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This study identified psychological profiles based on depressive symptoms, anxiety symptoms, positive affect, and posttraumatic growth in 298 patients receiving maintenance dialysis, and examined their relationships with self-management at baseline and 1-year follow-up. Five psychological response profiles were identified: well-being (42.95%), resilient (26.17%), moderate-distress-with-growth (17.79%), distressed (11.07%), and high-distress-with-growth (2.01%). Patients were more likely to be in the distressed profile if they were younger, had less social support, received peritoneal dialysis, and suffered from a greater symptom burden of kidney disease. The well-being profile showed better self-management behavior at baseline and 1-year follow-up. The distressed profile was associated with worse self-management at baseline and the resilient profile was associated with worse self-management at follow-up. The findings highlighted the beneficial role of positive psychological constructs in promoting self-management behavior, which implied that beyond eliminating psychological distress, it is important to facilitate positive psychological well-being.

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Bullying victimization is prevalent among adolescents and often linked to emotional problems. Prior studies have been focused on the concurrent or longitudinal associations between bullying victimization and emotional problems, but the daily associations and the underlying mechanisms remain unclear. Implementing daily diary method, the study aimed to examine the links between daily victimization and positive and negative affect as well as the mediating role of sleep quality and disturbance. A total of 265 Chinese adolescents (Mage = 11.65, SD = 0.74; 32.80% females) participated in this study and completed 7-day daily diaries on bullying victimization (traditional and cyber victimization), sleep quality and disturbance, and affect. As hypothesized, at the between-person level, sleep disturbance mediated the relationships between both traditional and cyber victimization and subsequent negative affect. At the within-person level, sleep quality mediated the pathway between traditional victimization and next-day negative affect; furthermore, sleep disturbance mediated the pathway between traditional victimization and positive affect the following day. These findings highlight the mediating roles of sleep quality and sleep disturbance in the relationships between stressful victimizing experiences and emotional problems and also provide novel insights into these associations.

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Pregnancy involves various physiological, physical, and social changes that can impact the mental health of the woman, causing her to have a stressful experience. Physical fitness (PF) is postulated as a powerful marker of health in this population. Therefore, this longitudinal study examined the association of PF with maternal emotional well-being and ill-being outcomes at 16th and 34th gestational weeks (g.w.) in a sample of 158 pregnant women (32.9 ± 4.7 years old). Self-reported PF was assessed with the valid and feasible International Fitness Scale [i.e., overall PF, cardiorespiratory fitness (CRF), muscular strength, speed-agility, and flexibility]; positive and negative affect, emotional intelligence, and resilience were measured using validated questionnaires specifically designed for this purpose. The results showed that women with greater overall PF and its components showed higher positive affect and lower negative affect (all, p < 0.05); greater emotional intelligence (all, p < 0.05); and greater resilience (all, p < 0.05), with similar results both in the 16th and the 34th g.w. These findings underscore the pivotal role of PF in promoting emotional health and resilience during pregnancy, thereby highlighting the need for integrating PF enhancement strategies in prenatal care programs.

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BACKGROUND: Positive expressive writing is associated with enhanced psychological wellbeing. Several individual differences are known to moderate the enhancement effects of positive expressive writing, but no studies to date have investigated the optimal dietary conditions under which expressive writing effects occur. In this pilot study, we sought to investigate whether diet quality and dietary fibre intake moderate the effects of positive writing on mood. METHODS: The participants (12 males, 25 females, Mage = 33.0, SDage = 13.1) completed self-reported measures of dietary quality, dietary fibre intake, and positive and negative affect. They were then randomly allocated to complete either a positive expressive writing or neutral writing activity for 10 min. Positive and negative affect were measured again immediately after each activity. RESULTS: Those participants who reported better diet quality and greater dietary fibre intake exhibited a significantly greater increase in positive affect following positive expressive writing relative to neutral writing. No significant effects were observed for negative affect. CONCLUSIONS: For the first time, we report that the effects of positive expressive writing on positive mood are enhanced under optimal dietary conditions. Further replication studies are needed to determine whether dietary factors can influence the conditions under which positive expressive writing benefits occur. We speculate that dietary influences on the gut-brain axis are a potential mechanism.

