Brief report: Cognitive emotion regulation strategies and psychological adjustment in adolescents with a chronic disease

Objective of the study was to examine how cognitive emotion regulation strategies were related to psychological maladjustment in adolescents with a chronic disease. The sample consisted of adolescents with a diagnosis of Juvenile Idiopathic Arthritis (JIA). A self-report questionnaire was used to assess Internalizing problems and Quality of Life. The specific cognitive emotion regulation strategies that were used in response to the disease were measured by the Cognitive Emotion Regulation Questionnaire (CERQ). Correlations and Multiple regression analyses showed that Rumination and Catastrophizing were the most important 'predictors' of psychological maladjustment in adolescents with JIA, suggesting that they should be considered as maladaptive cognitive emotion regulation strategies in response to a chronic disease such as JIA. Challenging these maladaptive cognitive emotion regulation strategies may therefore play an important role in intervention strategies.     

医学生认知情绪调节对心理症状水平的影响

目的研究医学生认知情绪调节策略对心理症状水平的影响。方法运用症状自评量表(SCL-90)与认知情绪调节问卷中文版(CERQ-C)对江苏某大学医学部586名本科生进行调查,按SCL-90界值分组后进行认知情绪调节策略比较,并对两个工具各因子间的相关性进行分析。结果医学生阳性组(SCL-90总评分160分)较多运用责难自己、沉思、灾难化策略,而较少运用理性分析策略;2不适应性调节策略与SCL-90各因子分及总均分呈正相关(P0.01),其中,沉思和灾难化与各因子分及总均分正相关;责难自己与强迫症状、人际关系敏感、抑郁、焦虑、精神病性及总均分正相关(P0.01),与躯体化、敌对呈正相关(P0.05);3灾难化、责难自己、沉思三种策略可联合预测心理症状水平15.9%的变异程度。结论医学生越多运用不适应性调节策略,其心理症状水平越高。     

Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives

Green MJ, Lino BJ, Hwang E‐J, Sparks A, James C, Mitchell PB. Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives. Objective: We examined the use of particular cognitive strategies for regulating negative emotion in relation to mood and temperament in BD‐I, unaffected relatives of bipolar patients (UR), and healthy controls (HC). Method: Participants were 105 patients with BD‐I, 124 UR, and 63 HC; all participants completed the Cognitive Emotion Regulation Questionnaire (CERQ), the Depression Anxiety Stress Scales (DASS), and the Hypomanic Personality Scale (HPS). Results: The BD‐I group reported more frequent use of rumination, catastrophizing and self‐blame, and less frequent use of putting into perspective, in response to negative life events, relative to the UR and HC groups. In BD‐I, more frequent use of rumination was associated with increased DASS and HPS scores. By contrast, within the UR group, more frequent use of catastrophizing and self‐blame were associated with increased DASS and HPS scores. In all participants, less frequent use of adaptive cognitive reframing strategies (e.g. putting into perspective) were associated with increased DASS scores. Conclusion: Both BD‐I and UR groups reported more frequent use of maladaptive regulatory strategies previously associated with depression. Emotion regulation strategies of catastrophizing, self‐blame, and cognitive reframing techniques may be associated with vulnerability for mood disorders, with the latter active within the general population regardless of biological vulnerability to disorder.     

认知情绪调节策略与抑郁症状的相关性

目的 探讨认知情绪调节策略与抑郁症状水平的关系.方法 采用认知情绪调节问卷中文版(CERQ)和Beck抑郁自评问卷(BDI)对90例住院抑郁发作患者和90名健康对照组人群进行评定.结果 抑郁组CERQ非适应性策略得分[(38.38±11.68)分]高于健康对照组[(31.27±7.91)分],而适应性策略得分[(41.33±10.79)分]低于健康对照组[(45.43±12.08)分],差异均有统计学意义(P＜0.05);灾难化、积极重新评价、重新关注计划与抑郁组的抑郁症状水平显著相关(r值分别为0.429,-0.402,-0.384;P＜0.01);多元线性回归结果表明,灾难化和积极重新评价是预测抑郁发作患者抑郁症状最重要的变量,而沉思是预测健康人群抑郁症状的重要变量.结论 认知情绪调节与抑郁密切相关,提升积极重新评价策略可能有助于改善和缓解抑郁患者的抑郁症状水平.     

