Advancing our understanding of the intersection between emotion regulation and alcohol and drug use problems: Dyadic analysis in couples with intimate partner violence and alcohol use disorder

BackgroundPatients with depression struggle with significant emotion regulation difficulties, which adversely affect their psychological well-being and hinder recovery. Traditional therapeutic approaches often fail to adequately address these challenges, leading to a persistent gap in effective mental health care. This research seeks to address this gap by investigating the impact of emotion regulation skills training on patients with depression.AimTo assess the difficulties in emotion regulation among patients with depression and evaluate the impact of an emotion regulation skills training intervention on those with higher levels of emotion regulation difficulties, specifically focusing on increasing the use of adaptive emotion regulation strategies and reducing the use of maladaptive emotion regulation strategies.MethodA quasi-experimental research design was utilized, using three tools: a socio-demographic and Clinical Data structured interview schedule, Difficulties in Emotional Regulation Scale, and Cognitive Emotion Regulation Questionnaire. Eighty patients with depression were recruited to assess those with higher levels of emotion regulation difficulties; out of those with greater difficulties, 30 patients were chosen to participate in the emotion regulation skills training intervention.ResultThe 80 studied subjects' emotion regulation difficulties scores ranged from 158 to 169 (164.5 ± 3.21), and they indicated less use of adaptive cognitive emotion regulation strategies and more use of maladaptive cognitive emotion regulation strategies (56.07 ± 2.67). Regarding the intervention group, the overall mean score of the 30 patients’ emotion regulation difficulties decreased from 167.35 ± 2.21 pre-intervention to 105.85 ± 3.33 post-intervention (p < 0.0001). Cognitive emotion regulation total scores improved markedly from 54.07 ± 1.66 to 35.2 ± 3.46 (p < 0.01).ImplicationHealthcare providers should routinely assess emotion regulation difficulties in patients with depression and integrate personalized treatment plans that target individual emotion regulation difficulties.ConclusionThe findings suggest that the emotion regulation intervention has the potential to improve emotion regulation difficulties and cognitive emotion regulation strategies among patients with depression.

The purpose of this research is to examine the mediating role of automatic thoughts and cognitive emotion regulations strategies on the relationship among childhood maltreatment experiences, behavioral problems and resilience of adolescents. The sample of the study has consisted of 671 adolescents (338-girl, 322-boy). Childhood Trauma Questionnaire Short Form, Youth Self Report, Children’s Automatic Thoughts Scale, Resiliency Scale and Cognitive Emotion Regulation Questionnaire have been used. Research findings have shown that adaptive cognitive emotion regulation strategies and automatic thoughts have entire mediator role in relation between adolescents’ childhood abuse/neglect experience and resilience. However maladaptive cognitive emotion regulation strategies and automatic thoughts have partial mediating role in the relation between adolescents’ childhood abuse/neglect experience and behavioral problems. On the other hand maladaptive cognitive emotion regulation strategies have no mediating effect on relationship between adolescents’ childhood abuse/neglect experience and resilience levels and adaptive cognitive emotion regulation strategies have no mediating effect on relationship between adolescents’ childhood abuse/neglect experience and behavioral problems. In explaining the variance of behavioral problems, it has been found that the most effective variables are respectively the automatic thoughts, childhood abuse / neglect experiences and maladaptive cognitive emotion regulation strategies; adaptive cognitive emotion regulation strategies and automatic thoughts are respectively the most important variables to explain variance of resilience.

