Publikationsserver der Universitätsbibliothek Marburg

Titel: Emotion regulation and delusions
Autor: Westermann, Stefan
Weitere Beteiligte: Lincoln, Tania M. (Prof. Dr.)
Veröffentlicht: 2011
URN: urn:nbn:de:hebis:04-z2011-06581
DDC: Psychologie
Titel(trans.): Emotion regulation and delusions
Publikationsdatum: 2011-12-19


Regulation, Sozialer Stress, Gefühlsausdruck, Neubewertung, Emotion regulation, Gefühlsausdrucksunterdrückung, Verfolgungswahn, Gefühl, Bewältigung, Wahn, Stressbewältigung, Expressive suppression, Emotionsregulation, Paranoide Schizophrenie, Reappraisal

Mounting evidence suggests a causal role of negative emotion in delusions. Particularly, fluctuations in anxiety and self-esteem seem to trigger delusional ideation. Consequently, the ability to down-regulate negative emotions is likely to help to prevent or reduce delusional ideation. Despite the clear theoretical relevance, emotion regulation strategies such as reappraisal (i.e. changing the perspective on a situation in order to modify emotional responses) or expressive suppression (i.e. inhibiting facial expressions of emotions; „poker face‟) have not been researched in delusions so far. The present dissertation project fills this gap by investigating emotion regulation in paranoia- and delusion-prone samples. Study 1 revealed bivariate and multivariate associations between emotion regulation difficulties and paranoia-proneness. Study 2 experimentally demonstrated that delusion-prone individuals had difficulties in successfully applying the emotion regulation strategy reappraisal while watching anxiety-eliciting pictures, but not in applying expressive suppression. Furthermore, unsuccessful emotion regulation was correlated with state delusional ideation exclusively during reappraisal. The potentially maladaptive nature of reappraisal in delusion was further corroborated in study 3. Under social stress, paranoia-prone individuals who habitually use reappraisal experienced an increase in state paranoia. Taken together, the present dissertation project provides subclinical evidence for specific difficulties in applying the generally helpful and adaptive emotion regulation strategy reappraisal. A working model of emotion regulation in delusions that incorporates a vulnerability-stress-approach, cognitive models of positive symptoms and the process model of emotion regulation was proposed in order to stimulate further theory-driven research in populations with clinically relevant delusions. A preliminary clinical implication might be that reappraisal in social high-stress situations should be applied with caution in delusion-proneness.

Eine zunehmende Anzahl von Studien legt einen kausalen Einfluss von negativen Emotionen bei Wahn nahe. Insbesondere Schwankungen von Angst und Selbstwertgefühl scheinen Wahnideen anstoßen zu können. Die Fähigkeit, negative Emotionen aktiv zu verringern bzw. herunter zu regulieren, könnte folglich hilfreich beim Abschwächen oder Verhindern von Wahnideen sein. Dennoch wurden Emotionsregulations-Strategien wie Neubewertung (d.h., die Perspektive auf eine Situation ändern, um die emotionale Reaktion zu beeinflussen) oder Unterdrückung des Gefühlsausdrucks bei Wahn bisher nicht erforscht. Das vorliegende Dissertationsprojekt schließt diese Lücke, indem Emotionsregulation bei Wahn- und Paranoia-Neigung untersucht wird. Studie 1 zeigte bivariate und multivariate Zusammenhänge zwischen Paranoia-Neigung und Schwierigkeiten bei der Emotionsregulation auf. Studie 2 demonstrierte, dass Wahnneigung mit Schwierigkeiten bei der Anwendung von Neubewertung in bedrohlichen Situationen einhergeht. Bei der Unterdrückung des Gefühlsausdrucks war das nicht der Fall. Zudem standen Emotionsregulations-Schwierigkeiten ausschließlich beim Neubewerten mit paranoiden Gedanken in Zusammenhang. Die möglicherweise maladaptive Natur von Neubewertung bei Wahn wurde in Studie 3 bestätigt. Bei sozialem Stress konnte ein Anstieg von paranoiden Gedanken nur bei Personen nachgewiesen werden, die Neubewertung als Emotionsregulationsstrategie häufig anwenden und zu Paranoia neigen. Auf Grundlage von sub-klinischen Stichproben weist das Dissertationsprojekt insgesamt auf spezifische Schwierigkeiten bei der Anwendung der üblicherweise hilfreichen und adaptiven Emotionsregulations-Strategie Neubewertung bei Wahn hin. Ein Arbeitsmodell der Emotionsregulation bei Wahn, welches einen Vulnerabilität-Stress-Ansatz, kognitive Modelle von Positivsymptomen und das Prozessmodell der Emotionsregulation integriert, wird postuliert um weitere Theorie-geleitete Forschung in Stichproben mit klinisch relevantem Wahn anzustoßen. Als vorläufige praktische Implikation kann gelten, dass Neubewertung in sozial belastenden Situationen bei Wahnneigung nur mit Vorsicht angewendet werden sollte.