未治疗抑郁障碍患者自杀风险与认知情绪调节策略的关系

目的探讨具有自杀风险的抑郁障碍患者在认知情绪调节策略方面的特征及其影响因素,以早期识别具有自杀风险的患者,有针对性地给予干预。方法选取117例来自北京回龙观医院门诊、经简明国际神经精神访谈(MINI)5. 0中文版筛查符合抑郁障碍诊断标准的未治疗抑郁障碍患者,根据MINI 5. 0中文版自杀模块的访谈结果,将患者分为自杀风险组(n=52)和无自杀风险组(n=65)。采用认知情绪调节问卷(CERQ-C)进行认知调节策略的测评,采用汉密尔顿抑郁量表17项版(HAMD-17)评定抑郁症状的严重程度。结果抑郁障碍患者自杀风险发生率为44. 4%(52/117)。与无自杀风险组相比,自杀风险组患者更多见于女性、未婚、平均年龄更小、发病年龄更早、HAMD-17总评分更高、伴精神病性症状率较高,自杀风险组自我责难、接受、沉思、灾难化4个认知调节策略维度及消极认知情绪调节评分均高于无自杀风险组(P均<0. 05)。Logistic回归分析显示,女性(OR=3. 539,95%CI:1. 383~9. 057)、发病年龄(OR=0. 931,95%CI:0. 895~0. 968)、HAMD-17总评分(OR=1. 207,95%CI:1. 063~1. 370)和灾难化(OR=1. 143,95%CI:1. 002~1. 305)与抑郁障碍患者自杀风险相关(P均<0. 05)。结论女性、发病年龄早、抑郁症状严重和灾难化可能为未治疗抑郁障碍患者自杀风险的危险因素。     

Cognitive emotion regulation strategies and emotional problems in 9–11-year-old children

The present study describes the development of the child version of the Cognitive Emotion Regulation Questionnaire (CERQ-k). Like the adult version of the CERQ, the CERQ-k measures nine cognitive emotion regulation strategies that children may use after having experienced negative life events. The original CERQ was considered suitable for adults and adolescents aged 12 and older. The CERQ-k was constructed for children of 9, 10 and 11 years of age. The present study describes some psychometric properties of the CERQ-k and relationships with measures of depression, fearfulness and worry among 717 primary school youngsters. Principal component analyses confirmed the allocation of most items to subscales, while Cronbach’s alphas of most subscales exceeded 0.70. Cognitive emotion regulation strategies were found to be related to the reporting of symptoms of depression, fearfulness and worry, which provided some evidence for criterion-related validity.     

大学生认知情绪调节与抑郁、焦虑的相关性研究

目的 研究大学生认知情绪调节与抑郁、焦虑的关系,为大学生心理健康教育提供支持证据.方法 应用认知情绪调节问卷、Beck抑郁自评量表、Beck焦虑量表对504名大一新生进行测评,运用Pearson相关分析,多元线性回归分析,分析大学生认知情绪调节与抑郁、焦虑的相关性.结果 61.9%的学生有抑郁症状,6.9%的学生有焦...     

How is impulsivity related to depression in adolescence? Evidence from a French validation of the cognitive emotion regulation questionnaire

The aim of this study was to validate a French version of the Cognitive Emotion Regulation Questionnaire (CERQ; Garnefski, N., Kraaij, V., & Spinhoven, P., 2001. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 1311-1327) and to explore its relationships with impulsivity and depression. Teenagers from a junior secondary (n=107, 13-16 years) and a secondary school (n=110, 15-19 years) completed the CERQ, which assesses regulation strategies in response to negative events. The secondary school adolescents also completed the UPPS Impulsive Behavior Scale (Whiteside, S. P., & Lynam, D. R., 2001. The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689) and the Reynolds Adolescent Depression Scale (Reynolds, W. M., 1987. Reynolds Adolescent Depression Scale: Professional manual. Odessa, FL: Psychological Assessment Resources). Factor analysis for the CERQ confirmed the presence of the nine original regulation strategies. In the secondary school students, impulsivity was related to depression. A path analysis revealed that regulation strategies mediated this relationship. The role of emotion regulation in the development of adolescent psychopathology is discussed.     

