Relaciones entre la regulación de las emociones y los síntomas de depresión y ansiedad: un análisis de redes
DOI:
https://doi.org/10.18800/psico.202601.013Palabras clave:
regulación emocional, síntomas de depresión, síntomas de ansiedad, análisis de redesResumen
Los síntomas parecen ser partes constitutivas de un problema clínico complejo, más que expresiones de una enfermedad, como se consideraba tradicionalmente. El análisis de redes ha demostrado ser útil para identificar correlaciones entre ellos. Este estudio aborda las asociaciones entre estrategias de regulación y síntomas depresivos y ansiosos, así como el riesgo y la capacidad protectora de las estrategias de regulación de las emociones, en una muestra de 1103 adultos de la Ciudad de Buenos Aires y el Gran Buenos Aires con edades entre 18 y 65 años (M= 31,96; DE = 10,32). Los resultados mostraron que la reevaluación cognitiva (RC) y la supresión expresiva (SE) podrían estar asociadas de manera diferente con los síntomas de ansiedad y depresión, aunque ambas mostraron una influencia esperada negativa como nodos puente en las redes, lo que sugiere un rol protector. Estos hallazgos tienen varias implicaciones para los tratamientos.
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Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
Aldao, A., Gee, D. G., De Los Reyes, A., & Seager, I. (2016). Emotion regulation as a transdiagnostic factor in the development of internalizing and externalizing psychopathology: Current and future directions. Development and Psychopathology, 28(4), 927–946. https://doi.org/10.1017/S0954579416000638
American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. www.apa.org/ethics/code/principles.pdf
Bargh, J. A., y Williams, L. E. (2007). On the nonconscious of emotion regulation. En J. Gross (Ed.), Handbook of emotion regulation (pp. 429?445). Guilford Press.
Beard, C., Millner, A. J., Forgeard, M. J., Fried, E. I., Hsu, K. J., Treadway, M. T., Leonard, C. V., Kertz, S. J., & Björgvinsson, T. (2016). Network analysis of depression and anxiety symptom relationships in a psychiatric sample. Psychological medicine, 46(16), 3359–3369. https://doi.org/10.1017/S0033291716002300
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897. https://doi.org/10.1037/0022-006X.56.6.893
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42(6), 861–865. https://doi.org/10.1037/h0037562
Beck, A. T., Steer, R. A. & Brown, G. K. (2006). Inventario de Depresión de Beck (BDI-II), Manual. Paidós.
Borsboom D. (2017). A network theory of mental disorders. World psychiatry: official journal of the World Psychiatric Association (WPA), 16(1), 5–13. https://doi.org/10.1002/wps.20375
Borsboom, D., & Cramer, A. O. (2013). Network analysis: an integrative approach to the structure of psychopathology. Annual review of clinical psychology, 9, 91–121. https://doi.org/10.1146/annurev-clinpsy-050212-185608
Borsboom, D., Cramer, A. O. J., Schmittmann, V. D., Epskamp, S., & Waldorp, L. J. (2011). The Small World of Psychopathology. PLoS ONE, 6(11), Article e27407. https://doi.org/10.1371/journal.pone.0027407
Bos, F. M., Fried, E. I., Hollon, S. D., Bringmann, L. F., Dimidjian, S., DeRubeis, R. J., & Bockting, C. L. H. (2018). Cross-sectional networks of depressive symptoms before and after antidepressant medication treatment. Social psychiatry and psychiatric epidemiology, 53(6), 617–627. https://doi.org/10.1007/s00127-018-1506-1
Boschloo, L., van Borkulo, C. D., Borsboom, D., & Schoevers, R. A. (2016). A Prospective Study on How Symptoms in a Network Predict the Onset of Depression. Psychotherapy and psychosomatics, 85(3), 183–184. https://doi.org/10.1159/000442001
Borsboom, D., & Cramer, A. O. J. (2013). Network analysis: An integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology, 9(1), 91–121. https://doi.org/10.1146/annurev-clinpsy-050212-185608
Bringmann, L. F., & Eronen, M. I. (2018). Don’t blame the model: Reconsidering the network approach to psychopathology. Psychological Review, 125(4), 606–615. https://doi.org/10.1037/rev0000108
Brenlla, M. E., & Rodríguez, C. M. (2006). Adaptación argentina del Inventario de Depresión de Beck (BDI-II). Paidós.
