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接触个人最痛苦的侵入性想法后多重调节的预测因素及其有效性。

Predictors of polyregulation and its effectiveness following exposure to One's most personally distressing intrusive thought.

作者信息

Daniel Katharine E, Wilhelm Sabine, Jacoby Ryan J

机构信息

Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, USA; Harvard Medical School, Cambridge, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, USA.

Harvard Medical School, Cambridge, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, USA.

出版信息

J Behav Ther Exp Psychiatry. 2025 Mar;86:102001. doi: 10.1016/j.jbtep.2024.102001. Epub 2024 Dec 1.

Abstract

BACKGROUND AND OBJECTIVES

Using multiple emotion regulation strategies in response to a single stressor-known as polyregulation-is an understudied but common event. The role of polyregulation in psychological disorders characterized by repetitive negative thinking (RNT) is unexplored, despite well-documented difficulties in emotion regulation and strong urges to avoid and escape one's intrusive thoughts in RNT.

METHODS

Participants (N = 60) either had clinical levels of RNT (n = 15 with worries, n = 14 with ruminations, n = 16 with obsessions) or non-clinical levels of RNT (n = 15) and were exposed to their most personally distressing intrusive thought during an in-lab task. Proportional odds logistic regressions were used to test if RNT group and situation-level factors predicted greater polyregulation following the thought exposure. Multilevel regressions were used to test the short-term effectiveness of polyregulation on subjective distress and psychophysiological responding (heart rate, skin conductance).

RESULTS

Ninety percent of participants reported using two or more strategies following intrusive thought exposure. Extent of polyregulation was not significantly predicted by RNT group, most situation-level factors, or short-term regulatory effectiveness. Endorsing a greater need to control one's intrusive thought did, however, predict use of more strategies.

LIMITATIONS

This is a secondary analysis in a small sample.

CONCLUSION

Given treatments for psychological disorders characterized by RNT attempt to disrupt the connection between a person's urge to control their distressing thoughts and efforts to escape or avoid those thoughts, continued investigation into the role of polyregulation in intrusive thinking may guide clinical intervention.

摘要

背景与目的

针对单一应激源使用多种情绪调节策略(即多元调节)是一个研究不足但常见的现象。尽管有充分证据表明在以反复消极思维(RNT)为特征的心理障碍中存在情绪调节困难,且患者强烈渴望避免和逃避侵入性思维,但多元调节在这类心理障碍中的作用仍未得到探索。

方法

参与者(N = 60)中,一部分具有临床水平的RNT(15名有担忧症状、14名有反刍思维、16名有强迫观念),另一部分具有非临床水平的RNT(15名),他们在实验室任务中接触到各自最困扰自己的侵入性思维。使用比例优势逻辑回归来检验RNT组和情境水平因素是否能预测思维暴露后更高程度的多元调节。使用多层回归来检验多元调节对主观痛苦和心理生理反应(心率、皮肤电导率)的短期有效性。

结果

90%的参与者报告在侵入性思维暴露后使用了两种或更多策略。RNT组、大多数情境水平因素或短期调节有效性均未显著预测多元调节的程度。然而,认可更强烈的控制侵入性思维的需求确实能预测更多策略的使用。

局限性

这是对小样本的二次分析。

结论

鉴于针对以RNT为特征的心理障碍的治疗试图打破个体控制痛苦思维的冲动与逃避或回避这些思维的努力之间的联系,继续研究多元调节在侵入性思维中的作用可能会为临床干预提供指导。

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