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Adolph D, Margraf J. Differential effects of trait-like emotion regulation use and situational emotion regulation ability across the affective and anxiety disorders spectrum: a transdiagnostic examination. Sci Rep 2024; 14:26642. [PMID: 39496705 PMCID: PMC11535244 DOI: 10.1038/s41598-024-76425-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 10/14/2024] [Indexed: 11/06/2024] Open
Abstract
Here, we investigated the association of different emotion regulation (ER) indices with symptom severity across a large transdiagnostic sample of patients with emotional disorders (cross-sectional approach) and the predictive validity these ER indices have for the outcome of routine care CBT (longitudinal approach). We assessed the trait-like use of adaptive (reappraisal) and maladaptive (suppression, externalizing behaviors) ER strategies via questionnaire as well as the situational ability to regulate emotions with an experimental ER paradigm. Psychopathology was assessed dimensionally using the depression, anxiety, and stress scale. Cross-sectionally symptom severity was predicted by less trait-like use of adaptive and more trait-like use of maladaptive ER strategies, but no associations were found for situational ER ability. This association was more pronounced for depression and stress symptoms rather than anxiety symptoms. In a striking dissociation, the longitudinal analyses revealed the reverse picture: Better situational ER ability, but not trait-like use of ER strategies was associated with less symptom severity after the CBT treatment. Our data argues in favor of a distinction between trait-like and situational ER abilities in individuals with emotional disorders, highlighting challenges in applying adaptive ER strategies in daily life despite demonstrating intact ER skills in experimental settings. Our findings also inform transdiagnostic models of psychopathology and suggest that distress/depression rather than anxiety symptomatology to be driving forces for the occurrence of ER deficits across the depression/anxiety disorders spectrum.
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Affiliation(s)
- Dirk Adolph
- Department of Psychology, Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstraße 9-13, 44787, Bochum, Germany.
| | - Jürgen Margraf
- Department of Psychology, Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstraße 9-13, 44787, Bochum, Germany
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Sorgi-Wilson KM, McCloskey MS. Emotion regulation strategies among individuals with borderline personality disorder relative to other groups: A review. Clin Psychol Psychother 2022; 29:1655-1678. [PMID: 35366040 DOI: 10.1002/cpp.2738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/28/2022] [Accepted: 03/29/2022] [Indexed: 11/11/2022]
Abstract
Borderline personality disorder (BPD) is associated with difficulties in emotion regulation (ER) abilities. Investigations of ER strategies in BPD have been less robust. This systematic review identified 55 studies comparing ER strategy use between individuals diagnosed with BPD versus psychiatric and non-psychiatric comparison groups. Individuals with BPD reported more frequent maladaptive and less frequent adaptive ER strategy use than non-psychiatric controls. Results were less consistent relative to psychiatric comparison groups, though individuals with BPD reported greater self-criticism and avoidance. Groups responded comparably to instructed use of adaptive (but not maladaptive) ER strategies. This body of research would benefit from further examination of the roles of psychiatric comorbidity and problematic behaviours in the relationship between BPD and ER strategies.
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Affiliation(s)
- Kristen M Sorgi-Wilson
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
| | - Michael S McCloskey
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
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Tiruneh FN, Tenagashaw MW, Asres DT, Cherie HA. Associations of early marriage and early childbearing with anemia among adolescent girls in Ethiopia: a multilevel analysis of nationwide survey. ACTA ACUST UNITED AC 2021; 79:91. [PMID: 34082813 PMCID: PMC8173845 DOI: 10.1186/s13690-021-00610-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/17/2021] [Indexed: 02/05/2023]
Abstract
Background Early marriage and early childbearing are common practices in Ethiopia. Girls who get married and give birth at a very young age are more likely to experience several health problems including anemia among others. However, the effects of early marriage and early childbearing on anemia status of adolescent girls have not been quantified in previous studies. In this study, we assessed whether early marriage and early childbearing measured at both individual and community levels are associated with adolescent anemia. Methods We analyzed data from the 2016 demographic and health survey of Ethiopia. Our study focused on 3172 late female adolescents (15–19 years). We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between early marriage and childbearing with anemia was evaluated using multilevel binary logistic regression models while controlling other determinants. Results Overall prevalence of anemia among female adolescents was 23.8% (95% CI; 22.3–25.2). Our multivariable multilevel analysis showed that individual-level marital status (AOR = 1.53, 95% CI = 1.06–2.02) and community-level childbearing status (AOR = 2.80, 95% CI 1.25–6.29) were positively associated with anemia among female adolescents. Conclusion Our findings show the presence of significant association between early marriage & early childbearing with adolescent anemia. Therefore, there is a need for effective policies and programs to end the practice of early child marriage and the consequent adolescent pregnancy in Ethiopia. This will help to improve nutritional status of adolescent girls as well as nutritional outcomes of their children.