Briganti, G., Scutari, M., & Linkowski, P. (2021). Network structures of symptoms from the Zung Depression Scale. Psychological Reports, 124(4), 1897–1911. https://doi.org/10.1177/0033294120942116
Bringmann, L. F., Lemmens, L. H., Huibers, M. J., Borsboom, D., & Tuerlinckx, F. (2015). Revealing the dynamic network structure of the Beck Depression Inventory-II. Psychological medicine, 45(4), 747–757. https://doi.org/10.1017/S0033291714001809
Burger, J., Isvoranu, A.-M., Lunansky, G., Haslbeck, J. M. B., Epskamp, S., Hoekstra, R. H. A., Fried, E. I., Borsboom, D., & Blanken, T. F. (2022). Reporting standards for psychological network analyses in cross-sectional data. Psychological Methods. Advance online publication. https://doi.org/10.1037/met0000471
Chen, J., & Chen, Z. (2008) Extended Bayesian Information Criteria for Model Selection with Large Model Spaces. Biometrika, 95, 759-771. https://doi.org/10.1093/biomet/asn034
Cía, A. H., Stagnaro, J. C., Aguilar Gaxiola, S., Vommaro, H., Loera, G., Medina-Mora, M. E., Sustas, S., Benjet, C., & Kessler, R. C. (2018). Lifetime prevalence and age-of-onset of mental disorders in adults from the Argentinean Study of Mental Health Epidemiology. Social psychiatry and psychiatric epidemiology, 53(4), 341–350. https://doi.org/10.1007/s00127-018-1492-3
Clark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M. (2017). Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health's Research Domain Criteria (RDoC). Psychological science in the public interest: a journal of the American Psychological Society, 18(2), 72–145. https://doi.org/10.1177/1529100617727266
Clark, D. A. (2022). Cognitive reappraisal. Cognitive and Behavioral Practice, 29(3), 564-566. https://doi.org/10.1016/j.cbpra.2022.02.018
Cludius, B., Mennin, D., & Ehring, T. (2020). Emotion regulation as a transdiagnostic process. Emotion, 20(1), 37–42. https://doi.org/10.1037/emo0000646
Costantini, G., Epskamp, S., Borsboom, D., Perugini, M., Mõttus, R., Waldorp, L. J., & Cramer, A. O. J. (2015). State of the aRt personality research: A tutorial on network analysis of personality data in R. Journal of Research in Personality, 54, 13–29. https://doi.org/10.1016/j.jrp.2014.07.003
Cramer, A. O. J., Waldorp, L. J., van der Maas, H. L. J., & Borsboom, D. (2010). Comorbidity: A network perspective. Behavioral and Brain Sciences, 33(2-3), 137–150. https://doi.org/10.1017/S0140525X09991567
Cuijpers, P., Karyotaki, E., Eckshtain, D., Ng, M. Y., Corteselli, K. A., Noma, H., Quero, S., & Weisz, J. R. (2020). Psychotherapy for depression across different age groups: A systematic review and meta-analysis. JAMA Psychiatry, 77(7), 694–702. https://doi.org/10.1001/jamapsychiatry.2020.0164
Cuthbert, B. N., & Kozak, M. J. (2013). Constructing constructs for psychopathology: the NIMH research domain criteria. Journal of abnormal psychology, 122(3), 928–937. https://doi.org/10.1037/a0034028
Cutuli D. (2014). Cognitive reappraisal and expressive suppression strategies role in the emotion regulation: an overview on their modulatory effects and neural correlates. Frontiers in systems neuroscience, 8, 175. https://doi.org/10.3389/fnsys.2014.00175
Dattani, S., Ritchie, H., & Roser, M. (2021). Mental Health. Our World in Data. https://ourworldindata.org/mental-health
Dryman, M. T., & Heimberg, R. G. (2018). Emotion regulation in social anxiety and depression: a systematic review of expressive suppression and cognitive reappraisal. Clinical psychology review, 65, 17–42. https://doi.org/10.1016/j.cpr.2018.07.004
Eaton, N. R., Bringmann, L. F., Elmer, T., Fried, E. I., Forbes, M. K., Greene, A. L., ... & Waszczuk, M. A. (2023). A review of approaches and models in psychopathology conceptualization research. Nature Reviews Psychology, 2(10), 622-636. https://doi.org/10.1038/s44159-023-00218-4
