Successful Application of Adaptive Emotion Regulation Skills Predicts the Subsequent Reduction of Depressive Symptom Severity but neither the Reduction of Anxiety nor the Reduction of General Distress during the Treatment of Major Depressive Disorder

ObjectiveDeficits in general emotion regulation (ER) skills have been linked to symptoms of depression and are thus considered a promising target in the treatment of Major depressive disorder (MDD). However, at this point, the extent to which such skills are relevant for coping with depression and whether they should instead be considered a transdiagnostic factor remain unclear. Therefore, the present study aimed to investigate whether successful ER skills application is associated with changes in depressive symptom severity (DSS), anxiety symptom severity (ASS), and general distress severity (GDS) over the course of treatment for MDD.MethodsSuccessful ER skills application, DSS, ASS, and GDS were assessed four times during the first three weeks of treatment in 175 inpatients who met the criteria for MDD. We computed Pearson correlations to test whether successful ER skills application and the three indicators of psychopathology are cross-sectionally associated. We then performed latent growth curve modelling to test whether changes in successful ER skills application are negatively associated with a reduction of DSS, ASS, or GDS. Finally, we utilized latent change score models to examine whether successful ER skills application predicts subsequent reduction of DSS, ASS, or GDS.ResultsSuccessful ER skills application was cross-sectionally associated with lower levels of DSS, ASS, and GDS at all points of assessment. An increase in successful skills application during treatment was associated with a decrease in DSS and GDS but not ASS. Finally, successful ER skills application predicted changes in subsequent DSS but neither changes in ASS nor changes in GDS.ConclusionsAlthough general ER skills might be relevant for a broad range of psychopathological symptoms, they might be particularly important for the maintenance and treatment of depressive symptoms.

普遍情绪调节（emotion regulation, ER）技能的缺陷与抑郁症状存在关联，因此被视为重度抑郁症（Major depressive disorder, MDD）治疗中极具潜力的干预靶点。然而当前，此类技能在应对抑郁症中的关联程度，以及其是否应被视为跨诊断因素，仍尚不明确。为此，本研究旨在探究在MDD治疗过程中，成功运用情绪调节技能是否与抑郁症状严重程度（depressive symptom severity, DSS）、焦虑症状严重程度（anxiety symptom severity, ASS）以及一般痛苦严重程度（general distress severity, GDS）的变化存在相关性。
本研究纳入175名符合MDD诊断标准的住院患者，在治疗初始三周内开展4次评估，评估内容涵盖成功情绪调节技能运用情况、DSS、ASS与GDS。首先通过Pearson相关分析检验成功情绪调节技能运用与三项精神病理学指标的横断面关联；随后采用潜在增长曲线模型，检验成功情绪调节技能运用的变化与DSS、ASS或GDS的降低是否呈负相关；最后利用潜在变化得分模型，探究成功情绪调节技能运用能否预测后续DSS、ASS或GDS的减轻。
在所有评估节点，成功运用情绪调节技能均与更低水平的DSS、ASS及GDS存在横断面关联。治疗期间成功运用情绪调节技能的提升，与DSS和GDS的降低显著相关，但与ASS的变化无明显关联。此外，成功运用情绪调节技能能够预测后续DSS的变化，但无法预测ASS或GDS的变化。
尽管普遍情绪调节技能可能与广泛的精神病理症状相关，但其对于抑郁症状的维持与治疗或许尤为关键。