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Stress among college students is a well-explored area with profound implications for their emotional well-being. Despite extensive research, the literature presents inconsistent and mixed findings regarding its relationship with emotional well-being, particularly focusing on medical students. Moreover, there is no meta-analytic study to address this inconsistency. To bridge these gaps, this study conducts a systematic review and meta-analysis to explore the nuanced association between stress among non-medical college students and their emotional well-being. The systematic review utilized databases: PubMed, Scopus, and Web of Science, search engine: Google Scholar, and gray literature sources: ProQuest and Research Gate. The dataset consisted of 46 eligible studies (k), comprising 26,214 participants across 20 countries. The mean age was 21.86 (k = 32), with females constituting 60 % (k = 45). The majority of studies employed a cross-sectional/correlational design. The estimated pooled correlation is found to be -0.27 (95 % CI: -0.33, -0.21, p < .01; I2 = 97.5 %, k = 46). Subgroup analysis revealed significant influences of the type of stress (p < .01), emotional well-being (p < .01), tools (p < .01) used, significance status of findings (p < .001), and demographic factors - country (p < .001) and income level (p < .05). The study found an inversely significant and moderate association between stress and emotional well-being in non-medical college students, consistent with existing literature. Significant moderation by study and demographic variables suggests substantial heterogeneity among studies, highlighting potential influences from demographics, methodologies, and populations.

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There is emerging interest in understanding positive affect dysfunction in relation to anxiety, including worry. This set of two studies examined the association between the inhibition of affect expression (general affect expressivity in Study 1, positive affect expressivity in Study 2) and worry, with a particular interest in the moderating role of proneness to experience positive affect. Subjects were US-residing adults (Study 1 N = 502, Study 2 N = 250) who were recruited through a crowdsourcing website and completed self-report measures of study variables. Moderated regression was used to examine study predictions that affect expression would negatively correlate with worry when coupled with diminished positive affect. Proneness toward negative affect was included as a covariate within multivariate analyses. An interactive effect between affect expressivity and positive affect was supported in Study 2 (positive affect expressivity) but not Study 1 (general affect expressivity) in relation to worry. A diminished tendency to express positive affect was associated with greater worry when coupled with less positive affect. Study results and future directions are discussed in terms of the potential emotion-regulatory functions of positive affect expressivity as it relates to worry.

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Fibromyalgia, characterized by chronic pain and cognitive impairments, significantly impacts patients' quality of life. Physical exercise has been shown to improve cognitive functions and reduce pain severity. Additionally, positive affect enhances cognitive flexibility and facilitates better adaptation to chronic pain, suggesting that combining physical activity and positive affect could mitigate cognitive deficits in fibromyalgia patients. Objectives: The objective of this work is to explore the relationship between pain severity and cognitive performance through time spent doing moderate physical activity while taking into account the role of positive affect in fibromyalgia. Methods: This prospective study was structured into two phases of evaluation. First, pain severity, positive affect, and time spent performing moderate physical activity were evaluated, and one week later cognitive performance (assessed through the Stroop test) was also evaluated. The final sample consisted of 231 women with fibromyalgia. Moderated mediation analyses were performed using PROCESS. Results: The moderated mediation model showed that the effect of moderate physical activity on the relationship between pain severity and cognitive performance was significant for low levels of positive affect but not for moderate or high levels. That is, the indirect effect of pain intensity on cognitive performance through time spent doing moderate physical activity only has an effect when patients with fibromyalgia present low levels of positive affect. However, there was no significant indirect effect in the simple mediation model. Conclusions: The findings of this study underscore the importance of considering the level of positive affect when examining the impact of moderate physical activity on cognitive performance in women with fibromyalgia.

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Anxiety disorders are common and highly distressing mental health conditions. Exposure therapy is a gold-standard treatment for anxiety disorders. Mechanisms of Pavlovian fear learning, and particularly fear extinction, are central to exposure therapy. A growing body of evidence suggests an important role of reward processes during Pavlovian fear extinction. Nonetheless, predominant models of exposure therapy do not currently incorporate reward processes. Herein, we present a theoretical model of reward processes in relation to Pavlovian mechanisms of exposure therapy, including a focus on dopaminergic prediction error signaling, coinciding positive emotional experiences (i.e., relief), and unexpected positive outcomes. We then highlight avenues for further research and discuss potential strategies to leverage reward processes to maximize exposure therapy response, such as pre-exposure interventions to increase reward sensitivity or post-exposure rehearsal (e.g., savoring, imaginal recounting strategies) to enhance retrieval and retention of learned associations.

