Tiffany Field, IJPRR, 2020 3:30

Review Article IJPRR (2020) 3:30

International Journal of Psychological Research and Reviews (ISSN:2639-6041)

Romantic breakup distress in university students: A narrative review

Tiffany Field University of Miami School of Medicine; Fielding Graduate University

ABSTRACT

This narrative review of literature on romantic breakup distress *Correspondence to Author: and recovery includes studies on the effects of this distress, risk Tiffany Field and protective factors for breakup distress and interventions. The University of Miami School of Medi- effects include sadness, anger and syndrome. The cine; Fielding Graduate University risk factors for breakup distress include being the “dumpee” ver- sus the “dumper”, internet surveillance of the “dumper”, having been in a spiritual relationship, intrusive thoughts, an orientation How to cite this article: towards future relationships or a fear of being single, having the Tiffany Field. Romantic breakup relationship as part of your identity or your self-worth and experi- distress in university students: A encing social constraints like criticism. Protective factors include narrative review. International Jour- having been more committed to the relationship and then con- nal of Psychological Research and tinuing to experience closeness in that relationship but also hav- Reviews, 2020, 3:30 ing a relationship. Effective interventions include a writ- ing task describing the breakup, online group discussions of the breakup and tryptophan for its serotonin-enhancing properties. Limitations of this literature include lack of generalizability from the mostly female university student samples and potentially bi- eSciPub LLC, Houston, TX USA. ased self-report data. Website: https://escipub.com/

Keywords: Rromantic breakup distress, university students

IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 1 Tiffany Field, IJPRR, 2020 3:30 Romantic breakups occur in as many as two- having been in a spiritual relationship, intrusive thirds of university student samples and they thoughts, an orientation towards future frequently lead to breakup distress, depression, relationships or a fear of being single, having the anxiety and stress (Field, 2017). In 2015 a U.S. relationship as part of your identity or your self- university counselling center reported an worth and experiencing social constraints like increase of 131% in yearly visits and 173% in criticism. Protective factors include having been total yearly visits (Beiter, Nash, McCrady, more committed to the relationship and then Rhoades & Linscomb, 2015). This narrative continuing to experience closeness in that review involved a search of the literature from relationship, having a rebound relationship and the last 10 years on PubMed and PsycINFO for having greater insight. Predictors of slower the terms romantic breakup distress and recovery that have been studied in laboratory heartbreak. For the selection process, exclusion situations include the use of personal pronouns criteria included non-English papers, case in writing about the breakup and showing more studies, under-powered samples, and non-juried facial activity when thinking about the breakup. papers. Following these screening criteria, those Interventions that have been serendipitous selected papers are briefly reviewed here. Only include experiencing less breakup distress when statistically significant results are given. being in a classroom where relationships were more common and being in more research This review of recent literature on romantic assessments, as if participating in research is an breakup distress and recovery suggests that intervention in itself. Some designed very little research is being conducted on this interventions include writing about the breakup, topic. In addition, although researchers are still online group discussions on the breakup, and studying the effects of romantic breakups, they the effects of tryptophan for its serotonin- are more often examining risk and protective enhancing properties. Accordingly, this review is factors for breakup distress. The salient effects divided into different sections that reflect the of breakup distress continue to be sadness and literature including effects of romantic breakups, anger as well as a broken heart syndrome. risk factors for breakup distress, protective The risk factors for breakup distress have factors, interventions and limitations of the included being the “dumpee” versus the literature. “dumper”, internet surveillance of the “dumper”,

Table 1. Effects of breakup distress and first author. Effect First author Sadness & anger Sbarra Sad facial expressions Heshmati Broken heart syndrome Field, Potu, Roshanzamir, Lacey, Ghadri Neural representations for breakup pain Kross, Woo

Effects of Romantic Breakup Distress syndrome and immune dysfunction (see Field Earlier research on breakup distress focused on 2011 for a review). In one of the earliest studies the immediate effects of romantic breakups on breakup distress, for example, the high including depression, anger, broken heart breakup distress group had higher scores on

IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 2 Tiffany Field, IJPRR, 2020 3:30 negative scales including depression, expressions may be a less biased and more anxiety and anger and on negative behaviors objective measure of spontaneous emotions including poor academic performance (Field, than self-report (Heshmati, Sbarra, & Mason, Diego, Pelaez, Deeds, & Delgado, 2010). Fewer 2017). In this study, computer expression studies were found on immediate effects in the recognition software was used to record the recent literature, although researchers continue facial expressions (sadness, fear, anger, to focus on depression, anger and the broken ) of 135 recently separated university heart syndrome. And, in the recent literature, students while they responded to interview research appeared on mood states including questions about their thoughts and feelings sadness and anger, facial expressions that regarding their breakups. The authors expected reflect those states and continuing research on that anger and contempt would serve as the broken heart syndrome (see table 1 for a list distancing emotions and therefore would be of these effects and first authors). associated with less breakup distress than Mood States sadness and fear which might sustain a longing for the relationship and thus lead to greater In a breakup effects study on mood states, breakup distress. Surprisingly, they found that young adults completed a daily diary for one anger, sadness and fear were not predictors of month describing their feelings about romantic distress. Instead, contempt was associated with breakups (Sbarra & Ferrer, 2006). A dynamic less distress initially but with greater distress factor analysis revealed that /longing, over the long-term. The authors interpreted sadness and anger were separate but correlated contempt as being an adaptive form of rejection mood states. Moderate correlations were noted of the other person but suggested that the between the love and sadness factors, continued feelings of contempt could be a suggesting emotional co-occurrence. To a marker of poor adjustment. lesser degree, sadness and anger were comorbid. This was expressed as sadness for Some limitations of this study include: 1) only the the loss of the relationship and anger attributed first minute of the breakup interview was to the partner who initiated the breakup. In their analyzed; 2) the study included three times as sequential analysis, sadness typically preceded many women as men and university students anger. This was particularly true for the good experiencing non-marital breakups which may adjustment versus the poor adjustment groups. not be generalizable to older adults or those in While the good adjustment group was ; 3) the study lasted only two months so experiencing sadness and anger, the poor the results did not reflect long-term outcomes; adjustment group was experiencing sadness and 4)the study did not include self-report without anger, suggesting that anger may help measures, so relationships between the facial sever the attachment. expressions and self-reported feelings could not be determined. Facial Expressions Broken Heart Syndrome Most of the research on breakup effects has been based on self-report (Field, 2011). Facial Broken heart syndrome has received increasing expressions have also been recorded and they attention across the last several years and has would be expected to be consistent with the been extensively reviewed (Potu, Raizada, negative emotions that have been self-reported. Gedela, & Stys, 2016; Roshanzamir & So, for example, photos of sadness would be Showkathali, 2013). This syndrome is reflected in an upturned mouth and furrowed characterized by left ventricular dysfunction and brow and a fearful face would feature widened accompanied by chest pain and T wave eyes and an open mouth. Some have argued inversion and is typically associated with that recording of behaviors such as facial emotional stress following loss or breakup IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 3 Tiffany Field, IJPRR, 2020 3:30 distress (Potu et al, 2016). Although broken Neural Representations for Breakup Pain heart syndrome mimics heart attack symptoms, A network of different regions of the brain is it does not usually result in permanent damage activated by breakup pain. In a study on and is asymptomatic within a few weeks. unwanted breakups, the participants viewed a Elevated catecholamines and a hyperactive photograph of their ex – partner as they thought sympathetic nervous system response are about being rejected (Kross, Berman, Mischel, thought to be underlying mechanisms.This Smith & Wager, 2011). Based on fMRI data, syndrome is typically verified by angiogram, areas of the brain that respond to physical pain ventriculogram, echocardiogram or cardiac became active including the secondary MRIs that differentiate the broken heart somatosensory cortex and the dorsal posterior syndrome from a heart attack (Roshanzamir & insula. The researchers concluded that Showkathali, 2013). unwanted breakup pain activates the same In an effort to identify psychological risk factors regions as are activated by physical pain. for broken heart syndrome, ten different Surprisingly, the same group of researchers psychiatric conditions were assessed in a reported different functional connectivity in a sample of people who experienced this later study on a larger sample using the same syndrome versus a group of healthy volunteers paradigm (Woo, Koban, Kross, Lindquist, (Lacey, Mulder, Bridgman, Kimber, Zarifeh, Banich, Ruzic et al., 2014). In this database, the Kennedy, et al, 2014). Although “neuroticism” neural representations for physical pain and differentiated the two groups, there was no breakup pain were not correlated and showed association between broken heart syndrome distinct functional connectivity with different and previous psychiatric illness. Another regions of the brain including the dorsal anterior research group compared international registry cingulate and the anterior insula. The authors broken heart syndrome patients who had an suggested that the difference in their two data “emotional trigger” including either a happy or a sets did not derive from the addition of 20 sad event (Ghadri, Sarcon, Diekmann, Bataiosu, participants but rather the differences related to Cammann, Jurisic, et al, 2016). Of those who a more complex multivariate fMRI pattern that had an emotional trigger, 4% had experienced a was sensitive and specific to rejection and that happy event and 96% a sad event. The clinical physical and breakup pain yielded distinct symptoms, for example, chest pain, and the patterns even in the overlapping regions that laboratory findings were similar for both groups, were activated by both physical and breakup although midventricular involvement was more pain. One of the problems with the comparison prevalent in the “happy heart syndrome” patients is that the ex-partner photos related to a past than the “broken heart syndrome” patients who experience while the physical pain was an acute had more left ventricular involvement. thermal stimulus. And they also used a cross– That these two syndromes share common sectional paradigm rather than a within–subjects pathways is not surprising inasmuch as fMRI longitudinal design. studies have revealed similar activity in the same Risk factors for breakup distress areas of the brain for both romantic love and Several risk factors for breakup distress have romantic breakups, and similar dopamine and been studied. These include being “dumped”, other catecholamine levels have also been internet surveillance by the “dumped” person, noted in both love and breakup conditions (Field, having been in a spiritual relationship, having 2016). The increased arousal levels and the intrusive thoughts, having a fear of being single, accompanying increase in dopaminergic activity being oriented towards future relationships, in similar parts of the brain may account for having one’s identity and self–worth dependent these similar profiles. on the relationship and experiencing social IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 4 Tiffany Field, IJPRR, 2020 3:30 constraints or criticism related to the breakup the responsibility onto the former partner, social (see table 2 for a list of these risk factors and first circumstances or personal characteristics authors). beyond their conscious control), and described Being “Dumped” or Rejected themselves as empathetic. Although the dumpees also used externalization strategies, Being dumped is a significant risk factor for they denied injury, emphasized their role in the breakup distress. In a narrative analysis study, breakup and described valuable changes that six biographical interviews based on 24 past happened to them following the breakup. Those relationships yielded three categories of who reported having consensus denied that any breakups including “dumpers”, “dumpees” and harm had been done in the breakup. Gender individuals who reported consensus about their differences included women claiming more breakups (Doering, 2010). The dumpers responsibility and men blaming their partners generally dismissed any conflict in the breakups, more frequently. they used externalization strategies (i.e. shifting

Table 2. Risk factors for breakup distress and first author. Risk factor Author Being “dumped” Doerring, Barber, Perilloux, Bronfman, Yildirim

Being initiator Carter, DeLecce

Internet surveillance Carter, Gershon, Tong, Fox, Lukacs, Tran,LeFebvre, Haimson, Spielmann Spirituality of relationship Hawley Intrusive thoughts Pierce, Field, Tran, Abassi, DelPalacio-Gonzalez Fear of being single Spielmann, Gilbert, Field, Norona Relationship contingent Boals, Park, Mason Self-worth Social constraints Harvey, Arnett

