The role of emotion regulation in the characterization, development and treatment of psychopathology

Aberrant emotional processes are evident in various mental disorders. This raises the question of whether specific difficulties in regulating emotions are a driving factor of psychopathology and thus a worthwhile transdiagnostic treatment target. In this Review, we provide an overview of theoretical models of emotion regulation, research on emotion regulation difficulties associated with various mental disorders, longitudinal studies that address the question of causality and clinical interventions. This synthesis suggests that psychopathology across a range of disorders is associated with an inflexible pattern of regulating emotions predominantly using avoidance, rumination and suppression strategies. This pattern of emotion regulation seems to be both a predictor and a consequence of psychopathology. However, most studies do not support the assumption that people with mental disorders have a basic deficit in effectively employing potentially helpful strategies, such as acceptance or reappraisal. A separate line of research has developed effective transdiagnostic interventions for emotion regulation, but whether these interventions produce better outcomes than pre-existing therapies remains an open question. Linking basic clinical and intervention research is likely to increase understanding of what can go wrong in emotion regulation and support development of more effective interventions.