Hostname: page-component-745bb68f8f-s22k5 Total loading time: 0 Render date: 2025-02-11T16:38:12.468Z Has data issue: false hasContentIssue false
  • English
  • Français

Transdiagnostic perspective on psychological inflexibility and emotional dysregulation

Published online by Cambridge University Press:  08 September 2020

Bruno Faustino Open the ORCID record for Bruno Faustino [Opens in a new window]
Bruno Faustino*
Affiliation:
Department of Cognitive, Behavioral and Integrative Psychotherapy, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
*
Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Psychological inflexibility and emotional dysregulation are a hallmark of psychopathology, being intrinsically embedded in emotional and personality disorders. However, the transdiagnostic mechanisms of psychological inflexibility and emotional dysregulation domains are still a matter of discussion.

Aims:

The present study aims to explore the relationships between cognitive fusion (as a measure of psychological inflexibility), emotion regulation strategies, such as cognitive reappraisal and emotional suppression and emotional dysregulation domains in two different samples.

Method:

In a cross-sectional design, 297 individuals were assessed with self-report measures and divided into non-clinical (n = 231) and clinical samples (n = 66), according to diagnosis.

Results:

Results showed that the degree of cognitive fusion was higher in the clinical sample. However, significant correlations between cognitive fusion, emotional regulation strategies and emotional dysregulation domains were found in the two samples. Cognitive reappraisal and emotional dysregulation domains predicted cognitive fusion and mediated the relationship between cognitive fusion and symptomatology in the two samples.

Conclusions:

Relationships between cognitive fusion and emotional dysregulation domains were found independent of diagnosis. The implementation of emotion regulation strategies may be related to individual differences. However, cognitive fusion, reappraisal and lack of strategies may be core transdiagnostic features in psychological inflexibility and emotion dysregulation.