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Affiliation(s)
- Fentanesh Nibret Tiruneh
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mesfin Wogayehu Tenagashaw
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Degnet Teferi Asres
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Hirut Assaye Cherie
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia.
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Mitchell T, du Preez E, Theadom A. An intervention to improve coping strategies in adult male prisoners with a history of traumatic brain injury: A pilot randomised clinical trial. Clin Rehabil 2021; 35:1185-1195. [PMID: 33706573 DOI: 10.1177/0269215521998535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether a psychological intervention improves coping, post-concussion symptoms and decreases in-prison infractions in adult males with a history of traumatic brain injury. DESIGN A single centre, randomised, wait-list, pilot study. SETTING A high security prison in New Zealand. SUBJECTS Fifty-five adult male participants who had experienced at least one traumatic brain injury in their lifetime (mean age 37.29 +/-9.81 years). INTERVENTION A manualised ten session, in-person, group based combined Cognitive Behavioural Therapy /Mindfulness Based Stress Reduction intervention versus wait list control. MAIN MEASURES The Negative Affect Repair Questionnaire and Rivermead Post-concussion Symptom Questionnaire were completed at baseline, post-intervention (five weeks) and at 12 week follow up. In-prison misconduct charges and negative file notes were reviewed for the previous five weeks at each assessment time point. RESULTS There was an improvement in the use of calming and distraction strategies in the intervention group from baseline (x̄ = 17.38, SD = 3.57) to post-intervention (x̄ = 18.67, SD = 3.84) and 12-week follow up (x̄ = 18.13, SD = 2.63). Participants in the intervention group had significantly higher negative affect repair on the calming and distractive strategies subscale following completion of the intervention, compared to wait-list controls (F = 4.69, P = 0.04) with a moderate effect size (ηp2 = 0.11). Improvements in use of calming and distractive strategies was not sustained at the twelve-week follow-up (F = 0.87, P = 0.36). There was no-significant improvement on other negative affect subscales or for post-concussion symptoms or decrease in-prison infractions. CONCLUSION A manualised psychological intervention may have the potential to facilitate the development of positive coping strategies in prisoners with a history of traumatic brain injury.
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Affiliation(s)
| | - Elizabeth du Preez
- Department of Psychology, School of Clinical Sciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand
| | - Alice Theadom
- Department of Psychology, School of Clinical Sciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand.,TBI Network, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand
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A Meta-analysis and Systematic Review of Emotion-Regulation Strategies in Borderline Personality Disorder. Harv Rev Psychiatry 2020; 27:217-232. [PMID: 31219881 DOI: 10.1097/hrp.0000000000000212] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Emotion dysregulation is often considered a core characteristic of individuals with borderline personality disorder (BPD). With the development and strength of a contemporary affective-science model that encompasses both healthy emotion regulation (ER) and emotion dysregulation, this model has increasingly been used to understand the affective experiences of people with BPD. In this meta-analysis and review, we systematically review six of the most commonly studied ER strategies and determine their relative endorsement in individuals with elevated symptoms of BPD compared to individuals with low symptoms of BPD and healthy controls, as well as to individuals with other mental disorders. Results from 93 unique studies and 213 different effect-size estimates indicated that symptoms of BPD were associated with less frequent use of ER strategies that would be considered more effective at reducing negative affect (i.e., cognitive reappraisal, problem solving, and acceptance) and more frequent use of ER strategies considered less effective at reducing negative affect (i.e., suppression, rumination, and avoidance). When compared to individuals with other mental disorders, people with BPD endorsed higher rates of rumination and avoidance, and lower rates of problem solving and acceptance. We also review important contributions from studies of ER in BPD that we were unable to incorporate into our meta-analysis. We conclude by discussing how the pattern of using ER strategies in BPD contributes to emotion dysregulation and also the potential reasons for this pattern, integrating both Gross's extended process model of ER and Linehan's updated theoretical account on the development of emotion dysregulation.
