Many psychiatric disorders are said to be characterized by problems with emotion and emotion regulation (estimates range from 40% to more than 75%; see Berenbaum, AbstractMany psychiatric disorders are widely thought to involve problematic patterns of emotional reactivity and emotion regulation. Unfortunately, it has proven far easier to assert the centrality of "emotion dysregulation" than to rigorously document the ways in which individuals with various forms of psychopathology differ from healthy individuals in their patterns of emotional reactivity and emotion regulation. In the first section of this article, we define emotion and emotion regulation. In the second and third sections, we present a simple framework for examining emotion and emotion regulation in psychopathology. In the fourth section, we conclude by highlighting important challenges and opportunities in assessing and treating disorders that involve problematic patterns of emotion and emotion regulation.

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Objective To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually-administered Cognitive-Behavioral Therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method A randomized controlled trial in which 75 adult patients (21–55 years of age; 53% male; 57% Caucasian) with a principal diagnosis of generalized SAD were randomly assigned to 16 sessions of I-CBT (n = 38) or a waitlist control (WL) group (n = 37). All patients completed self-report inventories measuring cognitive reappraisal self-efficacy (CR-SE) and social anxiety symptoms at baseline and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year post-treatment. Results Compared to WL, I-CBT resulted in greater increases in CR-SE and greater decreases in social anxiety. Increases in CR-SE during I-CBT mediated the effect of I-CBT on social anxiety. Gains achieved by patients receiving I-CBT were maintained 1-year post-treatment, and I-CBT-related increases in CR-SE were also associated with reduction in social anxiety at the 1-year follow-up. Conclusions Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.

OBJECTIVE Effective treatments for social anxiety disorder (SAD) exist, but additional treatment options are needed for non-responders as well as those who are either unable or unwilling to engage in traditional treatments. Mindfulness-Based Stress Reduction (MBSR) is one non-traditional treatment that has demonstrated efficacy in treating other mood and anxiety disorders, and preliminary data suggest its efficacy in SAD as well. METHOD Fifty-six adults (52% female; 41% Caucasian; Age (M ± SD): 32.8 ± 8.4) with SAD were randomized to MBSR or an active comparison condition, aerobic exercise (AE). At baseline and post-intervention, participants completed measures of clinical symptoms (Liebowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Beck Depression Inventory-II, and Perceived Stress Scale) and subjective well-being (Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Self-Compassion Scale and UCLA-8 Loneliness Scale). At 3-months post intervention, a subset of these measures were re-administered. For clinical significance analyses, 48 healthy adults (52.1% female; 56.3% Caucasian; Age (M ± SD): 33.9 ± 9.8) were recruited. MBSR and AE participants were also compared to a separate untreated group of 29 adults (44.8% female; 48.3% Caucasian; Age (M ± SD): 32.3 ± 9.4) with generalized SAD who completed assessments over a comparable time period with no intervening treatment. RESULTS A 2 (Group) × 2 (Time) repeated-measures analyses of variance (ANOVAs) on measures of clinical symptoms and well-being were conducted to examine pre to post and pre- to 3-month follow-up. MBSR and AE were both associated with reductions in social anxiety and depression and increases in subjective well-being, both immediately post intervention and at 3-months post intervention. When participants in the RCT were compared to the untreated SAD group, participants in both interventions exhibited improvements on measures of clinical symptoms and well-being. CONCLUSION Non-traditional interventions such as MBSR and AE merit further exploration as alternative or complementary treatments for SAD.

It is widely agreed that emotion regulation plays an important role in many psychological disorders. We make the case that emotion regulation is in fact a key transdiagnostic factor, using the Research Domain Criteria (RDoC) as an organizing framework. In particular, we first consider how transdiagnostic and RDoC approaches have extended categorical views. Next, we examine links among emotion generation, emotion regulation, and psychopathology, with particular attention to key emotion regulation stages including identification, strategy selection, implementation, and monitoring. We then propose that emotion regulation be viewed as a sixth domain in the RDoC matrix, and provide a brief overview of how the literature has used the RDoC units of analyses to study emotion regulation. Finally, we highlight opportunities for future research and make recommendations for assessing and treating psychopathology.

Objective To investigate treatment outcome and mediators of Cognitive-Behavioral Group Therapy (CBGT) vs. Mindfulness-Based Stress Reduction (MBSR) vs. Waitlist (WL) in patients with generalized social anxiety disorder (SAD). Method 108 unmedicated patients (55.6% female; mean age = 32.7, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT vs. MBSR vs. WL and completed assessments at baseline, post-treatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale – Self-Report (primary outcome) as well as measures of treatment-related processes. Results Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared to WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms. Conclusions CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.