Category: Adult Depression / Dysthymia
Background: Low behavioral activation is a well-known risk factor for depression. A potential mechanism for this effect is emotion dysregulation, defined as difficulty modulating one’s emotions adaptively within a range of contexts. Emotion dysregulation consists of five facets: nonacceptance of difficulties in emotion regulation; inability to engage in goal-directed behavior when distressed; difficulties controlling impulsive behaviors when distressed; limited access to effective emotion regulation strategies; and lack of emotional clarity. The current study sought to examine whether these emotion regulation deficits might explain the relationship between behavioral activation and depression severity.
Methods: Participants were Japanese adults who endorsed past and/or current diagnoses of depressive or anxiety disorders (n=1547). As part of a larger online study, subjects completed the Behavioral Activation for Depression Scale, the Overall Depression Severity and Impairment Scale, and the Brief Version of the Difficulties in Emotion Regulation Scale. Mediation analyses were conducted to examine whether the five subscales of emotion dysregulation mediated the effect of behavioral activation on levels of depression.
Results: As predicted, there was a significant positive main effect of behavioral avoidance/rumination on depression severity. Furthermore, nonacceptance of difficulties in emotion regulation (B = .22, p < .05), lack of impulse control (B = .27, p < .05), and inability to engage in goal-directed behavior (B = .21, p < .05), partially mediated the relationship between avoidance/rumination and depression severity. Emotional clarity (B = .11, p > .15 and limited access to effective emotion regulation (B = -.05, p > .25), did not significantly mediate this relationship.
Conclusions: Poor emotional acceptance, poor impulse control, and lack of goal-directed behavior partially explain the relationship between behavioral avoidance and depression. The results are consistent with prior research suggesting that poor acceptance of unwanted emotions contributes to the development and maintenance of depression. These findings highlight the importance of considering emotion regulation difficulties, specifically nonacceptance, in the treatment of depression.
Kristina Conroy– Research Technician, Boston University
Angelina Gómez– Boston University
Joshua Curtiss– Graduate Student, University of Delaware, Boston, Massachusetts
Masaya Ito– National Center of Neurology and Psychiatry
Stefan Hofmann– Professor of Psychology, Boston University