BackgroundChildhood trauma (CT) is considered as a highly risk factor for depression. Although the pathway of CT to depression, especially the mediating or moderating effects of cognitive emotion regulation strategies (CERS) or neuroticism, have investigated by several studies, the results were inconsistent and there is a paucity of full models among these interactive factors. This study aims to examine the relationships among CT, adaptive / maladaptive CERS, neuroticism, and current depression symptoms in university students.MethodsWe recruited 3009 freshman of 2019, aged averagely 18.00 (SD = 0.772) years, from universities in Hunan province in 2019. A moderated mediation model was built to examine the relationships among CT, CERS, neuroticism, and current depression using the SPSS PROCESS 3.5 macro. We conducted bootstrapping of regression estimates with 5000 samples and 95% confidence interval.ResultsResults revealed that the significant mediating effects of adaptive CERS (β = 0.012; 95% CI: 0.006 to 0.018) and maladaptive CERS (β = 0.028; 95% CI: 0.016 to 0.040) between CT and depression were observed, accounting for 5.69% and 13.52% of the total effect respectively. Then, moderated mediation analyses results showed that neuroticism simultaneously moderated the direct effect of CT on current depression (β = 0.035; 95% CI: 0.001 to 0.009), and the indirect effects of CT on current depression through adaptive CERS (adaptive CERS – current depression: β = − 0.034; 95% CI: − 0.007 to − 0.001) and maladaptive CERS (maladaptive CERS – current depression: β = 0.157; 95% CI: 0.017 to 0.025). However, the moderating effects of neuroticism in the indirect paths from CT to adaptive CERS (β = 0.037; 95% CI: 0.000 to 0.014) and maladaptive CERS (β = − 0.001; 95% CI: − 0.006 to 0.005) were not significant.ConclusionsThis study provides powerful evidences through a large university students sample for the mediating role of adaptive / maladaptive CERS and the moderating role of neuroticism between CT and current depression. This manifests that cognitive emotion regulation may be a vital factor for people who suffered from CT and current depression. Furthermore, the influence of neuroticism in this process cannot be ignored.

This study aimed to investigate the structural relationships of emotional neglect with risky behaviors in prisoners, considering the mediating role of emotion regulation strategies. The research method is descriptive-correlational. The statistical population consists of all prisoners in the city of Shiraz. The research sample included 409 prisoners from Shiraz, selected through purposive sampling. Data were collected using the Childhood Trauma Questionnaire (Bernstein et al., 2003), the Cognitive Emotion Regulation Questionnaire (Garnefski et al., 2001), and the Youth Risk Behavior Scale (Snow et al., 2019). Structural equation modeling (SEM) was conducted using AMOS 24 and SPSS 27 to evaluate the proposed model. The correlation coefficient results indicated a negative relationship between emotional neglect and adaptive cognitive emotion regulation strategies with risky behaviors (P ≤ 0.05). Additionally, there was a significant positive relationship between maladaptive cognitive emotion regulation strategies and risky behaviors (P ≤ 0.05). The findings suggest an adequate fit of the proposed model with the data. The results of the structural model showed that 25% of the variance in adaptive cognitive emotion regulation strategies and 30% of the variance in maladaptive cognitive emotion regulation strategies were explained by emotional neglect. Furthermore, 44% of the variance in risky behaviors was explained by emotional neglect, adaptive, and maladaptive cognitive emotion regulation strategies. Based on these findings, early intervention and preventive measures are crucial in reducing the negative impact of emotional neglect. Specifically, focusing on interventions based on mentalization and emotion regulation can significantly improve emotional and relational problems arising from adverse early life experiences.

Objective: The present study aimed to investigate the mediating role of cognitive emotion regulation strategies on the relationship between mindfulness, anxiety, and procrastination in high school students. Methods: The study sample consisted of 350 high school female students in Rasht City, Iran. The study subjects responded to the Academic Procrastination Scale (APS), the Cognitive Emotion Regulation Questionnaire (CERQ), the Cattell Anxiety Scale (CAS), and the Five Facet Mindfulness Questionnaire (FFMQ). Data analysis was performed by Pearson product-moment correlation coefficient and structural equation modeling technique in SPSS and AMOS. Bootstrap in Preacher and Hayes’ Macro program (2008) was also used to test the indirect relationships between the study variables. Results: There was a direct and significant relationship between academic procrastination, anxiety, and maladaptive cognitive emotion regulation strategies (P&lt;0.0001). There was an inverse and significant relationship between procrastination, adaptive cognitive emotion regulation strategies, and mindfulness (P&lt;0.0001). Mediation analysis data revealed that the maladaptive cognitive emotion regulation strategies exacerbated the effects of anxiety on academic procrastination; the indirect effect of anxiety on procrastination through adaptive strategies was significant. Conclusion: Procrastination in students could be reduced by minimizing anxiety, correcting maladaptive cognitive emotion regulation strategies, and strengthening adaptive cognitive emotion regulation strategies. Anxiety may aggravate academic procrastination by generating maladaptive mechanisms.

