Psychology Major, Department of Sociology, Faculty of Sociology, Kansai University, Japan.
Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Japan.
J Affect Disord. 2020 Dec 1;277:1-4. doi: 10.1016/j.jad.2020.07.132. Epub 2020 Jul 31.
Expressive suppression (ES) of emotion is considered a moderator that reduces the efficacy of cognitive behavioural therapy (CBT); however, whether and how ES moderates the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders (UP), a version of CBT targeting aversive/avoidant responses to emotions, including ES, remain unclear. We investigated whether and how emotion regulation, especially ES, moderates UP efficacy for anxiety symptoms in patients with anxiety and depressive disorders.
We conducted a secondary analysis of data from a previous trial. Seventeen patients with anxiety and/or depressive disorders were included. Changes (slope estimates) in the Structured Interview Guide for the Hamilton Anxiety Rating Scale from pre-treatment to post-treatment were measured using a latent growth curve model with empirical Bayesian estimation. Pre-treatment ES, cognitive reappraisal, and depressive symptoms were used as slope factor predictors.
Only pre-treatment ES significantly predicted the slope in the latent growth curve model (estimate value = 0.45; standard deviation = 0.21; 95% credible interval = 0.03-0.87, one-tailed p-value = 0.004), and an inverse correlation between pre-treatment ES levels and improvement magnitude of anxiety symptoms was demonstrated.
Because the data were obtained from a single-arm trial, this study did not have controls, and most participants received pharmacotherapy in addition to UP. Therefore, generalisability of the present findings might be compromised.
Low ES before UP was an effective predictor of greater improvement in anxiety symptoms after UP. The findings suggest that interventions intended to improve ES may improve UP efficacy.
情绪表达抑制（ES）被认为是一种调节因素，可降低认知行为疗法（CBT）的疗效；然而，ES 是否以及如何调节针对情绪的厌恶/回避反应的跨诊断情绪障碍统一治疗方案（UP）的疗效，包括 ES，尚不清楚。我们研究了情绪调节，特别是 ES，是否以及如何调节 UP 对焦虑和抑郁障碍患者的焦虑症状的疗效。
我们对先前试验的数据进行了二次分析。纳入了 17 名焦虑和/或抑郁障碍患者。使用具有经验贝叶斯估计的潜在增长曲线模型来衡量从治疗前到治疗后的汉密尔顿焦虑评定量表结构化访谈指南的变化（斜率估计）。治疗前 ES、认知重评和抑郁症状被用作斜率因子预测因子。
仅治疗前 ES 显著预测了潜在增长曲线模型中的斜率（估计值=0.45；标准差=0.21；95%可信区间=0.03-0.87，单侧 p 值=0.004），并且治疗前 ES 水平与焦虑症状改善幅度之间呈负相关。
由于数据来自单臂试验，因此本研究没有对照组，大多数参与者在接受 UP 治疗的同时还接受了药物治疗。因此，本研究结果的普遍性可能受到影响。
在接受 UP 治疗前 ES 水平较低是 UP 治疗后焦虑症状改善程度更大的有效预测指标。研究结果表明，旨在提高 ES 的干预措施可能会提高 UP 的疗效。
