The influence of an emotion regulation intervention on challenges in emotion regulation and cognitive strategies in patients with depression

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

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.

BackgroundIt is becoming widely recognized that emotion regulation difficulties are an essential feature present along the continuum from subclinical to clinical Attention Deficit/Hyperactivity Disorder (ADHD). Yet, it remains unclear whether and how specific processes related to emotion regulation contribute to daily life impairments, across different domains of functioning. The aim of this cross-sectional study in community adolescents was to investigate whether three processes commonly implicated in adaptive emotion regulation—emotion recognition, emotion reactivity and use of cognitive emotion regulation strategies—uniquely contribute to adolescent-rated functional impairment, above and beyond the effects of age and gender, ADHD symptoms, and individual differences in verbal ability and executive functions.Methods161 adolescents from the general population (mean age = 15.57; SD = 1.61) completed the Weiss Functional Impairment Scale, the Emotion Reactivity Scale, the Cognitive Emotion Regulation Questionnaire and the Geneva Emotion Recognition Test. Hierarchical regression analysis examined the unique contributions of candidate predictors to impairment scores.ResultsTotal impairment scores were best predicted by older age, inattention symptoms, higher emotion reactivity, and higher use of maladaptive cognitive emotion regulation strategies. Emotion regulation processes were associated with interpersonal difficulties and self-concept impairments, whereas inattention symptoms were associated with school and life skills impairments.ConclusionsThis study stresses that emotion reactivity and maladaptive cognitive emotion regulation represent major sources of perceived social and emotional difficulties in community adolescents. Our results also support the continuum hypothesis of attention difficulties, where emotion regulation abilities may at least partially explain the association between ADHD symptoms and social impairments. Together, these findings highlight the vital importance of targeting emotion regulation in psychotherapeutic interventions aiming to improve socio-emotional outcomes in adolescents.

Background Eating disorder (ED) symptoms are common in the general population and are often associated with childhood maltreatment (CM). Emotion regulation difficulties are likewise linked to both CM and ED symptoms, yet the role of cognitive emotion regulation strategies (CERS) in this relationship remains underexplored. Culturally specific forms of adversity, such as parental overprotection and overcontrol (OP–OC), have also been largely overlooked. Method This cross‐sectional study investigated whether adaptive and maladaptive CERS mediate the associations between six forms of CM and ED symptoms in a non‐clinical sample of 352 Turkish adults. Participants completed the Childhood Trauma Questionnaire–Expanded, the Eating Disorder Examination Questionnaire–Short Form, and the Cognitive Emotion Regulation Questionnaire. Mediation analyses were conducted using the PROCESS macro (Model 4) in SPSS v29. Results The results revealed that, except for physical abuse, maladaptive CERS significantly mediated the associations between all CM types and ED symptoms, with full mediation found for emotional neglect and sexual abuse. Although adaptive CERS did not mediate these relationships, their use was significantly lower among individuals exposed to emotion‐related maltreatment, including OP–OC. Discussion These findings underscore the potential of maladaptive CERS as early indicators and modifiable risk factors in subclinical populations. Tailoring emotion regulation components within interventions like Cognitive Behavioural Therapy–Enhanced (CBT‐E) and Dialectical Behaviour Therapy (DBT) may enhance efficacy, especially for trauma‐exposed individuals. Preventive psychoeducational programmes in youth and community settings could offer timely support before clinical symptoms emerge.

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.

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.

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 & Kraaij (2006) Cognitive Emotion Regulation Questionnaire, the Kentucky Inventory of Mindfulness Skills (Baer, Smith & Allen, 2004), and the Cognitive Flexibility Inventory (Dennis & 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.

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.

