Emotions play a central role in human life. They help us to respond to problems and challenges in our environment; they help us to organize our thoughts and actions, both explicitly and implicitly; and they guide our behavior. Perhaps because our emotions exert such widespread influence, we spend a good deal of time trying to influence or regulate how we feel and how we present our emotions to others. Given their centrality, it is not surprising that emotion disturbances figure prominently in many different forms of psychopathology. By one analysis, as many as 85% of psychological disorders include disturbances in emotional processing of some kind (Thoits, 1985), whether they be “excesses” in emotion; “deficits” in emotion, or the lack of coherence among emotional components. Indeed, as illustrated in Table 14.1, many of the disorders found in the current Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSM-IV-TR; American Psychiatric Association, 2000) include one or more symptoms reflecting an emotion disturbance, Research designed to uncover the nature of emotion disturbances in different psychological disorders has flourished in the last 15 years (for reviews, see Berenbaum, Raghavan, Le, Vernon, & Gomez, in press; Keltner & Kring, 1998; Kring, 2001). At the same time, research in the emerging field of emotion regulation has also burgeoned, with an emphasis on understanding the basic properties associated with the regulation of the experience and expression of emotion (e.g., Cicchetti, Ackerman, & Izard, 1995; Gross, 1998; Thompson, 1994). As the aforementioned quote illustrates, the notion that unregulated emotions lead to madness has a firm place in history. Moreover, contemporary writings on emotion and psychopathology often cast emotion disturbances as problems in regulation. Unfortunately, the framing of emotion disturbances in psychopathology as problems in emotion regulation has often been done with limited empirical support. The central goal of this chapter is to critically consider the extent to which the emotion disturbances in psychopathology can be construed as problems in emotion regulation. To do so, we first discuss current definitions of emotion and emotion regulation and the ways in which these two constructs may (or may not) be distinguishable. Second, we consider the concept of emotion dysregulation and the ways in which dysregulation can be distinguished from regulation. Next, we review the evidence for emotion regulation problems in different types of psychological disorders, focusing our attention primarily on disorders that affect adults (for consideration of emotion regulation problems and developmental psychopathology, see Calkins & Howse, this volume). Finally, we conclude with a consideration of the implications that emotion regulation problems in psychopathology have for assessment and treatment, with an eye toward future research.
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