Deconstructing Emotion Regulation In Schizophrenia: The Nature Of Abnormalities At The Selection Stage

Past studies using trait self-report indicate that people with schizophrenia (SZ) are less likely to use adaptive emotion regulation strategies and more likely to use maladaptive emotion regulation strategies than controls (CN). However, more recent evidence using ecological momentary assessment (EMA) indicates that regulation effectiveness and adaptiveness may vary across strategies. The present study aimed to systematically understand abnormalities in state-level emotion regulation strategy selection, effectiveness, and adaptiveness in SZ compared to CN using EMA. Participants (n = 50 SZ; n = 53 CN) completed six days of EMA assessment of emotional experience, emotion regulation, and symptoms. Results indicated that SZ selected interpersonal emotion regulation and avoidance more often than CN. Overall, strategies were effective at reducing negative emotion and adaptive for reducing delusions over time. Strategy selection appears relatively normal in SZ compared to CN. The present results have implications for how cognitive therapy for psychosis may target delusions.