May 27, 2024

New study highlights sleep and adaptive emotion regulation as key factors in mental health resilience

High-quality sleep and adaptive cognitive emotion regulation strategies can help to promote resilience to depression and anxiety when faced with negative or stressful experiences, according to new research published in the scientific journal Cortex.

The researchers were interested in understanding why some individuals experiencing chronic stress develop mental health problems, while others do not. They believed that pre-existing vulnerabilities and coping strategies, such as cognitive emotion regulation strategies and sleep quality, might play a crucial role in determining the mental health outcomes of individuals facing chronic stress.

Cognitive emotion regulation refers to the mental processes and strategies that individuals use to manage and regulate their emotional experiences in response to various situations, events, or stressors. These strategies involve cognitive (thinking) processes and can be voluntarily engaged by individuals to influence their emotions. There are different types of cognitive emotion regulation strategies, and researchers often categorize them into two broad groups: adaptive and maladaptive strategies.

Adaptive cognitive emotion regulation strategies include thought processes such as reinterpreting a situation in a positive light (positive reappraisal) or shifting attention towards problem-solving (refocus on planning). Maladaptive cognitive emotion regulation strategies include thought processes such as repetitively focusing on the negative aspects of a situation (rumination) or assuming the worst possible outcomes (catastrophizing).

“Since school, I’ve always been interested in sleep research,” said study author Emma Sullivan (@emmacsullivan_), a PhD student in cognitive neuroscience and neuroimaging at the University of York.

“We spend about a 1/3 of our lives asleep, so it surely serves some vital purpose. Over the last few years during my PhD, I’ve become interested in the intricate link between sleep, emotion regulation, and mental health. More specifically, how emotion regulation and sleep can promote resilience to mental health problems and on the other hand, how emotion dysregulation and sleep loss can contribute to the development of mental health problems.”

To conduct their study, the researchers performed a secondary analysis of data collected by the Boston College Daily Sleep and Well-being Survey during the COVID-19 pandemic.

“We have known for a long time that high-quality sleep is associated with better health and wellbeing outcomes, but we wanted to know whether this would change if sleep and coping strategies were put under intense and prolonged periods of stress, as it was for so many during the pandemic,” said Scott Cairney, the PhD supervisor on the project, in a news release.

Participants completed several questionnaires, including the Cognitive Emotion Regulation Questionnaire (CERQ) to assess their use of adaptive and maladaptive CER strategies, the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality, and the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) to assess levels of depression and anxiety. The researchers obtained demographic information from the participants as well.

After analyzing the data, the researchers found that greater use of adaptive cognitive emotion regulation strategies and higher levels of sleep quality were associated with lower levels of depression and anxiety. However, sleep quality was a more significant predictor of anxiety, whereas the benefits of adaptive cognitive emotion regulation strategy use were more relevant for depression.

“There are two key messages from my research that can be taken when we are next facing a chronic stressful situation,” Sullivan told PsyPost. “First, using positive coping strategies more frequently (e.g. appraising the situation in a positive light) can help to reduce depression and anxiety in the face of this stressor. Secondly, obtaining good sleep quality can also help to reduce depression and anxiety when faced with this stressor.”

Despite observing a positive correlation between sleep quality and adaptive cognitive emotion regulation strategy use, there was no significant interaction between these factors in predicting mental health outcomes. In other words, using positive coping strategies and obtaining good sleep quality each independently supported resilience to depression and anxiety, but they did not have a synergistic influence on mental health outcomes.

“We did expect to find an interaction between positive emotion regulation strategy use and sleep quality i.e. that using positive emotion regulation effectively (to reduce depression and anxiety) would depend on individuals being able to obtain high sleep quality,” Sullivan explained. “However, positive emotion regulation strategy use and sleep quality were independent predictors of reduced depression and anxiety, so each on their own can promote resilience to mental health problems.”

But the study, like all research, includes some caveats.

“It is important to note that we relied on subjective reports to measure positive emotion regulation strategy use and sleep quality,” Sullivan told PsyPost. “Therefore, in the future, these measures should be combined with objective assessments of emotion regulation and sleep quality, potentially through the use of wearables tracking sleep, and physiological arousal (e.g. heart rate variability).

“In addition, there was a lack of socio-demographic diversity in our data. Participants were predominantly female, white, well-educated individuals residing in the USA. As a result, our findings cannot be easily generalized to different societies, environments, and cultures, and replication across broader populations will be a crucial next step.”

“Given that we found positive emotion regulation and sleep quality to predict both depression and anxiety, this calls attention to the potential transdiagnostic benefits of targeting both positive emotion regulation strategies and sleep quality when enduring chronic periods of stress,” Sullivan added.

The study, “The influence of emotion regulation strategies and sleep quality on depression and anxiety“, was authored by Emma C. Sullivan, Emma James, Lisa-Marie Henderson, Cade McCall, and Scott A. Cairney.

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