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Gepubliceerd in: Cognitive Therapy and Research 3/2013

01-06-2013 | Original Article

Enhanced Anger Reactivity and Reduced Distress Tolerance in Major Depressive Disorder

Auteurs: Alissa J. Ellis, W. Michael Vanderlind, Christopher G. Beevers

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2013

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Abstract

Difficulty with effective emotion regulation is a central feature of major depressive disorder (MDD). Correlational evidence suggests that people with MDD experience elevated levels of irritability and anger, although few studies have experimentally tested this idea. The current study examined emotional reactivity across self-report (anger ratings), behavioral (task persistence), and physiological (heart rate, skin conductance) domains in response to a standardized, frustrating task in young adults with MDD (n = 74) and without MDD (n = 107). A secondary goal was to determine whether regulating emotional response with reappraisal, acceptance, or no instruction mitigated emotional reactivity across these domains. People with MDD responded with greater self-reported anger, lower galvanic skin conductance, and less task persistence (i.e., lower distress tolerance) than non-MDD individuals. Emotion regulation strategy did not differentially attenuate emotional responses between MDD groups. Instructions to accept emotions increased anger for all participants compared to reappraisal and no strategy instructions. Results confirm that enhanced anger reactivity and poor distress tolerance are present in MDD compared to healthy controls. However, additional work is needed to further develop and implement strategies that help people with MDD manage their emotional reactivity and enhance distress tolerance.
Voetnoten
1
After selecting for individuals in the MDD group, individuals were grouped as yes (n = 26) or no (n = 45) for the presence of an additional Axis I disorder. A 2 (Axis I: yes or no) × 3 (condition) × 2 (time) mixed plot ANOVA was conducted to explore the effects of comorbidities on anger reactivity. Results indicated that individuals who had a comorbid disorder did not differ from those who were exclusively experiencing a major depressive episode in their anger responses over time. Thus, the interaction of Axis I × time was non-significant, (F (1, 65) = 0.01, p = 0.92, η2 = 0.00). Further, there were no condition effects, and the time × Axis I × condition interaction was also non-significant, (F (2, 65) = 0.30, p = 0.74, η2 = 0.01). For distress tolerance, the effect of an additional Axis I disorder was also non-significant, F (1, 72) = 0.39, p = 0.53, η2 = 0.01. The interaction of condition × Axis I disorder was also non-significant, F (2, 72) = 0.61, p = 0.54, η2 = 0.02, indicating that additional Axis I diagnoses did not moderate distress tolerance.
Within the MDD group, individuals were grouped into those who are currently taking anti-depressants (n = 9) and those who are not (n = 62). A 2 (anti-depressant use: yes or no) × 3 (condition) × 2 (time) mixed plot ANOVA was conducted to explore the effects of medication on anger reactivity. Results indicated that individuals who were taking anti-depressants did not differ from those who were not in their anger responses over time. Thus, the interaction of medication use × time was non-significant, (F (1, 66) = 0.12, p = 0.73, partial η2 = 0.00). Further, there were no condition effects, and the time × medication use × condition interaction was also non-significant, (F (2, 66) = 2.86, p = 0.10, partial η2 = 0.04). For distress tolerance, the effect of medication use was also non-significant, F (1, 67) = 0.07, p = 0.79, partial η2 = 0.00. The condition × medication use interaction was also non-significant, F (2, 67) = 0.65, p = 0.53, partial η2 = 0.02.
 
2
During task differences between MDD groups also remained when controlling for time to termination (p = 0.059).
 
3
Although MDD groups did not differ on overall skill level during the MTPT-C, we considered it as an important covariate of our interaction effect (i.e., MDD × anger reactivity) on task persistence. When skill was included in the model, additional variance was explained, (R 2 = 0.37, F (4, 168) = 23.7, p < 0.001). The MDD group by anger reactivity interaction remained significant (b = −0.03, β = −0.30, t = −2.81, p = 0.01).
 
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Metagegevens
Titel
Enhanced Anger Reactivity and Reduced Distress Tolerance in Major Depressive Disorder
Auteurs
Alissa J. Ellis
W. Michael Vanderlind
Christopher G. Beevers
Publicatiedatum
01-06-2013
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 3/2013
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-012-9494-z