In a study on university students, those who dumpees remained angrier across time. As the were dumped reported via an online diary authors suggested, those who were dumped method that they experienced greater distress had more trouble letting go of the relationship, and anger at one month following the breakup but being dumped was the best predictor of (Barber & Cooper, 2014). They also reported being on the rebound. This study, like several greater coping, self–affirmation, rebound and others, has questionable generalizability to other revenge motives for sex. Although the dumpees samples experiencing other types of breakups reported greater distress, they recovered more like as well as being at different stages quickly than the dumpers. However, the of life. IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 5 Tiffany Field, IJPRR, 2020 3:30 Dumpers and dumpees were called rejectors analysis, initiator status, existence of a new and rejectees in another university sample study partner, certainty of the breakup reasons and (Perilloux & Buss, 2008). In this study, 56% were social support were significant predictors of rejectors and 44% were rejectees. The rejectees breakup adjustment. However, these factors reported more depression and rumination over combined only explained 18% of the variance, the breakup and decreased self–esteem. They suggesting that several other unmeasured also reported feeling more angry, confused, factors were contributing to breakup adjustment. shocked and jealous after the breakup. They Other limitations of the study included its being experienced loss of concentration and concern a cross–sectional survey based on one period of about replacing ex-partners’ resources and time. And, the data were, once again, collected acquiring a new mate and perceived themselves from only one side of the breakup. Further, the as less desirable. The strategies they reported data derived from the Turkish culture may not using included discussing the breakup, crying generalize to other cultures, although the results and pleading with the ex-partner, avoiding the are very similar to those previously presented. ex-partner and threatening their ex-partner. Being the initiator of the breakup has also been Female rejectees reported feeling more sad, associated with positive outcomes and confused and scared. The rejectors, in contrast, especially being a female initiator. In a recent reported greater guilt but also greater study, being a female initiator was a key happiness, loss of shared friends, loss of sexual predictor of positive outcomes (Carter, Knox & access and loss of ex-partners’ resources. Their Hall, 2018). In another study, being a female strategies included remaining friends with the initiator was associated with greater happiness ex-partner, boosting the ex-partner’s self- but also a longer recovery (DeLecce & Weisfeld, esteem, drinking and using drugs, spending 2016). The longer recovery may relate to post- money to attract a new partner and showing breakup behavior of these participants with as affection to someone else in public. many as 40% continuing to text, 26% to In another study, female rejectees experienced communicate online and 20% to communicate more breakup distress but especially after being by phone (De Lecce & Weisfeld, 2016). in a long relationship (Bronfman, Ladd- Internet Surveillance Luthringshauser & Sockol, 2016).This study, like Although most of the breakup research is based many others, could have benefited from using on face–to–face breakups, one study compared other sources of data such as friends or the in person breakups with online breakups (46% in partners of the breakup students to establish person, 32% by text and 20% by phone)(Carter some convergence of the data. This, of course, et al., 2018). Surprisingly, no differences were would be a more difficult form of sampling. The noted for the different types of breakup distress. convenience sampling of university students is Nonetheless, while some have suggested that limited by age range and by experience, and it is texting is an appropriate breakup method, many likely that an older sample would have consider it inappropriate (Gershon, 2011). experienced even more adaptive problems. Online surveillance of the initiator may In another study, initiator status was entered contribute to greater distress. Post – breakup along with a few other variables into a regression surveillance has been reported by a few analysis as predictor variables for adjustment to research groups. In one study that featured breakup (Yildirim & Demir, 2015). This Facebook breakups, surveillance of the breakup convenience sample was taken from a large initiator led to greater distress (Tom-Tong, university in Turkey and comprised 140 women 2013). Similarly, in another study, internet and 143 men who had experienced at least one surveillance led to greater breakup distress for breakup during the last year. In the regression the person who was dumped (Lukacs & Quan- IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 6 Tiffany Field, IJPRR, 2020 3:30 Haase, 2015). Reciprocally, greater distress has the results of a cross-sectional, correlation also led to partner monitoring immediately after study. For example, some of the students may the breakup, especially by those who did not have become more religious as a result of the initiate the breakup (Fox & Tokunaga, breakup; 2) although the sample was large, it 2015).Thus, breakp-up distress and online involved students from the Midwest, and 72% of surveillance appear to be bi-directional. And, them were female, suggesting it was not a those who ruminate while examining the ex’s representative sample; 3) the students were at profile appear to have even greater distress different stages of the breakup after varying (Tran & Joormann, 2015). Some have quality relationships of different durations; and suggested that profile access should be limited 4)the self-report data came from individuals who in order to manage breakup distress (LeFebvre, had been in relatively short duration Blackburn & Brody, 2015), and Facebook has relationships rather than couples who had been reputedly limited access since then (Haimson, in more committed, long-term relationships. Andalibi, DeChoudhury & Hayes, 2018). Given Intrusive Thoughts these data, it is surprising that pursuing sex with Intrusive thoughts are distressing, compulsive an ex-partner has not been associated with thoughts that are recurrent and difficult to control breakup distress or recovery (Spielmann, Joel & (Peirce, 2007). These have seemed to derive Impett, 2019). And, in this study, most sexual from unrealistic beliefs, assumptions and pursuits were successful and the success rate expectations that have to be reconciled when was not associated with breakup recovery. something unexpected occurs like a romantic Spirituality of the Relationship breakup. In a study on intrusive thoughts and A surprising risk factor for breakup distress is the breakup distress, a self-report measure called spirituality of the relationship. In a study on 445 the Breakup Symptoms and Solutions Scale was university students who had experienced a created including subscales on intrusive recent romantic breakup, 49% reported that they thoughts, somatic symptoms, extracurricular had experienced a sacred loss and/or activities and social support (Field, Diego, desecration associated with their breakup Pelaez, Deeds, & Delgado, 2013). This scale (Hawley, Mahoney, Pargament, & Gordon, included intrusive thoughts items (having trouble 2015).This was based on their responses to 28 getting the ex-partner out of your mind and items on a scale that taps sacred loss (e.g. “In having dreams about that person), somatic this event, something central to my spirituality symptoms (sleep, appetite, hurt feelings and was lost”) or desecration (e.g. “A sacred part of physical health problems), extracurricular my life was violated”). In addition, the scores on activities (listening to favorite music, physical this scale mediated the links between greater exercise) and social support items (being able to pre-breakup sexual activity and greater breakup talk to friends, and professionals about the distress. As many as 78% of the participants breakup). The sample was comprised of 283 reported engaging in at least one of six sexual university students of which 66% had behaviors with their partner before the breakup. experienced a breakup within the last four And both the lost spirituality and sexual activity months. The breakup sample was divided into were directly related to greater distress and high and low breakup distress groups based on anger over the breakup. The mediation model a median split on the Breakup Distress Scale was especially strong for participants who scores. In a stepwise regression analysis with reported moderate to high religious involvement. the breakup distress scale scores as the Several limitations of the study were highlighted dependent measure, the subscales of the by the authors including: 1) the fact that Breakup Problems and Solutions Scale directionality or causality cannot be inferred from contributed to 38% of the variance including IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 7 Tiffany Field, IJPRR, 2020 3:30 intrusive thoughts scores (28% of the experienced a stronger fear of being single