Characteristics of emotion regulation in recovered depressed versus never depressed individuals

Alexithymia and emotional intelligence in patients with panic disorder, generalized anxiety disorder and major depressive disorder

Emotional Intelligence (EI) is a broad personality construct signifying the ability to perceive and to regulate affects within oneself. Alexithymia is another personality construct denoting difficulty in identifying and expressing emotions, with an externally oriented thinking style. Although previously considered to be independent, some studies have shown that these constructs overlap. The aim of this study was to evaluate and compare the levels of EI and alexithymia in patients with panic disorder, major depressive disorder (MDD), and generalized anxiety disorder (GAD). The subjects included 171 psychiatric patients and 56 non-clinical controls. Psychiatric diagnoses were based on DSM-IV criteria. The Emotional Intelligence Scale-34 (EIS-34) and the Toronto Alexithymia Scale (TAS-20) were used to assess EI and alexithymia. All three patient groups scored statistically significantly higher than the non-clinical controls on TAS-20 total score and the TAS-20 subfactors of difficulty identifying feelings and difficulty describing feelings. EIS-34 scores were lower in patient groups than in the non-clinical controls, but only the EIS-34 intrapersonal subscale was significant difference. Total TAS-20 and EIS-34 scores in the patient cohort were inversely and significantly correlated These results reaffirm an overlap between EI and alexithymia with the intrapersonal factor of EI to be more dependent on the difficulty identifying feelings dimension of alexithymia in subjects with MDD and GAD.

Differences between expressive suppression and cognitive reappraisal in opioids and stimulant dependent patients

Background

Substance use and affective disorders frequently co-occur, but the role of affective dysregulation in addiction is often overlooked. There is evidence shows that substance – dependent individuals have more problems in regulating their emotions.

Objectives

This study compared two commonly used emotional regulation strategies, cognitive reappraisal and suppression, in opioids and methamphetamine dependents.

Materials and Methods

One hundred forty men with substance dependence (70 Opioids, 70 Methamphetamine) were selected by accessible sampling, and they responded to Emotion Regulation Questionnaire (Gross & John) and Clinical drug addiction profile (CDAP) questionnaire. SPSS software was used to analyze the results, and descriptive statistics such as frequency tables and inferential statistics including independent t-test were used.

Results

Opioids and methamphetamine dependent patients differ in reappraisal strategy (P < 0.01). These groups differ not only in reappraisal strategy, but also in the suppression (P < 0.001).

Conclusion

Opioids and methamphetamine dependent individuals used different strategies for regulating their emotions. The key finding was that opioids dependents prefer suppression, and methamphetamine dependents usually use reappraisal for this purpose.

Anger and major depressive disorder: the mediating role of emotion regulation and anger rumination

Many studies have documented the existence of a close relationship between anger and depression. Furthermore, recent literature has emphasized the role of impaired emotion regulation and anger rumination in depression. The aim of this study was to explore the mediating role of emotion regulation and anger rumination on the relation between anger and major depressive disorder. Eighty-eight patients with major depressive disorder (20 males, 68 females) completed the Beck Depression Inventory (BDI), the Multidimensional Anger Inventory (MAI), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Anger Rumination Scale (ARS). Results illustrated that in clinically depressed people, there are positive relationships between anger, depression, emotion regulation, and anger rumination. Path analysis revealed that emotion regulation and anger rumination played a mediating role on the relation between anger and major depression. Anger was associated with depression via emotion regulation and anger rumination. Findings of the present study suggest that emotion regulation and anger rumination play an important role on the relation between anger and depression. The current study implicates the complicated nature of depression, and emphasizes the understanding and conceptualization of diverse variables that influence depression.

Emotion regulation is the essential skill for improving depressive symptoms

BACKGROUND

For decades, research has shown that various skills (e.g., social skills) are associated with depressive symptoms. In recent years, much work has focused on skills for regulating emotion. Unfortunately, nearly all of these studies have investigated isolated skills. By contrast, the aim of the present study was the combined assessment of multiple skills in order to simultaneously analyze their relevance for depressive symptomatology. The authors wanted to identify skill domains that are essential for improving depressive symptoms.

