title: Dealing with feeling: Specific emotion regulation skills predict responses to stress in psychosis.
abstract: Elevated negative affect is an established link between minor stressors and psychotic symptoms. Less clear is why people with psychosis fail to regulate distressing emotions effectively. This study tests whether subjective, psychophysiological and symptomatic responses to stress can be predicted by specific emotion regulation (ER) difficulties. Participants with psychotic disorders (n=35) and healthy controls (n=28) were assessed for ER-skills at baseline. They were then exposed to a noise versus no stressor on different days, during which self-reported stress responses, state paranoia and skin conductance levels (SCL) were assessed. Participants with psychosis showed a stronger increase in self-reported stress and SCL in response to the stressor than healthy controls. Stronger increases in self-reported stress were predicted by a reduced ability to be aware of and tolerate distressing emotions, whereas increases in SCL were predicted by a reduced ability to be aware of, tolerate, accept and modify them. Although paranoid symptoms were not significantly affected by the stressors, individual variation in paranoid responses was also predicted by a reduced ability to be aware of and tolerate emotions. Differences in stress responses in the samples were no longer significant after controlling for ER skills. Thus, interventions that improve ER-skills could reduce stress-sensitivity in psychosis.
authors.affiliation: Clinical Psychology and Psychotherapy, Department of Psychology, University of Hamburg, Germany. Electronic address: tania.lincoln@uni-hamburg.de.
authors.forename: Tania M
authors.initials: TM
authors.lastname: Lincoln
authors.affiliation: Clinical Psychology and Psychotherapy, Department of Psychology, University of Hamburg, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Hartmann
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Köther
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Moritz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D010259:Paranoid Disorders / Q000523:psychology*; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000523:psychology*; D057566:Self Report; D013315:Stress, Psychological / Q000523:psychology*
keywords: Acceptance; Awareness; Emotion-regulation; Paranoia; Psychosis; Skin conductance levels; Stress