This chapter is focused on the third of the four identified theoretical constructs for behaviors: Theories in Emotional Regulation (TER). Behavioral categories emanating from TER are the result of impairment / changes in our emotional regulation. Such impairments can be a consequence of dysregulation of normal physiology or structural decline, as is the case in cognitive impairments.  In order to understand the implications of the impairment in regulation of emotion on the generation of behaviors, it is imperative to understand the role of this regulation in individuals with normal cognitive function.


Emotions arise in the context of specific extrinsic or intrinsic situations. They are experienced as a “whole body phenomenon” and have control precedence 1. This means that emotions invade and interrupt our consciousness.

Our response to emotions includes modifying or changing the situation that caused the emotion.


Moods are persistent, long lasting and not situation specific. They are diffuse and are tied to cognitions rather than actions. Our mood lacks control precedence and does not involve modifying or changing situations (usually) 2.

Mood and Dementia

As dementia/major neurocognitive (D/NCD) disorder processes, cognitive impairment increases with the disease.

Reliability of one’s mood recall is dictated by the level of their cognitive impairment, which will progressively worsen with advancing D/NCD. This issue with this is that impaired memory and reduced mood recall can inhibit proper diagnosis of depression in a person, preventing them from receiving appropriate depression treatment.

Classification of Emotions

People are typically capable of two types of emotions: primary and secondary. These emotions can be expressed verbally and non-verbally, and can be regulated intrinsically (self-management, learned strategies, etc.) as well as extrinsically (social interactions, milieu structure. etc.).

Primary Emotions:

  • Sadness or melancholy
  • Discontentment
  • Fear
  • Anger
  • Joy or happiness

Secondary Emotions:

  • Optimism
  • Love
  • Awe
  • Disappointment
  • Remorse
  • Contempt
  • Aggression

Secondary emotions are a combination of primary emotions.

Emotions and Dementia

In advancing D/NCD, there is an imbalance between generation and regulation of emotions. Emotional comprehension is preserved despite the cognitive impairment, but behaviors may manifest.

Imbalance in emotional regulation may result in:



1. Parkinson, B., Totterdell, P., Briner, R. B., & Reynolds, S. (1996). Changing moods: The psychology of mood and mood regulation. London: Addison Wesley Longman.
2. Clore, G. L., Schwarz, N., & Conway, M. (1994). Affective causes and consequences of social information processing. In R. S. Wyer Jr., & T. K. Srull ( Eds.), Handbook of social cognition, 2nd edition. (pp. 323-418). Hillsdale, NJ: Erlbaum.