Maladaptive cognitive emotion regulation strategies and positive symptoms in schizophrenia spectrum disorders: The mediating role of global emotion dysregulation

Previous studies have identified a positive association between maladaptive cognitive emotion regulation strategies and positive symptoms (e.g., hallucinations and delusions) among patients with schizophrenia spectrum disorders. However, translating this finding to clinical practice is challenging. Some patients are reported to experience difficulties in correcting the use of maladaptive cognitive emotion regulation strategies in psychological therapy, which may be due to an underlying effect of global emotion dysregulation. Therefore, the present study aimed to determine the mediating or moderating role of global emotion dysregulation in the relationship between maladaptive cognitive emotion regulation strategies and positive symptoms. A total of 123 newly diagnosed patients with schizophrenia spectrum disorders completed self-report measures of maladaptive cognitive emotion regulation strategies (rumination, catastrophic thinking, self-blame, other-blame) and global emotion dysregulation. The severity of positive symptoms was rated on the Brief Psychiatric Rating Scale-Expanded. Mediation and moderation analyses were performed to test the hypothesized models. Mediation analysis revealed that global emotion dysregulation mediated the relationship between maladaptive cognitive emotion regulation strategies and positive symptoms after controlling for age, gender, ethnicity, duration of untreated psychosis, medication dosage, psychiatric comorbidities, and family history of mental illness (R2 = 23.3%, moderate effect size = 0.30). There was no moderating effect of global emotion dysregulation. The present study presents preliminary evidence on the mediating role of global emotion dysregulation in the relationship between maladaptive cognitive emotion regulation strategies and positive symptoms in schizophrenia spectrum disorders. This finding adds to our current understanding on emotion regulation phenomena in schizophrenia spectrum disorders.