Emotion Regulation and Mentalization in Patients With Depression and Anxiety
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Emotion Regulation and Mentalization in Patients With Depression and Anxiety. / Christensen, Anne Bryde; Poulsen, Stig; Højberg, Trine Munk; Jessen, Stine Bech; Reinholt, Nina; Hvenegaard, Morten; Eskildsen, Anita; Arendt, Mikkel; Arnfred, Sidse.
In: Clinical Psychology & Psychotherapy, Vol. 31, No. 3, e2995, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Emotion Regulation and Mentalization in Patients With Depression and Anxiety
AU - Christensen, Anne Bryde
AU - Poulsen, Stig
AU - Højberg, Trine Munk
AU - Jessen, Stine Bech
AU - Reinholt, Nina
AU - Hvenegaard, Morten
AU - Eskildsen, Anita
AU - Arendt, Mikkel
AU - Arnfred, Sidse
N1 - © 2024 John Wiley & Sons Ltd.
PY - 2024
Y1 - 2024
N2 - 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; Mage = 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 (MERSQ_Total = 1.77; SD = 0.59). However, only mildly impaired reflective functioning was found (MRFQ-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.
AB - 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; Mage = 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 (MERSQ_Total = 1.77; SD = 0.59). However, only mildly impaired reflective functioning was found (MRFQ-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.
KW - Humans
KW - Female
KW - Emotional Regulation
KW - Male
KW - Adult
KW - Mentalization
KW - Surveys and Questionnaires
KW - Cognitive Behavioral Therapy/methods
KW - Anxiety Disorders/psychology
KW - Depressive Disorder/psychology
KW - Middle Aged
U2 - 10.1002/cpp.2995
DO - 10.1002/cpp.2995
M3 - Journal article
C2 - 38723660
VL - 31
JO - Clinical Psychology & Psychotherapy
JF - Clinical Psychology & Psychotherapy
SN - 1063-3995
IS - 3
M1 - e2995
ER -
ID: 391741002