缓解期单相与双相抑郁障碍患者功能失调性态度及认知应对策略比较

目的 探讨缓解期单相与双相抑郁障碍患者功能失调性态度和认知应对策略的差异,为其心理干预提供参考。 方法 选取符合《国际疾病分类（第10版）》（ICD-10）情感障碍诊断标准的缓解期双相抑郁障碍患者（n=83）和缓解期单相抑郁障碍患者（n=76）作为研究对象。采用认知情绪调节问卷中文版（CERQ-C）、贝克抑郁量表21项版（BDI-21）和功能失调性态度问卷（DAS）对两组患者进行评定。 结果 双相抑郁组DAS总评分及各因子评分均高于单相抑郁组,差异均有统计学意义（P均<0.01）。双相抑郁组CERQ-C积极重新关注、积极重新评价、自我责难、沉思因子评分和不适应性调节策略总评分均高于单相抑郁组,差异均有统计学意义（P均<0.01）。 结论 缓解期双相抑郁患者较单相抑郁患者可能具有更严重的功能失调性态度与认知应对策略问题。     

Cognitive coping strategies and symptoms of depression and anxiety: a comparison between adolescents and adults

The present study focused on comparability of adolescents and adults in the reporting of cognitive coping strategies and their relationship to symptoms of depression and anxiety. Two samples were included: 487 adolescents attending a secondary school and 630 adults from a general practitioners practice. Data were obtained on symptoms of depression and anxiety and the use of nine cognitive coping strategies: acceptance, catastrophizing, other-blame, positive reappraisal, putting into perspective, refocus on planning, positive refocusing, rumination and self-blame.The results showed that all cognitive coping strategies were reported by adolescents to a significantly lesser extent than by adults. Further, it was shown that both in adolescents and adults a considerable percentage of the variance in symptomatology was explained by the use of cognitive coping strategies. Although adolescents and adults differed in relative strength of the relationships, generally speaking, conclusions were the same: in both groups, the cognitive coping strategies self-blame, rumination, catastrophizing and positive reappraisal were shown to play the most important role in the reporting of symptoms of psychopathology, showing the importance of introducing prevention and intervention programmes at an early stage.     

北京市350名职业人员睡眠质量和情绪调节的认知策略调查

目的 了解受过高等教育职员的睡眠质量及其所采用的情绪调节认知策略.方法 采用匹兹堡睡眠质量指数(PSQI)问卷、失眠严重指数(ISI)问卷、简式简明心境问卷(POMS-SF)和认知情绪调节问卷(CERQ),对采取整群随机抽样法抽取的北京市6所单位的350名大专以上在职人员的睡眠质量与情绪调节策略进行调查.结果 (1)98例(28%)存在睡眠质量问题(PSQI≥7分),146例(41.7%)日常状态受失眠影响(ISI＞7分);(2)遭遇负性生活事件后,在所有受访人员中使用频率最高的3种情绪调节策略依次为积极重新评价、重新关注计划、积极重新关注;(3)在情绪调节认知策略的灾难化维度上,主观不失眠组(ISI≤7分)得分(34.21±12.85)分,低于轻度失眠组(7分＜ISI≤14分)[(39.62±15.02)分]与中重度失眠组(ISI≥15分)[(41.48±11.25)分],差异有统计学意义(t=3.466,P=0.001;t=2.625,P=0.009);在沉浸维度上,主观不失眠组得分(46.43±12.78)分,低于轻度失眠组[(49.92±13.55)分]与中重度失眠组[(51.67±11.44)分],差异有统计学意义(t=2.332,P=0.020;t=1.974,P=0.049).结论 受访职员睡眠质量问题及主观失眠现象较多见,多能运用积极认知策略调节情绪;主观失眠组职员有更多灾难化、沉浸的消极认知策略的运用.     

Cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders

Objective

Research suggests that resilience is associated with favorable treatment outcome in patients with depression and/or anxiety disorders. In this regard, the identification of specific characteristics related to resilience that could provide targets for resilience-enhancement interventions is needed. Since the type of cognitive coping strategies is a possible marker of resilience, we investigated adaptive and maladaptive cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders.

Methods

A total of 230 outpatients with depression and anxiety disorders were consecutively recruited and completed the Cognitive Emotion Regulation Questionnaire, the Connor–Davidson Resilience Scale, the Beck Depression Inventory, and the State Anxiety Inventory. A linear regression model was used to determine which cognitive emotion regulation strategies predicted resilience after controlling for relevant covariates. Additionally, this model of resilience was compared with those of depression and anxiety symptoms.

Results

Adaptive strategies were more strongly correlated with resilience than maladaptive strategies. In the regression model, more use of refocus on planning and positive reappraisal as well as less use of rumination predicted high resilience after controlling for age, gender, marital status, depression, and anxiety. Among these strategies, refocus on planning was the common strategy contributing to resilience and depression.

Conclusion

These results suggested that the cognitive emotion regulation strategies of refocus on planning, positive reappraisal, and less rumination contribute to resilience in patients with depression and anxiety disorders. It might provide potential targets for psychotherapeutic intervention to improve resilience in these patients.     

