Effectiveness of Emotion Regulation in Daily Life in Individuals With Psychosis and Nonclinical Controls-An Experience-Sampling Study

Individuals with psychosis report employing more maladaptive and less adaptive emotion regulation (ER) strategies compared to nonclinical controls (NCs). However, it is unknown whether this is predictive of affect experienced in daily life and whether ER strategies are used less frequently and effectively by individuals with psychosis in daily life. Individuals with psychosis and current delusions (PDs; n = 71) and NCs (n = 42) completed questionnaires of habitual ER and experience sampling over 6 consecutive days, in which they reported 10 times a day on the presence of negative and positive affect and deployment of ER strategies (reappraisal, acceptance, awareness, suppression, rumination, distraction, and social sharing). Effectiveness of strategy use was operationalized by examining successive differences in positive and negative affect. Multilevel regression analyses were conducted. Questionnaires of habitual ER were largely predictive of affect in daily life. There was indication of a more frequent use of putatively maladaptive strategies but either no differences in individual adaptive strategies or even a more frequent use (reappraisal) in PDs compared to NCs. Several ER strategies (e.g., reappraisal, rumination) proved effective in reducing negative affect by the next prompt, independent of group, but suppression was effective in only PDs and acceptance had unfavorable effects in both groups. Thus, PDs demonstrated an increased use of ER strategies in daily life, of which the majority helped them to reduce negative affect. This indicates that their increased levels of negative affect are not explicable by difficulties in deploying explicit ER strategies.