Negative affect instability predicts elevated depressive and generalized anxiety disorder symptoms even when negative affect intensity is controlled for: an ecological momentary assessment study.

Introduction: Mood and anxiety disorders are characterized by abnormal levels of positive affect (PA), negative affect (NA) and changes in how emotions unfold over time. To better prevent and treat those disorders, it is crucial to determine which kind of indices of emotion dynamics best predict elevated depressive and generalized anxiety symptoms. Methods: 221 individuals (60 men; mean age = 46 years, SD = 15 years) completed a 7-day ecological momentary assessment study, where their positive and negative affective experience was assessed 5 times a day. For each participant, the intensity, instability, inertia, and differentiation of PA and NA were calculated. The Estonian Emotional State Questionnaire was used to assess depressive and generalized anxiety disorder (GAD) symptoms. Results: We found that NA and PA intensity, and NA instability predicted elevated depressive and GAD symptoms. Models including NA instability alongside PA and NA intensity showed the best fit for both depression and generalized anxiety, as NA instability alongside other variables significantly increased the odds of having elevated depressive and GAD symptoms. Affective inertia, differentiation, and PA instability were not associated with depressive and GAD symptoms. Discussion: In addition to the mean levels of affect, it is important to study other emotion dynamic indices such as NA instability, as these offer a more nuanced view of underlying emotion dysregulation processes. This could, in the long-term, help tailor more specific prevention and intervention methods for mood and anxiety disorders.

Estonian National Mental Health Study: Design and methods for a registry-linked longitudinal survey.

OBJECTIVES: The Estonian National Mental Health Study (EMHS) was conducted in 2021-2022 to provide population-wide data on mental health in the context of COVID-19 pandemic. The main objective of this paper is to describe the rationale, design, and methods of the EMHS and to evaluate the survey response. METHODS: Regionally representative stratified random sample of 20,000 persons aged 15 years and older was drawn from the Estonian Population Register for the study. Persons aged 18 years and older at the time of the sampling were enrolled into three survey waves where they were invited to complete an online or postal questionnaire about mental well-being and disorders, and behavioral, cognitive, and other risk factors. Persons younger than 18 years of age were invited to fill an anonymous online questionnaire starting from wave 2. To complement and validate survey data, data on socio-demographic, health-related, and environmental variables were collected from six national administrative databases and registries. Additionally, a subsample was enrolled into a validation study using ecological momentary assessment. RESULTS: In total, 5636 adults participated in the survey wave 1, 3751 in wave 2, and 4744 in wave 3. Adjusted response rates were 30.6%, 21.1%, and 27.6%, respectively. Women and older age groups were more likely to respond. Throughout the three survey waves, a considerable share of adult respondents screened positive for depression (27.6%, 25.1%, and 25.6% in waves 1, 2, and 3, respectively). Women and young adults aged 18 to 29 years had the highest prevalence of depression symptoms. CONCLUSIONS: The registry-linked longitudinal EMHS dataset comprises a rich and trustworthy data source to allow in-depth analysis of mental health outcomes and their correlates among the Estonian population. The study serves as an evidence base for planning mental health policies and prevention measures for possible future crises.

Exploring the role of momentary positive and negative affect in overeating and binge eating: Evidence for different associations among men and women.

Momentary positive and negative emotions have shown to affect eating behaviour. In this study, we used experience sampling method (ESM) to assess how momentary positive affect (PA) and negative affect (NA) relate to overeating (OE) and binge eating (BE) episodes among men and women compared to no OE/BE episodes. We additionally looked at how situational and social context moderate these relationships. For this purpose, 87 women and 94 men participated in the study where they were instructed to rate their levels of various positive and negative emotions, situational whereabouts, and the presence of OE/BE 7 times a day for 3 consecutive days. We found that men and women greatly differed in how momentary PA and NA relate to OE and BE. In women, NA was highest before BE, followed by OE compared to no OE/BE. Further, an interaction between the type of an eating episode and situational context demonstrated that this relationship was significant when at home, but not away from home. No differences in the momentary NA between the types of eating episodes were found in men. In men, PA was significantly higher before OE compared to BE and no OE/BE. Additionally, an interaction between the type of eating episode and situational context showed that this relationship was significant when at home, but not when away from home. Our results further confirm the role of negative affect in overeating and binge eating in women, whereas also suggesting that the role of positive affect in eating behaviour is warranted more research, particularly in men.

Investigating phenotypes of emotional eating based on weight categories: A latent profile analysis.

