Emotion regulation in depression and anxiety: Examining diagnostic specificity and stability of strategy use

Many psychological disorders are characterized by difficulties in emotion regulation. It is unclear, however, whether different disorders are associated with the use of specific emotion regulation strategies, and whether these difficulties are stable characteristics that are evident even after recovery. It is also unclear whether the use of specific strategies is problematic across all disorders or whether disorders differ in how strongly strategy use is associated with symptom severity. This study investigated (1) the specificity of use of emotion regulation strategies in individuals diagnosed with current major depressive disorder (MDD), with social anxiety disorder (SAD), and in never-disordered controls (CTL); and (2) the stability of strategy use in formerly depressed participants (i.e.; remitted; RMD). Path analysis was conducted to examine the relation between strategy use and symptom severity across diagnostic groups. Compared to the CTL group, participants in both clinical groups endorsed more frequent use of rumination and expressive suppression, and less frequent use of reappraisal. Specific to SAD were even higher levels of expressive suppression relative to MDD, as well as a stronger relation between rumination and anxiety levels. In contrast, specific to MDD were even higher levels of rumination and lower levels of reappraisal. Interestingly, elevated rumination, but not decreased reappraisal, was found to be a stable feature characterizing remitted depressed individuals. These results may provide insight into ways in which emotion regulation strategy use maintains psychological disorders.