METHODS

The sample consisted of N=124 inpatients assessed at admission and discharge. Seven different skills were measured using a structured multidimensional interview. In addition, the severity of depressive symptoms was assessed.

RESULTS

Correlations between the improvements in skills and depressive symptoms reached significance for every skill domain ranging from r=.21 to r=.54. A multiple hierarchical regression analysis was conducted with pre-treatment scores of skills. Compared to other domains, only emotion regulation significantly predicted the improvement of depressive symptomatology. Moreover, emotion regulation at pre-treatment turned out to be a moderator of the association between improvements in skills and the reduction of depressive symptoms.

LIMITATIONS

Because this study primarily focused on skills, no conclusions can be drawn regarding the relevance of these skills in relation to other predictors of therapy outcome.

CONCLUSIONS

Even when various skills are tested simultaneously, emotion regulation appears to be the essential skill influencing depressive symptom improvement. Therefore, a targeted enhancement of this skill may help to optimize the outcome regarding the treatment of depressive symptomatology.

The role of attention to emotion in recovery from major depressive disorder

Major Depressive Disorder (MDD) is characterized by several emotional disturbances. One possible but not well-examined disturbance is in attention to emotion, an important facet of emotional awareness. We examined whether attention to emotion predicted recovery from MDD. Fifty-three adults with current MDD completed a week of experience sampling (Time 1). At each prompt, participants reported attention to emotion, negative affect (NA), and positive affect (PA). Approximately one year later (Time 2), the depressive status of 27 participants was reassessed. Participants who had recovered from MDD (n = 8) indicated paying less attention to their emotions at Time 1 than did participants who had not fully recovered (n = 19). Attention to emotion was better predictor of recovery than was severity of MDD, NA, or PA at Time 1. Levels of attention to emotion at Time 1 in participants who recovered from MDD did not differ significantly from the levels reported by 53 never-depressed individuals who had participated in the experience sampling. Findings indicate that high levels of an otherwise adaptive emotional facet can adversely affect the course of MDD.

Ressourcentagebuch: Verbesserung der Emotionsregulation und der Ressourcenrealisierung durch therapeutisches Schreiben im Anschluss an eine Psychotherapie

Theoretischer Hintergrund: Defizite in Emotionsregulation und Ressourcenrealisierung können auch nach Behandlung und Remission der psychischen Störung bestehen bleiben und langfristig Rückfälle verursachen. Fragestellung: Können mittels einer vierwöchigen Schreibintervention in Form eines Ressourcentagebuchs Stimmung, Emotionsregulation und Ressourcenrealisierung bei Patienten nach stationärer Psychotherapie verbessert werden? Methode: 41 Patienten wurden randomisiert entweder der Interventionsgruppe (N = 21) oder der unbehandelten Kontrollgruppe (N = 20) zugeteilt. Die Ergebnisvariablen wurden im Abstand von fünf Wochen erhoben. Ergebnisse: Die Interventionsgruppe zeigte gegenüber der Kontrollgruppe einen signifikanten Anstieg der positiven Stimmung, sowie der Emotionsregulationsstrategie Neubewertung. Unterschiede in der Ressourcenrealisierung zeigten sich nicht zwischen den Gruppen. Schlussfolgerungen: Die Ergebnisse dieser Pilotstudie geben erste Hinweise auf eine Verbesserung der Stimmung und der Emotionsregulation durch das Schreiben eines Ressourcentagebuchs.

Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder

Differences in attachment style have been linked to both emotion regulation and psychological functioning, but the emotion regulatory mechanism through which attachment style might impact symptoms of depression and anxiety is unclear. The present study examined the explanatory role of emotion dysregulation in the relation between adult attachment style and symptoms of depression and generalized anxiety disorder (GAD) in a sample of 284 adults. Secure attachment was associated with lower depression and GAD symptoms and lower emotion dysregulation, whereas insecure attachment styles were generally associated with higher depression and GAD scores and higher emotion dysregulation. Perceived inability to generate effective emotion regulation strategies mediated the relation between insecure attachment and both depression and GAD symptoms. Nonacceptance of negative emotions and inability to control impulsive behaviors emerged as additional mediators of the relation between insecure attachment styles and GAD symptoms. The differential contribution of attachment style and emotion regulation to the prediction of depression and GAD symptoms may reflect differences in vulnerability to depression and GAD.

