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Purpose: This study aims to delve into the process of men confronting infertility. Design: This research employed the Straussian grounded theory approach. Methods: The study encompassed interviews with 16 participants from a private fertility center in Isfahan, Iran, between March 2023 and March 2024. The interviews were semistructured. Data analysis was carried out concurrently using constant comparative methods and standard grounded theory techniques. the participants' main concerns were identified, culminating in developing a substantive theory centered around a core category. Findings: The primary category for men struggling with infertility was "forced concealment." This was exhibited through the suppression of emotions, maintaining secrecy about infertility, hiding treatment, and attributing infertility to their wives to counteract threats to their masculinity. Factors such as partners, family, societal surroundings, care providers, and beliefs influenced the adopting of the "forced concealment" strategy. Conclusions: The "forced concealment" theory offers insights into the experiences of men struggling with infertility. The study highlights the necessity of formulating culturally sensitive strategies that enable healthcare providers, nurses, and health system managers to effectively fulfill their roles and address the challenges and needs of couples confronting male infertility. This can be realized through a comprehensive approach that integrates nursing skills and competencies.

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OBJECTIVE: This study aimed to investigate the emotional experiences and beliefs of individuals who engage in self-harm by analyzing data from an online self-harm forum. Emphasis was placed on understanding how these individuals describe and evaluate their emotions (emotion beliefs) and the role these beliefs play in their emotion regulation and self-harming behaviors. METHOD: A total of 119 posts from a self-harm discussion board on the forum were analyzed. Thematic analysis, following a critical realist perspective, was employed to identify and interpret recurring patterns in how posters articulated their emotion beliefs. RESULTS: Four themes were created during analysis: "My emotions are too much," "Self-harm as control or controlled by self-harm," "Suppression is better than expression," and "Self-harm helps me escape my emotional pain." Posters described experiencing overwhelming, uncontrollable, and unacceptable emotions, resulting in a desire to suppress or escape them through self-harm. CONCLUSIONS: Individuals struggling with self-harm hold negative beliefs about their emotions, which intensify emotional experiences and contribute to feelings of shame and guilt. The findings highlight the necessity of interventions targeting these negative emotion-related beliefs to foster alternative emotional regulation strategies and reduce reliance on self-harm, as well as the importance of increased education on these emotional beliefs for those who support them, in order to reduce stigma. Furthermore, the study emphasizes the potential of online forums in gaining valuable insights into sensitive behaviors.

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Two studies were conducted to explore the differences in the effect of adolescents' strategies for expressing academic emotions. In Study 1 a total of 65 adolescents participated in the study of the relationship between academic emotions and strategies for expressing them in competitive and cooperative situations. In Study 2 a total of 113 adolescents participated in the study of the relationship between the strategies and peer acceptance in competitive and cooperative situations. The results showed that the relationship between academic emotions and strategies for expressing them in competitive and cooperative situations was situation stable while the relationship between the strategies and peer acceptance was situation specific. Furthermore, emotional expression may be more adaptive when experiencing positive academic emotions. When adolescents experience negative academic emotions, expressing them is more adaptive from the perspective of their own academic emotional experience; whereas suppressing them is more adaptive from the perspective of peer acceptance. These findings (a) clarify how to use more adaptive strategies for emotional expression in various situations and (b) serve as a guide for helping adolescents use strategies to express emotions flexibly according to the situation.

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Intimate partner violence (IPV) is considered a serious public health concern among couples, regardless of the sexual orientation. However, there is a dearth of data about the determining factors of IPV among couples with mixed-romantic orientations, and not much is known about the role that intra-psychic factors play in the relationship between psychological factors and IPV. Therefore, the study set out to examine the mediating role of emotional suppression in the relationship between psychological factors and IPV among couples with mixed-romantic orientations in Nigeria. The study adopted a correlational research design. A total of 241 respondents (61.4% identified as heterosexual and 38.6% as bisexual) in mixed-romantic orientation marriages, were engaged using respondents-driven sampling. Outcomes revealed that emotional suppression (indirectly) mediated the relationship between depressive symptoms [c'-path analysis; b = .029, t(240) = 108, p = <.01; bootstrap =.0573-1715], anxiety [c'-path analysis; b = .027, t(240) = -0.044, p = <.05; bootstrap = .108-.004], stress [c'-path analysis; b = 0.019, t(240) = 0.057, p = <.001; bootstrap = .0247-.0992] and IPV among couples with mixed-romantic orientations. It was concluded that emotional suppression directly and indirectly mediated the relationship between psychological factors and IPV. Recommendations and limitations are discussed.

