Emotion regulation across the psychosis continuum

Abstract

Emotion regulation dysfunction is characteristic of psychotic disorders, but little is known about how the use of specific types of emotion regulation strategies differs across phases of psychotic illness. This information is vital for understanding factors contributing to psychosis vulnerability states and developing targeted treatments. Three studies were conducted to examine emotion regulation across phases of psychosis, which included (a) adolescent community members with psychotic-like experiences (PLEs; n = 262) and adolescents without PLEs (n = 1,226); (b) adolescents who met clinical high-risk criteria for a prodromal syndrome (n = 29) and healthy controls (n = 29); and (c) outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ; n = 61) and healthy controls (n = 67). In each study, participants completed the Emotion Regulation Questionnaire and measures of psychiatric symptoms and functional outcome. The three psychosis groups did not differ from each other in reported use of suppression; however, there was evidence for a vulnerability-related, dose-dependent decrease in reappraisal. Across each sample, a lower use of reappraisal was associated with poorer clinical outcomes. Findings indicate that emotion regulation abnormalities occur across a continuum of psychosis vulnerability and represent important targets for intervention.

Testing whether implicit emotion regulation mediates the association between discrimination and symptoms of psychopathology in late childhood: An RDoC perspective

“…Results contribute to investigations finding implicit emotion regulation related to functioning and symptom severity in psychotic spectrum disorders (Hoid et al, 2020; Kimhy et al, 2020; Tully & Niendam, 2014). Findings also corroborate literature finding that difficulty regulating affect can precede psychotic experiences and increase severity of distress and impairment related to psychosis symptoms (Chapman et al, 2020; Lawlor, Hepworth, Smallwood, Carter, & Jolley, 2020; Strauss et al, 2019). It is unclear why evidence of mediation was not found with regards to emotional inhibitory control.…”

“…Similarly, a growing body of evidence suggests that emotion regulatory abilities are compromised in depressive (Bocharov, Knyazev, & Savostyanov, 2017; Hopp, Troy, & Mauss, 2011; Powers, Etkin, Gyurak, Bradley, & Jovanovic, 2015; Zhang et al, 2016) and psychotic disorders (Chapman et al, 2020; Lincoln, Hartmann, Köther, & Moritz, 2015; Lincoln, Sundag, Schlier, & Karow, 2018). Further, neurocognitive functions which can be exerted outside conscious awareness, supporting implicit emotion regulation (including cognitive control and working memory) show evidence of impairment in individuals with depressive (Dotson et al, 2020; Koster, Hoorelbeke, Onraedt, Owens, & Derakshan, 2017; Quinn, Harris, Felmingham, Boyce, & Kemp, 2012; Rock, Roiser, Riedel, & Blackwell, 2014) and psychotic disorders (Allott, Liu, Proffitt, & Killackey, 2011; Bozikas & Andreou, 2011; de Gracia Dominguez, Viechtbauer, Simons, van Os, & Krabbendam, 2009; Schmidt et al, 2017).…”

“…The current study utilized a nationally representative sample of 9–11-year-old youth to examine associations between discrimination, depressive and psychotic-like symptoms. The first aim was to determine whether discrimination would relate to depressive and psychotic-like symptoms; based on the literature of adolescents and adults, we hypothesized that increased discrimination would relate to increased PLEs (Chapman et al, 2020; Lincoln et al, 2015, 2018) and depressive symptoms (Bocharov et al, 2017; Hopp et al, 2011; Powers et al, 2015; Zhang et al, 2016). The second aim was to assess whether differing measures of implicit emotion regulation indexing inhibitory control (emotional stroop) and updating working memory (emotional n -back) would relate to discrimination; it was hypothesized that these measures would relate to discrimination, given models of impacts of stress on emotion regulatory capacities during sensitive developmental periods (Drzewiecki & Juraska, 2020).…”

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

“…Germane to schizophrenia, previous reports have documented increased use of suppression and more limited use of reappraisal among individuals with psychotic spectrum disorders including in individuals with schizophrenia 7,15,16 , at clinical high-risk for psychosis 16,17 , as well as in nonclinical psychosis-prone individuals 16,18 . A recent large systematic review and metaanalysis incorporating data from 42 studies (2498 individuals with psychosis and 3381 healthy controls) provided strong support for these associations 19 .…”

<p>The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial</p>

“…271-299, copyright © 1998 by SAGE Publications, Adapted with permission from SAGE Publications, Inc. 22 emotion, affective blunting, exacerbation of symptoms, and relapse. [28][29][30][31][32] The increased use of suppression is closely associated with reduced emotional expressivity or blunted affect, alongside the normal or even stronger emotional experience and intensity. 33 Emotion regulation difficulties were also linked to the disruption of daily life and social function impairment.…”