Epskamp, S., Borsboom, D., & Fried, E. I. (2018). Estimating psychological networks and their accuracy: A tutorial paper. Behavior research methods, 50(1), 195–212. https://doi.org/10.3758/s13428-017-0862-1
Epskamp, S., & Fried, E. I. (2018). A tutorial on regularized partial correlation networks. Psychological Methods, 23(4), 617–634. https://doi.org/10.1037/met0000167
Epskamp, S., Kruis, J., & Marsman, M. (2017). Estimating psychopathological networks: Be careful what you wish for. PloS one, 12(6), e0179891. https://doi.org/10.1371/journal.pone.0179891
Etchevers, M. J., Garay, C. J., Putrino, N., Grasso, J., Helmich, N. & Rojas, L. (2021). Relevamiento del estado psicológico de la población argentina. Observatorio de Psicología Social Aplicada, Facultad de Psicología, Universidad de Buenos Aires. http://www.psi.uba.ar/opsa/#informes
Everaert, J., & Joormann, J. (2019). Emotion regulation difficulties related to depression and anxiety: A network approach to model relations among symptoms, positive reappraisal, and repetitive negative thinking. Clinical Psychological Science, 7(6), 1304–1318. https://doi.org/10.1177/2167702619859342
Fassbinder E, Schweiger U, Martius D, Brand-de Wilde O and Arntz A (2016) Emotion Regulation in Schema Therapy and Dialectical Behavior Therapy. Front. Psychol. 7:1373.
Fernandes, M. A., & Tone, E. B. (2021). A systematic review and meta-analysis of the association between expressive suppression and positive affect. Clinical psychology review, 88, 102068. https://doi.org/10.1016/j.cpr.2021.102068
Fonseca-Pedrero, E. (2018). Network analysis in psychology. Papeles del Psicólogo, 39(1), 1-12. https://doi.org/10.23923/pap.psicol2018.2852
Forbes, M. K., Ringwald, W. R., Allen, T., Cicero, D. C., Clark, L. A., DeYoung, C. G., Eaton, N., Kotov, R., Krueger, R. F., Latzman, R. D., Martin, E. A., Naragon-Gainey, K., Ruggero, C. J., Waldman, I. D., Brandes, C., Fried, E. I., Goghari, V. M., Hankin, B., Sperry, S., . . . Wright, A. G. C. (2024). Principles and procedures for revising the hierarchical taxonomy of psychopathology. Journal of Psychopathology and Clinical Science, 133(1), 4–19. https://doi.org/10.1037/abn0000886
Fried, E. I., Epskamp, S., Nesse, R. M., Tuerlinckx, F., & Borsboom, D. (2016). What are 'good' depression symptoms? Comparing the centrality of DSM and non-DSM symptoms of depression in a network analysis. Journal of Affective Disorders, 189, 314–320. https://doi.org/10.1016/j.jad.2015.09.005
Fried, E. I., & Nesse, R. M. (2015). Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study. Journal of affective disorders, 172, 96–102. https://doi.org/10.1016/j.jad.2014.10.010
Fried, E. I., van Borkulo, C. D., Cramer, A. O. J., Boschloo, L., Schoevers, R. A., & Borsboom, D. (2017). Mental disorders as networks of problems: A review of recent insights. Social Psychiatry and Psychiatric Epidemiology: The International Journal for Research in Social and Genetic Epidemiology and Mental Health Services, 52(1), 1–10. https://doi.org/10.1007/s00127-016-1319-z
Friedman, J., Hastie, T., & Tibshirani, R. (2008). Sparse inverse covariance estimation with the graphical lasso. Biostatistics, 9(3), 432–441. https://doi.org/10.1093/biostatistics/kxm045
Fusar-Poli, P., Solmi, M., Brondino, N., Davies, C., Chae, C., Politi, P., Borgwardt, S., Lawrie, S. M., Parnas, J., & McGuire, P. (2019). Transdiagnostic psychiatry: a systematic review. World psychiatry: official journal of the World Psychiatric Association (WPA), 18(2), 192–207. https://doi.org/10.1002/wps.20631
González, A., del Río-Casanova, L., & Justo-Alonso, A. (2017). Integrating neurobiology of emotion regulation and trauma therapy: reflections on EMDR therapy. Reviews in the Neurosciences, 28(4), 431-440. https://doi.org/10.1515/revneuro-2016-0070
