Leslie Essence, Weittenhiller Lauren P, Sloan Ali F, Sheffield Julia M
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN 37212, USA.
Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. Bldg. 206, Room 15, Los Angeles, CA 90073, USA.
Schizophr Bull Open. 2025 May 23;6(1):sgaf010. doi: 10.1093/schizbullopen/sgaf010. eCollection 2025 Jan.
The distressing nature of delusional beliefs is considered key to their persistence. One potential mechanism underlying delusional distress is global emotion dysregulation. Global emotion dysregulation is associated with general psychotic symptom severity, but its specific relationship to delusional distress has yet to be closely examined.
People with ( = 100) and without ( = 52) schizophrenia-spectrum disorders completed measures of delusional ideation (Peters Delusion Inventory; PDI-21) and global emotion dysregulation (Difficulties in Emotion Regulation Scale; DERS-16). Participants with schizophrenia also completed a measure of delusion severity (Psychotic Symptom Rating Scales; PSYRATS). Relationships between delusion severity and global emotion dysregulation were assessed with linear regression, controlling for age, sex, and group. Associations between delusional distress and aspects of emotion dysregulation were determined using stepwise linear regression.
Global emotion dysregulation was significantly elevated in those with schizophrenia compared to non-clinical controls, across all subscales ( < .001). Emotion dysregulation was significantly associated with delusional distress on both the PDI-21 ( < .001) and PSYRATS ( < .001). Stepwise regressions revealed a specific association between limited access to emotion regulation strategies and delusional distress on both scales ('s < .001). Delusional distress remained associated with emotion dysregulation when controlling for delusional preoccupation, and emotion dysregulation was not significantly associated with delusional conviction on either scale.
Emotion dysregulation, particularly the sense that there is little one can do to regulate themselves when upset, relates to delusional distress. Interventions that increase access to more emotion regulation strategies may help decrease distress associated with delusional thinking.
妄想信念令人苦恼的本质被认为是其持续存在的关键。妄想性苦恼背后的一个潜在机制是整体情绪调节障碍。整体情绪调节障碍与一般精神病性症状的严重程度相关，但其与妄想性苦恼的具体关系尚未得到仔细研究。
100名患有精神分裂症谱系障碍的人和52名未患精神分裂症谱系障碍的人完成了妄想观念测量（彼得斯妄想量表；PDI - 21）和整体情绪调节障碍测量（情绪调节困难量表；DERS - 16）。患有精神分裂症的参与者还完成了妄想严重程度测量（精神病性症状评定量表；PSYRATS）。通过线性回归评估妄想严重程度与整体情绪调节障碍之间的关系，并对年龄、性别和组别进行控制。使用逐步线性回归确定妄想性苦恼与情绪调节障碍各方面之间的关联。
与非临床对照相比，精神分裂症患者在所有分量表上的整体情绪调节障碍均显著升高（P <.001）。情绪调节障碍在PDI - 21（P <.001）和PSYRATS（P <.001）上均与妄想性苦恼显著相关。逐步回归显示，在两个量表上，情绪调节策略的获取受限与妄想性苦恼之间存在特定关联（P's <.001）。在控制妄想专注后，妄想性苦恼仍与情绪调节障碍相关，且情绪调节障碍在两个量表上与妄想坚信度均无显著关联。
情绪调节障碍，尤其是在心烦意乱时感觉自己几乎无法调节自身情绪，与妄想性苦恼相关。增加获取更多情绪调节策略的干预措施可能有助于减轻与妄想思维相关的苦恼。