Effects of suppression and acceptance of sadness on the urge for non-suicidal self-injury and self-punishment

The present study wanted to test the course of the urge for non-suicidal self-injury (UNSSI) and the urge for self-punishment (USP) when suppressing or accepting upcoming emotions in response to a sadness-inducing film clip in female participants with borderline personality disorder (BPD). Thirty-six women with BPD were allocated either to a condition in which they were asked to engage in expressive suppression or acceptance while watching a sadness-inducing film clip. Ratings of UNSSI, USP, and positive and negative emotions were assessed prior to the clip (baseline), immediately after it (t1) and after a 5min waiting period (t2), during which participants viewed landscape pictures. Additionally, physiological measures were obtained. Main results revealed a significant increase in UNSSI from baseline to t2 in the acceptance, but not in the suppression group. Furthermore, USP scores significantly increased from baseline to t2 in the acceptance, but not in the suppression condition. However, there was no differential impact on the sympathetic and parasympathetic branch depending on strategy. The results are in line with recent literature showing that expressive suppression in BPD may also have an adaptive function.

Increased suppression of negative and positive emotions in major depression

BACKGROUND

Patients with major depression (MDD) show increased suppression of negative emotions. Emotion suppression is related to depressive symptoms such as depressive mood and anhedonia. It is not clear whether MDD patients also suppress positive emotions. In the present study we aim to investigate suppression of both negative and positive emotions in MDD patients as well as the relation between emotion suppression and depressive symptoms. In addition, we suggest that emotion suppression might be associated with fear of emotions.

METHODS

39 MDD patients and 41 matched healthy control subjects were investigated for emotion suppression and fear of emotions with the Emotion Acceptance Questionnaire (EAQ). In addition, we applied additional questionnaires to validate emotion suppression findings and to assess depressive symptoms.

RESULTS

MDD patients reported increased suppression of both negative and positive emotions. Suppression of negative and positive emotions was related to depressive symptoms. Patients also reported more fear of emotions than healthy subjects and this fear was related to emotion suppression in both study samples.

LIMITATIONS

Due to the cross-sectional and correlational study design, causal directions between the variables tested cannot be stated.

CONCLUSIONS

Fear of emotion might be one reason why MDD patients suppress emotions. With regard to positive emotions, our results strongly suggest that therapeutic approaches should not only encourage patients to participate in potentially enjoyable situations but that patients may also benefit from practicing the allowance of pleasant emotions.

Negative inferential style, emotional clarity, and life stress: integrating vulnerabilities to depression in adolescence

Negative inferential style and deficits in emotional clarity have been identified as vulnerability factors for depression in adolescence, particularly when individuals experience high levels of life stress. However, previous research has not integrated these characteristics when evaluating vulnerability to depression. In the present study, a racially diverse community sample of 256 early adolescents (ages 12 and 13) completed a baseline visit and a follow-up visit 9 months later. Inferential style, emotional clarity, and depressive symptoms were assessed at baseline, and intervening life events and depressive symptoms were assessed at follow-up. Hierarchical linear regressions indicated that there was a significant three-way interaction between adolescents' weakest-link negative inferential style, emotional clarity, and intervening life stress predicting depressive symptoms at follow-up, controlling for initial depressive symptoms. Adolescents with low emotional clarity and high negative inferential styles experienced the greatest increases in depressive symptoms following life stress. Emotional clarity buffered against the impact of life stress on depressive symptoms among adolescents with negative inferential styles. Similarly, negative inferential styles exacerbated the impact of life stress on depressive symptoms among adolescents with low emotional clarity. These results provide evidence of the utility of integrating inferential style and emotional clarity as constructs of vulnerability in combination with life stress in the identification of adolescents at risk for depression. They also suggest the enhancement of emotional clarity as a potential intervention technique to protect against the effects of negative inferential styles and life stress on depression in early adolescence.

