One of the fastest growing areas within psychology is the field of emotion regulation. However, enthusiasm for this topic continues to outstrip conceptual clarity, and there remains considerable uncertainty as to what is even meant by “emotion regulation.” The goal of this review is to examine the current status and future prospects of this rapidly growing field. In the first section, I define emotion and emotion regulation and distinguish both from related constructs. In the second section, I use the process model of emotion regulation to selectively review evidence that different regulation strategies have different consequences. In the third section, I introduce the extended process model of emotion regulation; this model considers emotion regulation to be one type of valuation, and distinguishes three emotion regulation stages (identification, selection, implementation). In the final section, I consider five key growth points for the field of emotion regulation.

Emotion Regulation: Current Status and Future Prospects

Context Morbidity and mortality rates in patients with eating disorders are thought to be high, but exact rates remain to be clarified. Objective To systematically compile and analyze the mortality rates in individuals with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS). Data Sources A systematic literature search, appraisal, and meta-analysis were conducted of the MEDLINE/PubMed, PsycINFO, and Embase databases and 4 full-text collections (ie, ScienceDirect, Ingenta Select, Ovid, and Wiley-Blackwell Interscience). Study Selection English-language, peer-reviewed articles published between January 1, 1966, and September 30, 2010, that reported mortality rates in patients with eating disorders. Data Extraction Primary data were extracted as raw numbers or confidence intervals and corrected for years of observation and sample size (ie, person-years of observation). Weighted proportion meta-analysis was used to adjust for study size using the DerSimonian-Laird model to allow for heterogeneity inclusion in the analysis. Data Synthesis From 143 potentially relevant articles, we found 36 quantitative studies with sufficient data for extraction. The studies reported outcomes of AN during 166 642 person-years, BN during 32 798 person-years, and EDNOS during 22 644 person-years. The weighted mortality rates (ie, deaths per 1000 person-years) were 5.1 for AN, 1.7 for BN, and 3.3 for EDNOS. The standardized mortality ratios were 5.86 for AN, 1.93 for BN, and 1.92 for EDNOS. One in 5 individuals with AN who died had committed suicide. Conclusions Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN. The mortality rates for BN and EDNOS are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/1107207/yma15002_724_731_1613431074.93299.pdf

Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies

Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15–19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.

/pdf/epidemiology-of-eating-disorders-incidence-prevalence-and-1g6c2y7dul.pdf

Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates

Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.

/pdf/racism-as-a-determinant-of-health-a-systematic-review-and-5b9bfaoy6w.pdf

Racism as a Determinant of Health: A Systematic Review and Meta-Analysis

Data Sources: A systematic literature search, ap­ praisal, and meta-analysis were c onducted of the MFDUNElPuhMed. PsycINFO, and Embase databases and 4 full-text collections (ie, ScienceOirect, lngenta Se­ lect, Ovid, and Wiley-Blackwell Interscience) . Data Synthesis: From 143 potentially relevant ar ticles, we found 36 quantitative studies with sufficient data for extraction. The studies reported outcomes of AN during 166 642 person-years, BN during 32 798 person­ years, and EDNOS during 22 644 person-years. The weighted mortality rates (ie, deaths per 1000 person years) were 5.1 for AN, 17 for BN, and 3.3 for EONO� The standardized mortality ratios were 5.86 for AN, I.\)3 for BN, and 1.92 for FONOS. One in 5 individuals wllh AN who died had committed suicide

/pdf/mortality-rates-in-patients-with-anorexia-nervosa-and-other-lf0m2gdc61.pdf

Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders

Objective

We determined the standardized mortality ratio (SMR) in our anorexia nervosa (AN) patient population.



Method

We used a cross-sectional design to study an inception cohort (1981–2000) drawn from the provincial tertiary care eating disorders program at St. Paul's Hospital (British Columbia, Canada). All patients who completed their initial assessment for an eating disorder were included in the study. Vital status, date and cause of death from British Columbia Vital Statistics Agency, date of assessment, date of birth, and diagnosis at the time of assessment were collected for each patient.



