An ecological momentary assessment evaluation of emotion regulation abnormalities in schizophrenia

Visser, Katherine Frost; Esfahlani, Farnaz Zamani; Sayama, Hiroki; Strauss, Gregory P.

doi:10.1017/s0033291717003865

Cited by 58 publications

(86 citation statements)

References 56 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One possible explanation may be related to the distinction between the employment of reappraisal strategies vs. their actual effectiveness. While individuals with schizophrenia have been shown to be able to use reappraisal when instructed to do so in laboratory settings and such effort lead to down regulation of anxiety 20,35 , results from real-world studies employing mobile assessments support the view of adequate ER effort, but poor effectiveness 27 . Specifically, individuals with schizophrenia have been observed to initiate ER efforts at a lower threshold of negative emotion intensity compared to healthy controls 27 .…”

Section: Discussionmentioning

confidence: 99%

“…While individuals with schizophrenia have been shown to be able to use reappraisal when instructed to do so in laboratory settings and such effort lead to down regulation of anxiety 20,35 , results from real-world studies employing mobile assessments support the view of adequate ER effort, but poor effectiveness 27 . Specifically, individuals with schizophrenia have been observed to initiate ER efforts at a lower threshold of negative emotion intensity compared to healthy controls 27 . They also tended to use more ER strategies, yet the attempted strategies were less contextually appropriate, and despite moderate to high levels of effort, use of such strategies was ineffective at decreasing negative emotion 27 .…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, individuals with schizophrenia have been observed to initiate ER efforts at a lower threshold of negative emotion intensity compared to healthy controls 27 . They also tended to use more ER strategies, yet the attempted strategies were less contextually appropriate, and despite moderate to high levels of effort, use of such strategies was ineffective at decreasing negative emotion 27 . These results are also consistent with reports from investigations utilizing eventrelated potentials indicating such efforts to regulate emotion are often ineffective [36][37][38] .…”

Section: Discussionmentioning

confidence: 99%

“…To address some of the limitations associated with use of retrospective assessments, researchers have employed experience sampling method (ESM), an ecologically valid, time-sampling method of self-reports developed to study the dynamic process of person-environment interactions 26 that has been used extensively to study psychosis 26 . A number of authors have used ESM to investigate the links between ER and psychosis-Visser et al examined ER in 28 individuals with schizophrenia and 28 demographically matched healthy controls and found adequate ER effort in the schizophrenia group, but poor effectiveness 27 . Specifically, the schizophrenia group initiated ER efforts at a lower negative emotion threshold; they selected more strategies than the control group and those strategies were less contextually appropriate; and when employing moderate to high levels of effort, they were less effective at decreasing negative emotions.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, Nittel et al examined 32 individuals with psychosis and found that use of suppression in response to negative emotions was associated with increases in paranoia during daily functioning 30 . Yet, these ESM studies had a number of limitations-Visser et al used ESM to assess ER, however psychotic symptoms were evaluated using retrospective measures 27 . Nittel et al employed a robust ESM design to assess both ER and symptoms; however, their examination was rather narrow, focusing solely on paranoia 30 .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The impact of emotion awareness and regulation on psychotic symptoms during daily functioning

et al. 2020

View full text Add to dashboard Cite

Emotion regulation (ER) difficulties are ubiquitous among individuals with schizophrenia and have been hypothesized to contribute to stress sensitivity and exacerbation of psychotic symptoms in this population. However, the evidence supporting this link is equivocal, potentially due to previous studies' reliance on retrospective assessments of ER and psychosis, as well as lack of consideration of putative moderators such as emotion awareness. To address these limitations, we employed experience sampling method using mobile electronic devices to investigate the links between momentary in vivo use of ER strategies (m ER), emotion awareness, and psychotic symptoms during daily functioning. Fifty-four individuals with schizophrenia completed assessment of m ER and psychotic symptoms, along with traditional retrospective measures of ER and symptoms. Use of m ER suppression predicted significant increases in momentary experiences of thought insertion, mind reading, auditory and visual hallucinations. Use of m ER reappraisal predicted significant increases in momentary experiences of suspiciousness, thought insertion, and mind reading. Emotion awareness, driven primarily by difficulties identifying feelings, moderated the impact of ER on psychotic symptoms. There were no associations between retrospective measures of ER and symptoms. Our results indicate that, among individuals with schizophrenia, emotion awareness significantly impacts the relationship between use of ER and exacerbations in psychotic symptoms during the course of daily functioning. Our results highlight the need to incorporate emotion awareness and regulation difficulties into the development of treatment models and interventions for psychosis. In addition, our results underscore the need to employ in vivo, high time-resolution assessment methods to study dynamic clinical phenomena such as ER and psychotic symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The impact of emotion awareness and regulation on psychotic symptoms during daily functioning

et al. 2020

View full text Add to dashboard Cite

show abstract

Self‐reported emotion regulation difficulties in people with psychosis compared with non‐clinical controls: A systematic literature review

