Emotion Regulation in Depression and Anxiety: Examining Diagnostic Specificity and Stability of Strategy Use
- 2k Downloads
Many psychological disorders are characterized by difficulties in emotion regulation. It is unclear, however, whether different disorders are associated with the use of specific emotion regulation strategies, and whether these difficulties are stable characteristics that are evident even after recovery. It is also unclear whether the use of specific strategies is problematic across all disorders or whether disorders differ in how strongly strategy use is associated with symptom severity. This study investigated (1) the specificity of use of emotion regulation strategies in individuals diagnosed with current major depressive disorder (MDD), with social anxiety disorder (SAD), and in never-disordered controls (CTL); and (2) the stability of strategy use in formerly depressed participants (i.e., remitted; RMD). Path analysis was conducted to examine the relation between strategy use and symptom severity across diagnostic groups. Compared to the CTL group, participants in both clinical groups endorsed more frequent use of rumination and expressive suppression, and less frequent use of reappraisal. Specific to SAD were even higher levels of expressive suppression relative to MDD, as well as a stronger relation between rumination and anxiety levels. In contrast, specific to MDD were even higher levels of rumination and lower levels of reappraisal. Interestingly, elevated rumination, but not decreased reappraisal, was found to be a stable feature characterizing remitted depressed individuals. These results may provide insight into ways in which emotion regulation strategy use maintains psychological disorders.
KeywordsDepression Social anxiety Emotion regulation Rumination Suppression Reappraisal
This research was supported by NIMH Grants MH059259 and MH080683 awarded to Ian H. Gotlib.
Conflict of interest
The authors have no potential conflicts of interest pertaining to this manuscript.
- Abela, J. R. Z., Hankin, B. L., Sheshko, D. M., Fishman, M. B., & Stolow, D. (2012). Multi-wave prospective examination of the stress-reactivity extension of response styles theory of depression in high-risk children and early adolescents. Journal of Abnormal Child Psychology, 40(2), 277–287.PubMedCrossRefGoogle Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
- Beck, A. T., Steer, R. A., & Brown, G. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
- Campbell-Sills, L., & Barlow, D. H. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 542–559). New York: Guilford Press.Google Scholar
- Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. M. Heimberg, M. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment (pp. 69–93). New York: Guilford Press.Google Scholar
- First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured clinical interview for DSM-IV axis I disorders (SCID I). Washington, DC: American Psychiatric Association.Google Scholar
- Hankin, B. L. (2009). Development of sex differences in depressive and co-occurring anxious symptoms during adolescence: Descriptive trajectories and potential explanations in a multiwave prospective study. Journal of Clinical Child and Adolescent Psychology, 38(4), 460–472.PubMedCrossRefGoogle Scholar
- Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.Google Scholar
- Keller, M. B., Lavori, P. W., Mueller, T. I., Endicott, J., Coryell, R., & Hirschfeld, R. (1992). Time to recovery, chronicity, and levels of psychopathology in major depression: A 5-year prospective follow-up of 431 subjects. Archives of General Psychiatry, 49(10), 809–816.PubMedCrossRefGoogle Scholar
- Kline, R. B. (2005). Principles and practice of structural equation modeling. New York: Guilford.Google Scholar
- Liverant, G. I., Brown, T. A., Barlow, D. H., & Roemer, L. (2008). Emotion regulation in unipolar depression: The effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect. Behaviour Research and Therapy, 46(11), 1201–1209.PubMedCrossRefGoogle Scholar
- Muthén, L. K., & Muthén, B. O. (2006). Mplus user’s guide (4th ed.). Los Angeles: Muthén & Muthén.Google Scholar
- Spielberger, C. D., Gorsuch, R., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). STAI manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar