Does cognitive behavior therapy alter emotion regulation in inpatients with a depressive disorder?

Abstract

Thomas Forkmann,1 Anne Scherer,1 Markus Pawelzik,2 Verena Mainz,1 Barbara Drueke,1 Maren Boecker,1 Siegfried Gauggel11Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Aachen, Germany; 2EOS Hospital for Psychotherapy, Hammer Münster, GermanyIntroduction: Emotion regulation plays an important role in the development and treatment of depression. The present study investigated whether the emotion regulation strategies, expressive suppression (ES) and cognitive reappraisal (CR) change in the course of cognitive behavior therapy (CBT) of depressive inpatients. Furthermore, it also examined whether changes in CR and ES correlated with positive treatment outcomes.Methods: Forty-four inpatients from a psychotherapeutic hospital who suffered from a depressive disorder (mean age =36.4 years, standard deviation =13.4 years; 63.6% female) filled in the Emotion Regulation Questionnaire and the Beck Depression Inventory at admission and discharge. To detect changes in emotion regulation, and depression across treatment, data were analyzed using multivariate analyses of variance (MANOVA) for repeated measures, effect sizes, and Spearman correlations. A P-value of ≤0.05 was considered statistically significant.Results: Depression severity (F[1]=10.42, P=0.003; η2=0.22) and CR (F[1]=4.71, P=0.04; η2=0.11) changed significantly across CBT treatment. ES remained virtually stable. Post-treatment scores of CR were also positively correlated with reduction in depressive symptoms across treatment (ρ=0.30, P=0.05).Conclusion: The results suggest that CBT affects emotion regulation in depressive inpatients only for CR and that higher post-treatment scores in CR were related to greater reduction in depressive symptoms across treatment.Keywords: emotion regulation, depression, major depressive disorder, psychotherapy