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Chronic Kidney Disease (CKD) can be identified as one of the non-communicable diseases (NCDs) which affect millions of people worldwide, including in Sri Lanka and Poland. The prevalence of CKD has been rising over the last three decades due to the identification of CKD with unknown etiology and the increment of NCDs such as hypertension and diabetes mellitus among the Sri Lankan population. Poland can be identified as a European country that has 4 million patients with CKD, which is the second most common chronic disease in the country. CKD is associated with the physical, economic, psychological, and social burden on patients and their caregivers. The current study is aimed to investigate the psychosocial well-being of CKD patients and their caregivers in Sri Lanka and Poland. The current study is a mixed-method study aimed to investigate the psychosocial well-being of individuals with chronic kidney disease undergoing hemodialysis and their caregivers in Sri Lanka and Poland. Participants in the quantitative part of the project will be individuals with chronic kidney disease undergoing hemodialysis from Sri Lanka (n = 63) and Poland (n = 63) who are currently undergoing hemodialysis treatment. Kidney Disease Quality of Life-Sort Form, Beck Depression Scale, Test of Self-Conscious Affect, The Courtauld Emotional Control Scale, Acceptance of Illness Scale, and a demographic and medical information sheet will be used in both Sri Lankan and Polish samples. Apart from that, the qualitative phase of the study will involve semi-structured interviews with individuals diagnosed with CKD, selected randomly from the initial part of the research, and their close relatives. Notably, the participant count will remain undetermined, as this approach addresses the inherent challenges of exploratory research.

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Introduction: According to the World Health Organization (WHO), violence is widespread in the world, about 1 million people dying from various forms of violence each year. Currently, violence in the workplace is increasing, especially in emergency department against medical personal. Purpose of the research: to study the perception of violence by medical workers in ambulance stations in the cities of Yerevan and Gyumri, to identify the types, causes and qualitative characteristics of the prevalence of violence against medical ambulance workers. Give a comparative description of the violence situation in Yerevan and Gyumri stations. Material and methods: Qualitative research was carried out among the medical staff of emergency stations of Yerevan and Gyumri cities using the in-depth interview method in 2021. The tool was the guide, the total number of participants was 61. Results: The survey found that violence against emergency workers was common: 42 out of the 61 participants reported about lifetime experience of any type of violent behavior of patients or their relatives. Among the types of violence, physical and psychological were mentioned most often. Conclusions: Violence is a common, frequent occurrence in the emergency department. Emergency medical personnel primarily perceive violence in its psychological and physical manifestations. Among the reasons are, in particular, the apparent delays of the emergency personnel, the nervous and mental overstrain of the abusers, and the use of alcohol.

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Black sexual minority women have an increased risk for excessive alcohol use, which has been attributed to their use of alcohol to cope with oppression. Internalized stigma is suggested to be one of the most insidious byproducts of systemic oppression whereby people internalize ideologies of self-hatred. Still, research has yet to examine the association between internalized stigma and alcohol use among sexual minorities of color. This survey-based study investigated the associations between internalized homonegativity and internalized racism with coping motivated alcohol use among 330 Black sexual minority women. Additionally, we explored the role of emotional suppression within these associations. Internalized homonegativity was significantly positively associated with coping motivated alcohol use. The significant positive association between internalized racism and coping motivated alcohol use was strongest at higher levels of emotional suppression. Given the majority of our sample identified as having a masculine gender expression, we recommend research exploring whether the identity-based experiences of masculine Black sexual minority women impact their substance use behaviors. Implications for culturally sensitive and emotion-centered practice with Black sexual minority women are discussed.

