Adaptive Emotionsregulation im Kontext der Major Depression

Deficits in adaptive emotion regulation (ER) and associated increased negative affects have been suggested to be important risk factors for the development and maintenance of depressive episodes. Facilitating adaptive ER skills should help individuals reduce negative affects if necessary and may thus prevent the development, maintenance, and recurrence of Major Depressive Disorder. This dissertation aimed to identify ways to foster adaptive ER in currently and formerly depressed individuals. An emphasis was put on the construct of self-compassion. In a cross-sectional study, we tested the hypothesis of increased self-criticism and decreased selfcompassion and self-reassurance as stable vulnerability factors that persist over acute episodes of Major Depressive Disorder (Study 1). As expected, both currently and formerly depressed individuals showed higher habitual self-criticism and lower self-compassion and self-reassurance than healthy and never depressed controls. In an experimental study, we tested the effectiveness of self-compassion to decrease depressed mood in currently, formerly and healthy, never depressed individuals (Study 2). Decreases in depressed mood were greater in the self-compassion condition compared to the waiting and acceptance conditions. In recovered depressed and healthy, never depressed participants, self-compassion was also more effective than reappraisal. In a longitudinal study, we investigated prospective effects of various potentially relevant components of adaptive ER (including Awareness, Sensations, Clarity, Understanding, Modification, Acceptance, Tolerance, Self-Compassion and Readiness to Confront) on subsequent reduction in state negative affect over the course of depression treatment (Study 3). Using latent change score modeling, overall adaptive ER predicted subsequent reduction of state negative affect. Exploratory analyses indicated that self-compassion and the following components of adaptive ER were significant predictors of subsequent reduction of negative affect: the understanding of what has caused negative affects, the self-perceived ability to regulate negative affects, emotional acceptance and tolerance as well as readiness to confront distressing situations when necessary to attain personally relevant goals. A randomized-controlled trial should work to clarify whether systematically enhancing selfcompassion and further potentially relevant components of adaptive ER with specific interventions could help improving mental health, including decreasing depressive symptoms, in individuals with Major Depressive Disorder (Study 4). Additionally, future studies on formerly depressed and healthy, never depressed individuals will have to examine whether increasing adaptive ER skills with specific interventions can help prevent the onset and recurrence of Major Depressive Disorder.