Keywords

psychological inflexibilityemotional dysregulationcognitive fusiontransdiagnostic perspective
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 2 , March 2021 , pp. 233 - 246
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abravanel, B. T., & Sinha, R. (2015). Emotion dysregulation mediates the relationship between life cumulative adversity and depressive symptomatology. Journal of Psychiatric Research, 61, 89–96. doi: 10.1016/j.jpsychires.2014.11.012 CrossRefGoogle ScholarPubMed
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: a meta-analytic review. Clinical Psychological Review, 30, 217–237. doi: 10.1016/j.cpr.2009.11.004 CrossRefGoogle ScholarPubMed
Bardeen, J. R., & Fergus, T. A. (2016). The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. Journal of Contextual Behavioral Science, 5, 1–6. doi: 10.1016/j.jcbs.2016.02.002 CrossRefGoogle Scholar
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Conklin, L. R., Boswell, J. F., Ametaj, A., Carl, J. R., Boettcher, H. T., & Cassiello-Robbins, C. (2017). The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders. A randomized clinical trial. JAMA Psychiatry, 4, 875–884. doi: 10.1001/jamapsychiatry.2017.2164 CrossRefGoogle Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York, NY, USA: International Universities Press.Google Scholar
Blackledge, J., & Hayes, S. (2001). Emotion regulation in acceptance and commitment therapy. Psychotherapy in Practice, 57, 243–255.Google ScholarPubMed
Brockman, R., Ciarrochi, J., Parker, P., & Kashdan, T. (2017). Emotion regulation strategies in daily life: mindfulness, cognitive reappraisal and emotion suppression. Cognitive Behaviour Therapy, 46, 91. doi: http://dx.doi.org/10.1080/16506073.2016.1218926 CrossRefGoogle ScholarPubMed
Bateman, A., & Fonagy, P. (2006). Mentalizing and borderline personality disorder. In Allen, J. G. & Fonagy, P. (eds), The Handbook of Mentalization-Based Treatment (pp. 185–200). Hoboken, NJ, USA: John Wiley & Sons Inc. doi: http://dx.doi.org/10.1002/9780470712986.ch9 Google Scholar
Castelo-Branco, M. (2016). Relações entre regulação emocional, regulação da satisfação das necessidades psicológicas, bem-estar/distress psicológicos e sintomatologia. Masters thesis, Faculty of Psychology of University of Lisbon. [Relationships between emotional regulation, regulation of the satisfaction of psychological needs, psychological well-being/distress and symptomatology].Google Scholar
Canavarro, M. C. (1999). Inventário de sintomas psicopatológicos – BSI. In Simões, M. R., Gonçalves, M., Almeida, L. S. (eds), Testes e Provas Psicológicas em Portugal (vol. II, pp. 95–109). Braga: APPORT/SHO.Google Scholar
Coutinho, J., Ribeiro, E., Ferreirinha, R., & Dias, P. (2010). Versão portuguesa da escala de dificuldades de regulação emocional e sua relação com sintomas psicopatológicos. Revista de Psiquiatria Clínica, 37, 145–151. doi: http://dx.doi.org/10.1590/S0101-60832010000400001 [Portuguese version of emotional dysregulation domains and relationship with psychopatological symptoms].CrossRefGoogle Scholar
Derogatis, L. R. (1993) The Brief Symptom Inventory (BSI): Administration, Scoring and Procedures Manual. National Computer Systems, Minneapolis, MN, USA.Google Scholar
Dimaggio, G., Montano, A., Popolo, R., & Salvatore, G. (2015). Metacognitive Interpersonal Therapy for Personality Disorders: A Treatment Manual. London, UK: Routeledge.CrossRefGoogle Scholar
Dudley, R., Kuyken, W., & Padesky, C. A. (2011). Disorder specific and transdiagnostic case conceptualization. Clinical Psychological Review, 31, 213–224. doi: 10.1016/j.cpr.2010.07.005 CrossRefGoogle Scholar
Faustino, B. & Vasco, A. B. (2020a). Schematic functioning, interpersonal dysfunctional cycles and cognitive fusion in the complementary paradigmatic perspective: analysis of a clinical sample. Journal of Contemporary Psychotherapy, 1, 47–55. doi: 10.1007/s10879-019-09422-x CrossRefGoogle Scholar
Faustino, B. & Vasco, A. B. (2020b). Early maladaptive schemas and cognitive fusion on the regulation of psychological needs. Journal of Contemporary Psychotherapy, 1, 105–112. doi: 10.1007/s10879-019-09446-3 CrossRefGoogle Scholar
Faustino, B. & Vasco, A. B. (2020c). Relationships between emotional processing difficulties and early maladaptive schemas on the regulation of psychological needs. Clinical Psychology and Psychotherapy. doi: 10.1002/cpp.24643 CrossRefGoogle ScholarPubMed
Faustino, B., Vasco, A. B., Silva, A. N., & Marques, T. (2020). Relationships between emotional schemas, mindfulness, self-compassion and unconditional self-acceptance on the regulation of psychological needs. Research in Psychotherapy: Psychopathology, Process and Outcome, 23, 145–156. doi: 10.4081/ripppo.2020.442 Google ScholarPubMed
Faustino, B., Vasco, A. B., Oliveira, J., Lopes, P., & Fonseca, I. (2019). Metacognitive Self-assessment Scale: psychometric properties and clinical applications. Applied Neuropsychology: Adult. doi: 10.1080/23279095.2019.1671843 CrossRefGoogle Scholar
Foa, E. B., Steketee, G., & Young, M. C. (1984). Agoraphobia: phenomenological aspects, associated characteristics and theoretical considerations. Clinical Psychology Review, 4, 43l–457.CrossRefGoogle Scholar
Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., Kerr, S., Tansey, L., Noel, P., Ferenbach, C., Masley, S., Roach, L., Lloyd, J., May, L., Clarke, S., & Remington, R. (2014). The development and initial validation of the Cognitive Fusion Questionnaire. Behavior Therapy, 45, 83–101. doi:https ://doi.org/10.1016/j.beth.2013.09.001 CrossRefGoogle ScholarPubMed
Gouveia, P., Dinis, A., Gregório, S., & Pinto, P. (2013). Questionário de Fusão Cognitiva: Versão Portuguesa. Unpublished manuscript. [Cognitive fusion questionnaire: Portuguese version].Google Scholar
Gratz, K. L., & Roemer, L (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54. doi: 10.1023/B: JOBA.0000007455.08539.94 CrossRefGoogle Scholar
