Emotion Regulation and Mentalization in Patients With Depression and Anxiety

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-05-09 DOI:10.1002/cpp.2995

Anne Bryde Christensen, Stig Poulsen, Trine Munk Højberg, Stine Bech Jessen, Nina Reinholt, Morten Hvenegaard, Anita Eskildsen, Mikkel Arendt, Sidse Arnfred

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Abstract

Objective

Theoretical conceptualizations of emotion and affect regulation have a considerable common ground. However, mentalization theory considers the ability to regulate affects as being contingent on the ability to mentalize. The aim of the present study is to examine the association between emotion regulation and mentalization, operationalized as reflective functioning, in a sample of patients with depression and/or anxiety.

Methods

The study used data from the TRAns-diagnostic Cognitive behavioural Therapy versus standard cognitive behavioural therapy (TRACT-RCT) trial. Patients with depression and/or anxiety (N = 291; 64.4% female; M_age = 32.2; SD = 11.0) completed the Emotion Regulation Strategies Questionnaire (ERSQ) and the Reflective Functioning Questionnaire (RFQ-6). Correlation and regression analyses were performed to determine associations of the measures of ERSQ and RFQ-6 in relation to the outcome variables, global well-being (World Health Organization Well-being Index; WHO-5) and social functioning (Work and Social Adjustment Scale; WSAS).

Results

Overall, the patients had a reduced level of emotion regulation (M_{ERSQ_Total} = 1.77; SD = 0.59). However, only mildly impaired reflective functioning was found (M_RFQ-6 = 3.57; SD = 1.26). ERSQ correlated significantly with RFQ-6 (r = −0.31), that is, more frequent use of emotion regulation strategies was associated with less hypomentalization. ERSQ was a stronger predictor of well-being and social function than RFQ-6.

Conclusion

In patients with anxiety and/or depression, hypomentalization as measured by the RFQ-6 is not a major problem, but emotion regulation is. It seems that these two, theoretically related constructs, do not necessarily co-occur. Alternatively, the RFQ-6 scale might not capture the mentalization construct in a valid way. Emotion regulation strategies are highly related to symptomatology; therefore, they are likely to be an important target for psychotherapy.

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抑郁症和焦虑症患者的情绪调节和心智化。

目的：情绪和情感调节的理论概念有相当多的共同点。然而，心智化理论认为情绪调节能力取决于心智化能力。本研究旨在对抑郁症和/或焦虑症患者样本中的情绪调节与心智化（操作化为反思功能）之间的关联进行研究：本研究使用了TRAns诊断认知行为疗法与标准认知行为疗法（TRACT-RCT）试验的数据。抑郁症和/或焦虑症患者（N = 291；64.4%为女性；Mage = 32.2；SD = 11.0）填写了情绪调节策略问卷（ERSQ）和反思功能问卷（RFQ-6）。研究人员对ERSQ和RFQ-6的测量结果进行了相关性和回归分析，以确定它们与结果变量--全球幸福感（世界卫生组织幸福指数；WHO-5）和社会功能（工作和社会适应量表；WSAS）--的关系：结果：总体而言，患者的情绪调节能力下降（MERSQ_Total = 1.77; SD = 0.59）。然而，患者的反思功能只有轻度受损（MRFQ-6 = 3.57; SD = 1.26）。ERSQ与RFQ-6有明显的相关性（r = -0.31），也就是说，更频繁地使用情绪调节策略与较少的低意念化有关。与 RFQ-6 相比，ERSQ 对幸福感和社会功能的预测作用更强：结论：在焦虑症和/或抑郁症患者中，RFQ-6 测定的意念减退不是主要问题，但情绪调节却是。看来，这两个理论上相关的概念并不一定同时存在。或者说，RFQ-6 量表可能并没有以有效的方式捕捉到心智化结构。情绪调节策略与症状学高度相关，因此很可能成为心理治疗的重要目标。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.