North Lambeth Focused Support Team, South London and Maudsley NHS Foundation Trust, London, UK.
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Clin Psychol Psychother. 2020 Mar;27(2):107-135. doi: 10.1002/cpp.2408. Epub 2020 Feb 12.
Emotions play a key role in the development and experience of psychosis, yet there are important gaps in our understanding of how individuals with psychosis understand and respond to their emotions. This systematic review investigated self-reported emotion regulation difficulties in individuals with psychosis compared with non-clinical controls. An electronic database search was conducted in Medline, PsychINFO, and Embase and supplemented by searches of reference lists and citations. Seventeen studies were included. A narrative synthesis was conducted because contextual diversity was present across the studies and outcomes. Individuals with psychosis reported greater difficulties in (i) emotional clarity (specifically with identifying, describing, and understanding their emotions), (ii) emotional acceptance, (iii) engaging in goal-directed behaviours when experiencing negative emotions, and (iv) willingness to experience emotional distress in the pursuit of meaningful activities in life. Evidence pertaining to other self-reported emotion regulation difficulties was less clear. Effect sizes were generally large in magnitude but there were few studies on some self-reported emotion regulation difficulties, and all studies were at moderate to high risk of bias. Further research is needed to clarify the nature of emotion regulation difficulties in individuals with psychosis to inform the provision of targeted clinical interventions.
情绪在精神病的发展和体验中起着关键作用，但我们对精神病患者如何理解和应对自己的情绪知之甚少。本系统评价调查了与非临床对照组相比，精神病患者自我报告的情绪调节困难。在 Medline、PsychINFO 和 Embase 中进行了电子数据库搜索，并通过对参考文献和引文的搜索进行了补充。共纳入了 17 项研究。由于研究之间存在背景多样性和结果差异，因此进行了叙述性综合。精神病患者报告在以下方面存在更大的困难：(i) 情绪清晰度（特别是识别、描述和理解自己的情绪），(ii) 情绪接受，(iii) 在经历负面情绪时采取目标导向的行为，以及 (iv) 愿意在追求有意义的生活活动中体验情绪困扰。与其他自我报告的情绪调节困难相关的证据则不太清楚。效应量通常较大，但关于某些自我报告的情绪调节困难的研究较少，而且所有研究都存在中度至高度的偏倚风险。需要进一步的研究来阐明精神病患者情绪调节困难的性质，以便为有针对性的临床干预措施提供信息。
