(PS2-A22) Emotion Regulation in Anxiety Disorders – Patterns and Changes Due to CBT

Background: Emotion regulation plays a crucial role in the development and maintenance of psychological disorders, especially anxiety disorders. Less is known about the association of maladaptive emotion regulation strategies and specific anxiety disorders. The aim of the current study was to investigate patterns of maladaptive emotion regulation in different anxiety disorders as well as to examine chances of those regulation strategies as a result of undergoing cognitive-behavioral therapy (CBT). In addition, we wanted to identify a possible link between certain emotion regulation patterns and remission.

Methods: (1) The first sample consisted of N = 917 outpatients receiving CBT. They completed the “Affective Style Questionnaire” (ASQ) as well as the “Emotion Regulation Questionnaire” (ERQ) before the beginning of treatment. (2) The second sample consisted of outpatients (N = 101) suffering from panic disorder, specific phobia, or agoraphobia who completed the ASQ before and after therapy, as well as at a 6-month follow-up assessment. (3) The third sample derived from the largest RCT trial of anxiety disorders in Germany. N = 726 patients suffering from panic disorder, agoraphobia, social anxiety disorder, or multiple specific phobias, who received exposure-CBT, completed the ERQ before treatment as well as at follow-up assessment. Multivariate analyses of variance were conducted to test for changes due to therapy. Logistic regression analyses were calculated to test for the impact of emotion regulation strategies on remission from anxiety disorders, and hierarchical regression analyses were calculated to examine the association between changes in specific strategies and symptom reduction.

Results: Results indicated significant increases on the ASQ subscales adjusting and tolerating after therapy. Concealing did not decrease significantly after therapy. In addition, higher scores on adjusting significantly predicted remission from anxiety disorders. Finally, we found a significant association between increases on the adjusting scale and the reduction of anxiety symptoms. Furthermore, the results of the regression analyses showed that the ASQ adjusting and concealing behavior seem to play a more important role than the ERQ reappraisal and suppression for anxiety disorder.

Discussion: Emotion regulation strategies, although not directly addressed, appear to change due to CBT. A more detailed understanding of maladaptive patterns in anxiety disorders might contribute to improving therapy outcomes.