A Pilot Study of Emotion Regulation Therapy for Generalized Anxiety and Depression: Findings From a Diverse Sample of Young Adults

Abstract

Emotion regulation therapy (ERT) for generalized anxiety disorder (GAD) and accompanying major depressive disorder (MDD) is a theoretically derived, evidence-based treatment that integrates principles from traditional and contemporary cognitive-behavioral and experiential approaches with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding self-referential regulatory characteristics. Preliminary evidence supports the efficacy of a 20-session version of ERT. However, previous trials of ERT and other traditional and contemporary cognitive-behavioral therapies have often utilized relatively homogeneous samples. Various contextual and demographic factors may be associated with challenges that increase risk for negative mental and social outcomes for young adults ages 18-29, particularly for individuals from diverse backgrounds. The aim of this pilot study was to examine the effectiveness of a briefer 16-session version of ERT in a racially and ethnically diverse sample of young adults. Participants (N = 31) were enrolled at an urban-based, commuter college who consented to treatment for anxiety, worry, or depression at an on-campus counseling center. Open-trial results demonstrate strong ameliorative changes in worry, rumination, self-reported and clinician-rated GAD and MDD severity, social disability, quality of life, attentional flexibility, decentering/distancing, reappraisal, trait mindfulness, and negative emotionality from pre- to posttreatment. These gains were maintained throughout a 3- and 9-month follow-up. These findings provide preliminary evidence for the efficacy of ERT in treating a racially and ethnically heterogeneous population. Further, this study highlights comparable effectiveness of a briefer 16-session version of ERT.

Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress

“…(16,33). Similarly, a recent open trial demonstrated efficacy for a slightly shortened ERT format among a diverse sample of young adults diagnosed with an anxiety or mood disorder, with strong effect sizes for changes pre-to-post treatment in worry, rumination, generalized anxiety, anhedonic depression, clinician-rated severity of Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD), social disability, and QOL (35).…”

“…ERT has demonstrated considerable preliminary efficacy as well as initial support for the role of regulatory mechanisms using both behavioral and neural indices associated with ERT clinical outcomes (e.g., 34,35). In an open and randomized controlled trial of adults diagnosed with generalized anxiety, with or without co-occurring depression, patients evidenced gains on measures of PNT (e.g., worry, rumination) and reductions in trait anxiety, depressive symptoms, and quality of life.…”

Changes in Functional Connectivity following Treatment with Emotion Regulation Therapy

“…Participants were 25 treatment-seeking young adults, a subsample of the 31 patients treated in Renna et al (2018a) who were drawn from an undergraduate and graduate student population in a large urban commuter-based university. Participants completed 16 weeks of ERT (Mennin and Fresco, 2014) and completed fMRI scans before and after treatment, with an average length of time between treatment and scan of less than 2 weeks.…”

“…Three recently published trials of ERT attest to its efficacy in treating GAD and MDD (Mennin et al, , 2018Renna et al, 2018a). Following promising results from an initial open trial , Mennin et al (2018) found that GAD patients (with and without MDD) treated with 20 sessions of ERT vs. an attentional control intervention) evidenced statistically and clinically meaningful improvement on clinical indicators of GAD and MDD, worry, rumination, comorbid disorder severity, functional impairment, quality of life, as well as hypothesized mechanisms reflecting mindful attentional, metacognitive, and overall emotion regulation.…”

“…The present study is drawn from a larger intervention trial (Renna et al, 2018a) and the baseline rsFC prediction study from the subset of the sample (Fresco et al, 2017). Findings from aforementioned trials with mindfulness interventions demonstrated changes in intrinsic functional connectivity in the DMN.…”