Higher emotion regulation flexibility predicts more stable negative emotions and faster affective recovery in early psychosis: an experience sampling study.

BACKGROUND: While evidence shows that people with early psychosis are flexible in using different emotion regulation (ER) strategies to manage the varying contextual demands, no studies have examined the effectiveness of such regulatory flexibility in this population. We addressed this issue by investigating whether and how ER flexibility relate to different dynamic aspects (variability, instability, inertia, and recovery) of negative affect (NA) in a combined early psychosis sample, consisting of both individuals at high clinical risk for psychosis and those diagnosed with first-episode psychosis. METHODS: Participants were 148 individuals from the INTERACT project, a multi-center randomized controlled trial on the efficacy of acceptance and commitment therapy in early psychosis. We utilized data from the baseline assessment, during which all participants completed six days of experience sampling assessment of momentary NA, as well as end-of-day assessments of ER strategy use. RESULTS: Multilevel models of within-person associations showed that greater ER flexibility was associated with more stable NA, and quicker recovery of NA from stressors during the day. Linear regression analyses of between-person associations showed that people who had more variable and unstable NA reported greater ER flexibility generally. No evidence was found for associations with NA inertia. CONCLUSIONS: The current study identified unique within-person and between-person links between ER flexibility and dynamics of NA in early psychosis. These findings further provide evidence for ER flexibility in early psychosis, emphasizing the adaptive nature of regulatory flexibility in relation to reduced instability in NA and faster recovery from NA in everyday life.

[German S3 guidelines on borderline personality disorder]. / S3-Leitlinie Borderline-Persönlichkeitsstörung.

Research on the understanding and especially on the treatment of borderline personality disorder (borderline PD) has made considerable progress in recent years, so that evidence-based German treatment guidelines have now been produced for the first time. This article highlights the development as well as the main content priorities and recommendations of the guidelines: first, the recommendations on the diagnostics are presented and in this context the upcoming changes to the International Classification of Diseases 11th reversion (ICD-11) are also explained. Subsequently, the most important recommendations on guideline-compliant psychotherapy, pharmacotherapy and treatment settings are presented. Finally, the recommendations concerning relatives (or other significant persons for people with borderline PD) as well as parenthood and borderline PD are presented.

Ecological monitoring of emotional intensity, variability, and instability in individuals with schizophrenia spectrum disorders: Results of a multicentre study.

BACKGROUND: Evaluating emotional experiences in the life of people with Schizophrenia Spectrum Disorder (SSD) is fundamental for developing interventions aimed at promoting well-being in specific times and contexts. However, little is known about emotional variability in this population. In DiAPAson project, we evaluated between- and within-person differences in emotional intensity, variability, and instability between people with SSD and healthy controls, and the association with psychiatric severity and levels of functioning. METHODS: 102 individuals diagnosed with SSD (57 residential patients, 46 outpatients) and 112 healthy controls were thoroughly evaluated. Daily emotions were prospectively assessed with Experience Sampling Method eight times a day for a week. Statistical analyses included ANOVA, correlations, and generalized linear models. RESULTS: Participants with SSD, and especially residential patients, had a higher intensity of negative emotions when compared to controls. Moreover, all people with SSD reported a greater between-person-variability of both positive and negative emotions and greater intra-variability of negative emotions than healthy controls. In addition, the emotion variability in people with SSD does not follow a linear or quadratic trend but is more "chaotic" if compared to controls. CONCLUSIONS: Adequate assessments of positive and negative emotional experiences and their time course in people with SSD can assist mental health professionals with well-being assessment, implementing targeted interventions through the identification of patterns, triggers, and potential predictors of emotional states.

Emotion dynamics and somatic symptoms in everyday life: Ecological momentary assessment in somatic symptom disorder and healthy controls.