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Introduction: Global implementation of social and emotional learning (SEL) has been suggested to incorporate a systematic cultural adaptation process which relies on ground-up empirical data of a target cultural group in tailoring a culturally sensitive SEL intervention. Preliminary formative studies among local parents and educators were done to explore the conceptualization of social and emotional competencies (SECs) in various cultural settings, such as the continent of Africa and among the indigenous and refugee groups. Unfortunately, little scholarship has been devoted to studying the SEL adaptation process in Southeast Asian regions. This formative study aimed to explore Malaysian parents' and teachers' cultural conceptualization of adolescent SECs. Methods: This qualitative study interviewed 12 Malaysian parents and 10 Malaysian teachers comprising of Malay (82%), Chinese (9%) and Indian (9%) races in an online focus group discussion. Sampling is purposive to parents of adolescents and teachers at secondary school only. Data were analyzed thematically to determine the culturally sensitive SEL constructs for Malaysian adolescents. Results: All themes and sub-themes of SEC regarded as crucial for Malaysian adolescents are aligned with CASEL's five domains of competencies. Our findings extended the conceptualization of subskills under CASEL's relationship skills and responsible decision-making domains, which reflect Asian cultural values. The main themes of social competency: (a) preserving interpersonal relationships, (b) utilizing intrapersonal skills, and (c) communicating effectively, are shared with the established CASEL constructs. However, the underlying subthemes denote the unique cultural manifestation of social competency in Malaysia. Two of the emotional competency themes represent the established CASEL constructs: (a) practicing self-regulation, (b) demonstrating help-seeking behavior, and the other two themes signify Asian values: (c) upholding altruism, and (d) maintaining cultural display rules. Discussions: This formative study revealed the habitual use of experiential and expressive suppressions as adaptive emotion regulation strategies in Malaysian collectivist culture and offered a potential alternative emotion regulation pathway suitable for Malaysian adolescents. It also informed the feasibility of implementing SEL modules developed based on the CASEL framework in Malaysia and suggested two key lessons to enhance the cultural sensitivity of SEL in Malaysia: effective, respectful communication and expressive writing.

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BACKGROUND AND OBJECTIVES: Maladaptive emotion regulation strategies increase prolonged grief and depressive symptoms following bereavement. However, less is known about the role of adaptive emotion regulation strategies in adaptation to loss. Therefore, we examined the concurrent and longitudinal associations of three putative adaptive emotion regulation strategies (cognitive reappraisal, emotional expression, and mindfulness) with prolonged grief and depression symptoms. DESIGN: A two-wave longitudinal survey. METHODS: A sample of 397 bereaved Dutch adults (89% female, mean age 54 years) completed validated questionnaires to assess trait cognitive reappraisal, emotional expression, mindfulness and prolonged grief and depression symptoms at baseline (T1) and 344 participants completed symptom measures again six months later (T2). RESULTS: Zero-order correlations demonstrated that mindfulness, cognitive reappraisal and emotional expression relate negatively to T1 and T2 prolonged grief and depression symptoms. In multiple regression analyses, controlling for relevant background variables, all emotion regulation strategies related negatively to T1 prolonged grief and depression symptoms. In multiple regression analyses, controlling for T1 symptoms and background variables, mindfulness predicted lower T2 depression symptoms. CONCLUSIONS: Adaptive emotion regulation strategies relate negatively to post-loss psychopathology symptoms, yet only mindfulness longitudinally predicts lower depression symptoms. Dispositional mindfulness may be a protective factor in psychological adaptation to bereavement.

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Drawing on the self-control perspective, this study investigated the buffering effect of emotional suppression in reducing the harmful influence of workplace ostracism on employee performance. The research also studied the mediating role of employee silence and voice behaviors based on social exchange theory. We performed moderated mediation analysis on responses received from 159 employees working in the financial industry of the Southern Punjab region of Pakistan. The results showed that workplace ostracism harms employee performance via employee silence and voice behaviors. Furthermore, emotional suppression moderated the mediated relationship between workplace ostracism and employee performance. The results indicated that if ostracized employees adopt voice behavior, emotional suppression cannot aid them in performing better as compared to those who remain silent and regain their self-esteem. Our findings highlight the importance of emotional suppression capability in reducing the damaging outcomes of ostracism in organizational settings.

