Emotion regulation strategies in mania risk: A systematic review

Abstract

Objectives Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess how emotion regulation strategies reported by individuals at risk of mania compare with clinical and nonclinical controls. Methods Search terms relating to mania risk and emotion regulation were entered into three databases. Sixteen studies were included. Results Mania risk was typically associated with overall endorsement of emotion regulation strategies, particularly dampening, and positive and negative rumination. Conclusions Findings were limited by overall lack of evidence for individual strategies, lack of consideration of key mediating factors and reliance upon self‐report designs.

27. A Lesion-Derived Brain Network for Emotion Regulation

“…Lesions causing mania, criminality, and depressiondisorders associated with impaired emotional regulation -were more likely to impact our lesionderived emotion regulation network than lesions associated with disorders not associated with emotional regulation impairment. This is consistent with prior work suggesting that emotion regulation impairment may serve as a transdiagnostic risk factor [5][6][7][8]60,61 for a variety of neuropsychiatric disorders, including those studied here, e.g., mania 62 , criminal behavior 63 , and depression 64,65 . Moreover, the "hub regions" for these disorders identified in our prior lesion network mapping work also fall within our lesion-derived network for emotion regulation: right orbital PFC for mania 43 , inferior orbital PFC and anterior temporal lobes for criminal behavior 44 , and the left dlPFC for depression 42 .…”

Correlation between emotion dysregulation and mood symptoms of bipolar disorder: A systematic review and meta‐analysis

“…It is worth noting that the scale used in the considered studies (i.e., the DERS) predominantly measures negative ER, so people with an ongoing depressive episode or euthymic patients with prevalent depressive symptomatology may be more likely to score high, making the correlations stronger while individuals at risk of mania showed most problems on positive ER. 71,72 Confirming this hypothesis, meta-regression analyses showed that as the percentage of depressed patients and the mean scores of ED rating scales increase, the correlation between ED and (hypo)manic symptoms increases significantly. It is reasonable to speculate that assessment tools giving more relevance to positive emotion ER strategies would better capture the relationships between ED and (hypo)manic symptoms.…”

“…76 So far, rumination was proposed among the risk factors of (hypo)manic symptoms and mania onset. 72 We hypothesize that rumination is an ER strategy stably present in patients with BD and stably related to BD symptomatology, which content may change depending on the symptom's polarity experienced. However, only one study 67 used ED rating scales that investigate positive rumination in the context of positive ER strategies (i.e., the Responses to Positive Affect questionnaire (RPA) 77 ), and found no correlation between this type of rumination and BD symptoms.…”

“…A direct example of the relationship between rumination and BD symptoms comes from an RCT on a ER‐focused therapy, which reported that a greater reduction in rumination during and after therapy predicts a greater response to depressive symptoms 76 . So far, rumination was proposed among the risk factors of (hypo)manic symptoms and mania onset 72 . We hypothesize that rumination is an ER strategy stably present in patients with BD and stably related to BD symptomatology, which content may change depending on the symptom's polarity experienced.…”

Are context-specific measures of positive emotion regulation more predictive of mania risk and mood symptoms than trait measures?

“…how they regulate their emotions). The link between putatively maladaptive emotion regulation strategies and both mania risk and bipolar disorder have been supported by research (for reviews of emotion regulation in mania risk and bipolar disorder, see Dodd et al, 2019;McGrogan et al, 2019). Emotion regulation strategies are often conceptualised as being either adaptive or maladaptive, in light of the association between the latter and psychopathology (not just bipolar disorder; Aldao, 2013).…”