The role of emotion regulation in subclinical symptoms of mental disorders in adolescence is not yet well understood. This meta-analytic review examines the relationship between the habitual use of prominent adaptive emotion regulation strategies (cognitive reappraisal, problem solving, and acceptance) and maladaptive emotion regulation strategies (avoidance, suppression, and rumination) with depressive and anxiety symptoms in adolescence. Analyzing 68 effect sizes from 35 studies, we calculated overall outcomes across depressive and anxiety symptoms as well as psychopathology-specific outcomes. Age was examined as a continuous moderator via meta-regression models. The results from random effects analyses revealed that the habitual use of all emotion regulation strategies was significantly related to depressive and anxiety symptoms overall, with the adaptive emotion regulation strategies showing negative associations (i.e., less symptoms) with depressive and anxiety symptoms whereas the maladaptive emotion regulation strategies showed positive associations (i.e., more symptoms). A less frequent use of adaptive and a more frequent use of maladaptive emotion regulation strategies were associated with depressive and anxiety symptoms comparably in the respective directions. Regarding the psychopathology-specific outcomes, depressive and anxiety symptoms displayed similar patterns across emotion regulation strategies showing the strongest negative associations with acceptance, and strongest positive associations with avoidance and rumination. The findings underscore the relevance of adaptive and also maladaptive emotion regulation strategies in depressive and anxiety symptoms in youth, and highlight the need to further investigate the patterns of emotion regulation as a potential transdiagnostic factor.
Emotion dysregulation has long been thought to be a vulnerability factor for mood disorders. However, there have been few empirical tests of this idea. In this study, we tested the hypothesis that depression vulnerability is related to difficulties with emotion regulation by comparing recovered-depressed and never-depressed participants (N = 73). In the first phase, participants completed questionnaires assessing their typical use of emotion regulation strategies. In the second phase, sad mood was induced using a film clip, and the degree to which participants reported to have spontaneously used suppression versus reappraisal to regulate their emotions was assessed. In the third phase, participants received either suppression or reappraisal instructions prior to watching a second sadness-inducing film. As predicted, suppression was found to be ineffective for down-regulating negative emotions, and recovered-depressed participants reported to have spontaneously used this strategy during the first sadness-inducing film more often than controls. However, the groups did not differ regarding the effects of induced suppression versus reappraisal on negative mood. These results provide evidence for a role for spontaneous but not instructed emotion regulation in depression vulnerability.
Objective: To provide a comprehensive meta-analysis on the efficacy of psychological and medical treatments for binge-eating disorder (BED), including those targeting weight loss. Method: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSM-IV] and Fifth Edition [DSM-5]), were retrieved and analyzed using random-effect modeling. Results: In RCTs with inactive control groups, psychotherapy, mostly consisting of cognitivebehavioral therapy, showed large-size effects for the reduction of binge-eating episodes and abstinence from binge eating, followed by structured self-help treatment with medium-to-large effects when compared with wait-list. Pharmacotherapy and pharmacological weight loss treatment mostly outperformed pill placebo conditions with small effects on binge-eating outcome. These results were confirmed for the most common treatments of cognitive-behavioral therapy, self-help treatment based on cognitivebehavioral therapy, and lisdexamfetamine. In RCTs with active control groups, there was limited evidence for the superiority of one treatment category or treatment. In a few studies, psychotherapy outperformed behavioral weight loss treatment in short-and long-term binge-eating outcome and led to lower longer-term abstinence than self-help treatment, while combined treatment revealed no additive effect on binge-eating outcome over time. Overall study quality was heterogeneous and the quality of evidence for binge-eating outcome was generally very low. Conclusions: This comprehensive meta-analysis demonstrated the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy for patients with BED. More high quality research on treatments for BED is warranted, with a focus on long-term maintenance of therapeutic gains, comparative efficacy, mechanisms through which treatments work, and complex models of care. What is the public health significance of this article?This comprehensive meta-analysis on psychological and medical treatments for binge-eating disorder demonstrates the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy. Psychotherapy may be prioritized over behavioral weight loss treatment, self-help treatment, and combined treatment. These results can be used as guidance in translating evidence-based treatments into clinical practice.