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of general psychology, 2(3), 271-299. https://doi.org/10.1037%2F1089-2680.2.3.271
Gross, J. J. (2001). Emotion Regulation in Adulthood: Timing Is Everything. Current Directions in Psychological Science, 10(6), 214-219. https://doi.org/10.1111/1467-8721.00152
Gross, J. J. (2015). The extended process model of emotion regulation: Elaborations, applications, and future directions. Psychological Inquiry, 26(1), 130-137. https://doi.org/10.1080/1047840X.2015.989751
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality and social psychology, 85(2), 348. https://doi.org/10.1037/0022-3514.85.2.348
Hakulinen, C., Fried, E. I., Pulkki-Råback, L., Virtanen, M., Suvisaari, J., & Elovainio, M. (2020). Network structure of depression symptomology in participants with and without depressive disorder: the population-based Health 2000-2011 study. Social psychiatry and psychiatric epidemiology, 55(10), 1273–1282. https://doi.org/10.1007/s00127-020-01843-7
Hevey D. (2018). Network analysis: a brief overview and tutorial. Health psychology and behavioral medicine, 6(1), 301–328. https://doi.org/10.1080/21642850.2018.1521283
Henry, T. R., Robinaugh, D. J., & Fried, E. I. (2022). On the control of psychological networks. Psychometrika, 87(1), 188–213. https://doi.org/10.1007/s11336-021-09796-9
Hu, T., Zhang, D., Wang, J., Mistry, R., Ran, G., & Wang, X. (2014). Relation between emotion regulation and mental health: a meta-analysis review. Psychological reports, 114(2), 341–362. https://doi.org/10.2466/03.20.PR0.114k22w4
Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., & Wang, P. (2010). Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. The American Journal of Psychiatry, 167(7), 748–751. https://doi.org/10.1176/appi.ajp.2010.09091379
JASP Team (2022). JASP (Version 0.16.4) [Computer software]. https://jasp-stats.org
Jones, P. J., Ma, R., & McNally, R. J. (2021). Bridge centrality: A network approach to understanding comorbidity. Multivariate Behavioral Research, 56(2), 353–367. https://doi.org/10.1080/00273171.2019.1614898
Kaiser, T., Herzog, P., Voderholzer, U., & Brakemeier, E. L. (2021). Unraveling the comorbidity of depression and anxiety in a large inpatient sample: Network analysis to examine bridge symptoms. Depression and anxiety, 38(3), 307–317. https://doi.org/10.1002/da.23136
Kihlstrom, J. F. (2021). Ecological Validity and “Ecological Validity”. Perspectives on Psychological Science, 16(2), 466-471.https://doi.org/10.1177/1745691620966791
Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., Brown, T. A., Carpenter, W. T., Caspi, A., Clark, L. A., Eaton, N. R., Forbes, M. K., Forbush, K. T., Goldberg, D., Hasin, D., Hyman, S. E., Ivanova, M. Y., Lynam, D. R., Markon, K., … Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477. https://doi.org/10.1037/abn0000258
Krueger, R. F., Kotov, R., Watson, D., Forbes, M. K., Eaton, N. R., Ruggero, C. J., Simms, L. J., Widiger, T. A., Achenbach, T. M., Bach, B., Bagby, R. M., Bornovalova, M. A., Carpenter, W. T., Chmielewski, M., Cicero, D. C., Clark, L. A., Conway, C., DeClercq, B., DeYoung, C. G., . . . Zimmermann, J. (2018). Progress in achieving quantitative classification of psychopathology. World Psychiatry, 17(3), 282–293. https://doi.org/10.1002/wps.20566
Lahey, B. B., Moore, T. M., Kaczkurkin, A. N., & Zald, D. H. (2021). Hierarchical models of psychopathology: empirical support, implications, and remaining issues. World psychiatry: official journal of the World Psychiatric Association (WPA), 20(1), 57–63. https://doi.org/10.1002/wps.20824
Liang, S., Liu, C., Rotaru, K., Li, K., Wei, X., Yuan, S., Yang, Q., Ren, L., & Liu, X. (2022). The relations between emotion regulation, depression and anxiety among medical staff during the late stage of COVID-19 pandemic: a network analysis. Psychiatry research, 317, 114863. https://doi.org/10.1016/j.psychres.2022.114863
