Date of this Version
Bottoms, H. C. (2013). Pathways to social functioning via emotion regulation in people with serious mental illness (PhD dissertation). University of Nebraska, Lincoln, NE.
Recent research on social cognitive deficits associated with serious mental illness (SMI) has demonstrated a range of emotion processing difficulties, from emotion perception to emotion regulation. Whereas emotion perception deficits are well documented in this population, little is understood about emotion regulation and the relationship of emotion regulation to other abilities and impairments.
Method. Participants included 41 individuals with SMI recruited from a day rehabilitation program. Assessments included a range of functional domains, including symptom severity, neurocognition, social cognition, emotion regulation, and social functioning.
Results. Emotion dysregulation was hypothesized to be associated with more severe positive symptoms, poorer neurocognitive functioning, and poorer social and community functioning. Results were mixed across the various assessments. There was some evidence of a relationship between psychiatric symptom severity and emotion dysregulation. However, global neurocognition explained very little of the variance in emotion regulation. Individuals with poorer emotion regulation tended to have poorer self-reported social functioning, and positive symptom severity accounted for some of the variance in this relationship. Path analysis modeling summarized these relationships.
Conclusions. This study demonstrates that emotion regulation explains variance in social functioning, but much remains to be understood about how emotion regulation relates to other biosystemic domains in this population. Limitations in valid assessment in the SMI population hinder ongoing progress, and this should be a key focus of future research, as orthogonal functional domains require individual attention in clinical assessment and research. Assessing segregated processes and investigating interactions among those processes reveal important relationships among subgroups of this population that would otherwise be missed. Though symptom severity and neurocognitive impairments have historically been the focus of treatment development for SMI, this work clearly demonstrates that individuals with SMI also have impaired emotion regulation abilities. Furthermore, that these abilities share an interactive relationship with social functioning and symptom severity reinforces their importance as potential treatment targets. Integrating emotion regulation skills training into the psychiatric rehabilitation toolkit is therefore a worthwhile future endeavor.
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