Emotion suppression,not reappraisal,predicts psychotherapy outcome

Objectives: The aim of this study was to identify whether trait emotion regulation strategies predict successful or unsuccessful psychotherapy outcomes in cognitive behaviour therapy. Methods: Three emotion regulation strategies (reappraisal, suppression, and externalizing behaviour) were assessed in 358 in- and outpatients. Patients were then grouped by therapy outcome. Emotion regulation strategies and confounding variables were entered as predictors in multinomial logistic regression analyses. Results: Emotion suppression, but not reappraisal, was found to predict therapy outcomes for in- and outpatients, with patients high in suppression experiencing worse outcomes. Externalizing behaviour was only relevant in inpatient treatment. Conclusions: High suppression might be detrimental to psychotherapy outcome and should be assessed early on. Further research should investigate the influence of suppression on the mechanisms that facilitate change in psychotherapy.     

缓解期抑郁症患者述情障碍与认知应对策略关系的初步研究

目的 探讨缓解期抑郁症患者述情障碍与认知应对策略的特征及二者的关系.方法 采用多伦多述情量表（TAS-20）中文版、认知情绪调节问卷中文版（CERQ-C）对130例缓解期抑郁症患者进行评定,并与95例健康志愿者（对照组）比较.结果 （1）抑郁症组TAS-20总分及因子I、III分仍显著高于对照组,依次为（51.00±9.25）分vs（48.04±8.79）分、（16.97±5.46）分vs（15.90±4.26）分、（21.31±4.11）分vs（19.09±3.03）分,P＜0.05或P＜0.01.CERQ-C中责难自己、沉思、积极重新关注、理性分析、责难他人因子分低于对照组,接受、重新关注计划、积极重新评价因子分高于对照组,依次为（10.63±3.21）分vs（12.56±2.26）分、（9.72±3.13）分vs（12.01±2.44）分、（11.08±2.94）分vs（12.11±2.65）分、（8.88±3.07）分vs（11.66±2.41）分、（8.88±3.69）分vs（10.19±2.35）分、（13.26±3.67）分vs（12.56±2.26）分、（13.56±3.56）分vs（12.51±3.65）分、（13.81±4.06）分vs（12.47±3.70）分,P＜0.01;（2）CERQ-C沉思、接受、责难他人等因子依次进入TAS-20总分的回归方程;自杀行为、医疗费用、抑郁总分等因子依次进入TAS-20因子I的回归方程;沉思因子、父母文化程度进入TAS-20因子II的回归方程; 接受、责难他人与积极评价因子等依次进入TAS-20因子III的回归方程.结论 缓解期抑郁症仍存在明显的述情障碍与不良的认知应对策略.述情障碍的不同纬度影响因素不同,不适应性的应对策略可能仍为缓解期抑郁症患者述情障碍重要的影响因素.     

Thinning of the lateral prefrontal cortex during adolescence predicts emotion regulation in females

Adolescence is a crucial period for the development of adaptive emotion regulation strategies. Despite the fact that structural maturation of the prefrontal cortex during adolescence is often assumed to underlie the maturation of emotion regulation strategies, no longitudinal studies have directly assessed this relationship. This study examined whether use of cognitive reappraisal strategies during late adolescence was predicted by (i) absolute prefrontal cortical thickness during early adolescence and (ii) structural maturation of the prefrontal cortex between early and mid-adolescence. Ninety-two adolescents underwent baseline and follow-up magnetic resonance imaging scans when they were aged approximately 12 and 16 years, respectively. FreeSurfer software was used to obtain cortical thickness estimates for three prefrontal regions [anterior cingulate cortex; dorsolateral prefrontal cortex (dlPFC); ventrolateral prefrontal cortex (vlPFC)]. The Emotion Regulation Questionnaire was completed when adolescents were aged approximately 19 years. Results showed that greater cortical thinning of the left dlPFC and left vlPFC during adolescence was significantly associated with greater use of cognitive reappraisal in females, though no such relationship was evident in males. Furthermore, baseline left dlPFC thickness predicted cognitive reappraisal at trend level. These findings suggest that cortical maturation may play a role in the development of adaptive emotion regulation strategies during adolescence.     

