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Themenschwerpunkt

Emotionsregulationstraining bei bipolaren Patienten – Erste Befunde einer Pilotstudie

Published Online:February 28, 2015https://doi.org/10.1024/1661-4747/a000205

Abstract

Patienten mit bipolaren Störungen zeigen im Vergleich zu Gesunden einen gesteigerten Einsatz maladaptiver und einen verminderten Einsatz adaptiver Emotionsregulationsstrategien. Dabei scheint es sich um ein Performanz- und nicht um ein Kompetenz-Defizit zu handeln, was nahelegt, dass es möglich sein sollte, die Emotionsregulationsfähigkeiten bipolarer Patienten über ein Training zu verbessern. Vor diesem Hintergrund erhielten 12 bipolare Patienten ein eintägiges Emotionsregulationstraining im Gruppensetting. Anschließend wurden sie vier Wochen lang per SMS, Emails und Telefonaten begleitet. Es zeigte sich, dass eine solche Kurzintervention sowohl den Umgang mit den eigenen Emotionen verbessern als auch den Einsatz adaptiver Emotionsregulationsstrategien steigern kann. Letzteres konnte nicht nur anhand von Selbstberichten (EmoCheck, ERQ, CERQ) sondern auch anhand eines objektiven Maßes (PASAT) gezeigt werden. Darüber hinaus war die Akzeptanz des Trainings durch die Patienten sehr groß. Diese Befunde verdeutlichen, dass weitere Untersuchungen zur Effektivität von Emotionsregulationstrainings bei bipolaren Patienten wünschenswert sind.


Emotion-regulation training for patients with bipolar disorder – First results of a pilot study

Compared to healthy controls, patients with bipolar disorder display an increased use of maladaptive and a decreased use of adaptive emotion regulation strategies. As this seems to be a performance- rather than a competence-deficit it should be possible to improve the emotion regulation ability of bipolar patients by training. Based on this background 12 patients were administered a one-day emotion regulation training in group-setting. Afterwards patients were attended for four weeks by text-messages, emails and telephone calls. This study shows that a short intervention like this is able to improve the handling with one's own emotions and to increase the use of adaptive emotion regulation strategies. The latter has not only been shown by means of self-reports (EmoCheck, ERQ, CERQ) but also on the basis of an objective measure (PASAT). In addition, the training was highly accepted by patients. These results illustrate that further studies examining the effectiveness of emotion regulation trainings for bipolar patients are desirable.

Literatur

  • Abler, B. , Kessler, H. (2009). Emotion Regulation Questionnaire – Eine deutsche Version des ERQ von Gross & John. Diagnostica, 55, 144–152. First citation in articleLink, Google Scholar

  • Aldao, A. , Nolen-Hoeksema, S. , Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30, 217–237. First citation in articleCrossref, Google Scholar

  • Angst, J. , Gamma, A. , Sellaro, R. , Lavori, P. W. , Zhang, H. (2003). Recurrence of bipolar disorders and major depression: A life-long perspective. European Archives of Psychiatry and Clinical Neuroscience, 253, 236–240. First citation in articleCrossref, Google Scholar

  • Azizi, A. , Borjali, A. , Golzari, M. (2010). The effectiveness of emotion regulation training and cognitive therapy on the emotional and addictional problems of substance abusers. Iranian Journal of Psychiatry, 5, 60–65. First citation in articleGoogle Scholar

  • Barnow, S. (2012). Emotionsregulation und Psychopathologie: Ein Überblick. Psychologische Rundschau, 63, 111–124. First citation in articleLink, Google Scholar

  • Berking, M. (2008). Training emotionaler Kompetenzen. Berlin: Springer. First citation in articleGoogle Scholar

  • Berking, M. , Ebert, D. , Cuijpers, P. , Hofmann, S. G. (2013). Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 82, 234–245. First citation in articleCrossref, Google Scholar

  • Berking, M. , Meier, C. , Wupperman, P. (2010). Enhancing emotion-regulation skills in police officers: Results of a controlled study. Behavior Therapy, 41, 329–339. First citation in articleCrossref, Google Scholar

  • Clyne, C. , Blampied, N. M. (2004). Training in emotion regulation as treatment for binge eating: A preliminary study. Behaviour Change, 21, 269–281. First citation in articleCrossref, Google Scholar