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Fromberger P, Schröder S, Bauer L, Siegel B, Tozdan S, Briken P, Buntrock C, Etzler S, Rettenberger M, Leha A, Müller JL. @myTabu-A Placebo Controlled Randomized Trial of a Guided Web-Based Intervention for Individuals Who Sexually Abused Children and Individuals Who Consumed Child Sexual Exploitation Material: A Clinical Study Protocol. Front Psychiatry 2020; 11:575464. [PMID: 33488416 PMCID: PMC7820175 DOI: 10.3389/fpsyt.2020.575464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background: There is a high demand for evidence-based and cost-effective treatment concepts for convicted individuals who sexually abused children (ISAC) and individuals who consumed child sexual exploitation material (ICCSEM) under community supervision (CS). The @myTabu-consortium developed a guided web-based intervention for convicted ISAC and ICCSEM under CS consisting of six online modules targeting psychological meaningful risk factors. The study aims to evaluate the effectiveness of this guided web-based intervention in reducing dynamic risk factors and the risk to re-offend compared to a placebo condition. Furthermore, these dynamic risk factors are measured before and after every module to evaluate their individual effectiveness to reduce the respective risk factor as well as risk to re-offend. This clinical trial protocol describes the planned methods as well as the intervention concept. Methods: The methodological design is a placebo controlled randomized add-on trial (N = 582) with follow-ups at 8 points in time. The placebo condition controls for attention and expectation effects and comprises the same amount of modules with a comparable temporal effort as the experimental intervention. The trial is conducted as an add-on to community supervision as usually done. Primary outcomes are dynamic risk factors assessed by self-report risk assessment tools and officially recorded re-offenses. Discussion: To the best of our knowledge, the study is the first to compare the (cost-) effectiveness of a guided web-based intervention for convicted ISAC and ICCSEM under community supervision against a placebo condition. Methodological limitations (e.g., potential ceiling- or volunteers-effects) are discussed. Clinical Trial Registration: German Clinical Trial Register (DRKS 00021256). Prospectively registered: 24.04.2020.
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Affiliation(s)
- Peter Fromberger
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Sonja Schröder
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Louisa Bauer
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Bruno Siegel
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Safiye Tozdan
- Center for Psychosocial Medicine, Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Center for Psychosocial Medicine, Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Andreas Leha
- Department of Medical Statistics, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Jürgen L Müller
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
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Effects of Psychotherapy on Neuronal Correlates of Reappraisal in Female Patients With Borderline Personality Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:548-557. [PMID: 29653096 DOI: 10.1016/j.bpsc.2016.07.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 07/18/2016] [Indexed: 11/23/2022]
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Sauer C, Sheppes G, Lackner HK, Arens EA, Tarrasch R, Barnow S. Emotion regulation choice in female patients with borderline personality disorder: Findings from self-reports and experimental measures. Psychiatry Res 2016; 242:375-384. [PMID: 27344452 DOI: 10.1016/j.psychres.2016.04.113] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 03/09/2016] [Accepted: 04/29/2016] [Indexed: 11/26/2022]
Abstract
Emotion dysregulation is a core feature of borderline personality disorder (BPD). So far, many studies have tested the consequences of the implementation of certain emotion regulation (ER) strategies, but there have been no investigations about ER choices in BPD. Thus, the aim of this study was to investigate habitual ER choices by self-report questionnaires and experimentally by testing the preference to select between distraction and reappraisal when facing different emotional intensities (high vs. low) and contents (borderline-specific vs. unspecific negative) in patients with BPD (n=24) compared with clinical controls (patients with major depression, n=19) and a healthy control group (n=32). Additionally, heart rate (HR) responses were continuously assessed. Main results revealed that both patient groups showed maladaptive self-reported ER choice profiles compared with HC. We found, however, no differences between the groups in the choice of distraction and reappraisal on the behavioral level and in HR responses. In BPD, within-group analyses revealed a positive correlation between symptom severity and the preference for distraction under high-intensity borderline-specific stimuli. Our findings provide preliminary evidence of ER choices in BPD and show the robustness of the choice effect in patients with affective disorders.
