Emotion Regulation and Repetitive Negative Thinking Before and After CBT and SSRI Treatment of Internalizing Psychopathologies

Emotion regulation (ER) strategies (i.e., reappraisal, suppression) and repetitive negative thinking (RNT) tendencies (i.e., brooding rumination, worry) are transdiagnostic and contribute to the maintenance of internalizing psychopathologies. Cognitive Behavioral Therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are both effective in reducing symptom severity, however, their impact on ER and RNT is unclear. Therefore, the goal of the current study was to examine whether CBT and SSRIs improved ER and RNT in a transdiagnostic sample. The current sample comprised 91 patients with anxiety, depression, and/or posttraumatic stress disorder randomly assigned to receive either CBT (n = 45) or an SSRI (n = 46) and 49 healthy controls as a comparator group. Patients completed measures of clinical symptoms, reappraisal, suppression, brooding rumination, and worry before and after treatment. Controls completed the same measures at baseline. Compared to controls, patients reported greater symptom severity, suppression, brooding, and worry, and less reappraisal. Both treatments improved symptom severity, ER, and RNT. However, patients who completed CBT reported greater improvement in reappraisal than patients who completed treatment with an SSRI. Finally, change in RNT, but not ER, was associated with symptom improvement. Findings suggest treatment improves ER and RNT and provides preliminary evidence of a treatment modality effect on reappraisal.