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1.  The Role of Attention to Emotion in Recovery from Major Depressive Disorder 
Major Depressive Disorder (MDD) is characterized by several emotional disturbances. One possible but not well-examined disturbance is in attention to emotion, an important facet of emotional awareness. We examined whether attention to emotion predicted recovery from MDD. Fifty-three adults with current MDD completed a week of experience sampling (Time 1). At each prompt, participants reported attention to emotion, negative affect (NA), and positive affect (PA). Approximately one year later (Time 2), the depressive status of 27 participants was reassessed. Participants who had recovered from MDD (n = 8) indicated paying less attention to their emotions at Time 1 than did participants who had not fully recovered (n = 19). Attention to emotion was better predictor of recovery than was severity of MDD, NA, or PA at Time 1. Levels of attention to emotion at Time 1 in participants who recovered from MDD did not differ significantly from the levels reported by 53 never-depressed individuals who had participated in the experience sampling. Findings indicate that high levels of an otherwise adaptive emotional facet can adversely affect the course of MDD.
PMCID: PMC3703346  PMID: 23853719
2.  Walk on the Bright Side: Physical Activity and Affect in Major Depressive Disorder 
Journal of abnormal psychology  2011;121(2):297-308.
Although prescribed exercise has been found to improve affect and reduce levels of depression, we do not know how self-initiated everyday physical activity influences levels of positive affect (PA) and negative affect (NA) in depressed persons. Fifty-three individuals diagnosed with Major Depressive Disorder (MDD) and 53 never-depressed controls participated in a seven-day experience sampling study. Participants were prompted randomly eight times per day and answered questions about their physical activity and affective state. Over the week, the two groups of participants did not differ in average level of physical activity. As expected, participants with MDD reported lower average PA and higher average NA than did never-depressed controls. Both participants with MDD and controls reported higher levels of PA at prompts after physical activity than at prompts after inactive periods; moreover, for both groups of participants, PA increased from a prompt after an inactive period to a subsequent prompt at which activity was reported. Depressed participants in particular showed a dose-response effect of physical activity on affect: longer duration and/or higher intensity of physical activity increased their PA significantly more than did short duration and/or lower intensity physical activity. Physical activity did not influence NA in either group. In contrast to previous treatment studies that examined the effects of prescribed structured exercise, this investigation showed that self-initiated physical activity influences PA. These findings also underscore the importance of distinguishing between PA and NA to gain a more comprehensive understanding of the effects of physical activity on affect in MDD.
PMCID: PMC3982878  PMID: 21553939
depression; experience sampling; positive affect; negative affect; exercise
3.  The Everyday Emotional Experience of Adults with Major Depressive Disorder: Examining Emotional Instability, Inertia, and Reactivity 
Journal of abnormal psychology  2012;121(4):819-829.
Investigators have begun to examine the temporal dynamics of affect in individuals diagnosed with Major Depressive Disorder (MDD), focusing on instability, inertia, and reactivity of emotion. How these dynamics differ between individuals with MDD and healthy controls have not before been examined in a single study. In the present study, 53 adults with MDD and 53 healthy adults carried hand-held electronic devices for approximately seven days and were prompted randomly eight times per day to report their levels of current negative affect (NA), positive affect (PA), and the occurrence of significant events. In terms of NA, compared with healthy controls, depressed participants reported greater instability and greater reactivity to positive events, but comparable levels of inertia and reactivity to negative events. Neither average levels of NA nor NA reactivity to, frequency or intensity of, events accounted for the group difference in instability of NA. In terms of PA, the MDD and control groups did not differ significantly in their instability, inertia, or reactivity to positive or negative events. These findings highlight the importance of emotional instability in MDD, particularly with respect to NA, and contribute to a more nuanced understanding of the everyday emotional experiences of depressed individuals.
PMCID: PMC3624976  PMID: 22708886
emotional variability; affective instability; experience sampling method; depression
4.  Concurrent and Prospective Relations between Attention to Emotion and Affect Intensity: An Experience Sampling Study 
Emotion (Washington, D.C.)  2011;11(6):1489-1494.
