Posttraumatic stress symptom trajectories of Chinese university students during the first eight months of the COVID-19 pandemic and their association with cognitive reappraisal,expressive suppression,and posttraumatic growth

Objective: To identify the moderating effects of cognitive reappraisal(CR) and expressive suppression(ES) on the relationship between posttraumatic stress(PTS) symptoms and posttraumatic growth(PTG) in university students. Methods: The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis.Results: Sex, SARS-Co V-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’(n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’(n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’(n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-Co V-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them.Conclusions: Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.

Neural bases of reappraisal regulatory effect on negative emotion in high reappraisers

Previous studies have reported that individual differences in reappraisal use are associated with partJcular patterns of neural activity. We hypothesized that if ＇high reappraisers＇ （individuals who use reappraisal well in a behavioral experiment） completed two training sessions, they would exhibit more reliable patterns of neural activity related to cognitive reappraisal. In the present study, 13 high reappraisers were selected from 27 healthy volunteers through an initial behavioral experiment （first training） followed by a functional MRI experiment （second training）. Emotional images selected from the International Affective Picture System were used for both the behavioral and functional MRI sessions of the experiment. The behavioral results revealed that reappraisal reduced subjective unpleasantness. The functional MRI results revealed that the cognitive reappraisal used by high reappraisers decreased the activation of emotion-responsive regions, including the amygdala, insula, and cingulate gyrus, and increased the activation of regulation-related regions, including the inferior prefrontal cortex, orbital prefrontal cortex, and dorsal medial prefrontal cortex. These findings suggest the involvement of inferior orbital and dorsal medial prefrontal cortex in constructing reappraisal strategies that modulate activity in emotion-processing systems.

Serial Multiple Mediation of the Relationshipbetween Positive Coping Style and PostTraumatic Growth among Chinese CollegeStudents in the Aftermath of COVID-19

Given the ongoing character of COVID-19, higher-education students encountered multifaceted pressures brought about by thepandemic and had to overcome many difficulties during this period. Accordingly, it is imperative to identify the factors that mayhave protective effects on the social functioning and mental status of college students in the aftermath of COVID-19. This crosssectional study sought to ascertain the internal mechanism of positive coping (PC) styles affecting post-traumatic growth (PTG)and considered the mediating roles of cognitive reappraisal (CR), psychological resilience (PR), and deliberate rumination (DR),which are essential for understanding how and to what extent these factors shaped PTG in the context of the present pandemic. 463Chinese college students recruited via a convenience sampling method completed a set of online self-report measures of PC, PTG,CR, PR and DR. The findings revealed that the abovementioned five variables were positively correlated with each other, and theindependent variable directly predicted the dependent variable. More importantly, two out of three mediators in parallel mediatedthe relationship between PC and PTG, illustrating that more PC adoption was associated with increased PTG through high levels ofPR and DR, respectively. The two significant serial mediating effects also indicated that PC could contribute to CR, which furtherfacilitates either PR or DR and subsequently promotes the development of PTG. Colleges should adopt routine protectivebehaviors in accordance with such evidence to strengthen students’ mental health education and establish scientific methods toboost their psychological well-being. Overall, our results may shed new light on the process of positive adaption and providetheoretical support for targeted crisis intervention during the late phase of the pandemic.

Psychological impacts of the COVID-19 epidemic on Chinese people: Exposure, post-traumatic stress symptom, and emotion regulation

Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.

Suppression dampens unpleasant emotion faster than reappraisal:Neural dynamics in a Chinese sample

The timing dynamics of regulating negative emotion with expressive suppression and cognitive reappraisal were investigated in a Chinese sample. Event-Related Potentials were recorded while subjects were required to view, suppress emotion expression to, or reappraise emotional pictures. The results showed a similar reduction in self-reported negative emotion during both strategies. Additionally, expressive suppression elicited larger amplitudes than reappraisal in central-frontal P3 component(340–480 ms). More importantly, the Late Positive Potential(LPP) amplitudes were decreased in each 200 ms of the 800–1600 ms time intervals during suppression vs. viewing conditions. In contrast, LPP amplitudes were similar for reappraisal and viewing conditions in all the time windows, except for the decreased amplitudes during reappraisal in the 1400–1600 ms. The LPP(but not P3) amplitudes were positively related to negative mood ratings, whereas the amplitudes of P3, rather than LPP, predict self-reported expressive suppression. These results suggest that expressive suppression decreases emotion responding more rapidly than reappraisal, at the cost of greater cognitive resource involvements in Chinese individuals.

Implicit,But Not Explicit,Emotion Regulation Relieves Unpleasant Neural Responses Evoked by High-Intensity Negative Images

Evidence suggests that explicit reappraisal has limited regulatory effects on high-intensity emotions,mainly due to the depletion of cognitive resources occupied by the high-intensity emotional stimulus itself.The implicit form of reappraisal has proved to be resource-saving and therefore might be an ideal strategy to achieve the desired regulatory effect in high-intensity situations.In this study,we explored the regulatory effect of explicit and implicit reappraisal when participants encountered low-and high-intensity negative images.The subjective emotional rating indicated that both explicit and implicit reappraisal down-regulated negative experiences,irrespective of intensity.However,the amplitude of the parietal late positive potential(LPP;a neural index of experienced emotional intensity)showed that only implicit reappraisal had significant regulatory effects in the high-intensity context,though both explicit and implicit reappraisal successfully reduced the emotional neural responses elicited by low-intensity negative images.Meanwhile,implicit reappraisal led to a smaller frontal LPP amplitude(an index of cognitive cost)compared to explicit reappraisal,indicating that the implementation of implicit reappraisal consumes limited cognitive control resources.Furthermore,we found a prolonged effect of implicit emotion regulation introduced by training procedures.Taken together,these findings not only reveal that implicit reappraisal is suitable to relieve high-intensity negative experiences as well as neural responses,but also highlight the potential benefit of trained implicit regulation in clinical populations whose frontal control resources are limited.