variance),somatic symptoms (8%) , and reported a greater longing for their ex-partner extracurricular activities (2%). irrespective of who initiated the breakup. These results may not be generalizable given Lagged-day analyses revealed that fear of being that 78% of the sample was comprised of single increased longing and renewal attempts Hispanic female university students. In addition, over time, but longing did not influence fear of analyses were conducted to determine the being single. convergent validity of five intrusive thoughts Future relationship orientation was a related risk scales that were administered. However, despite factor for breakup distress in an online survey of the fact that the high and low breakup distress 1404 university students (Gilbert & Sifers, 2011). groups differed on each of the intrusive thoughts Those with a greater future relationship scales, those scales were not entered into a orientation reported greater distress after the regression analysis to determine which of the breakup. Women also reported greater future scales contributed to the most variance on orientation and greater breakup distress. These breakup distress. findings were based on the Future Time In a seven–month longitudinal study, a higher Orientation Scale that consists of Future frequency of relationship– dissolution and Investment, Future Involvement and Future intrusive thoughts predicted breakup distress Communications subscales. (Del Palacio-Gonzalez, Clark & O’Sullivan, Fear of not finding another relationship would 2017). This relationship, however, was seemingly relate to fear of not finding intimacy confounded by greater brooding and less again, inasmuch as losing intimacy was given as reflection. Others have referred to intrusive the primary reason for ending a relationship in at thoughts as rumination. For example, in a study least two studies ( Field, Diego, Pelaez, Deeds, on individual differences in rumination, & Delgado, 2010; Norona, Olmstead, & Welsh, rumination was associated with the tendency to 2017). In a study on university students (N=156, experience maladaptive thoughts when looking 112 females) who had recently experienced a at ex—partners’ profiles on Facebook (Tran & breakup, high breakup distress versus low Joormann, 2015). In this study, high ruminators breakup distress groups (based on The Breakup experienced greater breakup distress, and Distress Scale) were compared on their reasons Facebook use mediated the relation between for breakup (Field et al, 2010). The Breakup rumination and breakup distress. Facebook Reasons Scale which was created for this study addiction has been related to romantic breakup was comprised of intimacy, affiliation, sexuality distress in at least one other study (Abbasi, and autonomy subscales. On this measure, only 2018). the intimacy subscale discriminated the high Fear of Being Single and Future Relationship breakup distress from the low breakup distress Orientation groups (Likert scale items on poor communication, distrust, unreciprocated love, Fear of being single (Spielmann, MacDonald, non-caring behavior, diminished empathy, Joel, & Impett, 2016) and a future relationship arguments, and hypersensitivity) The orientation (Gilbert & Sifers, 2011) are related groups also differed on the Relationship Scale ( risk factors for romantic breakup distress. In the Likert scales on five items including a fear of being single research, two studies were relationship rating, sharing activities/interests, conducted including a cross-sectional study on sharing thoughts/feelings, affection and 209 adults (64% women) as well as a one-month disagreements) and Missing the Partner Scale daily experience study of 117 adults (44% (Likert scales on three items including missing women) who had just experienced a romantic daily activities/rhythms, missing breakup (Spielmann et al, 2016). Those who IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 8 Tiffany Field, IJPRR, 2020 3:30 talking/emotional closeness and missing students (68 males) completed online measures touching/physical closeness). of depression, posttraumatic stress, centrality of Although the development of these three scales events, insight, closure and couples’ satisfaction makes a significant contribution to the literature, (Boals 2014). Ratings of event centrality and although the scales scores contributed to following a recent breakup were associated with breakup distress, the relative importance of depressive symptoms and posttraumatic stress these qualities was not assessed, as in a disorder symptoms at time one. Event centrality regression model. The results were thought to predicted time two depressive symptoms. have derived from the breakup but they may Similar to the event centrality variable, have also contributed to the breakup, as the relationship contingent self-worth is defined as data were collected retrospectively. the degree to which an individual bases self- In another study,113 young adults (47% women) worth on being in a romantic relationship (Park who had initiated a breakup within the previous et al, 2011). In this study, relationship contingent 6 months were recruited via Mturk on Amazon self-worth was measured by four items: “When I and asked to describe “what led up to the have a , my self-esteem breakup” (Connelly & McIsaac, 2009). Their increases”, “I feel worthwhile when I have a narratives given on Qualtrics were then coded significant other” “When I do not have a for themes. The need for intimacy was given significant other, I feel badly about myself”, “My more frequently than the needs for affiliation and self-esteem depends on whether or not I have a sexual reciprocity. Unfulfilled identity and significant other”. The results of this online study autonomy were given as the second and third of 312 adults (245 women) revealed that those reasons for romantic breakup. who based self-worth more strongly on being in a relationship reported greater emotional This study has some of the same limitations distress and obsessive pursuit of their ex- noted for the other studies including its being a partners. Not unlike other studies, no causal cross-sectional study with a predominantly direction of effects could be determined. The young and European-American sample. Further, relationship contingent self-worth could have the sample was self-selected which may mean derived from the breakup experience rather than the participants had already adjusted to the preceding it. The participants were also breakups, especially since they initiated the reporting retrospectively without a specific time breakups. Even though inter-coder reliability frame for the breakup so that the duration of was checked by a second researcher, the coding effects could vary widely. categories were selected by one researcher. And, although events leading up to the breakup In another study, self–worth has been labeled were not included in the qualitative data self–esteem, and their results suggested that analysis, this is a unique contribution to the failure to redefine the self contributed to breakup literature for focusing on relationship problems distress (Mason, Law, Bryan, Portley & Sbarra, that lead to breakups. 2012). Although self-reports are sometimes not correlated with physiological data, in this study, Event Centrality and Relationship negative facial expressions (greater activity in Contingent Self-worth the corrugator supercilia facial muscle) while Two other related risk factors for breakup thinking about an ex-partner predicted poor self– distress are “event centrality” which refers to concept recovery. construing an event as part of your identity Social Constraints (Boals, 2014) and “relationship contingent self- worth” (Park, Sanchez, & Brynildsen, 2011). In Social constraints have also been noted to the event centrality study, 312 university exacerbate breakup distress (Harvey & Karpinski, 2016). In this study, 238 university IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 9 Tiffany Field, IJPRR, 2020 3:30 students completed the Breakup Distress Scale between university student romantic and the Social Constraints Scale. Social relationships and marital relationships including constraints included criticism, withdrawal or the associated companionship, intimacy and minimizing opportunities for interaction. commitment. Example questions were how often has a friend Buffers or Protective Factors for Breakup or family member; 1) changed the subject when Distress you tried to discuss your breakup; 2) minimized Surprisingly, very few studies were found in the your breakup problems; 3) trivialized your recent literature on buffers or protective factors breakup problems; 4) told you not to worry so for breakup distress. These included pre- much about your breakup; and 5) gave you the breakup commitment to the relationship, getting idea that they didn’t want to hear about your into a rebound relationship, and cognitive breakup. Some limitations of this study are its processing. In addition, in a multivariate study, a cross-sectional, correlation model, making few personality traits were buffers including inferences about causality impossible. Although optimism, self-esteem and grit (see table 3 for a it also lacks generalizability to other types of list of these buffers and first authors). breakups, e.g. divorce, there may be similarities