Theorists contend that emotional awareness is vital to being able to use emotional information adaptively. The extent to which individuals attend to and value their feelings, or attention to emotion, is a facet of emotional awareness. Little research, however, has examined whether attention to emotion affects the magnitude or intensity of emotional experiences. In the present study we examined the relations between attention to emotion and levels of affect in 53 healthy adults. Participants carried hand-held electronic devices for approximately seven days and were randomly prompted eight times per day to answer a series of questions. At each prompt, participants reported attention to emotion, current negative affect (NA), and positive affect (PA). All findings presented were computed using multilevel modeling. Replicating findings obtained using trait-level measures, we found that attention to emotion was associated concurrently with higher levels of both NA and PA. We also found prospectively that attention to emotion at one prompt predicted a decrease in levels of NA, but no change in levels of PA, at the subsequent prompt. These findings suggest that emotional processes serve different functions over time and highlight the role of attention to emotion in affect regulation.
PMCID: PMC3204007  PMID: 21534663
affect intensity; attention to emotion; emotional awareness; emotion regulation; experience sampling
5.  Cross-Sectional and Longitudinal Relations Between Affective Instability and Depression 
Journal of affective disorders  2010;130(1-2):53-59.
There is growing recognition that emotional traits are important for understanding many mental health disorders, including major depressive disorder (MDD). The present research examined (a) the relation between MDD and the emotional trait of affective instability, and (b) whether individual facets of affective instability, affect intensity and affect variability, exhibited unique relations with anhedonic depression.
In Study 1, affective instability and MDD were both assessed via clinical interviews in an adult community sample (n=288). In Studies 2 and 3, the relations between anhedonic depression and affect variability and affect intensity were assessed cross-sectionally using self-report measures in a college student sample (n=142; Study 2) and a female community sample (n=101; Study 3). Study 3 also prospectively examined whether affect variability and/or intensity predicted changes in anhedonic depression over two months.
In Study 1, affective instability and MDD were significantly associated, even after excluding individuals experiencing a current major depressive episode. In Studies 2 and 3, affect variability but not affect intensity was significantly, positively associated with anhedonic depression. In Study 3, affect variability but not affect intensity prospectively predicted increases in anhedonic depression.
Future studies should assess the entire Bipolar Disorder spectrum and utilize event sampling, permitting the examination of other facets of affective instability (e.g., temporal dependency) and address other limitations of retrospective measures (e.g., recall bias).
These findings suggest that affective instability and particularly affect variability are associated with MDD and anhedonic depression. The tendency to experience frequent fluctuations in mood may constitute an important risk factor for depression.
PMCID: PMC3035756  PMID: 20951438
major depressive disorder; affective instability; affect intensity; affect lability; mood variability
6.  Interoceptive Awareness, Positive Affect, and Decision Making in Major Depressive Disorder 
Journal of affective disorders  2013;151(2):780-785.
Little work has examined the relation between interoceptive awareness and symptoms of Major Depressive Disorder (MDD). Existing research suggests that depressed individuals exhibit impaired heartbeat perception, though the results of this research have been equivocal. Importantly, depressed participants in these studies have had comorbid anxiety disorders, making it difficult to draw inferences about interoceptive awareness in MDD. The current study addresses this issue by assessing heartbeat perception in depressed women without current anxiety disorders and exploring the relation between interoception and perturbations in both affective intensity and decision making, components of MDD postulated to be related to bodily awareness.
Depressed women without concurrent anxiety disorders (n=25) and never-disordered controls (n=36) performed a heartbeat perception task. Participants completed the self-report Affect Intensity Measure (AIM), and decision-making difficulty was assessed in MDD participants using the Structured Clinical Interview for DSM-IV.
Depressed women exhibited poorer heartbeat perception accuracy than did control participants. Impaired accuracy in MDD participants was associated with reduced positive affectivity and difficulty in decision making.
Our sample was composed exclusively of females and was heterogeneous with respect to treatment status, thereby limiting our ability to generalize results to depressed males and to exclude the contribution of exogenous factors to the observed group differences.
Results of this study suggest that for depressed individuals without anxiety comorbidities, disrupted perception of bodily responses reduces both the experience of positive arousal and the ability to use interoceptive feedback to inform decision making.
PMCID: PMC3797260  PMID: 23972662
depression; interoception; affect; decision making
7.  Oxytocin Receptor Gene Polymorphism (rs2254298) Interacts with Familial Risk for Psychopathology to Predict Symptoms of Depression and Anxiety in Adolescent Girls 
Psychoneuroendocrinology  2010;36(1):144-147.