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Alterations in dynamic affective processes are associated with dysregulated affect and depression. Although depression is often associated with heightened inertia (i.e., greater moment-to-moment correlation) and variability (i.e., larger departures from typical levels) of affect in adults, less is known about whether altered affect dynamics are present in youth at risk for depression. This study investigated the association of clinical depression and depression risk with the inertia and variability of positive and negative affect in a sample of youth at varying risk for depression. Our sample included 147 adolescents aged 14 to 17, categorized into three groups: never-depressed lower-risk, never-depressed higher-risk (based on maternal history of depression), and currently depressed adolescents. Adolescents completed ecological momentary assessments of positive and negative affect up to seven times per day for a week. Multilevel models and ANOVAs were used to examine associations of affective inertia and variability with adolescent depression and risk based on maternal history, controlling for average affect. Depressed adolescents showed more inert and diminished positive affect, and more variable and elevated negative affect compared to lower- and higher-risk youth, though associations attenuated after controlling for average affect. No differences were identified between never-depressed higher-risk and lower-risk youth. Additional longitudinal studies are needed to evaluate whether altered affect dynamics in daily life precede depression onset to understand their utility for developing preventive interventions.

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OBJECTIVE: Increased attention has recently been paid to the well-being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength-based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions. METHODS: This is a secondary analysis of a randomized controlled trial. Seventy-eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; Mage = 40.31) treated by 13 therapists were selected. PA and strength-based behaviours of patients and therapists were coded on a minute-by-minute basis with the Resource-Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling. RESULTS: Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength-based behaviours were employed in one-fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength-based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend. CONCLUSION: Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).

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BACKGROUND: Mechanisms underlying psychostimulant euphoria remain poorly understood. In adult rats, positive emotional states are associated with alterations in 50-kHz ultrasonic vocalizations (USVs): specifically, "trill" calls are promoted over "flat" calls. Here, we investigated the effects of acute and repeated cocaine administration, and-based on previous findings with amphetamine-their possible dependence on beta-adrenergic receptors. METHODS: Adult male Long-Evans rats received intraperitoneal drug or saline injections before daily USV recording. Fourteen 50-kHz call subtypes were analyzed. In Experiments 1 and 2, cocaine (1-10 mg/kg) and propranolol (10 mg/kg) were tested alone. In Experiment 3, propranolol/cocaine interactions were sought within a conditioned place preference (CPP) procedure. Experiment 4 investigated acute and chronic cocaine effects (Phase 1), and propranolol/cocaine interactions either in an open field (Phase 2) or within a CPP procedure (Phase 3). RESULTS: In drug-naïve animals, cocaine increased the 50-kHz call rate, with sensitization developing rapidly. After more extended exposure, cocaine now also increased the relative prevalence of trill versus flat calls; effects on other subtypes were also revealed. The beta-blocker propranolol prevented neither cocaine CPP nor cocaine effects on USV emission or locomotion but exerted significant USV-related effects when given alone. CPP magnitude and USV-related measures were uncorrelated. CONCLUSIONS: With long-term intraperitoneal administration, cocaine can alter the relative prevalence of several 50-kHz call subtypes; its ability to promote trill versus flat calls, in particular, is consistent with a positive affect interpretation. Cocaine's behavioral effects (i.e., USV-related, locomotor, CPP) appear independent of beta-adrenergic receptor activity.

