Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany.
Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany.
Schizophr Res. 2021 Feb;228:206-217. doi: 10.1016/j.schres.2020.11.054. Epub 2021 Jan 14.
Patients with psychotic disorders report to apply more maladaptive and less adaptive emotion-regulation (ER) strategies compared to healthy controls. However, few studies have used experimental designs to investigate the success in ER and the results of those at hand are equivocal.
This study investigated whether patients with delusions show problems in downregulating negative affect via cognitive ER-strategies.
Patients with schizophrenia spectrum disorders and acute delusions (n = 78) and healthy controls (n = 41) took part in an ER-experiment, in which they were instructed to downregulate anxiety and sadness via three ER-strategies (reappraisal, distraction, acceptance) or not to regulate their emotions (control-condition). ER-success was measured as the change in subjective emotion-intensity and physiological indicators (skin conductance and heart rate) from before to after regulation and was analyzed with mixed-repeated-measures ANOVAs.
We found a significant effect of the ER-strategy in the sense that the subjective emotion-intensity was significantly lower after applying the reappraisal- and distraction-strategies than after the just view-condition (p's < .001). This effect was not found for the acceptance strategy (p = .060). There was no ER-strategy ∗ time ∗ group interaction-effect F(4.918, 575.416) = 0.778, p = .564, ƞ = 0.007. In all conditions, skin conductance decreased from pre- to post regulation (p < .001).
Our results indicate that patients with acute delusions can successfully apply cognitive ER-strategies. Before pursuing the relevant clinical implications of this finding, further research is needed to explore the role that the type of instruction has on ER-success and the extent to which the findings can be generalized to real life settings.
与健康对照组相比，患有精神病性障碍的患者报告使用更多的适应不良和较少的适应性情绪调节（ER）策略。然而，很少有研究使用实验设计来调查 ER 的成功，而且手头的结果是模棱两可的。
本研究旨在探讨妄想患者是否在通过认知 ER 策略下调消极情绪方面存在问题。
患有精神分裂症谱系障碍和急性妄想的患者（n=78）和健康对照组（n=41）参加了 ER 实验，他们被指示通过三种 ER 策略（重新评估、分心、接受）或不调节情绪（控制条件）来下调焦虑和悲伤。ER 成功的衡量标准是从调节前到调节后的主观情绪强度和生理指标（皮肤电导和心率）的变化，并通过混合重复测量方差分析进行分析。
我们发现 ER 策略的效果显著，即与仅观察条件相比，应用再评价和分心策略后主观情绪强度显著降低（p's<.001）。接受策略则没有这种效果（p=.060）。没有 ER 策略×时间×组交互效应 F(4.918, 575.416)=0.778，p=.564，η=0.007。在所有条件下，皮肤电导从调节前到调节后均降低（p<.001）。
我们的结果表明，急性妄想患者可以成功地应用认知 ER 策略。在探讨这一发现的相关临床意义之前，需要进一步研究来探索指令类型对 ER 成功的作用，以及研究结果在多大程度上可以推广到现实生活环境。
