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Objectives: Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. Methods: We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatmentvs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview. Results: Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. Conclusions: The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Emotion regulation plays an important role in the development and maintenance of psychopathology. However, the question whether specific ER skills are related to specific psychological symptoms has rarely been studied, but has important implications for targeted interventions. This analysis aims to explore potential differential associations between various ER skills and psychological symptoms using a network analysis approach.Routine data from a transdiagnostic clinical sample of 716 patients (460 females, 256 males) from an outpatient clinic for psychotherapy were analysed. Nine ER skills were assessed with the Emotion Regulation Skills Questionnaire, and nine symptom dimension scores were obtained using the Brief Symptom Inventory. A regularized partial correlation network models including ER skills and individual symptom domains were calculated. Bridge expected influence was calculated to estimate the strength of association of each ER skill with psychological symptoms.Only the following ER skills were most strongly related to psychological symptoms (bridge expected influence): Tolerance, Confrontation and Modification. All other ER skills were indirectly connected to symptom severity through these four skills. The strongest direct edges between ER skills and symptoms were Modification—Depression, Confrontation—Obsession‐Compulsion and Tolerance—Interpersonal Sensitivity, which were significantly stronger than the vast majority of other associations between ER skills and psychological symptoms.These exploratory findings provide valuable targets for future studies to investigate specific associations between ER skills and psychological symptoms which could help to improve outcome monitoring and efficacy of interventions targeting ER. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Deficits in emotion regulation (ER) skills are discussed as a transdiagnostic factor contributing to the development and maintenance of various mental disorders. However, systematic comparisons of a broad range of ER skills across diagnostic groups that are based on comparable definitions and measures of ER are still rare. Method: Therefore, we conducted two studies assessing a broad range of ER skills with the Emotion Regulation Skills Questionnaire in individuals meeting criteria for mental disorders (N1 = 1448; N2 = 137) and in a general population sample (N = 214). Results: Consistent across the two studies, participants in the clinical samples reported lower general and lower specific ER skills than participants in the general population sample. Also consistent across the two studies, diagnostic subgroups of the clinical samples differed significantly with regard to general and specific ER skills. Conclusion: The studies provide evidence that deficits in ER are associated with various forms of psychopathology. However, mental disorders seem to differ with regard to how strongly they are linked to ER skills. [ABSTRACT FROM AUTHOR]

Objective: Deficits in general emotion regulation (ER) skills have been linked to symptoms of depression and are thus considered a promising target in the treatment of Major depressive disorder (MDD). However, at this point, the extent to which such skills are relevant for coping with depression and whether they should instead be considered a transdiagnostic factor remain unclear. Therefore, the present study aimed to investigate whether successful ER skills application is associated with changes in depressive symptom severity (DSS), anxiety symptom severity (ASS), and general distress severity (GDS) over the course of treatment for MDD. Methods: Successful ER skills application, DSS, ASS, and GDS were assessed four times during the first three weeks of treatment in 175 inpatients who met the criteria for MDD. We computed Pearson correlations to test whether successful ER skills application and the three indicators of psychopathology are cross-sectionally associated. We then performed latent growth curve modelling to test whether changes in successful ER skills application are negatively associated with a reduction of DSS, ASS, or GDS. Finally, we utilized latent change score models to examine whether successful ER skills application predicts subsequent reduction of DSS, ASS, or GDS. Results: Successful ER skills application was cross-sectionally associated with lower levels of DSS, ASS, and GDS at all points of assessment. An increase in successful skills application during treatment was associated with a decrease in DSS and GDS but not ASS. Finally, successful ER skills application predicted changes in subsequent DSS but neither changes in ASS nor changes in GDS. Conclusions: Although general ER skills might be relevant for a broad range of psychopathological symptoms, they might be particularly important for the maintenance and treatment of depressive symptoms. [ABSTRACT FROM AUTHOR]

Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state-of-the-art in psychotherapy treatment research, 'component analyses' aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large-scale public health strategies and treatments that can be applied to more patients in a simpler and cost-effective way. Increased research on efficacy and moderators of Internet-based treatments and e-mental health tools (e.g. to support 'real time' clinical decision-making to prevent treatment failure or relapse) might be one promising way forward. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Increasing evidence shows that mindfulness is positively related to mental health; however, the nature of this relationship is not fully understood. The current study used structural equation modeling to investigate the hypothesis that mindfulness moderates the association between the occurrence of unavoidable distressing experiences (UDE) and mental health. Participants from a community sample (N = 376) completed the Freiburg Mindfulness Inventory, the Positive and Negative Affect Scale, the Brief Symptom Inventory, the Inventory of Approach and Avoidance Motivation, and the Incongruence Scale. Results indicated that mindfulness moderated the association between unavoidable distressing events and psychopathological symptoms/negative affect. Thus, mindfulness may contribute to enhance the ability to cope with UDE and thus mitigate the detrimental effects of these experiences on mental health. [ABSTRACT FROM AUTHOR]

Abstract: Background and objectives: In order to clarify mechanisms underlying the association between emotion regulation and psychopathology, we tested whether the ability to modify negative emotions mediates the associations of other emotion-regulation skills with psychopathological symptoms in two studies. Methods: The first study included 151 college students; the second included 121 psychiatric inpatients. Bootstrapping-enhanced mediation analyses were utilized to assess associations between self-reports of emotion-regulation skills and psychopathology, as well as potential mediation effects. Results: In both samples, the ability to modify emotions completely mediated the association between symptoms and skills for most skills, but not for the skill of accepting/tolerating negative emotions. Limitations: Major limitations include the use of a cross-sectional design as well as exclusive use of self-report data. Conclusions: The ability to modify negative emotions may be the common pathway by which many emotion-regulation skills exert their influence on mental health; however, the skill of accepting/tolerating negative emotions may be beneficial to mental health regardless of whether or not it facilitates modification of emotions. [Copyright &y& Elsevier]

Abstract: Background: Deficits in emotion-regulation skills have been shown to be integral to the development and maintenance of a wide range of mental disorders. Aim: To evaluate the importance of these skills as a treatment target in psychotherapeutic interventions. Method: Nine specific emotion-regulation skills were assessed in a sample of 289 inpatients before and after cognitive-behavioural treatment. Self-reports of success in pretreatment skills application were first compared to those of 246 non-clinical controls. Pretreatment skills application and change in skills application during therapy were then related to a variety of outcome measures. Finally, the effects of integrating a brief training of general emotion-regulation skills into the CBT-based treatment were evaluated in a controlled trial. Results: Uni- and multivariate analyses identified the skills of acceptance, tolerance, and active modification of negative emotions as particularly important for current mental health and treatment outcome. Replacing parts of the standard CBT treatment with the emotion-regulation training enhanced the effects of the CBT treatment on skills application and on other measures of mental health. Conclusion: Incorporating interventions that directly target general emotion-regulation skills may improve the effectiveness of psychotherapeutic interventions. [Copyright &y& Elsevier]

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According to consistency theory, incongruence between individual perceptions and goals reduces well-being and increases the risk for the development and further maintenance of psychopathological disorders. Successful psychotherapy should therefore reduce the level of incongruence and therapy outcome should be associated with the reduction of incongruence. To test these hypotheses the level of incongruence was assessed in a sample of 62 inpatients undergoing cognitive-behavioural therapy (CBT) before and after treatment using the Incongruence Questionnaire. Pre–post differences were then correlated with other outcome measures and factor analysis was used to assess the underlying dimensionality of all outcome measures. The level of congruence was reduced substantially by inpatient CBT, changes were positively related to other measures of psychotherapy outcome and incongruence loaded strongly on only one of two emerging factors. Incongruence can be seen as an independent construct. It seems advisable to assess level of incongruence at the beginning of each psychotherapy for effective planning of treatment and at the end of therapy for a comprehensive outcome measurement. The reduction of high levels of incongruence must be seen as an important higher level goal in psychotherapy. Further research has to clarify under what conditions the reduction of incongruence is especially important and what methods are most effective to do so. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]