Table 3. Buffers for breakup distress and first author. Buffer First author Pre-breakup commitment Fox, Tan Negative reappraisal Langeslag Rebound relationships Brumbaugh, Carter Insight about breakup Boals, Marshall, Brumson, O’Sullivan

Pre-breakup Commitment commitment than satisfaction in this study. Although greater commitment to the breakup Although one might expect that partners relationship has been reported to lead to greater remaining close might prolong their breakup breakup distress in at least one study (Fox et al, distress, these authors used the Investment 2015), it has been a buffer in other studies. Model to support their data, namely that former Greater pre-breakup commitment was noted, for romantic partners can maintain a example, to predict greater post–breakup when they are able to provide resources that closeness in a study on 143 young adults who fulfill their needs. were involved in romantic relationships on the The conclusions of this study are tentative in that first day of the study and experienced a romantic the reasons for the breakup may have influenced breakup by the last day of the study (Tan, the post–romantic relationship closeness. Agnew, VanderDrift & Harvey, 2015). Those Breakup partners may have remained friends adults who reported greater romantic because both of them were in new romantic commitment to their partners also reported relationships or because the breakup was greater satisfaction and investment in that mutual or because friendship had been the relationship. Investments that are resources tied important feature of the old romantic to a relationship (e.g., self–disclosures and relationship. The couple may have also shared social networks) were more predictive of maintained closeness in the hope of getting back IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 10 Tiffany Field, IJPRR, 2020 3:30 together romantically. This study was also salient findings of the study were that those in limited by its sampling young adults from a low rebound relationships had less residual feeling socioeconomic background and from collecting for their ex-partners and less contact with their data from only one of the partners in the ex-partners. They also had more confidence in relationship. their “desirability” and higher levels of well- Negative Reappraisal being, self-esteem and trust. Those who started a relationship more quickly also tended to Negative reappraisal of the ex-partner is an compare their new partner to their ex-partner. effective strategy for down– regulating love Faster rebound even when controlled for secure feelings following a romantic breakup. In a attachment was associated with greater self- laboratory study, participants who were upset esteem and well-being, suggesting that about a romantic breakup were asked to use psychological adjustment was not a cause but three regulation strategies including negative rather the consequence of the new relationship. reappraisal of the ex-partner, reappraisal of love And, none of the previous relationship variables, feelings and distraction (Langeslag & Sanchez, i.e. attachment, satisfaction and commitment, 2018). They were then asked to view pictures of predicted the rebound relationships. their ex-partner during which EEG recordings were made. Negative reappraisal was an In a second study reported in the same effective love down–regulation strategy and the publication, a cross–sectional design was used EEG data showed decreased amplitude of the with a larger sample to validate the findings of late positive potential which accompanies the first study (Brumbaugh & Fraley, 2015). In decreased attention. However, this finding was this study, 236 participants from a northeastern confounded because the negative reappraisal university included partnered people who had also made the participants feel more unpleasant broken up with their ex-partner an average of 29 and distraction made them feel more pleasant. months previously and single people who had broken up an average of 13 months previously. Rebound Relationships For this study, the partnered participants were Rebound relationships can also be protective. compared with the single participants. Once Although rebound relationships are traditionally again, the partnered individuals reported more considered a relationship that happens too soon confidence in their desirability, greater well- after a breakup and being just a steppingstone being, less anxiety and avoidance, greater trust to a more legitimate relationship, at least one of the new partner, less lingering feelings for research group found that rebound relationships their ex-partner and less contact with their ex- are associated with greater resolution over the partner. These comparisons are confounded, ex-partner (Brumbaugh & Fraley, 2015). Two however, by the breakup being twice removed in studies were reported by these investigators. In time in the partnered versus the single the first study (a longitudinal study on participants (29 vs. 13 months). Both studies relationships), 77 people (60 women) from a featured more women and mostly college age Midwestern university as well as a local individuals. This age group typically has shorter- community sample completed several term relationships and more rebounding and it’s assessments on pre-breakup variables including not clear whether the rebounds occurred after experiences in close relationships and the more casual or serious relationships. It is also Investment Model Scale as well as scales on unclear what factors led to the rebound psychological adjustment, feelings about ex- relationships even though they appeared to partners, and new partners. At the time of the have positive effects. post-breakup follow-up, 23 of the participants Another research group reported the recovery (93% women) were involved in a new effects of a new relationship (Carter et al., 2018). relationship (mean duration=4 months). The IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 11 Tiffany Field, IJPRR, 2020 3:30 However, the buffering effects also included time relationships, but becoming involved in a new since the previous relationship, remembering relationship may have also affected the negative things about the ex-partner, being perceptions of insight on the previous distracted by work and having peer support. How relationships. much each of these variables contributed to the Some limitations include the large attrition rate variance in breakup distress was not clear in this which may have biased the new relationship study. results inasmuch as those who did not complete Insight About the Relationship Breakup the time two assessments were more distressed Insight about the relationship breakup may be and depressed at time one. The correlations one of the factors that leads to rebound between participant insight and the outcome relationships, as is suggested by a study measures may be spurious because both the measuring different forms of insight (Boals, insight and the outcome measures were self- Valentine, Beike, 2015). In this study, 188 reports completed by the same person. And, university students (141 females) were asked to once again, the generalizability of the findings is spend 20 minutes online describing their limited by the exclusive university student breakup and to complete the Perceived Insight sample. Nonetheless, the insight factor Scale including 12 items such as “I have a deep contributed to less distress and a faster understanding of this event” rated on a 9-point transition to a new relationship, highlighting it as Likert scale. Clinicians also rated their a protective or buffering factor. descriptions, and a word count program was Others have referred to cognitive processing of used to count the insight words in the the breakup as a buffer for the stress (Marshall, participants’ descriptions. Several depression Bejanyan & Ferenczi, 2013). But surprisingly and posttraumatic stress self-report measures greater initial breakup distress facilitated greater were also given. These measures and one on cognitive processing that, in turn, resulted in new relationship status were assessed during a greater personal growth, suggesting that these follow-up session eight weeks later. Greater may be bidirectional processes. ”Relational participant-rated insight predicted all 6 schema change” refers to changing beliefs measures including lower levels of distress, about relationships following breakups that can depression and health symptoms and higher buffer breakup distress (Brunson, Overup & psychological closure, posttraumatic growth and Acitelli, 2019). life satisfaction. The clinician-rated and the word Still others have referred to “grit” as a significant count insight measures had no predictive buffer for breakup distress, particularly the validity. Those participants who had higher breakup-associated rumination and depression insight scores about their previous romantic (O’Sullivan, Hughes, Talbot & Fuller, 2019). breakup were more likely to be involved with a However, “grit” was characteristic of those new partner by the end of the study. As the participants who had greater self–esteem and authors suggested, insight about the previous were more optimistic which are confounding relationship may have resulted in finding new variables.