  • Colom, F. , Vieta, E. (2006). Psychoeducation Manual for Bipolar Disorder, Cambridge:University Press. First citation in articleGoogle Scholar

  • DGBS e.V. & DGPPN e.V. (2012). S3-Leitlinie zur Diagnostik und Therapie Bipolarer Störungen. Langversion 1.0. Mai 2012. Online unter: www.dgppn.de. First citation in articleGoogle Scholar

  • Ellis, A. J. , Fischer, K. M. , Beevers, C. G. (2010). Is dysphoria about being red and blue? Potentiation of anger and reduced distress tolerance among dysphoric individuals. Cognition and Emotion, 24, 596–608. First citation in articleCrossref, Google Scholar

  • Farmer, A. , Lam, D. H. , Sahakian, B. , Roiser, J. , Burke, A. , O'Neil, N. , … McGuffin, P. (2006). A pilot study of positive mood induction in euthymic bipolar subjects compared with healthy controls. Psychological Medicine, 36, 1213–1218. First citation in articleCrossref, Google Scholar

  • Field, A. P. (2009). Discovering statistics using SPSS (3rd ed.). Los Angeles: Sage. First citation in articleGoogle Scholar

  • Frank, E. , Kupfer, D. J. , Thase, M. E. , Mallinger, A. G. , Swartz, H. A. , Eagiolini, A. M. , … Monk, T. (2005). Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry, 62, 996–1004. First citation in articleCrossref, Google Scholar

  • Garnefski, N. , Kraaij, V. (2007). The Cognitive Emotion Regulation Questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 23, 141–149. First citation in articleLink, Google Scholar

  • Gilbert, K. , Gruber, J. (2014). Emotion regulation of goals in bipolar disorder and major depression: A comparison of rumination and mindfulness. Cognitive Therapy and Research (online first). First citation in articleGoogle Scholar

  • Goldberg, J. F. , Harrow, M. , Grossman, L. S. (1995). Course and outcome in bipolar affective disorder: A longitudinal follow-up study. The American Journal of Psychiatry, 152, 379–384. First citation in articleCrossref, Google Scholar

  • Green, M. J. , Lino, B. J. , Hwang, E.-J. , Sparks, A. , James, C. , Mitchell, P. B. (2011). Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives. Acta Psychiatrica Scandinavica, 124, 307–316. First citation in articleCrossref, Google Scholar

  • Gronwall, D. M. (1977). Paced auditory serial-addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–373. First citation in articleCrossref, 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. First citation in articleCrossref, Google Scholar

  • Gruber, J. (2011a). A review and synthesis of positive emotion and reward disturbance in bipolar disorder. Clinical Psychology & Psychotherapy, 18, 356–365. First citation in articleGoogle Scholar

  • Gruber, J. (2011b). When feeling good can be bad: Positive emotion persistence (PEP) in bipolar disorder. Current Directions in Psychological Science, 20, 217–221. First citation in articleCrossref, Google Scholar

  • Gruber, J. , Eidelman, P. , Johnson, S. L. , Smith, B. , Harvey, A. G. (2011). Hooked on a feeling: Rumination about positive and negative emotion in inter-episode bipolar disorder. Journal of Abnormal Psychology, 120, 956–961. First citation in articleCrossref, Google Scholar

  • Gruber, J. , Harvey, A. G. , Purcell, A. (2011). What goes up can come down? A preliminary investigation of emotion reactivity and emotion recovery in bipolar disorder. Journal of Affective Disorders, 133, 457–466. First citation in articleCrossref, Google Scholar

  • Gruber, J. , Hay, A. C. , Gross, J. J. (2014). Rethinking emotion: Cognitive reappraisal is an effective positive and negative emotion regulation strategy in bipolar disorder. Emotion (online first). First citation in articleGoogle Scholar

  • Gruber, J. , Kogan, A. , Mennin, D. , Murray, G. (2013). Real-world emotion? An experience-sampling approach to emotion experience and regulation in bipolar I disorder. Journal of Abnormal Psychology, 122, 971–983. First citation in articleCrossref, Google Scholar