An investigation of the relationship between positive affect regulation and depression

There is preliminary evidence that dysphoric symptoms are associated with maladaptive regulation of positive emotion. We investigated to what extent this pattern is unique to depression symptoms, persists in recovery, and extends to apprehension of intense emotion experience. In Study 1, in a sample of undergraduates (N = 112), dysphoria was associated with apprehension about experiencing intense emotion and dampening of positive emotion. Reductions in the amplification of positive emotion experience were uniquely associated with anhedonic depressive symptoms. Study 2 compared a recovered depressed and never-depressed student sample (N = 123), and found that recovered individuals reported using more maladaptive responses to positive affect. In Study 3 we examined community-recruited depressed, recovered and never-depressed groups (N = 50), and found that depressed individuals reported a greater tendency to dampen positive emotion than their never-depressed counterparts, but did not significantly differ from recovered depressed individuals. Greater dampening and reduced amplification of positive experience were again uniquely associated with anhedonic depressive symptoms. Our findings converge on the proposal that current depressive symptoms, rather than a history of depression, are more strongly linked to difficulties with emotion regulation, and suggest that targeting positive emotion could reduce anhedonia and improve treatment outcomes.

Specificity of emotion regulation deficits in social anxiety: an internet study

OBJECTIVES

There is evidence for an association between social anxiety and emotion regulation difficulties. This study investigates that emotion regulation difficulties are specific to two domains of social anxiety.

DESIGN AND METHOD

An explorative study was conducted to examine the associations between emotion regulation facets and social anxiety in the normal population. N= 149 healthy volunteers participated in an internet-based survey.

MEASURES

Emotion regulation deficits were measured by the Difficulties in Emotion Regulation Scale which consists of six subscales. Social anxiety was measured by the Social Phobia Scale and the Social Interaction Anxiety Scale.

RESULTS

Hierarchical regression analyses showed that anxiety of interactive social situations is associated with non-acceptance of negative emotions, impulse control difficulties, and lack of functional emotion regulation strategies over and above the impact of age and general psychopathology. In contrast, anxiety of being observed by others was not specifically associated with emotion regulation strategies.

CONCLUSION

The results support the hypothesis that specific emotion regulation deficits are relevant to specific aspects of social anxiety. Implications for further research and therapy are discussed.

Is the association between various emotion-regulation skills and mental health mediated by the ability to modify emotions? Results from two cross-sectional studies

BACKGROUND AND OBJECTIVES

In order to clarify mechanisms underlying the association between emotion regulation and psychopathology, we tested whether the ability to modify negative emotions mediates the associations of other emotion-regulation skills with psychopathological symptoms in two studies.

METHODS

The first study included 151 college students; the second included 121 psychiatric inpatients. Bootstrapping-enhanced mediation analyses were utilized to assess associations between self-reports of emotion-regulation skills and psychopathology, as well as potential mediation effects.

RESULTS

In both samples, the ability to modify emotions completely mediated the association between symptoms and skills for most skills, but not for the skill of accepting/tolerating negative emotions.

LIMITATIONS

Major limitations include the use of a cross-sectional design as well as exclusive use of self-report data.

CONCLUSIONS

The ability to modify negative emotions may be the common pathway by which many emotion-regulation skills exert their influence on mental health; however, the skill of accepting/tolerating negative emotions may be beneficial to mental health regardless of whether or not it facilitates modification of emotions.

Emotion regulation deficits in eating disorders: a marker of eating pathology or general psychopathology?