Background: Although difficulties in emotion regulation (ER) are considered a core feature of borderline personality disorder (BPD), the specific strategies that individuals with BPD most commonly use, their diagnostic specificity, and their associations with harmful behaviors have not been firmly established. Sampling and Methods: Individuals with BPD (n = 30), mixed anxiety and/or depressive disorders (MAD; n = 30), and healthy controls (HC; n = 32) completed questionnaires assessing both cognitive ER strategies (e.g., cognitive reappraisal) and potentially harmful behaviors that individuals might use to regulate their emotions (e.g., self-injury). Results: BPD subjects endorsed more maladaptive cognitive ER strategies and fewer adaptive strategies compared to HC. Compared to MAD subjects, BPD individuals endorsed more maladaptive cognitive ER strategies, but only when those with subthreshold symptoms in the MAD group were excluded. BPD also endorsed engaging in potentially harmful behaviors more often than both HC and MAD. Discriminant analysis revealed that MAD endorsed lower rates of problem-solving and cognitive reappraisal compared to both HC and BPD. Higher maladaptive and lower adaptive ER strategies were associated with higher rates of potentially harmful behaviors, although the specific strategies differed for MAD versus BPD. Conclusions: BPD and MAD endorse cognitive ER strategies with a comparable frequency, although BPD subjects engage in potentially harmful behaviors more often. Subthreshold BPD symptoms may also affect rates of ER strategy use in individuals with other mental disorders.

The role of cognitive emotion regulation on depressive symptoms in mothers of children given a diagnosis of cancer is not yet well understood. The aim of this study was to investigate the effect of cognitive emotion regulation strategies on depressive symptoms in mothers of children with cancer. This study was conducted with a cross-sectional correlational design. The study included 129 participants. Participants completed the sociodemographic characteristics form, Beck Depression Inventory, and Cognitive Emotion Regulation Questionnaire. Hierarchical regression analysis was performed to determine the effect of cognitive emotion regulation strategies on depressive symptoms. Hierarchical multiple regression revealed that depressive symptoms were independently associated with self-blame (β = 0.279, P = .001) and catastrophizing (β = 0.244, P = .003) after controlling for sociodemographic characteristics of mothers. Emotion regulation strategies explained approximately 39.9% of the variance in depressive symptoms. The results of the study indicate that more frequent engagement of self-blame and catastrophizing were associated with more depressive symptoms. Nurses should screen mothers of children with cancer for depressive symptoms and identify mothers of children with cancer who use maladaptive cognitive emotion regulation strategies, such as self-blame and catastrophizing, as a risk group. Furthermore, nurses need to be involved in developing psychosocial interventions including adaptive cognitive emotion regulation strategies to help mothers coping with adverse emotions during a childhood cancer journey.

Adults with asthma who experience difficulties in emotion regulation are prone to developing psychopathological symptoms that may affect their self-management activities and symptom control. The current research investigated the role of psychological flexibility and cognitive emotion regulation strategies in relation to mental health outcomes (psychological distress and quality of life) among patients with asthma in Pakistan. A sample of 200 adults, diagnosed with asthma (32% men, 68% women; Mage = 42.32, SDage = 16.99), completed the acceptance and action questionnaire (AAQ-II) cognitive emotion regulation questionnaire (CERQ), depression, anxiety, stress scale-21 (DASS-21), asthma-related quality of life questionnaire (AQLQ) and a self-structured demographic sheet. Results of Pearson product moment correlation showed that most of the adaptive cognitive emotion regulation strategies (positive refocusing, refocus on planning, and positive reappraisal) were positively correlated with psychological flexibility and quality of life, whereas negatively correlated with psychological distress. All the maladaptive strategies of cognitive emotion regulation had a significant inverse relationship with psychological flexibility and quality of life, while positively correlated with psychological distress. Results of serial mediation analysis through PROCESS MACRO showed that catastrophising and anxiety fully mediated the relationship between psychological flexibility and asthma-related quality of life. Evidence-based interventions should focus on developing psychological flexibility and identifying maladaptive patterns of cognitive emotion regulation strategies for improved mental health and quality of life outcomes for adults with asthma.