Table 4. Laboratory predictor variables and first author. Predictor First author Personal pronouns in written narratives Boals Facial electromyography Mason, Coifman

IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 12 Tiffany Field, IJPRR, 2020 3:30 Laboratory Predictor Variables of the breakup narratives. Other studies have Although the previously discussed risk and also found elevated use of first-person singular protective factors for breakup distress might be pronouns in those experiencing psychological considered predictor variables, they are all distress. based on self–report and self-ratings. Two Although some would consider a word count simple predictor variables that have been analysis more objective, others have suggested assessed in laboratory situations include the use it is more superficial than the more dynamic of personal pronouns in written narratives and exploration of themes. Secondly, this study’s facial activity in response to romantic breakups. correlational design limits any causality These variables have been viewed as less interpretations. And, like most of the heartbreak subjective than self-reports by the researchers studies, it sampled only university students. using them (see table 4 for a list of these Facial Electromyography predictor variables and first authors). In a multivariate study on recovery following a Personal Pronouns in Written Narratives romantic breakup, both self-report and In the study on word use in emotional narratives physiological measures were taken (Mason, about romantic breakups, 218 University Law, & Sbarra, 2012), even though some students who had experienced breakups during researchers have reported inconsistencies the past year were invited to write a two-page between physiological and self-report measures narrative for 20 minutes on their previous in bereaved individuals (Coifman, Bonanno, relationship and the subsequent breakup (Boals Ray, & Gross, 2007). Seventy university & Klein, 2005). Word-use analysis was then students (22 men) who had experienced used to count and categorize the words in the breakups during the past six months were invited narrative including cognitive, causal, positive to attend a series of eight 30-minute laboratory , negative emotion, sensory words, first visits over a period of two months. During the and second person singular and plural first visit, facial electromyography (EMG) data pronouns, past, present and future tense words. were collected from the muscle above the brow In addition, questionnaires were used to assess while the participants were asked to reflect on intrusive thoughts, avoidance and grief. answers to seven breakup-related questions Relationship measures included the duration of that were presented on a computer screen. the relationship and the question of being Those questions included asking the participant involved in a new relationship. Although these to think about “the first meeting with the ex- two variables have been notably protective partner”, “whose idea was it to breakup”, “what factors in studies already discussed, they were do you remember about the breakup”, “how have surprisingly not related to any of the variables in you come to cope with the breakup” and “what this study. Higher scores on the grief measure was the worst part about the breakup”. At the were associated with greater use of causal end of the question period, self-ratings were words, less use of past tense, greater use of made on how emotionally difficult it was present tense and greater use of first-person reflecting on the breakup questions. singular pronouns. Inasmuch as grief involves The results revealed that greater activity in the hurtful feelings and an inability to accept the brow facial muscle when thinking about the ex- loss, the greater use of causal words by those partner predicted poor self–concept recovery reporting the greatest grief was presumably and suggested a negative association between related to the process of their searching for love for an ex-partner and self-concept recovery. meaning and trying to understand this negative The participants who reported poor self–concept experience. Less past and more present tense recovery at any given week tended to report poor words were noted in the more traumatic sections psychological well-being the next week instead IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 13 Tiffany Field, IJPRR, 2020 3:30 of the reverse. This suggests that changes in occurred here not only for the study being self–concept may be one mechanism that confined to a university sample but also because contributes to post breakup distress and the sample was limited in terms of age range and suggests why some recover better than others the average duration of the relationship. The following romantic breakups. These data are effects could have also been related to consistent with other data from the same geographical separations of the college students laboratory showing that continued contact with rather than the breakup distress itself. the ex-partner was associated with poor Incidental and Planned Interventions psychological outcomes (Sbarra & Emory, The few intervention studies that could be found 2005). The greater brow muscle activity in the literature on breakups could be classified suggested negative emotionality that the as incidental or planned interventions. One participants were unable or unwilling to report. incidental intervention was being in a classroom These data are consistent with other data where relationship breakups were common. showing inconsistencies between self–report Another incidental intervention was participating and physiological measures (Coifman, in more research assessments and experiencing Bonnano, Ray & Gross 2007). less distress, as if being in research was an Some methodological limitations of this study intervention in itself. The planned interventions include the significant attrition over the course of have included engaging in a narrative writing the two months which is consistent with other task about the breakup distress, online group longitudinal breakup studies. Also, the interactions by individuals who have relationships had ended approximately four experienced breakup distress and receiving months before the study began, suggesting that tryptophan treatment to facilitate serotonergic some of the self–concept recovery may have activity (see table 5 for a list of these already occurred before the study began. interventions and first authors). Finally, the typical generalizability problems also