Maladaptive cognitive emotion regulation strategies have been reliably associated with psychopathology while lower consistency has been found for adaptive strategies.The extent to which adaptive strategies may function as protective factors was explored by analyzing how adaptive and maladaptive strategies relate to a diverse range of symptoms in 370 college students.We used the Cognitive Emotion Regulation Questionnaire (CERQ), the Brief Symptom Inventory, and the Difficulties in Emotion Regulation Scale.We developed a Portuguese version of CERQ.Different cognitive strategies predicted the nine psychological symptoms tested.At least one maladaptive strategy predicted each symptom dimension, while the same was not true for adaptive strategies.Our study supports: 1) cognitive emotion regulation as a transdiagnostic process tha t encompasses va riability in the strategies underlying specific symptoma tology; 2) that lower adaptive strategies sometimes predict psychological symptoms, but that higher maladaptive strategies are more consistently associated with psychopathology; 3) Portuguese CERQ's validity.

Given the importance of mental health in self-care of patients with type 2 diabetes and the relationship between cognitive flexibility and emotion regulation with mindfulness, the present study aimed to investigate the mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes. The present study was conducted using correlation method and structural equation modeling. The statistical population of the study consisted of all men and women with type 2 diabetes referred to Imam Khomeini Hospital in Tehran. 253 participants were selected using convenience sampling. Participants completed the Garnefski &amp; Kraaij (2006) Cognitive Emotion Regulation Questionnaire, the Kentucky Inventory of Mindfulness Skills (Baer, Smith &amp; Allen, 2004), and the Cognitive Flexibility Inventory (Dennis &amp; Vander Wal, 2010). The results showed a positive overall path coefficient between adaptive cognitive emotion regulation strategies and mindfulness (P = 0.005, β = 0.243) and a negative overall path coefficient between maladaptive cognitive emotion regulation strategies and mindfulness (P = 0.001, β = -0.453). The path coefficient between cognitive flexibility and mindfulness was positive and significant (P = 0.009, β = 0.273). The indirect path coefficient between adaptive cognitive emotion regulation strategies and mindfulness was positive (P = 0.007, β = 0.094) and the indirect path coefficient between maladaptive cognitive emotion regulation strategies and mindfulness was negative and significant (P = 0.009, β = -0.117). With an increase in emotion regulation skills, cognitive flexibility and mindfulness also increase in patients with type 2 diabetes.

Alcohol use can operate as a chronic relationship stressor with adverse influences on individual and relationship functioning, including negative conflict behaviors; however, it remains unclear what modifiable individual-level factors may moderate this association. The current study examined the effects of maladaptive cognitive emotion regulation strategies on the relation between alcohol use problems and negative relationship conflict behaviors. Participants were 30 couples (N=60) wherein at least one partner engaged in recent hazardous drinking or illicit drug use. Participants completed a measure of maladaptive cognitive emotion regulation strategies (i.e., catastrophizing, self-blame, blaming others, rumination) and engaged in a 10-minute dyadic conflict task in the laboratory. Couple conflict behaviors were video-recorded and assessed using a validated coding system. Actor partner interdependence models indicated that (1) men with more maladaptive cognitive emotion regulation strategies displayed more negative relationship conflict behaviors and (2) among women who use fewer maladaptive cognitive emotion regulation strategies, those who report alcohol use problems display more negative relationship behaviors than women who report fewer alcohol use problems. These findings suggest that the tendency to engage in fewer maladaptive cognitive emotion regulation strategies buffers the effect of conflict among women without alcohol use problems. Results also suggest that women with alcohol use problems engaged in more negative conflict behaviors regardless of their tendency to use maladaptive cognitive emotion regulation strategies. This research has important implications for integrating emotion regulation skills into alcohol use treatment for women, particularly later in the course of treatment.

The mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes

Childhood maltreatment significantly impacts psychological development and resilience. The adaptive and maladaptive cognitive emotion regulation strategies play a crucial role in the relationship between childhood maltreatment and psychological resilience. The first aim of this study was to investigate gender differences in the subdimensions of childhood maltreatment, and the second aim was to explore the role of adaptive and maladaptive cognitive emotion regulation strategies in the relationship between childhood maltreatment and psychological resilience. The sample of the study consisted of 355 university students aged 18 to 35. The participants completed the Demographic Information Form, Childhood Trauma Questionnaire, Psychological Resilience Scale for Adults, and Cognitive Emotion Regulation Scale. In the data analysis, t-tests, Pearson correlation analysis, and mediation analysis using the Process macro (Model 4) were performed. The t-test results revealed gender differences in the dimensions of sexual abuse, emotional abuse, and physical neglect. Specifically, females scored higher in the sexual abuse subdimension, while males had higher scores in the emotional abuse and physical neglect subdimensions. The Pearson correlation analysis revealed that childhood maltreatment was negatively correlated with psychological resilience (r = -.51, p &lt; .01) and adaptive cognitive emotion regulation strategies (r = -.21, p &lt; .01), while positively correlating with maladaptive cognitive emotion regulation strategies (r = .25, p &lt; .01). In the mediation analyses, it was concluded that adaptive and maladaptive cognitive emotion regulation strategies significantly mediated the relationship between childhood maltreatment and psychological resilience (β = -.14, SE = .04, 95% CI [-.22, -.06]; β = -.07, SE = .02, 95% CI [-.12, -.03], respectively). This study emphasizes the importance of understanding of how childhood maltreatment impacts resilience, focusing on cognitive emotion regulation strategies, offering valuable insights for both theoretical understanding and practical interventions in promoting well-being.

Schizophrenia (SZ) and bipolar disorder (BD) are associated with impairments in facial emotion perception and Theory of Mind (ToM). These social cognitive skills deficits may be related to a reduced capacity to effectively regulate one’s own emotions according to the social context. We therefore set out to examine the relationship between social cognitive abilities and the use of cognitive strategies for regulating negative emotion in SZ and BD. Participants were 56 SZ, 33 BD, and 58 healthy controls (HC) who completed the Ekman 60-faces test of facial emotion recognition; a sub-set of these participants also completed The Awareness of Social Inference Test (TASIT) and the Cognitive Emotion Regulation Questionnaire (CERQ). SZ participants demonstrated impairments in emotion perception on both the Ekman and the TASIT Emotion Evaluation tests relative to BD and HC. While both SZ and BD patients showed ToM deficits (i.e., perception of sarcasm and lie) compared to HC, SZ patients demonstrated significantly greater ToM impairment compared to BD. There were also distinct patterns of cognitive strategies used to regulate emotion in both patient groups: those with SZ were more likely to engage in catastrophizing and rumination, while BD subjects were more likely to blame themselves and were less likely to engage in positive reappraisal, relative to HC. In addition, those with SZ were more likely to blame others compared to BD. Associations between social cognition and affect regulation were revealed for HC only: TASIT performance was negatively associated with more frequent use of rumination, catastrophizing, and blaming others, such that more frequent use of maladaptive cognitive emotion regulation strategies was associated with poor social cognitive performance. These associations were not present in either patient group. However, both SZ and BD patients demonstrated poor ToM performance and aberrant use of emotion regulation strategies consistent with previous studies. SZ also showed basic emotion recognition deficits relative to BD and HC. That there were no associations between social cognition and the capacity to self-regulate negative emotion in SZ and BD (in the context of poor social cognition and maladaptive regulatory strategies) suggests that dysfunction in fronto-limbic brain networks may underpin both social cognitive deficits and the use of maladaptive cognitive strategies in these disorders, albeit by potentially different routes.