OBJECTIVE: We aimed to investigate the phenotypes of individuals with emotional eating (EE) based on their levels of positive and negative EE, body mass index (BMI), and preoccupation with weight, and to assess differences in eating pathology and emotion regulation (ER) difficulties among them. METHOD: A community sample of 605 women (mean age = 29.8 years, SD = 9.6; mean BMI = 23.4 kg/m2 , SD = 4.7) filled out the Positive-Negative Emotional Eating Scale, Eating Disorders Assessment Scale, and Difficulties in Emotion Regulation Scale. Data of BMI, positive EE, negative EE, and preoccupation with body weight were submitted to a latent profile analysis. RESULTS: A four-profile model was discovered with normal weight individuals without EE (63%), normal weight individuals with EE (23%), overweight individuals without EE (9%), and obese individuals with EE (5%). A five-profile model was also included, as a class of normal weight individuals with positive EE was found. Obese and normal weight individuals with EE showed the highest level of ER difficulties and eating pathology. Overweight individuals without EE showed moderate levels of eating pathology and low levels of ER difficulties, suggesting that high BMI itself might not be related to eating disorder (ED) psychopathology. Normal weight individuals with positive EE showed low levels of eating pathology, but moderate levels of ER difficulties. DISCUSSION: Our results suggest that negative EE could be an important risk factor for disordered eating, independent of BMI. Further, individuals with EE could benefit from learning adaptive ER strategies to prevent the onset or maintenance of ED or weight gain.

Hunger enhances automatic processing of food and non-food stimuli: A visual mismatch negativity study.

Automatic detection of important and unexpected stimuli in the visual environment is crucial for survival. We sought to explore whether visual food stimuli are detected already in the pre-attentive stimulus processing phase, and whether hunger enhances such automatic detection. To attain these goals, we adapted an electroencephalography paradigm - visual mismatch negativity (vMMN). vMMN is a useful paradigm to study the processing of salient emotional stimuli which has not yet been applied in the context of eating behaviours. In our study, 18 right-handed women (25.2 ±â€¯7.4 years) underwent two experimental sessions: hunger and fed conditions. Participants had to focus on a 2-back working memory task in the center of the computer screen, while stimuli depicting high fat savoury (HFSA) and high fat sweet (HFSW) foods were presented as deviants in a stream of neutral standard stimuli in the four corners of the screen. Automatic detection of foods was observed within 80-360 ms after stimulus onset, although some foods were better detected than the others. In HFSA, hunger enhanced the processing of all deviant stimuli in the early (100-160 ms) and mid-latency (160-220 ms) time windows. As the modulating effect of hunger was not food-specific, hunger may enhance automatic detection of changes in the visual environment, regardless of the type of input. Nevertheless, hamburger in HFSA was better detected than other stimuli, indicated by larger peak amplitudes, which supports the food-specificity of hunger modulation. In HFSW, the modulating effect of hunger was not observed, possibly due to suboptimally chosen stimuli within this block. In conclusion, we believe that after careful stimulus selection vMMN has a great potential to be a reliable measure of early food-cue processing.

Positive and negative emotional eating have different associations with overeating and binge eating: Construction and validation of the Positive-Negative Emotional Eating Scale.

Research on emotional eating mostly focuses on negative emotions. Much less is known about how positive emotions relate to overeating and binge eating (BE). The aim of the current study was to construct a scale for positive and negative emotional eating and to assess its predictive validity. In study 1, the Positive-Negative Emotional Eating Scale (PNEES) was constructed and tested on 531 women, who also completed Eating Disorders Assessment Scale (EDAS). Results showed that a two-factor model constituting Positive emotional eating (PNEES-P) and Negative emotional eating (PNEES-N) fit the data well. PNEES-N also showed good convergent validity in assessing binge eating, correlating highly with EDAS subscale Binge eating. Further, a path analysis showed that after controlling for the mediating effect of PNEES-N, PNEES-P continued to significantly predict binge eating. In study 2 (N = 60), experience sampling method was used to assess overeating and BE in the natural environment. Palmtop computers were given to participants for a three-day study period that prompted them with questions regarding emotional experience, overeating, and BE. Results indicated that PNEES-P significantly predicted overeating, whereas PNEES-N predicted overeating and BE episodes only in a subsample of women who had experienced at least one overeating or BE episode. Thus, positive and negative emotional eating might have different relations with overeating and BE, with the latter being more characteristic of the severity/frequency of overeating and BE. New assessment tools that in addition to negative emotional eating also address positive emotional eating could be of potential help in planning intervention. Further, the tendency to overeat in response to positive emotions could be integrated into current models of eating disorders, especially when addressing relapse prevention.

Associations between neural correlates of visual stimulus processing and set-shifting in ill and recovered women with anorexia nervosa.

Women ill with anorexia nervosa (AN) have been shown to exhibit altered cognitive functioning, particularly poor set-shifting (SS). In this study, we investigated whether brain activation in frontal and parietal regions during visual stimulus processing correlates with SS ability. Women currently ill with AN (AN; N=14), recovered women (REC; N=14) and healthy controls (HC; N=15), viewed alternating blocks of food and non-food pictures during functional magnetic resonance imaging (fMRI). The Berg's Card Sorting Task was completed outside the scanner to measure SS. A priori regions of interest (ROIs) were defined in frontal and parietal regions. The activation during visual stimulus processing in several ROIs correlated positively with poor SS ability in REC, particularly in the left dorsal anterior cingulate cortex (dACC). The correlations with poor SS ability were opposite in AN patients, particularly in the right dACC. These findings underscore that addressing heightened levels of cognitive control associated with higher frontal activation could reduce cognitive inflexibility in recovered women. In AN, greater activation in frontal and parietal regions might be necessary to perform at normal levels during various tasks. Thus, weight restoration could be necessary for AN patients prior to addressing cognitive inflexibility.