Results

Of 954 patients, 326 diagnosed with AN completed an assessment over the 20 years. The SMR was 10.5 (95% confidence interval [CI] = 5.5–15.5) for AN.



Discussion

Some studies in the literature report that AN has the highest mortality rate of any psychiatric disorder in young females. However, others dispute this fact and report an SMR lower than the normal population mortality (SMR = 0.71). Contrary to some reports in the literature, our study confirms a high mortality rate within the AN population. © 2005 by Wiley Periodicals, Inc.

The mortality rate from anorexia nervosa.

Based on Markus and Kitayama's (1991) theory, this study was conducted to examine whether the association between emotional suppression and interpersonal harmony would be moderated by cultural group (i.e., Chinese and European Americans) and an Asian cultural value (i.e., emotional self-control). A total of 451 college students (205 Chinese and 246 European Americans) participated in this study. As expected, results indicated that the association between emotional suppression and interpersonal harmony was significantly positive for Chinese but not significant for European Americans. Similarly, when emotional self-control was examined as a moderator, the results still confirmed our hypotheses. That is, the association between emotional suppression and interpersonal harmony was significantly positive for those with stronger endorsement of emotional self-control but not for those with weaker endorsement of emotional self-control. Furthermore, we examined whether the above results could be replicated when forbearance (a construct similar to suppression) and distress disclosure (a construct opposite to suppression) were examined. The results showed the same pattern for forbearance and distress disclosure when cultural group or emotional self-control served as the moderator. The convergence of findings increased the robustness of our results. Finally, our data suggest that individuals from Eastern, interdependent cultures (e.g., Chinese) tend to value emotional suppression to preserve interpersonal harmony; individuals from Western, independent cultures may or may not necessarily suppress their emotions for this purpose. A comprehensive understanding of the different meanings of a specific strategy (i.e., emotional suppression) in different cultural contexts is important to promote effective cross-cultural counseling.

Suppression and interpersonal harmony: a cross-cultural comparison between Chinese and European Americans.

Two coping strategies-problem solving and social support seeking-were hypothesized to differentially moderate the effects of intergenerational family conflict on well-being and adjustment in a college sample of 117 Asian American young adult children. Results indicated that social support served as a protective-stabilizing factor that buffered the effects of family conflict on positive affect and somatic distress. Problem-solving coping served as a protective-reactive factor that had a positive effect on positive affect when family conflict was low and a negative effect when family conflict was high. The potential implications of these findings for counseling and conducting research on Asian American college students are discussed.

Coping with intergenerational family conflict among Asian American college students

The authors conducted 3 studies to test a socioecological model of procommunity action Study 1 showed that residents of stable communities purchased a "critical habitat" license plate to support preservation of the environment in their home state more often than did residents of mobile communities Study 2 demonstrated that home game baseball attendance was less dependent on the team's record in stable cities than in mobile cities Study 3, an experiment, showed that residential stability had a causal impact on procommunity behavior Moreover, the effect of stability was partially mediated by identification with the "community" Together, these studies indicate that residential stability can lead to stronger identification with one's community, which, in turn, leads to more procommunity behaviors

The socioecological model of procommunity action: the benefits of residential stability.

Problem solving and social support, as different styles of coping with intergenerational family conflict, were examined among 86 Hmong American college students. Problem solving and social support were hypothesized to differentially moderate the effects of family conflict on psychological adjustment. Furthermore, the effects of attributions of blame on the adjustment of Hmong American college students were examined. Results indicate that social support buffered and problem solving enhanced the negative effects of family conflict on symptoms of distress but not on affect. Additionally, there were significant interaction effects between family conflict and self-blame on distress. Specifically, students who were more likely to blame themselves reported higher levels of distress.

Jenny C. Su

Papers

The mortality rate from anorexia nervosa.

Suppression and interpersonal harmony: a cross-cultural comparison between Chinese and European Americans.

Coping with intergenerational family conflict among Asian American college students

The socioecological model of procommunity action: the benefits of residential stability.

Intergenerational family conflict and coping among Hmong American college students