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience difficulties with emotion regulation. Specific use of cognitive emotion regulation strategies may contribute to these challenges, albeit research in this area remain limited. Self-rated and task-specific use of adaptive and maladaptive cognitive emotion regulation strategies was assessed in children and adolescents with ADHD and typically developing controls (N=176, 10-17 years, 55.1% girls; subsample for self-rated use: N=94, 13-17 years, 61.7% girls). Self-rated use was measured with the short version of the Cognitive Emotion Regulation Questionnaire. Task-specific use was assessed by an experimental task involving viewing emotion-eliciting photos. Regression analyses were utilized to assess associations between ADHD and cognitive emotion regulation. Effects of sex and age were explored. Adjustments were made for co-occurring psychiatric symptoms. ADHD was associated with lower self-rated (β =-0.21, p = .044) and task-specific (β =-0.09, p = .015) use of adaptive strategies, and greater use of self-rated maladaptive strategies (β =0.27, p = .010). No associations remained after adjusting for co-occurring psychiatric symptoms and multiple comparisons. Rather, depressive symptoms may contribute to the self-rated use of maladaptive strategies. Post-hoc analyses revealed that ADHD was robustly linked to less self-rated use of acceptance (β =-0.38, p = .005). Lower use of self-rated acceptance may be characteristic for ADHD. Depressive symptoms may play a more vital role for maladaptive cognitive emotion regulation than ADHD. More studies are needed to explore the longitudinal relation between ADHD, emotion regulation and depression.

This study aimed to examine the relationships between illness perception, cognitive emotion regulation strategies (CERS), and psychological distress, and the mediating role of CERS in breast cancer patients and their spouses. A cross-sectional study recruited 305 pairs of breast cancer patients and their spouses to complete the sociodemographic and clinical characteristics questionnaire, the Cognitive Emotion Regulation Questionnaire-short, and the Hospital Anxiety and Depression Scale. Descriptive statistics, difference analysis, Pearson's correlation coefficient, and the actor-partner interdependence mediation model were conducted. There was a significant correlation between illness perception, CERS, and psychological distress in breast cancer patients and their spouses (r = -0.416 ~ 0.522, P < 0.05). Both patients' and spouses' illness perception could directly produce significant actor effects on psychological distress, or indirectly through the mediator of maladaptive or adaptive CERS of their own. Only spouses' illness perception could produce significant partner effect on patients' psychological distress. Moreover, only spouses' illness perception could produce significant effects on patients' psychological distress through patients' or spouses' maladaptive CERS. Our findings offered a new perspective on how illness perception, CERS, and psychological distress were interconnected at both personal and dyadic levels. The findings underscored the significance of intervening with breast cancer patients and spouses as a closely knit dyad to promote the adoption of adaptive CERS while reduce the use of maladaptive CERS, which may be associated with lower levels of psychological distress.

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 (R2 = 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.

BackgroundCognitive emotion regulation plays a crucial role in psychopathology, resilience and well-being by regulating response to stress situations. However, the relationship between personality and adaptive and maladaptive regulation has not been sufficiently examined.MethodsAdaptive and maladaptive cognitive emotion regulation strategies of 247 university students were measured using the Cognitive Emotion Regulation Questionnaire (CERQ) and their temperament and character characteristics were analyzed with the Temperament and Character Inventory—Revised Short (TCI-RS). Two-step hierarchical multiple regression analyses were used to analyze whether TCI-RS explains the use of adaptive and maladaptive cognitive emotion regulation strategies. The latent classes of cognitive emotion regulation strategies were extracted with Latent Class Analysis (LCA) and significant differences in the subscales of CERQ and TCI-RS were examined with Analysis of Covariance (ANCOVA) and Profile Analysis after controlling for sex and age.ResultsThe two-step hierarchical multiple regression model using the seven TCI-RS subscales explained 32.30% of the adaptive and 41.70% of the maladaptive CERQ subscale scores when sex and age were introduced in the first step as covariates. As for temperament, Novelty Seeking (NS) and Persistence (PS) were pivotal for adaptive and Harm Avoidance (HA) and PS for maladaptive CERQ total scores. In addition, the character traits Self-Directedness (SD) and Cooperativeness (CO) were critical for high adaptive and low maladaptive CERQ scores. Four latent emotion regulation classes were confirmed through LCA, and distinct TCI-RS profiles were found. The temperament trait HA and character trait SD were significantly different among the four latent emotion regulation classes.DiscussionThis study demonstrated that SD and CO are related to cognitive emotion regulation strategies along with psychological health and well-being, and that PS exhibits dualistic effects when combined with NS or HA on response to stressful situations. The importance of developing mature character represented by higher SD and CO in regard to mental health and its clinical implementation was discussed.