Does cognitive behavior therapy alter emotion regulation in inpatients with a depressive disorder?

Abstract

IntroductionEmotion regulation plays an important role in the development and treatment of depression. The present study investigated whether the emotion regulation strategies, expressive suppression (ES) and cognitive reappraisal (CR) change in the course of cognitive behavior therapy (CBT) of depressive inpatients. Furthermore, it also examined whether changes in CR and ES correlated with positive treatment outcomes.MethodsForty-four inpatients from a psychotherapeutic hospital who suffered from a depressive disorder (mean age =36.4 years, standard deviation =13.4 years; 63.6% female) filled in the Emotion Regulation Questionnaire and the Beck Depression Inventory at admission and discharge. To detect changes in emotion regulation, and depression across treatment, data were analyzed using multivariate analyses of variance (MANOVA) for repeated measures, effect sizes, and Spearman correlations. A P-value of ≤0.05 was considered statistically significant.ResultsDepression severity (F[1]=10.42, P=0.003; η2=0.22) and CR (F[1]=4.71, P=0.04; η2=0.11) changed significantly across CBT treatment. ES remained virtually stable. Post-treatment scores of CR were also positively correlated with reduction in depressive symptoms across treatment (ρ=0.30, P=0.05).ConclusionThe results suggest that CBT affects emotion regulation in depressive inpatients only for CR and that higher post-treatment scores in CR were related to greater reduction in depressive symptoms across treatment.

Examining emotion regulation as an outcome, mechanism, or target of psychological treatments

“…Moreover, these improvements in ER were found to mediate improvements in BPD symptoms [22], trichotillomania severity [26], eating disorder symptoms [21], deliberate self-harm [24], and hopelessness [22]. Both traditional cognitive-behavioral treatments and acceptance-based behavioral treatments for depression and social anxiety disorder have also been found to result in changes in the frequency of specific ER strategies (e.g., cognitive reappraisal, expressive suppression, rumination) [23,27–31]. Moreover, changes in the frequency of these strategies related to reductions in symptoms of depression [27] and social anxiety in cognitive-behavioral treatments for these disorders [28–31].…”

Emotion regulation and coping motives serially affect cannabis cessation problems among dually diagnosed outpatients.

“…Given that the data suggest that patients with more severe anxiety suffer from more problems with emotion regulation which may increase their reliance on cannabis to cope with negative affectivity (leading to greater cessation problems and withdrawal symptoms), clinicians may consider explicitly teaching these patients more adaptive ways to manage negative affect to reduce their reliance on cannabis. Both adaptive and maladaptive emotion regulation strategies have been found to change during cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and acceptance and commitment therapy (ACT) (Aldao, Jazaieri, Goldin, & Gross, 2014; Blackledge & Hayes, 2001; Forkmann et al, 2014; Gratz & Roemer, 2004; Moscovitch et al, 2012). Importantly, targeting emotional regulation skills during psychotherapy leads to enhancement in emotion regulation skills (Berking, Meier, & Wupperman, 2010) and better treatment outcomes (Berking et al, 2008).…”

Inpatient Cognitive Behavior Therapy Approaches for Suicide Prevention

“…Within the past two decades, CBT has been gaining increased usage within inpatient psychiatric settings and has been implemented for the treatment of a number of mental health conditions. For example, within the past 5 years alone, CBT inpatient studies have been published on the treatment of psychosis [7], anorexia nervosa [8], depression [9], and substance use disorders [10]. However, despite the increasing attention paid to inpatient cognitive behavioral interventions for a host of mental health conditions, research on inpatient CBT for individuals recently hospitalized following a suicide-related event remains limited.…”