Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders

Abstract

Both maladaptive and adaptive emotion regulation strategies have been linked with psychopathology. However, previous studies have largely examined them separately, and little research has examined the interplay of these strategies cross-sectionally or longitudinally in patients undergoing psychological treatment. This study examined the use and interplay of adaptive and maladaptive emotion regulation strategies in 81 patients receiving cognitive-behavioral interventions for comorbid alcohol use and anxiety disorders. Patients completed measures of emotion regulation strategy use and symptoms of psychopathology pre- and post-treatment. Cross-sectionally, higher use of maladaptive strategies (e.g., denial) was significantly related to higher psychopathology pre- and post-treatment, whereas higher use of adaptive strategies (e.g., acceptance) only significantly related to lower psychopathology post-treatment. Prospectively, changes in maladaptive strategies, but not changes in adaptive strategies, were significantly associated with post-treatment psychopathology. However, for patients with higher pre-treatment maladaptive strategy use, gains in adaptive strategies were significantly associated with lower post-treatment psychopathology. These findings suggest that psychological treatments may maximize efficacy by considering patient skill use at treatment outset. By better understanding a patient's initial emotion regulation skills, clinicians may be better able to optimize treatment outcomes by emphasizing maladaptive strategy use reduction predominately, or in conjunction with increasing adaptive skill use.

Emotion dysregulation as a mechanism linking anxiety and hazardous drinking among Latinos in primary care

“…For example, the results suggest that targeting emotion dysregulation in the context of anxiety and hazardous alcohol use among Latinos may be one therapeutic strategy to reduce severity of alcohol use (and hazardous drinking). Past work has found that emotion dysregulation is a malleable construct and that improvements in some emotion regulation strategies are associated with lower rates of psychopathology post‐treatment . As such, therapies developed with an emphasis on emotion regulation may be useful in reducing alcohol use severity/hazardous drinking among Latinos.…”

“…Theoretical models suggest that emotion dysregulation in the context of elevated anxiety symptoms may lead to psychological disorders, such as, anxiety/depressive disorders and substance use disorders . In line with such work, improvements in emotion dysregulation over the course of treatment are associated with reduced post‐treatment psychopathology among comorbid anxiety/alcohol use disorder patients . Thus, persons may experience emotion dysregulation when anxious, and consequently, engage in use of alcohol as a coping strategy.…”

Anxiety sensitivity and hazardous drinking among persons living with HIV/AIDS: An examination of the role of emotion dysregulation

“…Such an approach would be consistent with intervention work on emotion dysregulation and alcohol use disorders among non-HIV samples (e.g., Berking et al, 2011). For example, changes in the use of maladaptive emotion regulation strategies over the course of treatment have been shown to predict changes in anxiety- and alcohol-related psychopathology in a sample with comorbid anxiety and alcohol use disorders (Conklin et al, 2015). Given that newer treatments directly targeting emotion regulation are mounting growing evidence in treating a range of emotional outcomes (Gratz, Weiss, & Tull, 2015), such treatments may serve as additional options for the treatment of hazardous drinking among PLWHA.…”

Emotion dysregulation explains the relation between insomnia symptoms and negative reinforcement smoking cognitions among daily smokers

“…Such an approach would be consistent with intervention work on emotion dysregulation and substance use (e.g., Berking et al, 2011). For example, changes in the use of maladaptive emotion regulation strategies over the course of treatment have been shown to predict changes in anxiety/stress and alcohol-related psychopathology (Conklin et al, 2015). It is possible that tailoring these treatments to smokers with insomnia would offer a novel and more personalized approach to improve behavioral health and change smoking behavior.…”