  • Hautzinger, M. , Bailer, M. , Hofmeister, D. , Keller, F. (2012). Allgemeine Depressionsskala: Manual (2. Aufl.). Göttingen: Hogfrefe. First citation in articleGoogle Scholar

  • Iverson, K. M. , Follette, V. M. , Pistorello, J. , Fruzzetti, A. E. (2012). An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms. Personality Disorders: Theory, Research, and Treatment, 3, 415–422. First citation in articleCrossref, Google Scholar

  • Jacobi, F. , Wittchen, H.-U. , Hölting, C. , Höfler, M. , Pfister, H. , Müller, N. , Lieb, R. (2004). Prevalence, co-morbidity and correlates of mental disorders in the general population: Results from the German Health Interview and Examination Survey (GHS). Psychological Medicine, 34, 597–611. First citation in articleCrossref, Google Scholar

  • Johnson, S. L. (2005). Life events in bipolar disorder: Towards more specific models. Clinical Psychological Review, 25, 1008–1027. First citation in articleCrossref, Google Scholar

  • Jones, N. P. , Siegle, G. J. , Muelly, E. R. , Haggerty, A. , Ghinassi, F. (2010). Poor performance on cognitive tasks in depression: Doing too much or not enough? Cognitive, Affective & Behavioral Neuroscience, 10, 129–140. First citation in articleCrossref, Google Scholar

  • Just, N. , Alloy, L. B. (1997). The response styles theory of depression: Tests and an extension of the theory. Journal of Abnormal Psychology, 106, 221–229. First citation in articleCrossref, Google Scholar

  • Kessler, R. C. , McGonagle, K. A. , Zhao, S. , Nelson, C. B. , Hughes, M. , Eshleman, S. , … Kendler, K. S. (1994). Lifetime and 12-month-prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19. First citation in articleCrossref, Google Scholar

  • Knowles, R. , Tai, S. , Jones, S. H. , Highfield, J. , Morriss, R. , Bentall, R. P. (2007). Stability of self-esteem in bipolar disorder: Comparisons among remitted bipolar patients, remitted unipolar patients and healthy controls. Bipolar Disorders, 9, 490–495. First citation in articleCrossref, Google Scholar

  • Kraaij, V. , Pruymboom, E. , Garnefski, N. (2002). Cognitive coping and depressive symptoms in the elderly: A longitudinal study. Aging & Mental Health, 6, 275–281. First citation in articleCrossref, Google Scholar

  • Krüger, S. , Bräunig, P. , Shugar, G. (1997). Manie-Selbstbeurteilungsskala: Manual. Göttingen: Beltz. First citation in articleGoogle Scholar

  • Loch, N. , Hiller, W. , Witthöft, M. (2011). Der Cognitive Emotion Regulation Questionnaire (CERQ). Erste teststatistische Überprüfung einer deutschen Adaption. Zeitschrift für Klinische Psychologie und Psychotherapie: Forschung und Praxis, 40, 94–106. First citation in articleLink, Google Scholar

  • M'Bailara, K. M. , Demotes-Mainard, J. , Swendsen, J. , Mathieu, F. , Leboyer, M. , Henry, C. (2009). Emotional hyper-reactivity in normothymic bipolar patients. Bipolar Disorders, 11, 63–69. First citation in articleGoogle Scholar

  • Merikangas, K. R. , Jin, R. , He, J.-P. , Kessler, R. C. , Lee, S. , Sampson, N. A. , … Zarkov, Z. (2011). Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative. Archives of General Psychiatry, 68, 241–251. First citation in articleCrossref, Google Scholar

  • Meyer, T. D. , Hautzinger, M. (2004). Manisch-depressive Störungen. Kognitiv-verhaltenstherapeutisches Behandlungsmanual. Weinheim: Beltz. First citation in articleGoogle Scholar

  • Meyer, B. , Johnson, S. L. , Winters, R. (2001). Responsiveness to threat and incentive in bipolar disorder: Relations of the BIS/BAS scales with symptoms. Journal of Psychopathology and Behavioral Assessment, 23, 133–143. First citation in articleCrossref, Google Scholar

  • Miklowitz, D. J. , George, E. L. , Richards, J. A. , Simoneau, T. L. , Suddath, R. L. (2003). A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Archives of General Psychiatry, 60, 904–912. First citation in articleCrossref, Google Scholar

