Emotion Regulation and Repetitive Negative Thinking Before and After CBT and SSRI Treatment of Internalizing Psychopathologies

Feurer, Cope; Francis, Jennifer; Ajilore, Olusola; Craske, Michelle G.; Phan, K. Luan; Klumpp, Heide

doi:10.1007/s10608-021-10222-8

Original Article
Published: 21 April 2021

Emotion Regulation and Repetitive Negative Thinking Before and After CBT and SSRI Treatment of Internalizing Psychopathologies

Cope Feurer ORCID: orcid.org/0000-0002-0644-1961¹,
Jennifer Francis²,
Olusola Ajilore¹,
Michelle G. Craske³,
K. Luan Phan⁴ &
Heide Klumpp¹

Cognitive Therapy and Research volume 45, pages 1064–1076 (2021)Cite this article

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Abstract

Background

Emotion regulation (ER) strategies (i.e., reappraisal, suppression) and repetitive negative thinking (RNT) tendencies (i.e., brooding rumination, worry) are transdiagnostic and contribute to the maintenance of internalizing psychopathologies. Cognitive Behavioral Therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are both effective in reducing symptom severity, however, their impact on ER and RNT is unclear. Therefore, the goal of the current study was to examine whether CBT and SSRIs improved ER and RNT in a transdiagnostic sample.

Methods

The current sample comprised 91 patients with anxiety, depression, and/or posttraumatic stress disorder randomly assigned to receive either CBT (n = 45) or an SSRI (n = 46) and 49 healthy controls as a comparator group. Patients completed measures of clinical symptoms, reappraisal, suppression, brooding rumination, and worry before and after treatment. Controls completed the same measures at baseline.

Results

Compared to controls, patients reported greater symptom severity, suppression, brooding, and worry, and less reappraisal. Both treatments improved symptom severity, ER, and RNT. However, patients who completed CBT reported greater improvement in reappraisal than patients who completed treatment with an SSRI. Finally, change in RNT, but not ER, was associated with symptom improvement.

Conclusions

Findings suggest treatment improves ER and RNT and provides preliminary evidence of a treatment modality effect on reappraisal.

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Funding

This work was supported by National Institute of Mental Health of the National Institutes of Health grant R01MH101497 (KLP) and in part by R01MH112705 (HK), T32MH067631 (CF), and the Center for Clinical and Translational Research (CCTS) UL1RR029879.

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Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Street, Chicago, IL, 60612, USA
Cope Feurer, Olusola Ajilore & Heide Klumpp
Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
Jennifer Francis
Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, CA, USA
Michelle G. Craske
Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
K. Luan Phan

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Cope Feurer
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Jennifer Francis
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Olusola Ajilore
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Michelle G. Craske
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Heide Klumpp
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Correspondence to Cope Feurer.

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Cope Feurer, Jennifer Francis, Olusola Ajilore, Michelle G. Craske, K. Luan Phan, and Heide Klumpp declare that they have no conflict of interest.

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Feurer, C., Francis, J., Ajilore, O. et al. Emotion Regulation and Repetitive Negative Thinking Before and After CBT and SSRI Treatment of Internalizing Psychopathologies. Cogn Ther Res 45, 1064–1076 (2021). https://doi.org/10.1007/s10608-021-10222-8

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Accepted: 08 April 2021
Published: 21 April 2021
Issue Date: December 2021
DOI: https://doi.org/10.1007/s10608-021-10222-8

Keywords

Psychotherapy
Medication
Cognitive processes
Repetitive negative thinking
Emotion regulation