Greenberg, L. S. (2015). Emotion-Focused Therapy: Coaching Clients to Work Through Their Feelings (2nd edn). American Psychological Association.10.1037/14692-000CrossRefGoogle Scholar
Gross, J. J. (2002). Emotion regulation: affective, cognitive, and social consequences. Psychophysiology, 39, 281–291. doi: http://dx.doi.org/10.1017/S0048577201393198 CrossRefGoogle ScholarPubMed
Gross, J. J. (2014). Emotion regulation: empirical foundations. In Handbook of Emotion Regulation, ed. Gross, J., 2nd edn, pp. 3–20. New York, USA: The Guilford Press.Google Scholar
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362. doi: http://dx.doi.org/10.1037/0022-3514.85.2.348 CrossRefGoogle ScholarPubMed
Hallion, L. S., Steinman, S. A., Tolin, D. F., & Diefenbach, G. J. (2018). Psychometric properties of the Difficulties in Emotion Regulation Scale (DERS) and its short forms in adults with emotional disorders. Frontiers in Psychology, 9, 539. doi: 10.3389/fpsyg.2018.00539 CrossRefGoogle ScholarPubMed
Harris, R. (2009). ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy. Oakland, CA, USA: New Harbinger.Google Scholar
Hayes, A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, USA: Guilford Press.Google Scholar
Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40, 976–1002. doi: 10.1177/0011000012460836 CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd edn). New York, USA: The Guilford Press.Google Scholar
Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878. doi: 10.1016/j.cpr.2010.03.001 CrossRefGoogle ScholarPubMed
Krafft, J., Haeger, J. A., & Levin, M. E. (2019) Comparing cognitive fusion and cognitive reappraisal as predictors of college student mental health. Cognitive Behaviour Therapy, 48, 241–252. doi: 10.1080/16506073.2018.1513556 CrossRefGoogle ScholarPubMed
Lilly, M. M., & Lim, B. H. (2013). Shared pathogeneses of posttrauma pathologies: attachment, emotion regulation, and cognitions. Journal of Clinical Psychology, 69, 737–748. http://dx.doi.org/10.1002/jclp.21934 CrossRefGoogle ScholarPubMed
Leahy, R. L., Tirch, D., & Napolitano, L. A. (2011). Emotion Regulation in Psychotherapy. New York, USA: The Guilford Press.Google Scholar
Leahy, R. L. (2015). Emotional Schema Therapy. New York, USA: The Guilford Press.Google Scholar
Levin, M., MacLane, C., Daflos, S., Seeley, J. R., Hayes, S., Biglan, A., & Pistorello, J (2014). Examining psychological inflexibility as a transdiagnostic process across psychological disorders. Journal of Contextual Behavioral Science, 3, 155–163. doi: 10.1016/j.jcbs.2014.06.003 CrossRefGoogle ScholarPubMed
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, USA: The Guilford Press.Google Scholar
Marganska, A., Gallagher, M., & Miranda, R. (2013). Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder. American Journal of Orthopsychiatry, 83, 131–141. doi: http://dx.doi.org/10.1111/ajop.12001 CrossRefGoogle ScholarPubMed
Morris, L., & Mansell, W. (2018). A systematic review of the relationship between rigidity/flexibility and transdiagnostic cognitive and behavioral processes that maintain psychopathology. Journal of Experimental Psychopathology. https://doi.org/10.1177/2043808718779431 CrossRefGoogle Scholar
Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: a pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40–51. https://doi.org/10.1016/j.brat.2014.05.005 CrossRefGoogle ScholarPubMed
Plonsker, R., Gavish Biran, D., Zvielli, A., & Bernstein, A. (2017). Cognitive fusion and emotion differentiation: does getting entangled with our thoughts dysregulate the generation, experience and regulation of emotion? Cognition and Emotion, 31, 1286–1293. doi: http://dx.doi.org/10.1080/02699931.2016.1211993 CrossRefGoogle ScholarPubMed
Ruganci, R. N., & Gençöz, T. (2010). Psychometric properties of a Turkish version of the Difficulties in Emotion Regulation Scale. Journal of Clinical Psychology, 66, 442–455. https://doi.org/10.1002/jclp.20665 Google ScholarPubMed
Scott, L. N., Stepp, S. D., & Pilkonis, P. A. (2014). Prospective associations between features of borderline personality disorder, emotion dysregulation, and aggression. Personality Disorders: Theory, Research, and Treatment, 5, 278–288. http://dx.doi.org/10.1037/per0000070 CrossRefGoogle ScholarPubMed
Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: a systematic review. Clinical Psychology Review, 57, 141–163. doi: https://doi.org/10.1016/j.cpr.2017.09.002 CrossRefGoogle ScholarPubMed
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-Based Cognitive Therapy for Depression. New York, USA: The Guilford Press.Google Scholar
Rogers, C. R. (1961). On Becoming a Person. Oxford, UK: Houghton Mifflin.Google Scholar
Tirch, D. D., Leahy, R. L., Silberstein, L. R., & Melwani, P. S. (2012). Emotional schemas, psychological flexibility, and anxiety: the role of flexible response patterns to anxious arousal. International Journal of Cognitive Therapy, 5, 380–391. doi: http://doi.org/10.1521/ijct.2012.5.4.380CrossRefGoogle Scholar
Vasco, A. B., Conceição, N., Silva, A. N., Ferreira, J. F., & Vaz-Velho, C. (2018). O (meta)modelo de complementaridade paradigmática (MCP). In I. Leal (ed.), Psicoterapias. Lisbon: Pactor. [Paradigmatic Complementarity Metamodel].Google Scholar
Vaz, F., & Martins, C. (2009). Diferenciação e Regulação Emocional na Idade Adulta: Tradução e validação de dois instrumentos de avaliação para a população portuguesa. Master thesis, Minho University. [Differentiation and Emotional Regulation in Adulthood: translation and validation of two assessment instruments for the Portuguese population].Google Scholar
Webb, T. L., Miles, E., & Sheeran, P. (2012). Dealing with feeling:a meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological Bulletin, 138, 775–808. doi: http://dx.doi.org/10.1037/a0027600 CrossRefGoogle ScholarPubMed
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema Therapy: A Practitioner’s Guide. New York, USA: The Guilford Press.Google Scholar
Submit a response

Comments

No Comments have been published for this article.