  • Miklowitz, D. J. , Goldstein, M. J. (1997). Bipolar disorder: a family focused treatment approach. New York: Guilford. First citation in articleGoogle Scholar

  • Miklowitz, D. J. , Scott, J. (2009). Psychosocial treatments for bipolar disorder: Cost-effectiveness, mediating mechanisms, and future directions. Bipolar Disorders, 11, 110–122. First citation in articleCrossref, Google Scholar

  • Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511. First citation in articleCrossref, Google Scholar

  • Nolen-Hoeksema, S. (2012). Emotion regulation and psychopathology: The role of gender. Annual Review of Clinical Psychology, 8, 61–87. First citation in articleGoogle Scholar

  • Phillips, M. L. , Vieta, E. (2007). Identifying functional neuroimaging markers of bipolar disorder: Towards DSM-V. Schiophrenia Bulletin, 33, 893–904. First citation in articleCrossref, Google Scholar

  • Roberts, J. E. , Gilboa, E. , Gotlib, I. H. (1998). Ruminative response style and vulnerability to episodes of dysphoria: Gender, neuroticism, and episode duration. Cognitive Therapy and Research, 22, 401–423. First citation in articleCrossref, Google Scholar

  • Rowland, J. E. , Hamilton, M. K. , Lino, B. J. , Ly, P. , Denny, K. , Hwang, E.-J. , … Green, M. J. (2013). Cognitive regulation of negative affect in schizophrenia and bipolar disorder. Psychiatry Research, 208, 21–28. First citation in articleCrossref, Google Scholar

  • Schuppert, H. M. , Timmerman, M. E. , Bloo, J. , van Gemert, T. G. , Wiersema, H. M. , Minderaa, R. B. , … Nauta, M. H. (2012). Emotion regulation training for adolescents with borderline personality disorder traits: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 1314–1323. First citation in articleCrossref, Google Scholar

  • Scott, J. , Garland, A. , Moorhead, S. (2001). A pilot study of cognitive therapy in bipolar disorders. Psychological Medicine: Journal of Research in Psychiatry and the Allied Sciences, 31, 459–467. First citation in articleGoogle Scholar

  • Seiffge-Krenke, I. , Klessinger, N. (2000). Long-term effects of avoidant coping on adolescents' depressive symptoms. Journal of Youth and Adolescence, 29, 617–630. First citation in articleCrossref, Google Scholar

  • Sutton, S. K. , Johnson, S. J. (2002). Hypomanic tendencies predict lower startle magnitudes during pleasant pictures. Psychophysiology, 39, 80. First citation in articleGoogle Scholar

  • Svaldi, J. , Trentowska, M. , Bender, C. , Naumann, E. , Tuschen-Caffier, B. (2014). Pilotstudie zur Effektivität eines Emotionsregulationstrainings bei Frauen mit Binge-Eating-Störung. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 62, 19–26. First citation in articleLink, Google Scholar

  • Teper, R. , Segal, Z. V. , Inzlicht, M. (2013). Inside the mindful mind: How mindfulness enhances emotion regulation through improvements in executive control. Current Directions in Psychological Science, 22, 449–454. First citation in articleCrossref, Google Scholar

  • Thomas, J. , Knowles, R. , Tai, S. , Bentall, R. P. (2007). Response styles in bipolar disorder. Journal of Affective Disorders, 100, 249–252. First citation in articleCrossref, Google Scholar

  • Van Der Gucht, E. , Morriss, R. , Lancaster, G. , Kinderman, P. , Bentall, R. P. (2009). Psychological processes in bipolar affective disorder: Negative cognitive style and reward processing. British Journal of Psychiatry, 194, 146–151. First citation in articleCrossref, Google Scholar

  • Wittchen, H.-U. , Wunderlich, U. , Gruschwitz, S. , Zaudig, M. (1997). Strukturiertes klinisches Interview für DSM-IV, Achse-I (SKID). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Wolkenstein, L. , Zwick, J. C. , Hautzinger, M. , Joormann, J. (2014). Cognitive emotion regulation in euthymic bipolar disorder. Journal of Affective Disorders, 160, 92–97. First citation in articleCrossref, Google Scholar