were asked to place the emotion of the character pictured in one of the 13 emotional categories or to choose the category entitled 'none of the above'. To test the reliability scores, stimuli were presented again after a 20-minute break, in a different random order. The overall mean proportion correct obtained with this set was below the 0.70 criterion and test-retest reliability was high as measured by proportion agreement. In conclusion, improvements of the characters depicting emotion categories with low validity scores can make the new cartoon based emotional faces picture set a useful tool for developing new affective research and can be used within the REThink online therapeutic game.

Introduction: Rational and irrational beliefs (RBs/IBs) are key constructs that underlie coaching interventions aimed to promote better emotion regulation, respectively decrease emotional difficulties, within a Rational-Emotive Behavior Therapy/Coaching (REBT/REBC)([1]) framework. In this context, coaching children and adolescents' skills for identifying and distinguishing rational from irrational beliefs, as well as raising awareness on the importance of acquiring and practicing rational beliefs can bring important mental health benefits. The newly developed REThink platform aims at using online gaming for coaching emotion regulation skills in children and adolescents based on REBT/REBC principles.Objective: In the present study we tested the effectiveness of the ThinkUP mini video game, part of the REThink platform as resource activity that coaches the identification and distinction between RBs/IBs.Method: Our sample consisted of 23 children and adolescents, aged between 10 to 16 years. The ability to differentiate between RBs/IBs was indexed by the amount of acquired points for collecting rational beliefs.Results: Preliminary findings showed that children and adolescents registered an increase in their performance in thoughts differentiation (i.e., distinguish RBs from IBs) reflected in higher scores obtained after four trials of playing the game.Conclusions: Implications for the use of the serious video games in coaching emotion regulation based on rational thinking skills in children and adolescents are discussed.