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BACKGROUND: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) is a theory-derived approach that can target the common underlying processes, such as the cognitive, emotional, and behavioral processes in emotional disorders in children aged 8-12 years. This study aimed to investigate UP-C's efficacy in treating children's anxiety disorders compared to cognitive behavior therapy (CBT). MATERIALS AND METHODS: In this randomized control trial (RCT), with pre-test, post-test, and follow-up, 34 participants aged 8-12 with anxiety disorders were selected through the restricted randomization method and allocated to intervention (UP-C) or control (CBT) groups by random allocation rule. UP-C group consisted of 15 weekly individual sessions, and CBT included 16 weekly individual sessions. The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) and The Screen for Child Anxiety Related Disorders (SCARED-71) were completed in the pre-test, post-test, and three-month follow-up stages. The data of participants were analyzed using the repeated measure analysis of variance. A P- value under. 05 was regarded as significant. RESULTS: Based on the repeated measures ANOVA, UP-C, and CBT significantly reduced anxiety symptoms (P = .002) and emotional suppression (P = .032). Moreover, UP-C and CBT significantly increased emotion regulation (P = .000) and cognitive reappraisal (P = .000). CONCLUSION: The individual UP-C can be effective as anxiety-oriented CBT in treating anxiety disorders. Also, in the three months follow-up, the UP-C's effects were more stable and progressive than the CBT.

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BACKGROUND: Ego-strength refers to the individual's psychosocial capacity to self-regulate their emotions in the face of stress, developed over the course of the lifespan. Ego-strength may have an important role in understanding psychological adaptation to cancer, especially when considering the effects of emotional suppression in cancer populations. In the present study, we examined the effects of ego-strength and emotional suppression on depression and anxiety in patients coping with cancer. We also tested whether ego-strength may mediate the relationship between emotional suppression and psychological distress in cancer. METHODS: 120 cancer patients were recruited from a private hospital in Tabriz to complete baseline questionnaires. Depression, anxiety, ego-strength and emotional suppression were assessed by BDI-II, BAI, PIES and WAI respectively. Mediation models were tested using structural equation modeling, controlling for age and gender. RESULTS: Emotional suppression was positively associated with depression and anxiety, and negatively associated with ego-strength. Ego-strength was negatively associated with depression and anxiety. Ego-strength partially mediated the relationship between emotional suppression and depression, and fully mediated the relationship between emotional suppression and anxiety. CONCLUSION: Ego-strength may help prevent the onset or unfavorable course of depression and anxiety in cancer patients.

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BACKGROUND: Stress during pregnancy can increase physical and mental health risks in parents and offspring. Emotion regulation (ER) may protect against prenatal stress; however, ER is understudied in expectant parents, particularly expectant fathers. This study aimed to evaluate associations between ER strategies (reappraisal, suppression, ratio of suppression-to-reappraisal) and perceived stress among expectant parents, and also test whether expectant mothers and fathers differed in ER strategy use and perceived stress levels. METHODS: N = 83 expectant parents (62.7% mothers) in the third trimester completed measures assessing perceived stress,reappraisal, and suppression. ANCOVA, hierarchical regression, and multilevel models were used to evaluate associations between ER strategies and perceived stress, and test for sex differences. RESULTS: Controlling for age and education, lower reappraisal and higher suppression were associated with higher perceived stress; in addition, higher suppression-to-reappraisal ratios were associated with greater perceived stress. Mothers and fathers did not differ in perceived stress, reappraisal, or suppression; however, suppression-to-reappraisal ratios significantly differed. CONCLUSION: Increasing ER skills such as reappraisal while reducing suppression may be beneficial for decreasing stress in expectant parents. Expectant fathers report similar levels of perceived stress to mothers and would benefit from prenatal mental health screening and intervention.