Table 5. Incidental and planned interventions and first author. Interventions Author Classroom context Hou Participating in research Longwell, Larson, Mason Writing narratives about breakup Smyth, Diemer Asynchronous internet group support McKiernan Tryptophan Emanuele

Classroom Context and support from their classmates who had The moderating effect of classroom context on experienced similar breakups. Data were romantic breakups has been studied with collected from 47 schools containing 106 adolescents in China (Hou, Natsuaki, Zhang, classes that were serving 4,776 Chinese Guo, Huang, Wang, et al, 2013). The authors’ adolescents in 9 different cities. Questionnaires thesis was that classrooms that have many were given on the romantic relationship breakup, peers who are experiencing romantic breakups depressive symptoms on the Center for would provide greater opportunity for empathy Epidemiological studies–Depression Scale, delinquent behaviors on the Youth Self-Report IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 14 Tiffany Field, IJPRR, 2020 3:30 Inventory and on the classroom romantic context for a literature that predominantly derives from which was based on the students’ perceptions of Western countries. the percentage of classmates who had romantic Participating in Research relationships. Non– adolescents had the Participating in research has been noted to have lowest level of depressive symptoms and positive effects. For example, in one study on delinquent behaviors. Adolescents who had repeated assessments of depression, anxiety experienced breakups but had not started new and negative mood, a no–treatment group had romantic relationships in the past year had more low scores on these measures (Longwell & depressive symptoms than adolescents who Truax, 2005). Participating in a similarly had experienced both romantic involvement and intensive assessment may reduce breakup breakups in the past year. And the breakup only distress, as was noted in another study (Larson group had the highest level of depressive & Sbarra, 2015). In this measurement–intensive symptoms and delinquent behaviors. As the study, recently separated young adults were adolescents entered higher grades, breakup assigned to a group that received four effects were less negative including less assessments over a nine-week period (N =120) depression and delinquent behavior. And the or a group that received only intake and exit primary result was that the association between assessments (N=90). The participants in the breakups and depressive symptoms was intensive assessment condition completed self- weaker in classrooms with a greater prevalence report measures on breakup intrusion, of adolescent romantic relationships. avoidance, and self–concept These data come from adolescents from China disturbance. They also participated in a four- where the incidence of romantic relationships in minute stream of consciousness speaking adolescence is lower than the incidence in the exercise on their breakup thoughts and feelings, U.S.(16% males, 12% females as opposed to a color-naming and a serial subtraction math 53% males and 67% females in the US) (Hou et task. Shorter versions of these measures were al 2013). Nonetheless, they are consistent with repeated in the follow-up visits. In contrast, the data from the U.S., suggesting that adolescent pre—post condition group only completed the romantic relationships are associated with self–report measures which meant that their adjustment problems. However, the variances participation was 45 minutes versus the 3.5 explained by the classroom romantic contexts hours for the intensive assessment group. The were relatively low, suggesting that other findings suggested greater improvement in self- variables such as teachers’ support need further concept by the intensive assessment group, and examination. In addition, only the negative that improvement in self-concept mediated effects of adolescent breakups were examined decreases in self–reported loneliness and in this study, although positive effects would also intrusion. As the authors suggested, the be expected, as in posttraumatic growth. The intensive assessments may have increased self- incidence of posttraumatic growth, for example, monitoring and the sense of self and those, in has ranged from approximately 30 to 80% turn, improved psychological well-being, as (Linley & Joseph, 2004). Third, this study had happened in a study already discussed above some typical limitations including that the data (Mason et al, 2011). were cross–sectional and based on self-reports. Several confounds can be noted in this study And, the romantic involvement and breakups including that the intensive assessment group were assessed using a one–item measure. not only met for twice as many assessments but Nonetheless, these findings on classroom also engaged in more extensive assessments context are unique, and the data on breakup including the stream of consciousness measure effects on Chinese adolescents are also unique and autonomic monitoring. The samples also IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 15 Tiffany Field, IJPRR, 2020 3:30 differed in size and in attrition rates with the initially benefit from recalling the experience in intensive assessment group having a greater an open–ended writing task, while they might be attrition rate. And, again, these results may not encouraged to cognitively reflect on the breakup be generalizable as they were limited to a with the loss/gain writing task. predominantly female sample of non–marital This study has the usual problems associated breakups. with qualitative designs as well as being cross– Writing Narratives About the Breakup sectional with limited causation implications. Writing has been frequently used as a Although random assignment was used, the therapeutic technique (Smyth & Pennebaker, groups may have differed on some variables that 2008). Although romantic breakups are the most were not measured. Inasmuch as the breakups common reason given for university students were not that recent, the retrospective recall may seeking counseling, relatively little research has not be representative of the actual experience. been conducted on writing therapy for university And the sample was not only biased in its being student breakups (Diemer, Wang & Dunkle, primarily female but also could have self– 2009). In this study, two types of writing tasks selected for students who are more open to were explored including a general prompt with writing a narrative about their experience. Thus, the direction “please write about your romantic the generalizability of the findings is not clear. break up experience” (100 words minimum) or a This is also not a clinical sample which may have loss/gain