Preliminary evidence indicates that individuals with eating disorders (ED) show emotion regulation (ER) difficulties. However, it is yet unclear whether different types of ED differ in their ER profile and whether certain ER difficulties are specific for ED or rather a transdiagnostic factor. Twenty women with anorexia nervosa (AN), 18 with bulimia nervosa (BN), 25 with binge eating disorder (BED), 15 with borderline personality disorder (BPD), 16 with major depressive disorder (MDD) and 42 female healthy controls (HC) were administered the Emotion Regulation Questionnaire, the Inventory of Cognitive Affect Regulation Strategies, the Difficulties in Emotion Regulation Scale and the Affect Intensity Measure. The ED groups reported significantly higher levels of emotion intensity, lower acceptance of emotions, less emotional awareness and clarity, more self-reported ER problems as well as decreased use of functional and increased use of dysfunctional emotion regulation strategies when compared to HC. No significant differences between the ED groups emerged for most ER variables. However, there were indications that the BED group may show a slightly more adaptive pattern of ER than the two other ED groups. As a whole, all clinical groups performed very similar on most ER variables and reported more difficulties regulating their emotions than HC. The findings suggest that ER difficulties are not linked to a particular diagnostic category. Instead, ER difficulties appear to be a transdiagnostic risk and/or maintenance factor rather than being disorder-specific.

Cognitive Aspects of Depression

Depression is a prevalent and impairing psychiatric disorder that affects how we feel and how we think about ourselves and the world around us. Cognitive theories of depression have long posited that various thought processes are involved in the development, maintenance, and recurrence of depressive episodes. Contemporary research has utilized experimental procedures to examine cognitive processes in depressed individuals as well as the nature of the relation of these processes to the emotion dysregulation that is central to the disorder. For example, investigators have assessed the ways in which depression alters aspects of information processing, including attention and perception, interpretation, and memory processes; this research has generated relatively consistent findings. In addition, researchers have attempted to identify and elucidate the cognitive mechanisms that may link these biases in information processing to emotion dysregulation in depression. These mechanisms include inhibitory processes and deficits in working memory, ruminative responses to negative mood states, and the inability to use positive and rewarding stimuli to regulate negative mood. Results of these investigations converge on the formulation that depression is associated with increased elaboration of negative information, difficulties in cognitive control when processing this information, and difficulties disengaging from this information. Research examining cognitive aspects of depression not only enhances our understanding of this common and costly disorder, but also has implications for the treatment of depression and for future investigations of the biological foundations of this disorder.

Emotion regulation and mental health: recent findings, current challenges, and future directions

PURPOSE OF REVIEW

In recent years, deficits in emotion regulation have been studied as a putative maintaining factor and promising treatment target in a broad range of mental disorders. This article aims to provide an integrative review of the latest theoretical and empirical developments in this rapidly growing field of research.

RECENT FINDINGS

Deficits in emotion regulation appear to be relevant to the development, maintenance, and treatment of various forms of psychopathology. Increasing evidence demonstrates that deficits in the ability to adaptively cope with challenging emotions are related to depression, borderline personality disorder, substance-use disorders, eating disorders, somatoform disorders, and a variety of other psychopathological symptoms. Unfortunately, studies differ with regard to the conceptualization and assessment of emotion regulation, thus limiting the ability to compare findings across studies. Future research should systematically work to use comparable methods in order to clarify the following: which individuals have; what kinds of emotion regulation difficulties with; which types of emotions; and what interventions are most effective in alleviating these difficulties.

SUMMARY

Despite some yet to be resolved challenges, the concept of emotion regulation has a broad and significant heuristic value for research in mental health.

Emotion regulation in depression: relation to cognitive inhibition

Depression is a disorder of impaired emotion regulation. Consequently, examining individual differences in the habitual use of emotion regulation strategies has considerable potential to inform models of this debilitating disorder. The aim of the current study was to identify cognitive processes that may be associated with the use of emotion regulation strategies and to elucidate their relation to depression. Depression has been found to be associated with difficulties in cognitive control and, more specifically, with difficulties inhibiting the processing of negative material. We used a negative affective priming task to assess the relations among inhibition and individual differences in the habitual use of rumination, reappraisal, and expressive suppression in clinically depressed, formerly depressed, and never-depressed participants. We found that depressed participants exhibited the predicted lack of inhibition when processing negative material. Moreover, within the group of depressed participants, reduced inhibition of negative material was associated with greater rumination. Across the entire sample, reduced inhibition of negative material was related to less use of reappraisal and more use of expressive suppression. Finally, within the formerly depressed group, less use of reappraisal, more use of rumination, and greater expressive suppression were related to higher levels of depressive symptoms. These findings suggest that individual differences in the use of emotion regulation strategies play an important role in depression, and that deficits in cognitive control are related to the use of maladaptive emotion regulation strategies in this disorder.