OBJECTIVE: Negative affectivity (NA) is associated with the emergence and persistence of physical symptoms with unclear organic pathology. This study investigated the temporal dynamics of NA and somatic symptom burden using ecological momentary assessment (EMA) in adults with somatic symptom disorder (SSD) and healthy control participants (HC). METHODS: Participants underwent a seven-day, smartphone-based EMA, with 6 randomly-stratified time points per day. NA was assessed using a five-item short form of the Positive and Negative Affectivity Scale (PANAS) and somatic symptom burden with two self-constructed items. 22 persons with SSD and 20 HCs were included in multilevel analyses. RESULTS: Within-person analyses showed a significantly stronger (positive) association of concurrent NA with somatic symptom burden in participants with SSD than in HCs, ß = 0.15, SE = 0.04, p = .001. Time-lagged analyses demonstrated that, across groups, NA at a previous time point t-1 significantly predicted somatic symptom burden at the subsequent timepoint t, ß = 0.09, SE = 0.03, p = .005, but not in the other direction (somatic symptom burdent-1→ NAt, ß = 0.01, SE = 0.04, p = .79). Between-person analyses showed that both inertia (i.e., persistence of negative affective states), d = 0.74, and instability (i.e., magnitude of moment-to-moment fluctuations), d = 0.76 of NA were significantly higher in participants with SSD than in HCs. CONCLUSIONS: Our findings sustain the idea of (negative) affect-driven modulation in somatic signal processing and suggest that interoceptive and emotional differentiation training can advance the psychotherapeutic treatment of SSD.

The role of emotional instability in borderline personality disorder: a systematic review.

BACKGROUND: The emotional regulation process plays a pivotal role in daily-life functioning, modulating goal-directed and adaptive behavior. Conversely, altering this cognitive function can disrupt self-regulation and bring emotional dysregulation. Emotional instability could represent a core characteristic of BPD, also modulating the BPD symptom's onset. This systematic review aims to summarize the existing literature reporting the role of emotional instability in BPD to better define the role of the impairment of the emotional processes in the onset of the cognitive and behavioral symptoms of this complex mental disorder. METHODS: MEDLINE, Scopus and Web of Science were independently searched for relevant studies. Eligible studies had to be identifiable through database searching, published and accessible. This systematic review was conducted according to PRISMA guidelines. The search period was from 2012 to 14 September 2022. RESULTS: A pool of 120 studies was identified, out of which 11 met the selection criteria and were included. Overall, the studies confirm a relationship between emotional instability and borderline personality disorder. CONCLUSIONS: The evidences retrieved seem to point out the role of the emotional impairment not only in worsening of the disorder, but could also be one of the risk factors for its onset.

Aggression is more strongly associated with suicidality, independent of depression, than emotional instability and impulsivity in people with epilepsy.

PURPOSE: We evaluated the relative contributions of emotional instability, impulsivity, and aggression to the presence of suicide risk in people with epilepsy after adjusting for depressive symptoms. METHODS: This was a cross-sectional study that used the short form of the Affective Lability Scale (ALS-18), the Barratt Impulsiveness Scale Version 11 (BIS-11), the Brief Aggression Questionnaire (BAQ), and the Patient Health Questionnaire-9 (PHQ-9). Suicidality was assessed using the Mini International Neuropsychiatric Interview (MINI), and the presence of suicide risk was defined as a MINI suicidality score ≥1. Stepwise logistic regression and mediation analyses using a two-stage regression method were performed. RESULTS: Of the 171 subjects (63.2% men) included, suicide risk was present in 38 subjects (22.2%). The stepwise logistic regression analysis identified four variables that were independently associated with suicide risk: higher PHQ-9 score, higher BAQ score, longer duration of epilepsy, and unemployment. The univariate analysis showed that ALS-18 and BIS-11 scores were significantly associated with suicide risk; however, they were backward eliminated from the logistic model according to the criterion of p > 0.1. The mediating effects of ALS-18 and BIS-11 scores on suicide risk via PHQ-9 scores (but not BAQ scores) were significant, with the proportion mediated 61.5% and 54.0% of the total effect, respectively. CONCLUSIONS: Alongside depressive symptoms, aggression may be a more useful concept than emotional instability and impulsivity for identifying suicidal risk in people with epilepsy.