Lunansky, G., & Garay, C. J. (2022). Psicopatología como red causal compleja de síntomas interactivos. Interdisciplinaria, 39(2), 167-179. https://doi.org/10.16888/interd.2022.39.2.11
McRae, K., & Gross, J. J. (2020). Emotion regulation. Emotion, 20(1), 1–9. https://doi.org/10.1037/emo0000703
Pagano, A., & Vizioli, N. (2021a). Estabilidad temporal y validez discriminante del Inventario de Ansiedad de Beck. LIBERABIT. Revista Peruana De Psicología, 27(1), e450. http://dx.doi.org/10.24265/liberabit.2021.v27n1.03
R Core Team. (2023). R: A language and environment for statistical computing (Version 4.3.2) [Computer software]. R Foundation for Statistical Computing. https://www.R-project.org/
Pagano, A. E., & Vizioli, N. A. (2021b). Adaptación del Cuestionario de Regulación Emocional (ERQ) en población adulta de la Ciudad Autónoma de Buenos Aires y el Conurbano Bonaerense. Revista psicodebate: psicología, cultura y sociedad., 21(1), 18-32. https://doi.org/10.18682/pd.v21i1.3881
Rief, W., Hofmann, S. G., Berg, M., Forbes, M. K., Pizzagalli, D. A., Zimmermann, J., Fried, E., & Reed, G. M. (2023). Do We Need a Novel Framework for Classifying Psychopathology? A Discussion Paper. Clinical psychology in Europe, 5(4), e11699. https://doi.org/10.32872/cpe.11699
Robinaugh, D. J., Millner, A. J., & McNally, R. J. (2016). Identifying highly influential nodes in the complicated grief network. Journal of abnormal psychology, 125(6), 747–757. https://doi.org/10.1037/abn0000181
Robinaugh, D. J., Haslbeck, J. M. B., Waldorp, L. J., Kossakowski, J. J., Fried, E. I., & Borsboom, D. (2019). Advancing the network theory of mental disorders: A computational model of panic disorder. Psychological Medicine, 49(5), 741–748. https://doi.org/10.1017/S0033291718001563
Roepke, A. M., & Seligman, M. E. (2016). Depression and prospection. The British journal of clinical psychology, 55(1), 23–48. https://doi.org/10.1111/bjc.12087
Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical psychology review, 57, 141–163. https://doi.org/10.1016/j.cpr.2017.09.002
Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin
Sheppes, G., Suri, G., y Gross, J. J. (2015). Emotion regulation and psychopathology. Annual review of clinical psychology, 11, 379-405. https://doi.org/10.1146/annurev-clinpsy-032814-112739
Tibshirani, R. (1996). Regression shrinkage and selection via the lasso. Journal of the Royal Statistical Society: Series B (Methodological), 58(1), 267-288. https://doi.org/10.1111/j.2517-6161.1996.tb02080.x
Vizioli, N., & Pagano, A. (2020). Adaptación del Inventario de Ansiedad de Beck en población de Buenos Aires. Interacciones, 6(3), e171. https://doi. org/10.24016/2020.v6n3.171
Vizioli, N. A. (2024a). Beck Anxiety Inventory: Measurement Invariance, Latent Mean Comparison, and Reliability in Adults from Buenos Aires. Psychological Thought, 17(1), 35-57. https://doi.org/10.37708/psyct.v17i1.792
Vizioli, N. A. (2024b). Argentine adaptation of the emotion regulation questionnaire (ERQ): new psychometric evidence. Current Psychology, 43(7), 6396-6404. https://doi.org/10.1007/s12144-023-04830-8
Vizioli, N. A., & Pagano, A. E. (2022a). Inventario de Ansiedad de Beck: validez estructural y fiabilidad a través de distintos métodos de estimación en población argentina. Acta Colombiana de Psicología, 25(1), 28-41. https://doi.org/10.14718/ACP.2022.25.1.3
Vizioli, N. A., & Pagano, A. E. (2022b). Estabilidad Temporal, Validez Convergente e Incremental de la Versión Argentina del Cuestionario de Regulación Emocional (ERQ). Psychologia, 16(1), 71-81. https://doi.org/10.21500/19002386.5397
World Medical Association. (2013). Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA Network, 310(20), 2191-2194. https://doi.org/10.1001/jama.2013.281053