Background and Aim: Consequences of heart failure are along with experiencing more stressful situations for patients and increasing negative emotions in cardiovascular disease, is accompanied by a worsening of the course of the disease and in general, cardiovascular patients use more maladaptive and less adaptive strategies of cognitive emotion regulation strategies than the normal group; Therefore, the aim of this study was to compare the effectiveness of mindfulness-based cognitive therapy with acceptance and commitment therapy on cognitive emotion regulation in patients with heart failure. Methods: The design of this research is a quasi-experimental design with pre-test, post-test, control group and 3 months follow-up. The statistical population included all 35 to 55 years old males with heart failure who referred to medical centers in Isfahan in 1400.In this research, 45 people were selected by targeted sampling method to form 3 groups; and 15 people were randomly selected in the mindfulness-based cognitive therapy group, 15 people in the acceptance and commitment therapy group and 15 people in the control group. The data were collected by Cognitive Emotion Regulation Questionnaire, Garnefski, Kraaij, & Spinhoven (2001); and mindfulness-based cognitive therapy Segal, et al. (2013) and acceptance and commitment therapy Hayes & Strosahl (2010) were performed for 8 sessions of 90 minutes for the experimental groups. Data analysis was performed by descriptive statistics and mixed analysis of variance with repeated measures using SPSS-25. Results: The results showed that in comparison with the control group, both interventions significantly reducing the use of maladaptive and increasing the use of adaptive cognitive emotion regulation strategies (P= 0.05); Also, there was no significant difference between the effect of the interventions on cognitive emotion regulation strategies (P=0.05). Conclusion: According to the results, mindfulness-based cognitive therapy and acceptance and commitment therapy can use to reduce the use of maladaptive and increase the use of adaptive cognitive emotion regulation strategies in with heart failure patients and can use as effective complementary interventions along with medical treatments

While the exact mechanisms are not fully understood, there are significant links between sleep quality, anxiety, depressive symptoms, and cognitive emotion regulation. This research examines how sleep quality affects anxiety and depressive symptoms, as well as the potential of cognitive emotion regulation strategies (CERS) to moderate the impact of sleep quality on these symptoms. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), the Cognitive Emotion Regulation Questionnaire (CERQ), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7) were all completed online by students from two colleges in China's Xizang region. The study included 4325 subjects. The prevalence of poor sleep quality, anxiety symptoms, and depression symptoms was 45.69%, 36.81%, and 51.86%, respectively. We observed significant direct effects on poor sleep and severity of anxiety/depression: c'1 = 0.586 (0. 544-0.628), and c'2 = 0.728 (0.683-0.773). Adaptive CERS only had a mediating effect on the relationship between sleep quality and depression symptoms, with a1b3 = -0.005 (-0.011--0.001). The link between poor sleep quality and the intensity of anxiety and depression was significantly affected by the indirect effects of maladaptive CERS: effect a2b2 = 0.126 (0.106-0.147), and effect a2b4 = 0.145 (0.123-0.167). Individuals who experience poor sleep quality are more likely to have increased levels of anxiety and depression. However, enhancing sleep quality led to a decrease in anxiety and depression levels. Adaptive CERS did not predict anxiety, but they did predict depression. Multiple maladaptive CERS could increase levels of anxiety and depression. To prevent mental stress, it is crucial to examine sleep problems among college students, understand their cognitive strategies, promote the adoption of adaptive CERS, and reduce the reliance on maladaptive CERS.

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<0.0001). There was an inverse and significant relationship between procrastination, adaptive cognitive emotion regulation strategies, and mindfulness (P<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.

Cognitive and emotion regulation strategies play an influential role in the display of aggression, however much of this research has failed to identify specific regulation strategies related to aggression. The study’s objective was to assess how emotional processes and the habitual use of maladaptive cognitive emotion regulation strategies are associated with trait aggression. Participants (N = 306; Mage = 33.79; SD = 13.29), completed a self-report survey battery assessing four subtypes of trait aggression (physical, verbal and romantic relational and peer-directed relational), emotion (anger, hostility) and maladaptive cognitive emotion regulation strategies (blaming others, blaming self, ruminating, catastrophizing). Results indicated that anger and hostility (the emotion based variables) had greater influence on all subtypes of trait aggression (physical, verbal, and relational aggression), compared to cognitive emotion regulation strategies which had less of an influence. Blaming others had a positive association with physical and peer directed relational aggression. Low levels of rumination were associated with physical aggression, while low levels of self-blame were associated with peer directed relational aggression. Findings suggest that maladaptive cognitive emotion regulation strategies have differential impact on different forms of aggressive behavior.