Insomnia moderates the association between recurrent seizures and emotional instability in persons with epilepsy.

PURPOSE: We investigated the moderating effect of sleep disturbance on the association between seizure recurrence and emotional instability in patients with epilepsy, independent of psychological distress. METHODS: This was a cross-sectional study. Patients completed the short form of the Affective Lability Scale (ALS-18), Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A stepwise linear regression analysis and an analysis of covariance with an interaction term were performed. RESULTS: A total of 171 subjects (63.2% men) were included. The mean ALS-18 score was 15.6 ±â€¯11.3. An ISI ≥ 15, PHQ-9 ≥ 10, and GAD-7 ≥ 7 were noted in 20.5%, 18.1%, and 23.4% of subjects, respectively. A stepwise linear regression analysis found that recurrent seizures in the last year, an ISI ≥ 15, a GAD-7 ≥ 7, and use of levetiracetam were significant and independent factors that were positively associated with higher ALS-18 scores. The coefficient of determination for the model was 0.331. The interaction between recurrent seizures and an ISI ≥ 15 had a significant effect on the ALS-18 scores (F = 6.812, p = 0.010, partial eta2 = 0.040). An ISI ≥ 15 was associated with ALS-18 scores in patients without seizure recurrence (p < 0.001). This association almost reached significance (p = 0.084) in those with recurrent seizures. In contrast, the presence of recurrent seizures was associated with ALS-18 scores in patients with an ISI < 15 (p < 0.001), but not in those with an ISI ≥ 15 (p = 0.360). CONCLUSIONS: The significant interaction between insomnia and seizure status may have an effect on emotional instability. These findings have clinical implications in the development of potential interventions for emotional instability in patients with epilepsy.

Role of Equanimity on the Mediation Model of Neuroticism, Perceived Stress and Depressive Symptoms.

Background: Equanimity is widely and commonly practiced, but few have investigated the concept in clinical research. While the mediation model of neuroticism, perceived stress and depression have been demonstrated, it remains unclear whether equanimity mediates the relationship of these variables in parallel, serial or moderated mediation models. This study aimed to investigate the role of equanimity among those models. Methods: In all, 644 general participants (74.2% female, mean age = 28.28 (SD = 10.6)) provided data on the 10-item Perceived Stress Scale (PSS), the Neuroticism Inventory (NI), depression subscale of the Core Symptom Index, and the equanimity subscale of the inner Strength-based Inventory. Mediation and moderation analyses with the 5000 bootstrapping method were applied. Results: Equanimity was shown to moderate the relationship between NI/PSS and depressive symptom. Statistical evaluation supported all parallel, serial and moderated mediation models. Equanimity as a moderator provided a higher amount of percent variance explained by depressive symptoms than parallel and serial mediation models. Conclusions: Results suggest that the effect of perceived stress and neuroticism on depression can be mitigated by increasing levels of equanimity. The results demonstrated one potential benefit from practicing equanimity; enabling its extension to mental health problems could constitute an interesting focus for future research.

Home Alone: Implications of COVID-19 for Mental Health.

RATIONALE: The outbreak of the 2019 novel coronavirus disease (COVID-19) has induced a considerable degree of fear, emotional stress and anxiety among individuals around the world. OBJECTIVE: The objective of this study is to evaluate the relationship between COVID-19 virus cases per 1000 residents and mental health outcomes of individuals across the globe. METHODS: Using plausibly exogenous variation in daily country-level reports of new COVID-19 cases across the world, this study employs an individual-by-day global data set to assess the association between virus outbreak intensity and short-term measures of mental health outcomes. RESULTS: Results indicate that females are 20.02% (95 % CI [6.65 %, 33.39 %]) more likely than males to find life depressing, suggesting that they may bear a much larger mental health burden than males during the COVID-19 pandemic. The association between the pandemic and mental health is more pronounced among individuals staying at home for the past week, who are 14.81 % (95 % CI [3.46 %, 26.16 %]) more likely to feel anxious and 11.17 % (95 % CI [2.13 %, 20.21 %]) more likely to experience emotional instability than their counterparts. The association between virus outbreak intensity and the likelihood of anxiety among individuals staying at home increases with household size, ranging from 11.73 % (95 % CI [-4.65 %, 28.11 %]) among individuals with 0-1 members in the household to 21.02 % (95 % CI [5.73 %, 36.31 %]) among those with 4-8 members in the household. CONCLUSION: These short-run estimates of mental health damages associated with COVID-19 imply that welfare losses from pandemics among individuals are enormous across the globe.

