Lincoln Tania M, Hartmann Maike, Köther Ulf, Moritz Steffen
Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, 20246, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, D-20246, Germany.
Clin Psychol Psychother. 2015 Nov-Dec;22(6):637-46. doi: 10.1002/cpp.1923. Epub 2014 Sep 24.
Difficulties in emotion regulation (ER) are present in psychotic disorders, but their precise nature is not yet fully understood and it is unclear which difficulties are unique to psychosis compared with other disorders. This study investigated whether ER difficulties in psychosis are more prominent for the ability to modify emotions or for the ability to tolerate and accept them. Furthermore, it investigated whether ER difficulties occur for sadness, anxiety, anger and shame likewise. ER skills were assessed in participants with psychotic disorders (n = 37), participants with depression (n = 30) and healthy controls (n = 28) using the Emotion Regulation Skill Questionnaire that asks participants to rate the intensity of different emotions over the past week and the skills employed to handle each of them. Compared with healthy controls, participants with psychosis showed reduced skills related to awareness, understanding and acceptance of potentially distressing emotions, but not in the ability to modify them. These differences remained significant after controlling for depression. Participants with psychosis showed reduced ER skills in regard to all of the assessed emotions compared with the healthy controls, despite the fact that they only reported sadness as being significantly more intense. The participants with depression showed a similar pattern of ER skills to the psychosis sample, although with a tendency towards even more pronounced difficulties. It is concluded that psychosis is characterized by difficulties in using specific ER skills related to awareness, understanding and acceptance to regulate anger, shame, anxiety and sadness. These difficulties are not unique to psychosis but nevertheless present a promising treatment target.
The participants with psychosis found it more difficult to be aware of their emotions, to understand them and to accept them than the healthy control group. However, they reported equal skills when it came to actively modifying emotions. The difficulties in emotion regulation reported by the participants with psychosis were comparable with those reported by the participants with depression, and they occurred for all types of negative emotions likewise. The difficulties in using specific ER skills related to awareness, understanding and acceptance are a promising target for psychological treatment of psychosis. Interventions that are aimed specifically at increasing these skills need to be further developed.
情绪调节困难存在于精神障碍中，但其确切性质尚未完全明了，与其他疾病相比，哪些困难是精神障碍所独有的也尚不清楚。本研究调查了精神障碍中的情绪调节困难在改变情绪的能力方面还是在容忍和接受情绪的能力方面更为突出。此外，还调查了悲伤、焦虑、愤怒和羞耻等情绪是否同样存在情绪调节困难。使用情绪调节技能问卷对患有精神障碍的参与者（n = 37）、患有抑郁症的参与者（n = 30）和健康对照组（n = 28）的情绪调节技能进行评估，该问卷要求参与者对过去一周内不同情绪的强度以及处理每种情绪所采用的技能进行评分。与健康对照组相比，患有精神障碍的参与者在与潜在痛苦情绪的觉察、理解和接受相关的技能方面有所下降，但在改变情绪的能力方面未下降。在控制了抑郁症之后，这些差异仍然显著。与健康对照组相比，患有精神障碍的参与者在所有评估情绪方面的情绪调节技能均有所下降，尽管他们仅报告悲伤情绪明显更为强烈。患有抑郁症的参与者表现出与精神障碍样本相似的情绪调节技能模式，尽管困难程度有更为明显的趋势。研究得出结论，精神障碍的特征在于在使用与觉察、理解和接受相关的特定情绪调节技能来调节愤怒、羞耻、焦虑和悲伤方面存在困难。这些困难并非精神障碍所独有，但仍是一个有前景的治疗靶点。
与健康对照组相比，患有精神障碍的参与者发现觉察、理解和接受自己的情绪更加困难。然而，在积极改变情绪方面，他们报告称技能相当。患有精神障碍的参与者报告的情绪调节困难与患有抑郁症的参与者报告的困难相当，并且同样发生在所有类型的负面情绪上。在使用与觉察、理解和接受相关的特定情绪调节技能方面存在的困难是精神障碍心理治疗的一个有前景的靶点。需要进一步开发专门旨在提高这些技能的干预措施。
