Interventions targeting emotion regulation: A systematic umbrella review

Luigi F Saccaro; Alexis Giff; Maurilio Menduni De Rossi; Camille Piguet

doi:10.1016/j.jpsychires.2024.04.025

Interventions targeting emotion regulation: A systematic umbrella review

J Psychiatr Res. 2024 Apr 18:174:263-274. doi: 10.1016/j.jpsychires.2024.04.025. Online ahead of print.

Authors

Luigi F Saccaro¹, Alexis Giff², Maurilio Menduni De Rossi³, Camille Piguet⁴

Affiliations

¹ Psychiatry Department, Geneva University Hospital, Switzerland; Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland. Electronic address: LuigiFrancesco.Saccaro@unige.ch.
² Harvard Medical School, Boston, MA, USA.
³ Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, Pisa 56127, Italy; Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy.
⁴ Psychiatry Department, Geneva University Hospital, Switzerland; Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland.

PMID: 38677089
DOI: 10.1016/j.jpsychires.2024.04.025

Abstract

Background: Emotion dysregulation (ED), the difficulty in modulating which emotions are felt, and when and how they are expressed or experienced, has been implicated in an array of psychological disorders. Despite potentially different manifestations depending on the disorder, this symptom is emerging as a transdiagnostic construct that can and should be targeted early, given the associations with various maladaptive behaviors as early as childhood and adolescence. As such, our goal was to investigate the psychotherapeutic interventions used to address ED and gauge their effectiveness, safety, and potential mechanisms across various populations.

Methods: This umbrella systematic review, pre-registered under PROSPERO (registration: CRD42023411452), consolidates evidence from systematic reviews and meta-analyses on psychotherapeutic interventions targeting ED, in accordance with PRISMA guidelines.

Results: Our synthesis of quantitative and qualitative evidence from 21 systematic reviews (including 11 meta-analyses) points-with moderate overall risk of bias-to the effectiveness of Dialectical Behavior Therapy and Cognitive Behavioral Therapy in reducing ED in a wide range of adult transdiagnostic psychiatric patients and healthy participants. Similar results have emerged in other less extensively researched methods as well. However, results on adolescents and children are sparse, highlighting the need for additional research to tailor these interventions to the unique challenges of ED in younger populations with diverse externalizing and internalizing disorders.

Conclusions: These demonstrated transdiagnostic advantages of psychotherapy for ED underscore the potential for specifically designed interventions that address this issue directly, particularly for high-risk individuals. In these individuals, early interventions targeting transdiagnostic core dimensions may mitigate the emergence of full-blown disorders. Future research on the mediating factors, the durability of intervention effects, and the exploration of understudied interventions and populations may enhance prevention and treatment efficiency, enhancing the quality of life for those affected by varied manifestations of ED.

Keywords: Adolescents; Borderline personality disorder; Children; Emotional dysregulation; Mindfulness; Psychotherapy.

Publication types

Review