The nonapeptide oxytocin and its receptor have been implicated in the regulation of mammalian social behavior and stress physiology. Evidence is accumulating that the quality of the parental environment is associated with oxytocin biology in children. The present study was designed to examine the interaction of the single nucleotide polymorphism (SNP) rs2254298 within the oxytocin receptor (OXTR) gene and quality of parental environment in predicting children's psychosocial functioning. More specifically, in a sample of 92 Caucasian adolescent girls (9- to 14-years old), we examined whether adverse parental environment, operationalized as mothers' history of recurrent major depressive disorder, interacts with the rs2254298 SNP on the OXTR gene to predict daughters' symptoms of depression and anxiety. Caucasian girls who both were heterozygous for the OXTR rs2254298 polymorphism and had high early adversity reported the highest levels of symptoms of depression, physical anxiety, and social anxiety. These findings highlight the potential importance of this OXTR gene polymorphism in the etiology of depression and anxiety disorders.
PMCID: PMC2997902  PMID: 20708845
oxytocin receptor gene; rs2254298; maternal depression; anxiety; adolescents
8.  Maladaptive Coping, Adaptive Coping, and Depressive Symptoms: Variations across Age and Depressive State 
Behaviour research and therapy  2010;48(6):459-466.
Rumination has consistently been found to be associated with the onset and duration of major depressive episodes. Little research, however, has examined factors that may weaken the association between maladaptive coping, such as rumination, and depressive symptoms. In three samples of participants, including 149 never-depressed adolescent girls, 41 never-depressed women, and 39 depressed women, we examined whether generally adaptive forms of coping interacted with generally maladaptive coping to predict depressive symptoms. Age-appropriate measures of coping and depression were administered to participants in each sample. In never-depressed females, maladaptive coping / rumination were more strongly related to depressive symptoms in the presence of lower levels of adaptive coping. The relation between depression and maladaptive coping / rumination was weaker in the context of higher levels of adaptive coping. In contrast, for the depressed females, we found main effects for rumination and adaptive coping, with higher levels of rumination and lower levels of adaptive coping being associated with higher levels of depressive symptoms. The present findings highlight how adaptive coping and maladaptive coping, including rumination, differentially relate to each other and depressive symptoms depending on individuals’ current depressive state.
PMCID: PMC2872051  PMID: 20211463
depression; rumination; responses to stress; coping
9.  The Unique Relations between Emotional Awareness and Facets of Affective Instability 
The relation between affective instability and two facets of emotional awareness, attention to emotion and clarity of emotion, was examined in two community samples (Ns = 303, 101) and one student sample (N=409). Affective instability was positively associated with attention to emotion and negatively associated with clarity of emotion. The two facets of affective instability, affect intensity and emotional variability, were differentially associated with the two components of emotional awareness. As hypothesized, affect intensity was uniquely associated with attention to emotion, whereas emotional variability was uniquely (inversely) associated with clarity of emotion even after taking into account shared variance with neuroticism and gender.
PMCID: PMC2826712  PMID: 20190861
affective instability; affect intensity; lability; variability; emotional awareness
10.  Feeling Blue or Turquoise? Emotional Differentiation in Major Depressive Disorder 
Psychological science  2012;23(11):1410-1416.
Some individuals have very specific and differentiated emotional experiences, such as anger, shame, excitement, and happiness, whereas others have more general affective experiences of pleasure or discomfort that are not as highly differentiated. Considering that individuals with major depressive disorder (MDD) have cognitive deficits for negative information, we predicted that people with MDD would have less differentiated negative emotional experiences than would healthy people. To test this hypothesis, we assessed participants' emotional experiences using a 7-day experience-sampling protocol. Depression was assessed using structured clinical interviews and the Beck Depression Inventory-II. As predicted, individuals with MDD had less differentiated emotional experiences than did healthy participants, but only for negative emotions. These differences were above and beyond the effects of emotional intensity and variability.
PMCID: PMC4004625  PMID: 23070307
emotions; depression; happiness; emotional control; individual differences
11.  Flexible Emotional Responsiveness in Trait Resilience 
Emotion (Washington, D.C.)  2011;11(5):1059-1067.
