Negative emotion, suppression, and hope

Today, I address three articles that speak to negative emotion, emotion suppression, hope and gratitude. First, Pugach, Starr, Silvia & Wisco (2023) published “Negative Emotion Differentiation in Trauma-Exposed Community Members: Associations with posttraumatic stress disorder symptoms in daily life” in Journal of Psychopathology and Clinical Science.  Here’s the edited abstract and impact statement:

The ability to make fine-grained distinctions between discrete negative emotions—termed negative emotion differentiation (NED)—is important for emotion regulation and psychological well-being. Posttraumatic stress disorder (PTSD) is associated with elevated trauma-related negative emotions (e.g., fear, anger, guilt, shame) and self-reported difficulty identifying feelings, suggesting that low NED may be a feature of PTSD. PTSD is also characterized by overreliance on avoidance as an emotion regulation strategy—a characteristic that could be influenced by low NED. Here, we examined whether NED is reduced in PTSD and the role NED plays in the association between trauma-related avoidance and other PTSD symptoms (traumatic reexperiencing, negative alterations in cognition and mood, alterations in arousal and reactivity). Hypotheses were tested using 3 days of ecological momentary assessment (up to 17 prompts per day) in 80 trauma-exposed participants (39 with PTSD, 41 without PTSD; total completed surveys = 2,158). NED was reduced and self-reported difficulty identifying feelings was elevated in those with PTSD, and both predicted PTSD severity (Clinician-Administered PTSD Scale-5 score) and momentary PTSD symptoms. Furthermore, low NED, but not difficulty identifying feelings, predicted a stronger association between momentary trauma-related avoidance and PTSD symptoms. This study suggests that people with PTSD have more difficulty differentiating between these discrete negative emotions than people without PTSD. This difficulty, called low negative emotion differentiation, also uniquely contributes to the association between avoidance of trauma reminders and the experience of other PTSD symptoms. 

Although it’s not a huge sample, I find this study intriguing because it makes sense that, if you can’t differentiate negative emotions, your PTSD symptoms are more likely to lead to trauma-related avoidance. The next study, moving back to middle childhood, helps support this last one. Gross & Cassidy (2023) published “Hidden feelings: Expressive suppression in middle childhood and links with physiology and negative emotion” in Emotion.  Here’s the edited abstract:

A commonly used strategy for regulating emotions, expressive suppression (ES), involves attempts to conceal emotion-expressive behavior. The present study investigated the effects of two types of ES (trait and state) in middle childhood on two domains of functioning—subjective negative emotion (measured by self-report of sadness) and stress physiology (measured by skin conductance level [SCL], an indication of physiological arousal)—in a racially diverse sample. Children ages 9–10 (n = 117; 46% female) self-reported trait ES before coming into the lab, then were randomly assigned to receive instructions to suppress or receive no emotion regulation instructions (control condition) while watching a sad movie scene. SCL and self-reported emotions were measured before and during the movie scene, and children subsequently self-reported how much they had suppressed during the movie scene. Parents and children provided a wide range of additional measures as covariates. Data were collected from 2017 to 2018. Results from multiple regression analyses indicated that higher trait ES predicted greater SCL, but not subjective sadness, during the movie scene. The instructions to suppress did not affect children’s subjective sadness or SCL during the movie scene, but self-reported (noninstructed) ES during the movie scene was related to feeling more sadness. Although additional research is needed to generalize findings to other developmental periods, results converge with considerable research on adults and also with a growing number of studies pointing to the potential physiological and emotional correlates of frequent ES during childhood. 

I love this study because it makes so much sense. Kids who develop trait emotion suppression strategies have skin conductance levels suggesting physiological arousal but deny subject experiences of sadness in the condition in which they are encouraged to suppress emotions. Yet, their peers in the control group, not instructed to suppression their emotions, report feeling sad. Looking back to the first study, it seems to me that emotion suppression as a strategy is naturally going to be accompanied by failure to differentiate negative (and probably positive emotions) in ways that will exacerbate problems in processing PTSD. The final study is literally more hopeful.

Senger & Gallagher (2023) published “The unique effects of hope and gratitude on psychological distress and well-being in trauma-exposed Hispanic/Latino adults” in Psychological Trauma: Theory, Research, Practice, and Policy.  Here’s the edited abstract and impact statement:

Gratitude and hope are well-established predictors of well-being and buffers against posttraumatic stress disorder (PTSD) and anxiety symptoms. However, scarce literature exists that investigates these relationships in a Hispanic/Latino sample. The current study investigates gratitude’s and hope’s relationship to PTSD and anxiety symptoms and different domains of well-being in trauma-exposed Hispanic/Latino young adults at a large southern university. The sample was composed of 732 undergraduate students who were mostly female (80.7%) and young adults, (Mage = 21.8, SD = 4.3), who endorsed experiencing one or more traumatic events via the Life Events Checklist. Students completed an online survey for course credit. Structural equation models were used to analyze the data. Gratitude had a stronger inverse relationship with PTSD symptoms (β = −.43, 95% CI [−0.50, −0.35]) and anxiety symptoms (β = −.28, 95% CI [−0.36, −0.20]) compared to hope (β = .06, 95% CI [−0.01, 0.14]) (β = −.06, 95% CI [−0.14, 0.02]). Both gratitude and hope were robust predictors of the three domains of well-being. The current study found that hope and gratitude predicted resilience in trauma-exposed Hispanic/Latino young adults. Decreased levels of gratitude were a stronger predictor of psychological distress and subjective well-being than decreased levels of hope, but hope was a robust predictor of the three well-being domains. The findings of this study may lend support for the development of hope and gratitude interventions in a Hispanic/Latino population for the prevention of PTSD symptoms and anxiety symptoms via engendering higher levels of resilience. Decreased levels of gratitude and hope predicted posttraumatic stress disorder and anxiety symptoms while increased levels predicted the various domains of well-being in a Hispanic/Latino sample. Gratitude and hope both predicted these outcomes, although gratitude was generally a stronger predictor when compared to hope, except for social and psychological well-being. The current study may support the development of gratitude and hope interventions for Hispanic/Latino young adults who have experienced trauma. 

Although the sample is largely female and Hispanic/Latino, it makes sense that these findings are potentially generalizable to others dealing with past trauma. Both hope and gratitude require differentiation of positive emotions and may well signal emotional maturity. Many clients with trauma histories may not immediately be able to use these strategies, but developing them is likely to lead to resilience.