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Dopamine replacement therapy (DRT) of Parkinson's disease (PD) may trigger non-motor complications, some of which affect hedonic homeostatic regulation. Management of iatrogenic alterations in the affective state in PD is unsatisfactory, partly because of the limitations in the experimental models that are used in the preclinical investigation of the neurobiology and therapy of these alterations. In this connection, we recently employed a new experimental approach consisting in measuring the emission of 50-kHz ultrasonic vocalizations (USVs), a marker of positive affect, in hemiparkinsonian rats treated with drugs used in the DRT of PD. To further strengthen our approach, we here evaluated how the acute and repeated (× 5, on alternate days) administration of apomorphine (2 mg/kg, i.p.) or L-3,4-dihydroxyphenilalanine (L-DOPA, 12 mg/kg, i.p.) modified the immunoreactivity for Zif-268, a marker of neuronal activation, in the nucleus accumbens (NAc), caudate-putamen (CPu) and medial prefrontal cortex (mPFC), which are brain regions that regulate emotional states and drugs' affective properties. Acute and repeated treatment with either apomorphine or L-DOPA stimulated the emission of 50-kHz USVs in hemiparkinsonian rats, and this effect was paired with increased Zif-268 immunoreactivity in the NAc and CPu, but not mPFC. These findings indicate that subcortical and cortical regions may differently regulate the emission of 50-kHz USVs in hemiparkinsonian rats treated with dopaminergic drugs used in the DRT of PD. Moreover, they provide further evidence that measuring 50-kHz USV emissions in hemiparkinsonian rats may be a relevant approach to investigate at the preclinical level the affective properties of antiparkinsonian drugs.

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This study examined the impact of positive psychology variables, namely trait emotional intelligence (EI), positive affect and self-care, on academic engagement (AE) in an online learning environment during COVID-19. The study involved 717 undergraduates in Lebanon and utilised structural equation modelling for data analysis. The results demonstrated that positive affect and self-care mediated the relationship between trait EI and AE. In women, both self-care and positive affect were mediators, whereas in men, positive affect was the only mediator. For students who received a mix of synchronous and asynchronous lessons, both self-care and positive affect mediated the relationship between trait EI and AE. However, for those who received only synchronous lessons, positive affect was the sole mediator. Furthermore, AE significantly predicted academic performance (AP) in both models. These findings suggest the importance of interventions that enhance trait EI, positive emotions and self-care to improve AE and ultimately AP in online learning.

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The present study examines the extent to which a two-factor model of affect explains how caregiving appraisals experienced by caregivers influence their own well-being. We used data from three waves of Nation Study of Caregiving (NSOC) to conduct latent growth curve models with the time-varying predictors to investigate the effect of between-person (BP) and within-person (WP) caregiving appraisals on positive and negative affect. Furthermore, we simultaneously modeled WP differences in activity participation and affective experience with multilevel modeling. Then, we tested the moderating effect of activity participation in the association between WP caregiving appraisals and emotional valence. We found that BP and WP caregiving negative appraisal also contribute to caregiver positive affect similar to that of negative affect. Time-varying effects of negative appraisals and emotional valence are consistent with the two-factor model. Future longitudinal investigations could target WP and BP activity participation to alleviate caregiving cognitive appraisal among caregivers.

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INTRODUCTION: We test the effects of positive affect and its arousal subscale components of calm, wellbeing, and vigor on asthma control and symptom severity in adolescents with moderate to severe asthma. Additionally, we test whether positive affect (and its arousal components) moderate how stress impacts asthma control and symptom severity. METHODS: Adolescents with asthma (N = 66, ages 12-17) completed brief surveys 4 times a day for 7 days reporting on their positive affect, stress, and asthma symptom severity and conducted a morning peak expiratory flow assessment each day. Asthma control and psychological asthma triggers were assessed at the end of the 7 days. RESULTS: Positive affect moderated the association between stress and asthma control (b = -0.33, p = 0.009) as well as the association between psychological triggers and asthma control (b = -0.74, p = 0.007). When assessing the positive affect arousal components, calm and wellbeing seemed to be driving these effects. Additionally, calm moderated the association between stress and asthma symptom severity (b = -0.33, p = 0.036) as well as the association between psychological triggers and asthma symptom severity (b = -0.75, p = 0.021). CONCLUSIONS: When considering patient stress (e.g., general stress, psychological asthma triggers), positive affect and its arousal components of calm and wellbeing may be helpful for patients with higher levels of stress and/or for patients experiencing greater numbers of psychological triggers.