The Statistical Specificity of Emotion Dynamics in Borderline Personality Disorder.

Persons with borderline personality disorder (BPD) experience heightened emotional instability. Different components underlie instability, and the relation between instability and well-being could be confounded by average emotionality and within-person standard deviation across emotional states, reflecting variability. Therefore, the goal was to examine which pattern of emotion dynamics parsimoniously captures the emotional trajectories of persons with BPD. Forty persons with BPD, 38 clinical controls in a major depressive episode, and 40 healthy controls rated the intensity of their emotions 10 times a day for 1 week. After correction for differences in average emotionality, persons with BPD showed heightened emotional instability compared to both control groups. When additionally correcting for emotional variability, the authors found that instability indices did not differ between groups anymore. This shows that persons with BPD differ from control groups in the magnitude of emotional deviations from the emotional baseline, and not necessarily in the degree of abruptness of these deviations.

Emotional intelligence, resilience and personality traits neuroticism and extraversion: predictive capacity in perceived academic efficacy.

BACKGROUND: Recent studies have shown the importance of promoting emotional intelligence and resilience, as well as knowing the personality (extraversion versus emotional instability or neuroticism) in both nursing students and nursing professionals, for better academic adherence, due to stressful situations derived from high academic and attendance requirements for healthcare practices in clinical settings. However, there is little research that analyzes the importance of the perceived academic effectiveness of university students and its relationship with the psychological variables of resilience, emotional intelligence and personality. OBJECTIVE: To analyse the relationships between perceived academic efficacy, emotional intelligence (EI), resilience and the personality factors of emotional instability and extraversion, as well as to observe the variables that predict perceived academic efficacy. MATERIALS AND METHODS: Cross-sectional study on a sample of 434 nursing students in Valencia (Spain) aged 17-54 (M = 21; SD = 0.320). They filled in standard tests on perceived academic efficacy, EI, resilience, emotional instability and extraversion. RESULTS: Perceived academic efficacy is closely and positively related to EI and resilience; and to a lesser extent to emotional instability, but negatively. The academic efficacy predictor variables were EI (global trait, well-being and sociability), resilience (social support and emotional regulation) and emotional instability (R2 of 0.201). CONCLUSIONS: Perceived academic efficacy is fundamentally related to EI and resilience positively, and to a lesser extent to emotional instability negatively, fundamentally via these factors: global trait, social support, well-being, problem-solving capacity. Nursing students' perception of academic efficacy is relevant for building professional skills and carrying out the nurse's role in organisations. So, it is necessary to promote training programs to increase the emotional intelligence and resilience of nursing students, aimed at promoting competence in professional practice.

Association between schizotypal personality traits and emotional instability: mediation and moderation analysis among Chinese college students.

