Emotion Regulation Strategies Across Psychopathology

Aldao, Nolen-Hoeksema, and Schweize (2010) define emotional regulation as the process, unconscious or conscious, through which individuals modulate their emotions. Models of psychopathology and treatment have incorporated emotional regulation (ER) into their paradigms. Treatment interventions concentrate on aspects of mindfulness in emotional regulation (e.g., reappraisal, acceptance, and problem solving), whereas models of psychopathology are more apt to concentrate on automatic processes such as the paradoxical effects of trying to suppress unwanted thoughts, as well as rumination, and avoidance. Alado et al. was interested in the relationship of the aforementioned six strategies to the specific psychopathologies of depression, anxiety, substance abuse eating disorders, in terms of each one's sensitivity and specificity.

A meta-analysis of studies using self-report measures of ER dispositional tendencies in participants between the years 1985-2008 was performed. Inclusion criteria for the studies included at least one cross sectional relationship between an ER and pathology; ER was assessed via self-report questionnaires; published in peer reviewed journals; had English speaking participants; participants with no other medical conditions, only selected for their clinical diagnosis, did not have samples of recovered persons; had a control group; did not only provide data on GAD or PTSD; and did not include longitudinal portions of studies. The researchers ended up with 114 studies for their analysis.

Findings indicated that rumination, avoidance, and suppression had large to medium effect sizes overall and demonstrated a positive relationship to pathology. Problem solving generally produced medium effect sizes and reappraisal and acceptance had small to medium effect sizes, with the relationship for all three of these strategies being inversely related to the specific pathology. Rumination had the largest effect size of the three maladaptive ERs with each of the specific pathologies, whereas problem solving had the largest effect size by pathology of the adaptive ERs. Interestingly reappraisal generally had small effect sizes. Two potential moderator variables were also studied. Using sample type as a moderator variable indicated that clinical samples had larger effect sizes for maladaptive ERs, especially for rumination and suppression than non-clinical samples. Sample type was a marginally significant moderator of avoidance and problem solving in clinical samples. Age (adults compared to adolescents and children) the other moderator variable studied, did not account for a significant amount of variability in an overall maladaptive ER strategy.

With respect to specific pathologies, age was a significant moderator for problem solving and suppression in depression. Sample type was a significant moderator for avoidance and depression; rumination and anxiety; and rumination and suppression in eating disorders with clinical samples demonstrating stronger effect sizes. The researchers also provide a brief qualitative discussion of the longitudinal portions of the studies.