Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany.
Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Marburg, 35039 Marburg, Germany; Faculty of Health and Social Work, Frankfurt University of Applied Sciences, 60318 Frankfurt am Main, Germany.
Schizophr Res. 2020 Feb;216:161-167. doi: 10.1016/j.schres.2019.12.007. Epub 2019 Dec 28.
Numerous cross-sectional studies found psychosis to be associated with less awareness of emotions, a decreased use of adaptive (e.g. reappraisal) and an increased use of maladaptive emotion regulation (ER) strategies (e.g. suppression). In this study, we tested whether state levels of emotion awareness and momentary use of specific ER strategies moderate the link between negative affect at one timepoint (t-1) and paranoia at the next timepoint (t) in a six-day experience sampling study. Individuals with psychotic disorders (n = 71) reported on the presence of paranoia, negative affect, emotion awareness and the use of six ER strategies (reappraisal, acceptance, social sharing, distraction, suppression and rumination) ten times per day. Multilevel regression analysis revealed that higher awareness at t-1 reduced the association of negative affect at t-1 and paranoia at t, whereas rumination had an opposite, amplifying moderation effect. Our results provide novel insight into the conditions under which negative affect translates into delusional beliefs. The finding that emotion awareness and rumination have a relevant role corresponds with current psychological conceptualisations of psychosis and with the attempt to treat delusions by focusing on reducing ruminative thoughts. To investigate the causal effect, treatment trials with a focus on enhancing these components of emotion regulation are needed.
许多横断面研究发现，精神病与情绪意识降低、适应性情绪调节（如重新评价）减少和不适应情绪调节（如抑制）增加有关。在这项研究中，我们测试了在六天的经验采样研究中，个体在某一时刻（t-1）的消极情绪状态水平和特定情绪调节策略的即时使用是否会调节下一个时刻（t）的偏执状态。有精神病的个体（n=71）每天报告 10 次偏执、消极情绪、情绪意识和六种情绪调节策略（重新评价、接受、社会分享、分散注意力、抑制和沉思）的出现情况。多层次回归分析显示，t-1 时的情绪意识越高，t-1 时的消极情绪与 t 时的偏执之间的关联就越低，而沉思则具有相反的、放大的调节作用。我们的结果为消极情绪转化为妄想信念的条件提供了新的见解。情绪意识和沉思起相关作用的发现与精神病的当前心理概念以及通过关注减少沉思性思维来治疗妄想的尝试相一致。为了研究因果效应，需要进行以增强这些情绪调节成分为重点的治疗试验。