Zusammenfassung. Der Eating Disorder Examination-Questionnaire von Fairburn und Beglin (EDE-Q; 1994) ist die Fragebogenversion des strukturierten Essstörungsinterviews Eating Disorder Examination (EDE). Der EDE-Q erfasst die spezifische Essstörungspsychopathologie mithilfe von vier Subskalen zum gezügelten Essverhalten, zu Sorgen über das Essen, Gewicht und Figur. Die in diesem Beitrag vorgestellte deutschsprachige Übersetzung des EDE-Q wurde in Stichproben mit Anorexia nervosa, Bulimia nervosa und atypischen Essstörungen, sowie nicht-klinischen, subklinischen und psychiatrischen Vergleichsgruppen teststatistisch untersucht (N = 706). Der EDE-Q erwies sich als intern konsistent und stabil. Seine faktorielle Struktur wurde teilweise reproduziert. Die Kennwerte des EDE-Q waren signifikant mit denen des EDE korreliert, fielen erwartungsgemäß jedoch teilweise höher aus. Weitere Hinweise für die konvergente Validität ergaben sich durch Korrelationen mit konzeptverwandten Fragebögen. Der EDE-Q zeigte eine gute diskriminative Validität und war sensitiv in der Erfolgsmessung therapeutischer und präventiver Maßnahmen.
Psychotherapy and structured self-help, both based on cognitive-behavioral interventions, should be recommended as the first-line treatments.
Characteristics of emotion regulation in recovered depressed versus never depressed individuals Ehring, T.W.A.; Fischer, S.; Schnülle, J.; Bösterling, A.; Tuschen-Caffier, B. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. There is evidence that depressed individuals show a more dysfunctional use of emotion regulation strategies than controls. Some authors have suggested that these deficits are not confined to the acute phase but are a risk factor for the development of recurrent depressive episodes. The study aimed to provide a preliminary test of this hypothesis by comparing 42 students with a history of depression to 42 matched controls using self-report questionnaires.In line with the hypotheses, past depression was related to higher levels of self-perceived emotion regulation difficulties, a more frequent use of dysfunctional emotion regulation strategies and a less frequent use of 'putting things into perspective' as a functional strategy.In exploratory analyses, the groups also differed in emotion acceptance and clarity. As a whole, the results provide preliminary support for the idea that depression vulnerability is related to deficits in emotion regulation.
Zusammenfassung. Das Eating Disorder Examination (EDE) von Fairburn und Cooper (1993) ist ein strukturiertes Essstörungsinterview zur Erfassung der spezifischen Psychopathologie von Essstörungen. In der klinischen Forschung und Praxis gilt es weithin als Methode der Wahl für die Essstörungsdiagnostik. Die in diesem Beitrag vorgestellte deutschsprachige, reübersetzte Version des EDE zeigte in Stichproben von 80 Patientinnen mit Bulimia Nervosa, 144 Patientinnen mit Binge-Eating-Störung und 20 Patientinnen mit Anorexia Nervosa hohe Interrater-Reliabilitäten der Items sowie der Subskalen. Als Indikatoren für die konvergente Validität waren die EDE-Subskalen Shape Concern und Weight Concern mit Selbstbeurteilungsskalen zum Körperbild, z.B. dem Fragebogen zum Figurbewusstsein, hoch korreliert. Die EDE-Subskalen Restraint und Eating Concern zeigten signifikante Zusammenhänge mit dem in Ernährungstagebüchern protokollierten Essverhalten, z.B. Mahlzeiten- oder Essanfallshäufigkeit oder Nährstoffaufnahme. Die Subskalen des EDE unterschieden zwischen Gruppen mit verschiedenen Essstörungsdiagnosen und bildeten Veränderungen durch psychologische Psychotherapie sensitiv ab. Somit steht mit der deutschsprachigen Version des EDE ein dem englischsprachigen Original entsprechendes, geeignetes Instrument für die Erfassung der spezifischen Psychopathologie von Essstörungen zur Verfügung.
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