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ACT core processes from an emotion , affect , and mood regulation perspective. Michel André Reyes Ortega -Asociación Mexicana por las Ciencias Conductual Contextuales- -Instituto de Terapia Cognitivo Conductual en México- -Universidad Iberoamericana Cd. De México-. PAPER OBJECTIVES.
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ACT coreprocessesfromanemotion, affect, and moodregulationperspective Michel André Reyes Ortega -Asociación Mexicana por las Ciencias Conductual Contextuales- -Instituto de Terapia Cognitivo Conductual en México- -Universidad Iberoamericana Cd. De México-
PAPER OBJECTIVES • Define emotionregulation • Signalsimilaritiesbetween ACT and emotionregulationsclinicalperspectives • Review 3 differentemotion and affecttheories and theirclinicalimplications • Signal ACT beneffitsforemotiondisregulationtreatment • Describe anexample of anintegrativeapproach
ACT coreprocesses fromanemotion, affect, and moodregulationperspective Emotionregulation and act
EMOTION REGULATIONAND DYSREGULATION • Emotion regulation: The modification of any aspect of an emotional response (Fairholme, Boisseau, Ellard, Ehrenreich & Barlow, 2010). • Emotiondysregulation: Difficulty or inability in coping emotions. Manifests as and excessive intensification of emotion or excessive deactivation of emotion (Leahy, Tirch & Napolitano, 2011).
SIMILARITIES TO ACT ADAPTATIVE EMOTION REGULATION PSYCHOLOGYCAL FLEXIBILITY (Dahl, Plumb, Stewart & Lundgren, 2009) Repertoires of behavior that move the person in valued directions while contacting the present moment. • Flexible and context-sensitive, congruentwithlonger term personal goals (Barrett, Gross, Christensen, & Benvenuto, 2001; Linehan, 1993; McEwen, 2003).
SIMILARITIESTO ACT MALADAPTATIVE EMOTION REGULATION (Werner & Gross, 2010) EXPERIENTIAL AVOIDANCE (Hayes, Strosahl & Wilson, 1999) Tendencyto escape or avoid private experiences even when doing so is futile or interferes with valued actions. • Does not change the emotional response in the desired way or when the long-term costs outweigh the benefits of short-term changes in emotion.
TRANSDIAGNOSTIC MALADAPTATIVE EMOTION REGULATION STRATEGIES(Werner & Gross, 2010) • Situationalavoidance • Safety and control behaviors • Treatmonitoring • Thoughtsupression and Distraction • Ruminationand Worry • Expressiveemotionalinhibition • Impulsiveemotionaldrivenbehaviors
ACT coreprocesses fromanemotion, affect, and moodregulationperspective Emotionmodels and theirclinicalimplications
DISCRETE EMOTION MODELSBASIC IDEA • Emotions are governed by two distinct but partially communicating systems(Gross & Muñoz, 1995; Levenson, 1994). • Core system: Automatic, rigid and relatively insensitive to learning. Designed to accomplish evolutionarily adaptive functions. • Control system: Voluntary, flexible and sensitive to learning. • Indirectly regulates the activity of the coresystembymanipulating attention or regulating overt responses (Levenson, 1999).
DISCRETE EMOTION MODELS-CLINICAL IMPLICATIONS- • Characteristicclinicalproblem. • Impulsive and inflexible control systemactivity. • Goal(values) incongruent. • Favor emotionalintensity and durationscalation. • Clinical targets. • Control system training. • Enhancedistresstolerance (emotionalexperienceacceptance) and behavioralchangeskills. • Helpfulclinicalmodels • DialecticalBehaviorTherapy.
DIMENSIONAL EMOTION MODELSBASIC IDEA 1 • Affect results as a feedback loop that tracks and controls progress on personal goals achievement (Johnson, Carver & Fulford, 2010). • Progress toward a goal or avoidance of threat relates to positive affect. The contrary results in negative affect (Carver& Scheier, 1998). • Behavioral responses linked to affective states lead to regulation of affect . • Long-lasting extremes of affect occur when the system is not doing an effective job of self-regulating (Johnson, Carver & Fulford, 2010).
