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ViewAttendees 6

Symposia

Treatment - CBT

Session: Sharing and Leveraging the Lessons of CBT: Understanding How CBT Works and Using that Understanding to Inform Interventions

2 - (SYM 111) Reappraisal and Suppression as Mechanisms of Change in Transdiagnostic Cognitive Behavior Therapy for Internalizing Distress: Disaggregating Within- vs. Between-individual Variability

Saturday, November 18, 2023
4:30 PM – 6:00 PM PST
Location: Snohomish (605), Level 6
Emotion regulation strategies such as cognitive reappraisal (CR) and expressive suppression (ES) have emerged as potential transdiagnostic mechanisms of change in psychotherapy. Functional models of emotion dysregulation hypothesize that avoidance strategies like ES maintain internalizing distress symptoms, but these models have not received close empirical scrutiny in treatment studies. The objective of this study was to test whether week-to-week within-person changes in CR and ES predicted changes in psychological distress and well-being in a guided self-help intervention. N = 306 participants were recruited for a six-week remote trial of a guided self-help transdiagnostic CBT. Distress was measured with the Kessler Scale Psychological Distress Scale (K6) and well-being with the World Health Organization-5 Well-being Index (WHO-5). We used the Emotion Regulation Questionnaire (ERQ) to measure CR and ES and disaggregated within- versus between-person variability using a random intercept cross-lagged panel model. Participants (Mage = 36.31, SDage = 12.83, nfemale = 259, nnon-Hispanic white = 240) reported improvement in distress, well-being, CR, and ES with the smallest improvements in ES. At the between-person level, CR was associated with both distress (r = -0.14, p = .017) and well-being (r = 0.22, p < .001). At the within-person level, change in CR significantly predicted subsequent change in distress for most week-to-week lags across the trial. There was limited evidence for a relationship between week-to-week change in ES and subsequent change in distress. We also found limited evidence for relationships between changes in each CR and ES and subsequent change in well-being. Our findings support the role of cognitive reappraisal as a mechanism of change in transdiagnostic CBT.