Bibliographie / References

  1. Bora, E., Yucel, M., & Pantelis, C. (2009). Theory of mind impairment in schizophrenia: meta-analysis. Schizophrenia Research, 109(1-3), 1-9.
  2. Bauer, D. J., & Curran, P. J. (2005). Probing interactions in fixed and multilevel regression: Inferential and graphical techniques. Multivariate Behavioral Research, 40(3), 373-400.
  3. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362.
  4. Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106(1), 95-103.
  5. Livingstone, K., Harper, S., & Gillanders, D. (2009). An exploration of emotion regulation in psychosis. Clinical Psychology & Psychotherapy, 16(5), 418-430. doi: 10.1002/cpp.635
  6. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217-223. doi: 10.1016/j.cpr.2009.11.004
  7. van der Meer, L., Wout, M. V. t., & Aleman, A. (2009). Emotion regulation strategies in patients with schizophrenia. Psychiatry Research, 170(2-3), 108-113.
  8. Gilbert, P., Boxall, M., Cheung, M., & Irons, C. (2005). The relation of paranoid ideation and social anxiety in a mixed clinical population. Clinical Psychology & Psychotherapy, 12(2), 124-133.
  9. Martin, J. A., & Penn, D. L. (2001). Social cognition and subclinical paranoid ideation. British Journal of Clinical Psychology, 40(3), 261-265.
  10. Ritter, P., Lorig, K., Laurent, D., & Matthews, K. (2004). Internet versus mailed questionnaires: a randomized comparison. Journal of Medical Internet Research, 6(3).
  11. Taylor, K. N., Graves, A., & Stopa, L. (2009). Strategic cognition in paranoia: The use of thought control strategies in a non-clinical population. Behavioural and Cognitive Psychotherapy, 37(1), 25-38.
  12. Emotion regulation in schizophrenia: affective, social, and clinical correlates of suppression and reappraisal. Journal of Abnormal Psychology, 117(2), 473-478.
  13. Perry, Y., Henry, J. D., Sethi, N., & Grisham, J. R. (in press). The pain persists: How social exclusion affects individuals with schizophrenia. The British Journal of Clinical Psychology.
  14. Startup, H., Freeman, D., & Garety, P. A. (2007). Persecutory delusions and catastrophic worry in psychosis: Developing the understanding of delusion distress and persistence. Behaviour Research and Therapy, 45(3), 523-537.
  15. Meltzer, H. (2004). Prevalence and correlates of self-reported psychotic symptoms in the British population. The British Journal of Psychiatry, 185(4), 298-305.
  16. Freeman, D., Garety, P. A., Kuipers, E., Fowler, D., & Bebbington, P. E. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41(4), 331-347.
  17. Garety, P. A., Kuipers, E., Fowler, D., Freeman, D., & Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31(2), 189-195.
  18. Jones, S. R., Fernyhough, C., de-Wit, L., & Meins, E. (2008). A message in the medium? Assessing the reliability of psychopathology e-questionnaires. Personality and Individual Differences, 44(2), 349-359.
  19. Lincoln, T. M., Ziegler, M., Lüllmann, E., Müller, M. J., & Rief, W. (2009). Can delusions be self-assessed? Concordance between self-and observer-rated delusions in schizophrenia. Psychiatry Research, 178(2), 249-254.
  20. Chinman, M., Young, A. S., Schell, T., Hassell, J., & Mintz, J. (2004). Computer-assisted self-assessment in persons with severe mental illness. Journal of Clinical Psychiatry, 65(10), 1343-1351.
  21. Stemmler, G., Heldmann, M., Pauls, C. A., & Scherer, T. (2001). Constraints for emotion specificity in fear and anger: The context counts. Psychophysiology, 38(2), 275- 291.
  22. Williams, K. D., Cheung, C. K. T., & Choi, W. (2000). Cyberostracism: Effects of being ignored over the Internet. Journal of Personality and Social Psychology, 79(5), 748-762.
  23. Myin-Germeys, I., van Os, J., Schwartz, J. E., Stone, A. A., & Delespaul, P. A. (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry, 58(12), 1137-1144.
  24. Henry, J. D., Green, M. J., de Lucia, A., Restuccia, C., McDonald, S., & O'Donnell, M. (2007). Emotion dysregulation in schizophrenia: Reduced amplification of DISSERTATION STEFAN WESTERMANN 104 emotional expression is associated with emotional blunting. Schizophrenia Research, 95(1-3), 197-204.
  25. Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39(03), 281-291.
  26. Gross, J. J., & Munoz, R. F. (1995). Emotion regulation and mental health. Clinical Psychology: Science and Practice, 2(2), 151-164.
  27. Westermann, S., Rief, W., & Lincoln, T. M. (in preperation). Emotion regulation can backfire in delusions -Sub-clinical evidence for specific difficulties in the reappraisal of threat.
  28. Westermann, S., & Lincoln, T. M. (in press). Emotion regulation difficulties are relevant to persecutory ideation. Psychology and Psychotherapy: Theory, Research and Practice.
  29. Gross, J. J. (2001). Emotion regulation in adulthood: Timing is everything. Current Directions in Psychological Science, 10(6), 214-219.
  30. Abler, B., & Kessler, H. (2009). Emotion Regulation Questionnaire–Eine References Abler, B., & Kessler, H. (2009). Emotion Regulation Questionnaire – Eine deutschsprachige Fassung des ERQ von Gross und John [Emotion Regulation Questionnaire – A German version of the ERQ by Gross and John]. Diagnostica, 55(3), 144-152.
  31. Thewissen, V., Bentall, R. P., Oorschot, M., Campo, J. A., van Lierop, T., van Os, J., & Myin-Germeys, I. (2011). Emotions, self-esteem, and paranoid episodes: An experience sampling study. British Journal of Clinical Psychology, 50(2), 178- 195.
  32. Birnbaum, M. H. (2004). Human research and data collection via the Internet. Annual Review of Psychology, 55, 803-832.
  33. Lincoln, T. M., Peter, N., Schäfer, M., & Moritz, S. (2009). Impact of stress on paranoia: an experimental investigation of moderators and mediators. Psychological Medicine, 39(7), 1129-1139. APPENDIX C 105
  34. Lincoln, T. M., Mehl, S., Ziegler, M., Kesting, M. L., Exner, C., & Rief, W. (2010). Is Fear of Others Linked to an Uncertain Sense of Self? The Relevance of Self- Worth, Interpersonal Self-Concepts, and Dysfunctional Beliefs to Paranoia. Behavior Therapy, 41(2), 187-197.
  35. Lincoln, T. M., Reumann, R., & Moritz, S. (2010). Is there a functional way of responding to paranoid intrusions? Development of the Reactions to Paranoid Thoughts Scale. Cognitive Neuropsychiatry, 15(4), 377-396.
  36. Gerber, J., & Wheeler, L. (2009). On Being Rejected: A Meta-Analysis of Experimental Research on Rejection. Perspectives on Psychological Science, 4(5), 468-488.
  37. Combs, D. R., Michael, C. O., & Penn, D. L. (2006). Paranoia and emotion perception across the continuum. British Journal of Clinical Psychology, 45(1), 19-31.
  38. Gore, K. L., Carter, M. M., & Parker, S. (2002). Predicting anxious response to a social challenge: the predictive utility of the social interaction anxiety scale and the social phobia scale in a college population. Behaviour Research and Therapy, 40(6), 689-700.
  39. Kapur, S. (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry, 160(1), 13-23.
  40. Angermeyer, M. C., & Dietrich, S. (2006). Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatrica Scandinavica, 113(3), 163-179.
  41. Beck, A. T., Rector, N. A., Stolar, N., & Grant, P. (2008). Schizophrenia: Cognitive theory, research, and therapy: The Guilford Press.
  42. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
  43. Myin-Germeys, I., & van Os, J. (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review, 27(4), 409-424.
  44. Johns, L. C., & van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21(8), 1125-1141.
  45. Lincoln, T. M., Lange, J., Burau, J., Exner, C., & Moritz, S. (2010). The effect of state- anxiety on paranoid ideation and Jumping to Conclusions. An experimental investigation. Schizophrenia Bulletin, 36(6), 1140-1148.
  46. Badcock, J. C., Paulik, G., & Maybery, M. T. (2011). The role of emotion regulation in auditory hallucinations. Psychiatry Research, 185(3), 303-308.
  47. Wells, A., & Davies, M. I. (1994). The Thought Control Questionnaire: A measure of individual differences in the control of unwanted thoughts. Behaviour Research and Therapy, 32(8), 871-878.
  48. Kesting, M.-L., Rief, W., Westermann, S., & Lincoln, T. M. (under review). The impact of social stress on self-esteem and paranoia: An experimental study. Psychological Medicine.
  49. Moritz, S., Peters, M. J., Larøi, F., & Lincoln, T. M. (2010). Metacognitive beliefs in obsessive-compulsive patients: A comparison with healthy and schizophrenia participants. Cognitive Neuropsychiatry, 15(6), 531-548.
  50. Moritz, S., Burnette, P., Sperber, S., Kother, U., Hagemann-Goebel, M., Hartmann, M., & Lincoln, T. M. (in press). Elucidating the black box from stress to paranoia. Schizophrenia Bulletin.
  51. Koole, S. (2009). The psychology of emotion regulation: An integrative review. Cognition & Emotion, 23(1), 4-41.
  52. Rüsch, N., Corrigan, P. W., Todd, A. R., & Bodenhausen, G. V. (2010). Implicit self- stigma in people with mental illness. The Journal of Nervous and Mental Disease, 198(2), 150-153.

* Das Dokument ist im Internet frei zugänglich - Hinweise zu den Nutzungsrechten