DIMENSIONAL EMOTION MODELSBASIC IDEA 2 • Affectivestates can be undertood as activities of diferentbio-behavioralsystems. • Withdrawalsystems, relatedtoamygdala, limbic and serotoninergic activity (Gilbert, 2009; Gray, 1973). • Behavioral inhibition system - “anxious affect”. • Fight–flightsystem– “angryaffect”. • Approachsystems, relatedtodopaminergic and oxytocinactivity (Wang, 2005). • Behavioralactivationsystem – “hapyaffect”(Gilbert, 2007, 2009; Gray, 1973). • Afiliationfocusedsystem – “caring / lovingaffect” (Bowlby, 1968; Fonagy, 2002; Fonagy & Target, 2007; Sloman, Gilbert, & Hasey, 2003).
DIMENSIONAL EMOTION MODELS-CLINICAL IMPLICATIONS- • Charactesisticclinicalproblems. • Ineffectivegoalcongruentbehavior. • Leads toinhibitionof approachsystems and/oroveractivity of withdrawalsystems. • Clinicaltargets. • Stimulation of inhibitedsistems and moderation of overactivesystems. • Helpfulclinicalmodels. • BehavioralActivationtherapyforDepression. • ExposureTherapiesforAnxietyDisorders. • SensateFocusfor Sexual Disfunction.
ASSOCIATIONISTIC MODELSBASIC IDEA • Emotions are stored in memory as linked associations about stimulus, responses, and stimulus and experience meaning. • They are learned through associative process (e.g. respondent conditioning). • If the person is exposed to information related to any the elements of the network, the emotion is triggered.
ASSOCIATIONISTIC MODELS-CLINICAL IMPLICATIONS- • Characteristicclinicalproblem. • Problematic and impulsivebehaviors as response toactivation ofcondictionedpropositionalnetwork. • Goal (values) incongruent • Reinforcesproblematicassociations. • Clinical targets • Emotionalprocesing (Foaet al. 2006, Foa & Kozak, 1986) / Habituation – extinction(Carey, 2011). • Helpfulclinicalmodels. • ExposureTherapyforAnxietyDisorders.
ACT coreprocesses fromanemotion, affect, and moodregulationperspective Actchangemecanisms and emotiondisregulationtreatment
ACTCHANGE MECANISMS Acceptance and Mindfulness Processes Commitedaction and BehavioralchangeProcesses
ACCEPTANCE &MINDFULNESS STRATEGIES Impactonemotionregulationmecanisms Relationtoemotionmodelshhhh Prevent Discreteemotionsdisregulation (emotional crisis) Rigidization and generalization of conditionedemotions Promote Automaticregulation of emotions Emotionalprocessing • Prevent / Inhibit • Rumination and worry • Treatmonitoring • Cognitivesupression and stimulusdistraction • Emotionrejection and Experientialavoidance • Promote • Habituation – Extintion • Distresstolerance
COMMITMENT STRATEGIES Impactonemotionregulationmecanisms Relationtoemotionmodelshhhh Prevent Affectdisregulation Promote Possitiveaffectinduction Stablishing of goalcongruentbehavioral agendas Development of longtermgoalcongruentemotionregulationstrategies • Prevent / Inhibit • Situationalavoidance • Safety behaviors • Expressiveemotionalinhibition • Impulsiveemotionaldrivenbehaviors • Promote • Regulation of bio-behavioralsystems • Impulse control
CONCLUSIONS-ACT- • Combines thebenefits of • Exposurebasedtherapies • Behavioralactivationbasedtherapies • Metacognitivebasedtherapies • Skills training basedtherapies • Could be • Reinforced (ifneeded) withstrategiesfromthisapproacheswithoutloosingtheoreticalconsistency • And adds • Anintegrativetheoretical and filosophicalmodel • Anoportunity of developing a recilinetlifestyle
INTEGRATIVE EMOTION REGULATION TREATMENT PROPOSAL (Reyes, 2012) • IdentifyexperientialavoidancepatternwithspetialattentiontoInefffectiveemotionregulationstrategies. • Creativehopelessnesstochallengeutility of ineffectiveemotionregulationstrategies. • Cognitivedefusion and mindfulnessstrategiestofacilitate, and as interoceptiveexposure and experientialchallenges of emotionrejectionjudgements. • Willingness and acceptancestrategiesinfavor of in vivo exposureexcercises • Valuesdrivenbehavioralactivation • Relapseprevention