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BACKGROUND: Emotional clarity has often been assessed with self-report measures, but efforts have also been made to measure it passively, which has advantages such as avoiding potential inaccuracy in responses stemming from social desirability bias or poor insight into emotional clarity. Response times (RTs) to emotion items administered in ecological momentary assessments (EMAs) may be an indirect indicator of emotional clarity. Another proposed indicator is the drift rate parameter, which assumes that, aside from how fast a person responds to emotion items, the measurement of emotional clarity also requires the consideration of how careful participants were in providing responses. OBJECTIVE: This paper aims to examine the reliability and validity of RTs and drift rate parameters from EMA emotion items as indicators of individual differences in emotional clarity. METHODS: Secondary data analysis was conducted on data from 196 adults with type 1 diabetes who completed a 2-week EMA study involving the completion of 5 to 6 surveys daily. If lower RTs and higher drift rates (from EMA emotion items) were indicators of emotional clarity, we hypothesized that greater levels (ie, higher clarity) should be associated with greater life satisfaction; lower levels of neuroticism, depression, anxiety, and diabetes distress; and fewer difficulties with emotion regulation. Because prior literature suggested emotional clarity could be valence specific, EMA items for negative affect (NA) and positive affect were examined separately. RESULTS: Reliability of the proposed indicators of emotional clarity was acceptable with a small number of EMA prompts (ie, 4 to 7 prompts in total or 1 to 2 days of EMA surveys). Consistent with expectations, the average drift rate of NA items across multiple EMAs had expected associations with other measures, such as correlations of r=-0.27 (P<.001) with depression symptoms, r=-0.27 (P=.001) with anxiety symptoms, r=-0.15 (P=.03) with emotion regulation difficulties, and r=0.63 (P<.001) with RTs to NA items. People with a higher NA drift rate responded faster to NA emotion items, had greater subjective well-being (eg, fewer depression symptoms), and had fewer difficulties with overall emotion regulation, which are all aligned with the expectation for an emotional clarity measure. Contrary to expectations, the validities of average RTs to NA items, the drift rate of positive affect items, and RTs to positive affect items were not strongly supported by our results. CONCLUSIONS: Study findings provided initial support for the validity of NA drift rate as an indicator of emotional clarity but not for that of other RT-based clarity measures. Evidence was preliminary because the sample size was not sufficient to detect small but potentially meaningful correlations, as the sample size of the diabetes EMA study was chosen for other more primary research questions. Further research on passive emotional clarity measures is needed.

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Anhedonia is characterized by diminished reward processing, which may be explained in part by dampening appraisals, or thoughts that blunt positive emotions. Experiential processing, or attending to sensory and bodily experience, may curb dampening appraisals, as compared to analytical processing, or conceptually thinking about an event. In this study, 96 participants with elevated anhedonia completed writing tasks, in which they recalled positive autobiographical memories. Participants recalled the first memory as they naturally would to assess spontaneous use of processing mode and were then randomized to recall the second positive memory using either experiential, analytical, or control instructions. Both spontaneous and instructed experiential processing were associated with greater positive affect and less dampening compared to analytical processing. Clinical implications include savoring pleasant sensations to reduce dampening and enhance positive affect in anhedonia.

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BACKGROUND: Positive affect synchrony, or the reciprocal exchange of positive affect during free play, can scaffold infants' socioemotional development. However, parental stress may compromise the expression and exchange of positive affect within families. The current study assesses whether parenting stress and hair cortisol are associated with positive affect synchrony during a triadic play interaction. METHOD: Within 70 different-sex dyads consisting of first-time parents and their six-month-old infants who participated in a four-minute laboratory-based free-play task, facial affect of each member of the triad was observationally microcoded at the second-by-second level. Hair samples were collected from mothers and fathers for cortisol assay, and parents completed a self-report measure of parenting stress. RESULTS: Using dynamic structural equation modeling (DSEM), we found positive between-level and within-level affect synchrony across all family members, with one exception: infants' affect did not predict fathers' affect at the following timepoint. Mother-to-infant affect synchrony was greater in mothers with higher hair cortisol. Similarly, mothers with higher parenting stress tended to have greater infant-to-mother affect synchrony, and had infants that displayed less overall positive affect across the interaction. CONCLUSION: We found evidence for bidirectional, time-lagged synchrony in the momentary positive affect of mothers, fathers, and infants. Maternal hair cortisol concentration and parenting stress seem to increase affect synchrony between mothers and infants- suggesting that parental stress may correlate with greater affective attunement, but less overall positive affect in infants.

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