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Emotional suppression has been considered a critical factor in determining one's mental health and psychological well-being in intimate relationships such as marriage. The present study aimed to delineate the nuanced association between emotional suppression and psychological well-being in marriage by considering two critical factors: (a) individual differences in motivational orientation and (b) the perceived level of a partner's emotional suppression. A set of two online survey studies were conducted on a large sample of married participants. The participants were asked to indicate (a) their own level of emotional suppression, (b) the perceived level of their spouse's emotional suppression, (c) relationship motivation, and (d) satisfaction with marital life. The results consistently indicated that for prevention-focused individuals being emotionally suppressive was associated with greater marital satisfaction, but only for those who perceived their spouses as also emotionally suppressive. Conversely, for promotion-focused individuals, being less emotionally suppressive was associated with greater marital satisfaction, but again, only for those who perceived their spouses as also being less emotionally suppressive. These findings provide insights into research on emotion regulation and self-regulatory strategies in influencing psychological well-being and mental health in an intimate relationship.

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Emotional regulation is crucial to psychological functioning and mental health. Studies of male batterers indicate the critical role that emotional processing plays in the violence they exert upon their partners or ex-partners. The aim of this study was to investigate the neural bases of emotional regulation in male batterers-both in experiencing and suppressing emotions-when faced with pictures of intimate partner violence (IPV). We conducted a fMRI study to compare brain functioning when emotions were experienced or increased with the case in which emotions were suppressed or reduced in response to IPV pictures and unpleasant pictures. The sample consisted of three groups: Male Batterers Group (MBG, n = 26), that is, men convicted for IPV; Other Offenders Group (OOG, n = 27), men convicted of crimes other than IPV; and a Non-offenders Group (n = 29), that is, men without a criminal history. The results reveal that in MBG, the brain areas that previous studies have related to suppression and experience processes were activated when faced with unpleasant pictures. However, a different pattern of functioning was found when experiencing IPV pictures. That could be explained by a low capacity to empathize with their partners or ex-partners and by the use of maladaptive emotional regulation strategies. In addition, MBG showed activation in brain areas previously related to suppression but did not modulate their emotions, showing a similar emotional state after suppression and experience. The results of this preliminary study suggest that in psychological treatments for male batterers, it is important to promote empathy towards partners or ex-partners, along with adaptive strategies of emotional regulation.

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Childhood maltreatment (CM) and insecure attachment styles may partly explain grief severity following romantic breakup. Empirical studies examining the factors that could possibly explain this association, however, remain sparse. The present study tested whether the relations among CM, attachment styles, and romantic breakup grief severity could be explained by emotional suppression in Iranian college students. In a cross-sectional study, 239 Iranian college students (ages 18-45; M = 24.11, SD = 15.29; 50.6% women) with a recent romantic breakup experience were recruited from University of Tabriz. Participants completed a diagnostic interview and self-report battery, including the Persian version of the Child Abuse Self-Reported Scale, Revised Adult Attachment Scale, Romantic Breakup Grief Inventory, and Weinberger Adjustment Inventory. Structural equation modeling was used to empirically explore the relations among variables. Results indicated that those who reported higher levels of CM also reported higher levels of romantic breakup grief. Attachment closeness showed a significant negative and direct effect on romantic breakup grief severity. However, attachment anxiety was positively associated with greater levels of romantic breakup grief. Bootstrapping results showed that CM might affect romantic breakup grief severity via emotional suppression. Furthermore, attachment closeness and attachment anxiety exerted indirect effects on romantic breakup grief severity through emotional suppression. Clinical and empirical implications are discussed.

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PURPOSE: Emotional control, the attempt to suppress the expression of negative effects, is an essential factor in the prevalence of psychological distress in women with breast cancer. The Courtauld Emotional Control Scale (CECS) is a commonly used self-report tool for assessing emotional suppression in both clinical and general groups. This study aimed to validate the Chinese version of the Courtauld Emotional Control Scale (CECS) in women newly diagnosed with breast cancer. METHODS: The study involved 680 women newly diagnosed with breast cancer aged 25 to 76 (mean age = 48.19, standard deviation (SD) = 8.57) from Changsha (China). Data analysis included Cronbach's alpha coefficients, the intraclass correlation coefficient (ICC), Pearson's correlations, Independent-Samples T test, confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted to determine the optimal model. For the best fitting model stability was assessed with tests for invariance across age, educational level, and employment status. RESULTS: Internal consistency (α = 0.987) and test-retest reliability (ICC = 0.715) of the CECS were presented. Results confirm the structure of the Chinese version of the CECS with 21 items divided into three dimensions, anger suppression (CECS_AG), depression suppression (CECS_MD), and anxiety suppression (CECS_AX). Convergent and known-groups validity were acceptable. Additionally, this model remained invariant across age, educational levels, and employment status. CONCLUSIONS: The Chinese version of the CECS has good psychometric properties in terms of reliability and validity, remaining invariant across age, educational levels, and employment status in women newly diagnosed with breast cancer.