Interpersonal emotion regulation as a mechanism of social support in depression

Although social support is widely considered to be protective against depression, the mechanisms through which it acts on depressive psychopathology are not well known. This integrative review argues that emotion regulation serves as such a mechanism. First, the literature on the effects of social support on depression is reviewed, with an emphasis on open empirical questions regarding mechanisms linking support and depression. Then, the literature on emotion regulation is reviewed, highlighting its importance as a mechanism in the psychopathology of depression. Finally, potential interpersonal influences on depressive emotion regulation and dysregulation are suggested, drawing from theory and research on psychotherapy and on close relationships. The review suggests that emotion regulation is responsive to interpersonal influences, and that this responsiveness may account for the effects of social support on depression. Implications of an interpersonal perspective for basic and clinical research on depression, close relationships, and emotion regulation are discussed.

Emotion regulation difficulties are relevant to persecutory ideation

OBJECTIVES

Persecutory delusions are preceded and accompanied by negative emotions, which may be prolonged or even amplified by difficulties in the ability to regulate negative emotions. This study aims to gain insight into emotion regulation difficulties in persecutory ideation.

DESIGN AND METHOD

A correlational approach was adopted to explore bivariate and multivariate associations between emotion regulation difficulties and persecutory ideation in a subclinical sample. Furthermore, general psychopathology as well as positive symptoms of schizophrenia were assessed in order to estimate the specificity of emotion regulation difficulties. Data from 151 participants acquired via an Internet-based survey were analyzed.

RESULTS

There were substantial bivariate correlations between paranoid ideation and emotion regulation difficulties. However, only impulse control difficulties were specific to persecutory ideation after controlling for general psychopathology. Additionally, a multivariate analysis revealed unexpected positive associations between the acceptance of emotional responses and paranoid ideation as well as positive symptoms.

CONCLUSIONS

Besides the general difficulties in regulating emotion that are common to many clinical disorders and were associated with overall psychopathology, subclinical psychotic symptoms seem to be specifically associated with certain aspects of emotion regulation. Emotion regulation difficulties are likely to contribute to symptom formation and maintenance in persecutory delusions and might therefore present a valuable treatment target.

Regulation of affect in late adulthood: effects of mild depressive symptoms

BACKGROUND

Recent research has highlighted the important role of emotion dysregulation in the occurrence and maintenance of depressive symptomatology.

OBJECTIVES

The purpose of this study was to test the effects of mild depressive symptoms (MDS) on older adults' ability to regulate emotional experiences.

METHOD

A total of 70 community dwelling older adults completed self-report measures of affect and were asked to report how often they use specific emotion regulation strategies.

RESULTS

Consistent with previous theories older adults experiencing MDS reported greater difficulties in regulating affect compared to normal controls (NCs).

CONCLUSION

The present results provide support for previous findings demonstrating that experiencing depressive symptoms affects the ability to regulate emotional responses. Current findings are likely to be informative in terms of understanding emotion dysregulation in older adults at risk of experiencing clinical symptoms of depression.

Psychometrische Analyse eines neuen Fragebogens zur Erfassung der Akzeptanz von unangenehmen und angenehmen Gefühlen (FrAGe)