Field studies and laboratory experiments have documented that a key component of resilience is emotional flexibility – the ability to respond flexibly to changing emotional circumstances. In the present study we tested the hypotheses that resilient people exhibit emotional flexibility: a) in response to frequently changing emotional stimuli; and b) across multiple modalities of emotional responding. As participants viewed a series of emotional pictures, we assessed their self-reported affect, facial muscle activity, and startle reflexes. Higher trait resilience predicted more divergent affective and facial responses (corrugator and zygomatic) to positive versus negative pictures. Thus, compared with their low resilient counterparts, resilient people appear to be able to more flexibly match their emotional responses to the frequently changing emotional stimuli. Moreover, whereas high trait resilient participants exhibited divergent startle responses to positive versus negative pictures regardless of the valence of the preceding trial, low trait resilient participants did not exhibit divergent startle responses when the preceding picture was negative. High trait resilient individuals, therefore, appear to be better able than are their low-resilient counterparts to either switch or maintain their emotional responses depending on whether the emotional context changes. The present findings broaden our understanding of the mechanisms underlying resilience by demonstrating that resilient people are able to flexibly change their affective and physiological responses to match the demands of frequently changing environmental circumstances.
PMCID: PMC3183326  PMID: 21707168
resilience; emotional flexibility; affect; EMG; startle reflex
12.  5-HTTLPR Moderates the Effect of Relational Peer Victimization on Depressive Symptoms in Adolescent Girls 
Relational peer victimization is associated with internalizing symptoms. Compared to boys, girls are more likely to be both relationally victimized by peers and distressed by the victimization. While previous studies have reported that a functional polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) moderates the effect of stressful life events on depressive symptoms, the present study is the first to evaluate the interaction of this polymorphism with relational peer victimization to predict level of depressive symptoms in young girls.
Participants were 78 girls ages 10 to 14 who had no current or past Axis I disorder. Girls were genotyped for 5-HTTLPR; peer victimization was assessed with the Social Experiences Questionnaire, and depressive symptoms with the Children's Depression Inventory.
The 5-HTTLPR polymorphism alone did not predict level of depressive symptoms; the interaction of 5-HTTLPR and relational peer victimization, however, was a significant predictor of depressive symptoms. Follow-up analyses indicated that peer victimization significantly predicted level of depressive symptoms only for girls who were homozygous for the short allele, and not for girls homozygous for the long allele or who were heterozygous for the short and long alleles.
The findings support the diathesis-stress model of depression: having two 5-HTTLPR short alleles confers vulnerability to depressive symptoms in adolescent girls when they experience relational peer victimization. These findings also suggest that relational peer victimization, at least for girls with genetic vulnerability, is a significant source of stress and should be recognized in the monitoring and prevention of bullying.
PMCID: PMC2804775  PMID: 19754661
peer victimization; bullying; depression; genetic polymorphisms; 5-HTTLPR
13.  BDNF Genotype Moderates the Relation Between Physical Activity and Depressive Symptoms 
To test whether the BDNF gene interacts with exercise to predict depressive symptoms. Physical activity is associated with a range of positive health outcomes, including fewer depressive symptoms. One plausible mechanism underlying these findings involves Brain-Derived Neurotrophic Factor (BDNF), a protein hypothesized to limit or repair the damage caused by stress. Physical activity increases expression of BDNF, which may enhance brain health. BDNF expression is controlled by the BDNF gene. Compared with individuals without a BDNF met allele, met-allele carriers have a lower expression of BDNF, which has been associated with Major Depressive Disorder.
Eighty-two healthy adolescent girls were genotyped for the BDNF val66met polymorphism, and their depressive symptoms and physical activity were assessed using questionnaires.
Main Outcome Measures
BDNF genotype, Children's Depression Inventory, and the Physical Activity Questionnaire for Older Children and Adolescents.
The BDNF polymorphism was found to moderate the relation between exercise and depressive symptoms: being physically active was protective for girls with a BDNF met allele (fewer depressive symptoms) but not for girls with the val/val polymorphism.
By integrating psychological and biological factors, the present study enhances our understanding of how physical activity contributes to resilience to psychopathology.
PMCID: PMC2847262  PMID: 20230085
BDNF; exercise; depression; adolescents; physical activity

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