BACKGROUND: Previous studies identified an association between schizophrenia and emotional instability. However, the relationship between schizotypal personality traits and emotional instability has not been explored to date. Furthermore, both mediating and moderating factors need to be identified. METHODS: A total of 2936 students completed the Schizotypal Personality Questionnaire (SPQ), the Affective Lability Scale-Short Form (ALS-SF), and the Davos Assessment of Cognitive Biases Scale (DACOBS). RESULTS: 1) The total scores of DACOBS (and all dimensions) and ALS-SF (and all dimensions) in the high schizotypal personality trait group were higher than in the low schizotypal personality trait group (all P < 0.05). 2) SPQ score and DACOBS social cognition problems, subjective cognitive problems, jumping to conclusions bias, and external attribution bias subscale scores positively predicted the total score of ALS-SF (or the dimensions of ALS-SF) in both male and female populations (all P < 0.05). 3) In the male population, DACOBS social cognition problems, subjective cognitive problems, jumping to conclusions bias, and external attribution bias subscale scores mediated the relationship between SPQ score and ALS-SF total score (or its subscales). In the female population, DACOBS attention for threat bias, external attribution bias, jumping to conclusions bias, social cognition problems, and subjective cognitive problems subscale scores mediated the relationship between SPQ score and ALS-SF total score (or its subscales). 4) Gender exerted a moderating effect on this relationship between SPQ score and ALS-SF total/anxiety-depression score (all P < 0.05). CONCLUSIONS: Schizotypal personality traits might influence emotional instability through cognitive biases, and the degree of this influence varies depending on gender.

Cardiovascular Autonomic Modulation during Metronomic Breathing and Stress Exposure in Patients with Borderline Personality Disorder.

INTRODUCTION: Given the growing evidence of reduced heart rate variability in psychiatric diseases associated with emotional instability, we investigated cardiovascular autonomic modulation in patients with borderline personality disorder (BPD) during resting state, parasympathetic stimulation (metronomic breathing), and sympathetic stimulation (mental arithmetic stress test). METHODS: In 29 BPD outpatients and 30 controls, we recorded RR-intervals (RRI), blood pressure, skin conductance levels, and respiratory frequency during resting state, metronomic breathing, stress anticipation, stress exposure, and stress recovery. We calculated baroreflex sensitivity (BRS) and parameters of heart rate variability, including the root mean square of successive differences (RMSSD), an index of cardiovagal modulation. RESULTS: During resting state, BPD patients showed higher blood pressure and shorter RRI, as well as lower RMSSD and BRS than controls. Metronomic breathing increased RMSSD and BRS in BPD patients. During the stress exposure, BRS significantly decreased in controls, but not in BPD patients. Furthermore, BPD patients showed less cardioacceleration in response to stress exposure than controls. During stress recovery, we found increases in RMSSD and BRS in controls, but not in BPD patients. CONCLUSION: Our data show reduced cardiovascular autonomic modulation in BPD patients during resting state, psychophysiological relaxation, and stress exposure. The results indicate a vagal modulation deficit in this cohort. Breathing techniques, such as metronomic breathing, might be helpful to reduce stress and to increase vagal tone in BPD patients.

Creativity and Psychopathology: An Interdisciplinary View.

Since ancient philosophy, extraordinary creativity is associated with mental disorders, emotional and cognitive destabilization, and melancholia. We here summarize the results of empirical and narrative studies and analyze the most prominent case of a highly creative person who suffered from dysthymia and major depression with suicidality. Hereby, we focus on the interaction of different phases of the creative process with "bipolar" personality traits. Finally, we offer an interdisciplinary interpretation of the creative dialectics between order and chaos. The results show that severe psychopathology inhibits creativity. Mild and moderate disorders can inspire and motivate creative work but are only leading to new and useful solutions when creators succeed in transforming their emotional instability and cognitive incoherence into stable and coherent forms. The cultural idea that creativity emerges in dialectical processes between order and chaos, is also to be found in the psychologic interplay of coherence and incoherence, and in neuro-scientific models of the dynamics between tightening and loosening of neuronal structures. Consequences are drawn for the psychotherapeutic treatment of persons striving for creativity.

Vulnerability in Executive Functions to Sleep Deprivation Is Predicted by Subclinical Attention-Deficit/Hyperactivity Disorder Symptoms.