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Anxiety has been suggested to be a key contributing factor for compulsive exercise, however, existing literature has demonstrated contradictory relationships between anxiety and compulsive exercise among adolescents. According to the Emotional Cascade Model (ECM), factors such as rumination and emotional suppression may mediate the association between affect and exercise. The current study therefore aimed to investigate whether rumination and emotional suppression mediate the relationship between anxiety and compulsive exercise in predicting ED symptoms in adolescents. Questionnaires assessing compulsive exercise, anxiety, depressive rumination, emotional suppression, and ED symptoms were completed by 212 adolescent males (Mage = 13.39, SD = 1.22) and 189 adolescent females (Mage = 13.64, SD = 1.29). The structural equation model showed indirect effects between anxiety and compulsive exercise through rumination and emotional suppression in males but not in females. Moreover, anxiety had an indirect effect on eating disorder symptoms through rumination, emotional suppression and compulsive exercise in both males and females. In line with ECM, the results suggest that rumination and emotional suppression may have a key role in the association between anxiety, compulsive exercise and eating disorder symptoms in adolescents. These findings suggest that compulsive exercise may be used as a dysfunctional coping mechanism to escape from a negative emotional cascade generated by the interaction of anxiety, rumination and emotional suppression. Future longitudinal studies to test the role of compulsive exercise as a dysfunctional behaviour in the ECM are needed.

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Emotional suppression and cognitive reappraisal are emotion regulation strategies that have been linked to the severity of depression. Recent research has shown that greater ruminative inertia (i.e., rumination that is more resistant to change across time) is also associated with higher levels of depressive symptoms in clinical samples. However, it is unknown how tendencies to use suppression or reappraisal might be related to the inertia of rumination from day to day. After completing a baseline assessment of depressive symptoms and trait emotional suppression and cognitive reappraisal use, undergraduates (n = 94) completed daily-diary questionnaires assessing rumination for two weeks. Both higher depressive symptoms and greater tendencies to use suppression predicted stronger ruminative inertia, while tendencies to use reappraisal were unrelated to ruminative inertia. These results suggest that maladaptive emotion regulation strategies may contribute to a pattern of rumination that is more resistant to change over time. They also provide the first evidence that ruminative inertia is positively associated with depressive symptoms in a nonclinical sample.

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BACKGROUND: The devastation of the Syrian war can lead to a drastic re-evaluation of oneself and alteration in self-capacities. Yet, little is known regarding its impact on these domains among Syrian refugees. AIMS: To investigate the inter-relationship between trauma characteristics, trauma centrality, self-efficacy, emotional suppression, PTSD and psychiatric co-morbidity among Syrian refugees. METHODS: 1197 refugees from Turkey and Sweden completed the Harvard Trauma Questionnaire, General Health Questionnaire-28, Centrality of Event Scale, Generalized Self-Efficacy Scale and Courtauld Emotional Control Scale. RESULTS: Using the DSM-IV criteria for PTSD from the Harvard Trauma Questionnaire, 43% met the criteria. The PTSD group reported significantly higher levels of trauma characteristics, trauma centrality and psychiatric co-morbidity but a lower level of self-efficacy than the non-PTSD group. Trauma characteristics were positively associated with trauma centrality; trauma centrality was negatively correlated with self-efficacy. Contrary to hypothesis, self-efficacy was positively correlated with emotional suppression which was positively correlated with psychiatric co-morbidity but not PTSD. CONCLUSIONS: The experience of war can lead to the emergence of PTSD among Syrian refugees. Exposure to war can alter self-perception, belief of personal mastery over one's future and the way emotion is expressed, all of which can have specific effects on general psychological symptoms.

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