prompt with the direction “please write reported more pain and difficulty with the about some of the gains and losses that you breakup experience. Future studies might associate with your romantic breakup” (100 combine the two writing tasks and assess the words minimum). The sample included 15 men therapeutic effects of the writing experience and 26 women who were recruited from a mid- Asynchronous Internet Group Support western university. The time since breakup The Internet has also been used as a vehicle for averaged six months, 37% had initiated the expressing breakup distress. In an Irish study, breakup, 24% were mutual initiations, 27% had 31 users (16-25-years-old) and 10 moderators not initiated the breakup and 90% were not yet had asynchronous discussions (i.e. messages in another romantic relationship. exchanged over time rather than The general prompt group narratives were simultaneously) over a period of one year longer and featured more emotional responses (McKiernan, Ryan, McMahon & Butler, 2017). that were descriptive of the breakup experience. An asynchronous rather than a synchronous The loss/gain prompt responses were more forum was selected because it was considered a reflective and cognitive and contained more more anonymous, nonthreatening environment meaning–making statements. Students who for discussion. A coding system was developed were not initiators of the breakup expressed based on the types of interactions that took place significant pain, surprise and even a sense of on the forum. Content analysis was then “being ambushed” by the breakup. In contrast, conducted on the qualitative data. Personal students who were initiators of the breakup gave expressions including personal experiences and the partner’s neediness or clingy nature as a opinions were seen in 73% of the forum primary factor in ending the relationship. messages. Examples of these were an Although the quantitative literature has been experience (“it was the most painful thing ever”, mixed on whether males or females are more “it feels like she ripped my heart out and danced affected by breakups, this qualitative study on it”) and opinions (“the reality is that people revealed no gender differences. The authors breakup with other people for a whole array of suggested that these two types of writing task be different complex reasons”). The next most used together inasmuch as students might common interaction (35% of interactions) was a IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 16 Tiffany Field, IJPRR, 2020 3:30 nondirective query inquiring about the This literature has many limitations starting with experience or opinions of others (“all things there being very few studies on romantic considered, do you think the breakup was a heartbreak and, as a result, reviews are rare and good thing as it let you meet your new no meta-analyses could be found. Given that this ”). A supportive expression was noted is the primary presenting problem at university in around 29% of interactions (“everyone counselling centers,, it is not clear why there is a deserves to be in a relationship that is mutually dearth of this research. The problem may relate fulfilling”). to the absence of funding for research on Although this study was not intended to be an romantic breakups. intervention study, but rather a data collection Of the published studies, there are multiple study, the nature of the interactions represented limitations. They start with limited here suggests that this likely served as a cost– generalizability of the samples including that effective intervention for its participants. Further, almost all of them are young, university female as a qualitative study, it met the criteria for samples. They are not only limited trustworthiness of qualitative data including demographically that way but they do not credibility, dependability, and transferability. represent other types of heartbreak like divorce Unfortunately, no qualitative or quantitative and different stages of life. The university outcome data were collected in this study, student relationships are typically shorter, on- making it difficult to determine its intervention and-off, rebounding relationships. And, their effects. breakups are often confounded by geographical Tryptophan separations of the students. A more direct intervention study involved giving The quality and duration of the relationships are tryptophan (a natural precursor of serotonin) for rarely quantified but would certainly be highly a period of six weeks to 15 healthy participants variable as well as confounding factors in both (11 females) who had experienced a recent the breakup and the breakup distress. Further, romantic breakup (Emauele, Bertona, Minoretti, the type of relationship, be it casual, serious, & Geraldi, 2010). The participants were committed and/or cohabiting would be observed for romantic stress as measured by a contributing factors for breakup distress. In questionnaire, and brain–derived neurotrophic addition, the reasons for breakup have not been factor (BDNF) as well as platelet serotonin were factored into the breakup distress databases. assayed at baseline, three and six weeks. Reasons for breakup have varied from Significant improvements were noted in relationship dissatisfaction in women in one romantic stress scores at three weeks, and a study on relationship dissolution (Rosand, significant increase was noted in both BDNF and Slinning, Roysamb, & Tambs, 2014) to serotonin levels at six weeks. This study emotional or sexual extradyadic behaviors in suggests a direct modulation of the serotonergic another sample (Negash, Cui, Fincham, & system that could be used in individuals Pasley, 2014). And, in the latter study, those with romantic breakup distress. Unfortunately, behaviors occurred more often in high quality the physiological measures were not relationships, suggesting that high quality accompanied by other objective measures of relationships have more to lose by the breakup breakup distress such as behavioral and would certainly contribute to the breakup observations as opposed to the questionnaire distress. that was used to tap subjective stress levels. The outcome measures have been typically Limitations of these studies taken after a short period of time following the breakup although not immediately after. So “recovery” may have already occurred. And, the IJPRR:https://escipub.com/international-journal-of-psychological-research-and-reviews/ 17 Tiffany Field, IJPRR, 2020 3:30 assessments are typically one time-point relationship breakup. Arch Sex Behav. 43:251- measures. The rare longitudinal studies have 265. 3. Beiter, R., Nash, R., McCrady, M., Rhoades, D., been limited by large attrition rates. 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