BACKGROUND: Sleep loss results in state instability of cognitive functioning. It is not known whether this effect is more expressed when there is an increased cognitive demand. Moreover, while vulnerability to sleep loss varies substantially among individuals, it is not known why some people are more affected than others. We hypothesized that top-down regulation was specifically affected by sleep loss and that subclinical inattention and emotional instability traits, related to attention-deficit/hyperactivity disorder symptoms, predict this vulnerability in executive function and emotion regulation, respectively. METHODS: Healthy subjects (ages 17-45 years) rated trait inattention and emotional instability before being randomized to either a night of normal sleep (n = 86) or total sleep deprivation (n = 87). Thereafter, they performed a neutral and emotional computerized Stroop task, involving words and faces. Performance was characterized primarily by cognitive conflict reaction time and reaction time variability (RTV), mirroring conflict cost in top-down regulation. RESULTS: Sleep loss led to increased cognitive conflict RTV. Moreover, a higher level of inattention predicted increased cognitive conflict RTV in the neutral Stroop task after sleep deprivation (r = .30, p = .0055) but not after normal sleep (r = .055, p = .65; interaction effect ß = 6.19, p = .065). This association remained after controlling for cognitive conflict reaction time and emotional instability, suggesting domain specificity. Correspondingly, emotional instability predicted cognitive conflict RTV for the emotional Stroop task only after sleep deprivation, although this effect was nonsignificant after correcting for multiple comparisons. CONCLUSIONS: Our findings suggest that sleep deprivation affects cognitive conflict variability and that less stable performance in executive functioning may surface after sleep loss in vulnerable individuals characterized by subclinical symptoms of inattention.

Influence of Lack of Trust on Romantic Relationship Problems: The Mediating Role of Partner Cell Phone Snooping.

We investigated how a lack of trust in one's romantic partner exacerbates problems such as emotional instability, conflict, or intention to break up in relationships with the role of cell phone snooping as a mediator. A cross-sectional survey of married individuals (n = 329) was conducted using an online questionnaire. Results indicate that lack of trust is a significant predictor of romantic relationship problems. In addition, structural equation modeling results support the theoretical model indicating that cell phone snooping partially mediates the significant relationship between emotional instability, intention to break up, and conflicts. Findings support the development of trust in romantic partners as an approach to stability and avoidance of problems in romantic relationships.

Daily Patterns of Emotional Functioning on Drinking and Nondrinking Days.

BACKGROUND: Alcohol misuse continues to be a significant public health problem. Understanding the factors that may contribute to the harmful progression in drinking is an important aspect of public health. Previous research has shown that affect regulation is associated with problematic alcohol use. Additionally, emotion instability has been found as a predictor of alcohol-related problems and may be linked to reinforcement mechanisms. METHODS: The current study examined positive mood, negative mood, and mood instability in real time across drinking and nondrinking days utilizing ecological momentary assessment (EMA). Current drinkers (n = 74) were recruited for a 21-day EMA study. Participants completed up to 10 random assessments of positive mood, negative mood, and alcohol use per day. Mood instability was assessed as the squared difference in current mood from mood in the previous assessment. Data were analyzed using piecewise multilevel regression to examine mood trajectories across drinking and nondrinking days. RESULTS: Positive emotion across the day was higher on drinking days than nondrinking days and continued to increase after drinking initiation. In contrast, negative emotion across the day was lower on drinking days than nondrinking days and continued to decrease after drinking initiation. Emotional functioning was stable across the day on nondrinking days. However, on drinking days there was a steady increase in emotional instability leading up to drinking initiation, followed by a rapid stabilization after initiation. CONCLUSIONS: This study highlights the potentially reinforcing impact of alcohol via emotional stability. Overall, these findings highlight the importance of mood dynamics when examining the reinforcing effects of alcohol consumption.

Emotional regulation for adolescents: a group-based treatment pilot study through the STEPPS programme.