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Affiliation(s)
- Christina Sauer
- University of Heidelberg, Department of Clinical Psychology and Psychotherapy, Hauptstrasse 47-51, 69117 Heidelberg, Germany.
| | - Gal Sheppes
- Tel Aviv University, School of Psychological Science, Tel Aviv 69978, Israel.
| | - Helmut Karl Lackner
- Medical University of Graz, Institute of Physiology, Harrachgasse 21, 8010 Graz, Austria.
| | - Elisabeth A Arens
- Goethe University Frankfurt, Department of Clinical Psychology and Psychotherapy, 60486 Frankfurt am Main, Germany.
| | - Ricardo Tarrasch
- Tel Aviv University, School of Education and Sagol School of Neuroscience, Tel Aviv 69978, Israel.
| | - Sven Barnow
- University of Heidelberg, Department of Clinical Psychology and Psychotherapy, Hauptstrasse 47-51, 69117 Heidelberg, Germany
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Scherer A, Boecker M, Pawelzik M, Gauggel S, Forkmann T. Emotion suppression, not reappraisal, predicts psychotherapy outcome. Psychother Res 2015; 27:143-153. [DOI: 10.1080/10503307.2015.1080875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Forkmann T, Scherer A, Böcker M, Pawelzik M, Gauggel S, Glaesmer H. The relation of cognitive reappraisal and expressive suppression to suicidal ideation and suicidal desire. Suicide Life Threat Behav 2014; 44:524-36. [PMID: 24494723 DOI: 10.1111/sltb.12076] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 10/30/2013] [Indexed: 11/30/2022]
Abstract
The differential relations between the emotion regulation strategies "cognitive reappraisal" and "expressive suppression" and suicidality in a mixed inpatient sample (N = 232, 69.4% female) of a German psychotherapeutic hospital were examined. Patients filled in the Emotion Regulation Questionnaire and items on suicidal ideation and desire. A structural equation model fitted the data (RMSEA = .044; CFI = .96) and revealed that "expressive suppression" significantly predicted increased suicidal ideation. Moderation analysis showed that results were independent from a current depressive episode. Potential implications for psychotherapeutic treatment of suicidality are discussed.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Aachen, Germany
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Dorn C, Spindler G, Kullik A, Petermann F, Barnow S. Erfassung von Emotionsregulationsstrategien–eine Übersicht. PSYCHOLOGISCHE RUNDSCHAU 2013. [DOI: 10.1026/0033-3042/a000176] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Die vorliegende Übersicht stellt Verfahren zur Erfassung von Emotionsregulationsstrategien im Kindes-, Jugend- und Erwachsenenalter zusammen. Selbst- und Fremdbeurteilungsverfahren im Kindes- und Jugendalter sowie Fragebögen des Erwachsenenalters, für die eine validierte deutschsprachige Übersetzung vorliegt, werden betrachtet und hinsichtlich qualitativer Standards und psychometrischer Gütekriterien diskutiert. Es folgt die Darstellung der Methoden des Ecological Momentary Assessment, die es ermöglichen, emotionsregulierende Prozesse in der natürlichen Umwelt zu erfassen und Kontextfaktoren zu berücksichtigen. Der Beitrag schließt mit der Empfehlung, Emotionsregulationsstrategien multimethodal zu erfassen.
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