Zusammenfassung. Die Akzeptanz von Gefühlen ist eine zentrale, der psychischen Gesundheit dienliche Emotionsregulationsstrategie. Das Ziel dieser Untersuchung besteht in einer ersten Überprüfung der testtheoretischen Kennwerte eines neu entwickelten Fragebogens zur Akzeptanz von unangenehmen und angenehmen Gefühlen. In zwei Studien mit 171 und 207 nicht klinischen Probanden wurden die testtheoretischen Kennwerte des ‹Fragebogens zur Akzeptanz von Gefühlen (FrAGe)› bestimmt. Der FrAGe enthält Items aus den Bereichen Akzeptanz angenehmer Gefühle, Akzeptanz unangenehmer Gefühle, Unterdrückung angenehmer Gefühle und Unterdrückung unangenehmer Gefühle. Zur ersten Validierung wurden die ‹Difficulties in Emotion Regulation Scale (DERS)› und eine Kurzversion der ‹Symptomcheckliste (SCL-K-9)› eingesetzt. Die ursprüngliche Fragebogenversion mit 40 Items wurde in der ersten Studie auf Basis von Itemanalysen überarbeitet und auf 32 Items gekürzt. Die zweite Studie zeigte gute bis zufriedenstellende Itemkennwerte sowie eine entsprechende Reliabilität und Validität des FrAGe. Einige Items im Bereich angenehmer Gefühle zeigten bei den nicht klinischen Probanden erwartungsgemäß extremere Itemmittelwerte. Insgesamt sprechen die Ergebnisse für gute psychometrische Eigenschaften des FrAGe. Bei nicht klinischen Personen ist insbesondere die Erfassung von Emotionsakzeptanz unangenehmer Gefühle empfehlenswert.

Cross-sectional and longitudinal relations between affective instability and depression

BACKGROUND

There is a growing recognition that emotional traits are important for understanding many mental health disorders, including major depressive disorder (MDD). The present research examined (a) the relation between MDD and the emotional trait of affective instability, and (b) whether individual facets of affective instability, affect intensity and affect variability, exhibited unique relations with anhedonic depression.

METHODS

In Study 1, affective instability and MDD were both assessed via clinical interviews in an adult community sample (n=288). In Studies 2 and 3, the relations between anhedonic depression and affect variability and affect intensity were assessed cross-sectionally using self-report measures in a college student sample (n=142; Study 2) and a female community sample (n=101; Study 3). Study 3 also prospectively examined whether affect variability and/or intensity predicted changes in anhedonic depression over two months.

RESULTS

In Study 1, affective instability and MDD were significantly associated, even after excluding individuals experiencing a current major depressive episode. In Studies 2 and 3, affect variability but not affect intensity was significantly, positively associated with anhedonic depression. In Study 3, affect variability but not affect intensity prospectively predicted increases in anhedonic depression.

LIMITATIONS

Future studies should assess the entire Bipolar Disorder spectrum and utilize event sampling, permitting the examination of other facets of affective instability (e.g., temporal dependency) and address other limitations of retrospective measures (e.g., recall bias).

CONCLUSIONS

These findings suggest that affective instability and particularly affect variability are associated with MDD and anhedonic depression. The tendency to experience frequent fluctuations in mood may constitute an important risk factor for depression.

Cognition and depression: current status and future directions

Cognitive theories of depression posit that people's thoughts, inferences, attitudes, and interpretations, and the way in which they attend to and recall information, can increase their risk for depression. Three mechanisms have been implicated in the relation between biased cognitive processing and the dysregulation of emotion in depression: inhibitory processes and deficits in working memory, ruminative responses to negative mood states and negative life events, and the inability to use positive and rewarding stimuli to regulate negative mood. In this review, we present a contemporary characterization of depressive cognition and discuss how different cognitive processes are related not only to each other, but also to emotion dysregulation, the hallmark feature of depression. We conclude that depression is characterized by increased elaboration of negative information, by difficulties disengaging from negative material, and by deficits in cognitive control when processing negative information. We discuss treatment implications of these conclusions and argue that the study of cognitive aspects of depression must be broadened by investigating neural and genetic factors that are related to cognitive dysfunction in this disorder. Such integrative investigations should help us gain a more comprehensive understanding of how cognitive and biological factors interact to affect the onset, maintenance, and course of depression.

