Emotion regulation characteristics and cognitive vulnerabilities interact to predict depressive symptoms in individuals at risk for bipolar disorder: A prospective behavioural high-risk study

Abstract

Recent work has identified Behavioral Approach System (BAS) sensitivity as a risk factor for the first onset and recurrence of mood episodes in bipolar disorder, but little work has evaluated risk factors for depression in individuals at risk for, but without a history of, bipolar disorder. The present study evaluated cognitive styles and the emotion-regulatory characteristics of emotional clarity and ruminative brooding as prospective predictors of depressive symptoms in individuals with high versus moderate BAS sensitivity. Three separate regressions indicated that the associations between dysfunctional attitudes, self-criticism, and neediness with prospective increases in depressive symptoms were moderated by emotional clarity and brooding. Whereas brooding interacted with these cognitive styles to exacerbate their impact on depressive symptoms, emotional clarity buffered against their negative impact. These interactions were specific to high-BAS individuals for dysfunctional attitudes, but were found across the full sample for self-criticism and neediness. These results indicate that emotion-regulatory characteristics and cognitive styles may work in conjunction to confer risk for and resilience against depression, and that some of these relationships may be specific to individuals at risk for bipolar disorder.

Emotion regulation in bipolar disorder: Profile and utility in predicting trait mania and depression propensity

“…Although the heightened difficulty in accepting emotions in this cohort contradicts previous findings in which emotional acceptance (as measured by the Cognitive Emotion Regulation Questionnaire) in BD was no different to controls, the general pattern of results is consistent with broader research findings in which cognitive-change related emotion regulation has been demonstrated as being impaired in BD (Green et al, 2007(Green et al, , 2011Gruber et al, 2011Gruber et al, , 2012Townsend and Altshuler, 2012;Rowland et al, 2013a). Importantly, these present results also sit well in the context of a study that showed that emotional clarity buffered against the exacerbating effects of negative cognitive styles on depressive symptoms in a group at high risk for BD (Stange et al, 2013).…”

“…Although its aetiology remains unclear, difficulties in emotion regulation are becoming increasingly recognised in models of BD pathophysiology, particularly as mood lability and emotional regulation difficulties may contribute negatively to functional outcomes (Meyer et al, 2001; e.g., Green et al, 2007;Gruber et al, 2012;Townsend and Altshuler, 2012;Stange et al, 2013;Strejilevich et al, 2013;Rossell, 2014e, 2014d).…”

“…The few preliminary studies that have investigated isolated aspects of the functional response-tendency focussed emotion regulation approach in relation to BD have used measures that separately assesses either emotional clarity (Stange et al, 2013) or acceptance (in addition to antecedent-focussed regulation stategies: Green et al, 2011;Rowland et al, 2013aRowland et al, , 2013b, with indications of impairment in the former but not the latter. While these preliminary studies have provided useful information about these individual aspects of emotion regulation in clinical BD and individuals at high risk for the disorder, a better characterisation of the extent to which BD patients employ a broad range of emotion relevant response tendencies is needed to establish additional targets for the development and/or improvement of interventions for its treatment (Hill and Updegraff, 2012).…”

Adaptive cognitive emotion regulation moderates the relationship between dysfunctional attitudes and depressive symptoms during a stressful life period: A prospective study

“…The current findings are in line with a study of Crues et al (2002) who observed that the improvement in cognitive coping strategies and reduction in dysfunctional attitudes were closely associated with decreases in depressive symptoms in HIV-infected men. Moreover, a recent study of Stange et al (2013) observed in adolescents at risk for bipolar disorder that emotion-regulatory characteristics and cognitive styles may work in conjunction to confer risk for and resilience against future depression.…”

Deficits in Emotional Clarity and Vulnerability to Peer Victimization and Internalizing Symptoms Among Early Adolescents

“…Although the ability to identify complex emotions generally improves during adolescence (Burnett, Bird, Moll, Frith, & Blakemore 2009), some children and adolescents possess deficits in emotional clarity that increase the risk of depressive symptoms (Flynn & Rudolph, 2010, 2014; Resurreccion, Salguero, & Ruiz-Aranda, 2014; Stange, Alloy, Flynn, & Abramson, 2013a; Stange et al, 2013b). Recent research also indicates that deficits in emotional clarity may impair one’s ability to adaptively respond to stressful life events (Ramos, Fernandez-Berrocal, & Extremera, 2007), including perceived peer victimization (Flynn & Rudolph, 2010, 2014).…”