Lawlor

Hepworth

Smallwood

et al. 2020

Clin Psychology and Psychoth

View full text Add to dashboard Cite

Emotions play a key role in the development and experience of psychosis, yet there are important gaps in our understanding of how individuals with psychosis understand and respond to their emotions. This systematic review investigated self‐reported emotion regulation difficulties in individuals with psychosis compared with non‐clinical controls. An electronic database search was conducted in Medline, PsychINFO, and Embase and supplemented by searches of reference lists and citations. Seventeen studies were included. A narrative synthesis was conducted because contextual diversity was present across the studies and outcomes. Individuals with psychosis reported greater difficulties in (i) emotional clarity (specifically with identifying, describing, and understanding their emotions), (ii) emotional acceptance, (iii) engaging in goal‐directed behaviours when experiencing negative emotions, and (iv) willingness to experience emotional distress in the pursuit of meaningful activities in life. Evidence pertaining to other self‐reported emotion regulation difficulties was less clear. Effect sizes were generally large in magnitude but there were few studies on some self‐reported emotion regulation difficulties, and all studies were at moderate to high risk of bias. Further research is needed to clarify the nature of emotion regulation difficulties in individuals with psychosis to inform the provision of targeted clinical interventions.

show abstract

Maladaptive cognitive emotion regulation strategies and positive symptoms in schizophrenia spectrum disorders: The mediating role of global emotion dysregulation

Liu

Subramaniam

Chong

et al. 2020

Clin Psychology and Psychoth

View full text Add to dashboard Cite

Previous studies have identified a positive association between maladaptive cognitive emotion regulation strategies and positive symptoms (e.g., hallucinations and delusions) among patients with schizophrenia spectrum disorders. However, translating this finding to clinical practice is challenging. Some patients are reported to experience difficulties in correcting the use of maladaptive cognitive emotion regulation strategies in psychological therapy, which may be due to an underlying effect of global emotion dysregulation. Therefore, the present study aimed to determine the mediating or moderating role of global emotion dysregulation in the relationship between maladaptive cognitive emotion regulation strategies and positive symptoms. A total of 123 newly diagnosed patients with schizophrenia spectrum disorders completed self-report measures of maladaptive cognitive emotion regulation strategies (rumination, catastrophic thinking, self-blame, other-blame) and global emotion dysregulation. The severity of positive symptoms was rated on the Brief Psychiatric Rating Scale-Expanded. Mediation and moderation analyses were performed to test the hypothesized models. Mediation analysis revealed that global emotion dysregulation mediated the relationship between maladaptive cognitive emotion regulation strategies and positive symptoms after controlling for age, gender, ethnicity, duration of untreated psychosis, medication dosage, psychiatric comorbidities, and family history of mental illness (R 2 = 23.3%, moderate effect size = 0.30). There was no moderating effect of global emotion dysregulation. The present study presents preliminary evidence on the mediating role of global emotion dysregulation in the relationship between maladaptive cognitive emotion regulation strategies and positive symptoms in schizophrenia spectrum disorders. This finding adds to our current understanding on emotion regulation phenomena in schizophrenia spectrum disorders.

show abstract

An ecological momentary assessment evaluation of emotion regulation abnormalities in schizophrenia

Abstract: Findings suggest that although SZ attempt to control their emotions using various strategies, often applying more effort than CN, these efforts are unsuccessful; emotion regulation abnormalities may result from difficulties at the identification, selection, and implementation stages.

Cited by 58 publications

References 56 publications

The impact of emotion awareness and regulation on psychotic symptoms during daily functioning

The impact of emotion awareness and regulation on psychotic symptoms during daily functioning

Self‐reported emotion regulation difficulties in people with psychosis compared with non‐clinical controls: A systematic literature review

Maladaptive cognitive emotion regulation strategies and positive symptoms in schizophrenia spectrum disorders: The mediating role of global emotion dysregulation

Contact Info

Product

Resources

About