Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.
Research Division, Institute of Mental Health, Singapore, Singapore.
Early Interv Psychiatry. 2020 Dec;14(6):691-697. doi: 10.1111/eip.12895. Epub 2019 Nov 6.
Emotion dysregulation is relevant to the aetiology of schizophrenia spectrum disorders (SSD). While most studies have focused on the chronic phase of SSD, little is known about the effects of emotion dysregulation and associated cognitive risk factors during the early phase of the illness, with negative implications for early intervention. The purpose of this study is to examine the impact of maladaptive cognitive emotion regulation strategies, global emotion dysregulation, and cognitive insight on psychotic and comorbid depressive symptoms in patients with early SSD.
Participants included 150 newly diagnosed outpatients with SSD who were seeking treatment at the Early Psychosis Intervention Program. All participants completed the Cognitive Emotion Regulation Questionnaire, Difficulties with Emotion Regulation Scale, and Beck Cognitive Insight Scale. Severity of psychotic and depressive symptoms were rated on the Brief Psychiatric Rating Scale.
Multivariate regression adjusting for gender and psychiatric comorbidity revealed that global emotion dysregulation was associated with more severe positive and depressive symptoms. Further moderation analyses revealed a significant interaction between global emotion dysregulation and cognitive insight (self-certainty) on depression such that for patients with high self-certainty, greater global emotion dysregulation was associated with increased severity of depressive symptoms. There was no interaction between global emotion dysregulation and cognitive insight on positive symptoms.
Our findings provide preliminary support for the associations between emotion dysregulation and psychopathology in early SSD. Further research is needed to examine the transdiagnostic role of emotion dysregulation in the aetiology and treatment of a wider range of psychotic disorders.
情绪调节障碍与精神分裂症谱系障碍（SSD）的病因有关。虽然大多数研究都集中在 SSD 的慢性阶段，但对于疾病早期阶段的情绪调节障碍和相关认知风险因素的影响知之甚少，这对早期干预有负面影响。本研究旨在探讨适应不良的认知情绪调节策略、整体情绪调节障碍和认知洞察力对早期 SSD 患者的精神病性和共病抑郁症状的影响。
参与者包括 150 名在早期精神病干预计划中寻求治疗的新诊断 SSD 门诊患者。所有参与者都完成了认知情绪调节问卷、情绪调节困难量表和贝克认知洞察力量表。精神病性和抑郁症状的严重程度由简明精神病评定量表评定。
多元回归分析调整了性别和精神共病因素，结果表明整体情绪调节障碍与更严重的阳性和抑郁症状有关。进一步的调节分析显示，整体情绪调节障碍和认知洞察力（自我确信）之间存在显著的交互作用，即对于自我确信度高的患者，更大的整体情绪调节障碍与抑郁症状的严重程度增加有关。整体情绪调节障碍和认知洞察力之间对阳性症状没有交互作用。
我们的研究结果初步支持了早期 SSD 中情绪调节障碍与精神病理学之间的关联。需要进一步的研究来检查情绪调节障碍在更广泛的精神障碍的病因和治疗中的跨诊断作用。