BACKGROUND: Borderline personality disorder (BPD) usually begins in adolescence and manifests itself in adult life. Early intervention can improve the prognosis or reduce its severity. Nevertheless, there are currently few studies of adolescent patients with severe emotion instability and borderline personality traits. AIMS: To evaluate the effectiveness of the Systems Training for Emotional Predictability and Problem Solving (STEPPS) programme in a sample of 21 adolescents (aged 13-17 years) in the Child and Adolescents Mental Health Center of Tarragona in Spain. METHOD: We evaluated BPD traits using the Diagnostic Interview for Borderline Disorder-Revised (DIB-R) and the Global Clinical Impression Scale of Illness Severity for TLP (CGI-TLP). We compared pre- and post-treatment scores for the DIB-R, CGI-GI scale, general psychopathology using the Personality Inventory for Adolescents (PAI-A) and impulsivity with the Barratt Impulsivity Scale (BIS-11). The therapeutic objectives were evaluated with the Borderline Estimate Severity over Time (BEST) scale. RESULTS: There was a statistically significant improvement in the scores for the affective area and in the total score of the DIB-R, a decrease in the percentage of patients who failed to meet criteria for BPD, and an improvement (although not statistically significant) in the scores of the BEST scale throughout the treatment. The results of the CGI-GI scale showed global improvement in almost 72% of patients. CONCLUSION: Our study suggests that STEPPS can be an effective treatment to improve BPD symptoms and is very useful in community settings with limited resources in which efficient treatment alternatives must be sought. However, this conclusion must be interpreted with caution, as there is no comparison control group.

Emotional Instability Relates to Ventral Striatum Activity During Reward Anticipation in Females.

Both non-emotional symptoms, such as inattention, and symptoms of emotional instability (EI) are partially co-varying and normally distributed in the general population. Attention Deficit Hyperactivity Disorder (ADHD), which is associated with both inattention and emotional instability, has been related to lower reward anticipation activation in the ventral striatum. However, it is not known whether non-emotional dysregulation, such as inattention, or EI-or both-are associated with this effect. We hypothesized that altered reward processing relates specifically to EI. To test this, 29 healthy participants were recruited to this functional MRI study (n = 15 females). Reward processing was studied using a modified version of the Monetary Incentive Delay (MID) task. Brown Attention-Deficit Disorder Scales questionnaire was used to assess EI and inattention symptoms on a trait level. We observed less ventral striatal activation during reward anticipation related to the EI trait in females, also when controlling for the inattention trait, but not in the whole sample or males only. Our study suggests the existence of sex differences in the relationship between reward processing and EI/inattention traits.

Emotional instability as a trait risk factor for eating disorder behaviors in adolescents: Sex differences in a large-scale prospective study.

BACKGROUND: Temperament and personality traits, including negative emotionality/neuroticism, may represent risk factors for eating disorders. Further, risk factors may differ by sex. We examined longitudinal temperament/personality pathways of risk for purging and binge eating in youth stratified by sex using data from a large-scale prospective study. METHODS: Temperament, borderline personality features, sensation seeking, 'big five' personality factors, and depressive symptoms were measured at five time points from early childhood to adolescence in 5812 adolescents (3215 females; 2597 males) in the Avon Longitudinal Study of Parents and Children. We conducted univariate analyses with these predictors of binge eating and purging at 14 and 16 years for total and sex-stratified samples. We used structural equation modeling (SEM) to fit data to a path analysis model of hypothesized associations. RESULTS: Of the total sample, 12.54% engaged in binge eating and 7.05% in purging by 16 years. Prevalence was much greater and increased dramatically for females from 14 years (7.50% binge eating; 2.40% purging) to 16 years (15.80% binge eating; 9.50% purging). For both sexes, borderline personality, depressive symptoms and lower emotional stability predicted eating disorder behaviors; sensation seeking and conscientiousness were also significant predictors for females. SEM identified an 'emotional instability' pathway for females from early childhood into adolescence (RMSEA = 0.025, TLI = 0.937 and CFI = 0.970). CONCLUSIONS: Binge eating and purging are common in female and male adolescents. Early temperament/personality factors related to difficulty regulating emotions were predictive of later adolescent eating disorder behaviors. Results have important clinical implications for eating disorder prevention and intervention.