Self-reported emotional dysregulation but no impairment of emotional intelligence in borderline personality disorder: an explorative study

Emotional dysfunction is a key feature of patients with borderline personality disorder (BPD) but emotional intelligence (EI) has rarely been investigated in this sample. This study aimed at an investigation of ability EI, general intelligence, and self-reported emotion regulation in BPD. We included 19 patients with BPD and 20 healthy control subjects in the study. EI was assessed by means of the Mayer-Salovey-Caruso emotional intelligence test and the test of emotional intelligence. For the assessment of general intelligence, we administered the multidimensional "Leistungsprüfsystem-Kurzversion." The emotion regulation questionnaire and the difficulties in Emotion Regulation Scale were used to assess emotion regulation. The patients with BPD did not exhibit impairments of ability EI and general intelligence but reported severe impairments in emotion regulation. Ability EI was related both to general intelligence (patients and controls) and to self-reported emotion regulation (patients). In conclusion, emotional dysfunction in BPD might primarily affect self-perceived behavior rather than abilities. Intense negative emotions in everyday life may trigger dysfunctional emotion regulation strategies in BPD although patients possess sufficient theoretical knowledge about optimal regulation strategies.

Prodromal symptoms and atypical affectivity as predictors of major depression in juveniles: implications for prevention

BACKGROUND

Given the long-term morbidity of juvenile-onset major depressive disorder (MDD), it is timely to consider whether more effort should be dedicated to its primary and secondary prevention.

METHODS

We reviewed studies of prodromal symptoms that may herald a first episode pediatric MDD and considered whether that literature has made an impact on secondary prevention (efforts to prevent progression from symptoms to full disorder). We also reviewed studies of children at familial risk for MDD that addressed atypical affectivity and the regulation of sad, dysphoric affect (mood repair) and related physiological systems, and considered whether research in those areas has made an impact on primary prevention of pediatric MDD (efforts to prevent the disorder).

RESULTS

A compelling body of literature indicates that depressive symptoms in youngsters predict subsequent MDD across the juvenile (and early adult) years and that any combination of several symptoms for at least one week is informative in that regard. These findings are echoed in the case selection criteria used by many secondary prevention programs. Convergent findings also indicate that (compared to typical peers) young offspring at familial risk for depression manifest low positive affectivity and compromised mood repair, along with signs of dysfunction in three intertwined physiological systems that contribute to affectivity and mood repair (the hypothalamic-pituitary-adrenal (HPA) axis, cerebral hemispheric asymmetry, and cardiac vagal control). While all these affect-related parameters are suitable for case selection and as intervention targets, they have not yet made an impact on primary prevention programs.

CONCLUSIONS

According to recent meta-analyses, attempts to prevent pediatric depression have not lived up to expectations. Based on our review, possible reasons for this include: (a) the use of case selection criteria that yield samples heterogeneous with regard to whether the symptoms are truly prodromal to an episode of MDD or are trait-like (which could affect response to the intervention), (b) failure to fully capitalize on the broad-ranging literature on vulnerability to pediatric MDD, as evidenced by the infrequent use of family history of depression (a robust index of vulnerability) or combined indices of vulnerability for case selection, and (c) lack of synchrony between dimensions of vulnerability and the content of the prevention program, as indicated by the overwhelming use of cognitive-behavioral interventions, irrespective of subjects' age, developmental readiness, and whether or not they evidenced the relevant cognitive vulnerability. Prevention trials of pediatric MDD could benefit from new approaches to case selection that combine various indices of vulnerability, more effective use of existing findings, and new or modified interventions that are developmentally sensitive.

Measuring clarity of and attention to emotions

Previous research has found that understanding one's emotions and attending to them are 2 dimensions of emotional awareness. In this research, we examined whether improved subscales for measuring clarity of and attention to emotions could be developed by selecting the best items from 2 frequently used measures of emotional awareness. Using multidimensional scaling and confirmatory factor analysis, we analyzed the Toronto Alexithymia Scale-20 (Bagby, Parker, & Taylor, 1994) and the Trait Meta-Mood Scale (Salovey, Mayer, Goldman, Turvey, & Palfai, 1995) data from 867 college students. Results supported distinct clarity and attention constructs. New subscales were internally consistent and fared as well as or better than previous versions in terms of internal consistency and convergent validity.