Cognitive coping in anxiety-disordered adolescents

The present study investigated differences in cognitive coping strategies between anxiety-disordered and non-anxious adolescents. In addition, the interaction effect with gender as well as differences between specific anxiety diagnoses was examined. A clinical sample of 159 anxiety-disordered adolescents and a general community sample of 370 non-anxious adolescents were recruited. Nine cognitive coping strategies were assessed in all adolescents (aged 12-16 years). Results showed that anxiety-disordered adolescents had significantly higher scores on most of the cognitive coping strategies than non-anxious adolescents. The cognitive coping strategies rumination, self-blame and catastrophizing accounted for most of the variance. Gender did not modify the results. Further analyses within the anxiety-disordered sample indicated that adolescents with a generalized anxiety disorder scored significantly higher on rumination, but not on other cognitive coping strategies, than social phobic adolescents. The results suggest that cognitive coping is a valuable target for psychological assessment and treatment in adolescents.     

Cognitive coping and childhood anxiety disorders

To investigate differences in cognitive coping strategies between anxiety-disordered and non-anxious 9–11-year-old children. Additionally, differences in cognitive coping between specific anxiety disorders were examined. A clinical sample of 131 anxiety-disordered children and a general population sample of 452 non-anxious children were gathered. All children filled out the child version of the Cognitive Emotion Regulation Questionnaire (CERQ-k). Structured clinical interviews were used to assess childhood anxiety disorders. Results showed that anxiety-disordered children experience significantly more ‘lifetime’ negative life events than non-anxious children. Adjusted for the ‘lifetime’ experience of negative life events, anxiety-disordered children scored significantly higher on the strategies catastrophizing and rumination, and significantly lower on the strategies positive reappraisal and refocus on planning than non-anxious children. No significant differences in cognitive coping were found between children with specific anxiety disorders. Anxiety-disordered children employ significantly more maladaptive and less adaptive cognitive coping strategies in response to negative life events than non-anxious children. The results suggest that cognitive coping is a valuable target for prevention and treatment of childhood anxiety problems.     

Parenting styles,perceived social support and emotion regulation in adolescents with internet addiction

AimThe aim of this study is to investigate parental attitudes, perceived social support, emotion regulation and the accompanying psychiatric disorders seen in adolescents who, having been diagnosed with Internet Addiction (IA), were referred to an outpatient child and adolescent psychiatric clinic.MethodsOf 176 adolescents aged 12–17, 40 were included in the study group. These scored 80 or higher on Young's Internet Addiction Test (IAT) and met Young's diagnostic criteria for IA based on psychiatric interviews. Forty adolescents who matched them in terms of age, gender and socio-economic level were included in the control group. The Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL), the Parenting Style Scale (PSS), the Lum Emotional Availabilty of Parents (LEAP), the Social Support Appraisals Scale for Children (SSAS-C), the Difficulties in Emotion Regulation Scale (DERS) and the Toronto Alexithymia Scale-20 (TAS-20) were applied.ResultsThe results showed that the parents of adolescents with IA were more frequently inadequate in acceptance/involvement, supervision/monitoring and they had less emotional availability. The adolescents with IA had less perceived social support, greater difficulty in the identification and verbal expression of their feelings and emotion regulation. Lower parental strictness/supervision, higher alexithymia and the existence of an anxiety disorder were found to be significant predictors of IA. Internet addicted adolescents with comorbid major depressive disorder had higher levels of alexithymia and lower levels of emotional availability in their parents.ConclusionIt can be concluded that strategies for the prevention and treatment of IA in adolescents should focus on improving the quality of parenting parent-adolescent relationships, enhancing perceived social support and emotion regulation while reducing the associated psychiatric symptoms in adolescents.     

Peer facilitation of emotion regulation in adolescence

Emotion regulation is particularly important for adolescents as they undergo normative developmental changes in affective systems and experience heightened risk for psychopathology. Despite a high need for emotion regulation during adolescence, commonly studied emotion regulation strategies like cognitive reappraisal are less beneficial for adolescents than adults because they rely on neural regions that are still developing during this period (i.e., lateral prefrontal cortex). However, adolescence is also marked by increased valuation of peer relationships and sensitivity to social information and cues. In the present review, we synthesize research examining emotion regulation and peer influence across development to suggest that sensitivity to peers during adolescence could be leveraged to improve emotion regulation for this population. We first discuss developmental trends related to emotion regulation at the level of behavior and brain in adolescents, using cognitive reappraisal as an exemplar emotion regulation strategy. Next, we discuss social influences on adolescent brain development, describing caregiver influence and increasing susceptibility to peer influence, to describe how adolescent sensitivity to social inputs represents both a window of vulnerability and opportunity. Finally, we conclude by describing the promise of social (i.e., peer-based) interventions for enhancing emotion regulation in adolescence.