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Free AccessOriginal article

Proper Emotion Recognition, Dysfunctional Emotion Regulation

The Mystery of Affective Dysregulation in Adolescent Psychiatric Inpatients

Published Online:September 29, 2016https://doi.org/10.1024/1422-4917/a000479

Abstract

Abstract.Objective: A considerable number of adolescents exhibit severe self-regulation deficits in affect and behavior, which are referred to as affective dysregulation (AD). AD may be conceptualized as a dimensional trait that, in its extreme form, resembles the diagnostic categories of severe mood dysregulation (SMD) or disruptive mood dysregulation disorder (DMDD). Assuming a shared pathway of psychopathology in AD and SMD, similar underlying dysfunctional mechanisms in emotion processing, particularly emotion recognition (RECOG) and regulation (REGUL), may be postulated. Method: Adolescent inpatients with AD (CAD, N = 35), without AD (CCG, N = 28), and nonclinical controls (NCG; N = 28) were administered a morphed facial recognition task (RECOG). REGUL abilities, levels of irritability as well as depressive symptoms were also assessed. Results: We found no significant group differences in accuracy and thresholds for RECOG abilities. Patients with AD reported more dysfunctional REGUL strategies than did CCG and NCG. Both depression and AD, but not irritability, influenced the overall degree of maladaptive REGUL. Conclusion: The broad phenotype of AD does not involve the deficits in RECOG reported for adolescents with a narrow phenotype (SMD); regarding REGUL strategies, AD seems to be associated with specific impairments.


Störungen der Affektregulation

Zusammenfassung.Fragestellung:Eine nicht unerhebliche Zahl Jugendlicher berichtet Symptome affektiver und behavioraler Dysregulation (AD). AD kann als dimensionaler Trait konzeptualisiert werden und ähnelt in seiner extremsten Ausprägung den diagnostischen Kategorien der Schweren Störung der Stimmungsregulation (SMD) oder der Disruptiven Affektregulationsstörung (DMDD). Davon ausgehend, dass AD und SMD dieselben psychopathologischen Entwicklungspfade aufweisen, nehmen wir an, dass auch bei AD zugrundeliegende dysfunktionale Mechanismen hinsichtlich der Prozessierung emotionaler Reize, vor allem der Emotionserkennung (RECOG) und -regulation (REGUL) vorhanden sind. Methodik: Adoleszente stationäre Patienten mit AD (CAD, N = 35), ohne AD (CCG, N = 28), und nicht-klinische Kontrollen (NCG; N = 28) führten einen gemorphten Emotionserkennungstest (RECOG) durch. REGUL Fähigkeiten, Ausmaß von Irritabilität als auch depressive Symptome wurden zusätzlich erfasst. Ergebnisse: Wir fanden keine Unterschiede hinsichtlich Erkennensgenauigkeit und Intensitätsausmaß (Schwelle) zwischen den Gruppen. Patienten mit AD berichteten mehr dysfunktionale REGUL Strategien im Vergleich zu CCG und NCG. Das Ausmaß von maladaptiver REGUL wurde sowohl von Depressivität und AD vorhergesagt, aber nicht durch das Ausmaß von Irritabilität beeinflusst. Schlussfolgerung: Der breite Phänotyp AD scheint nicht mit Defiziten in RECOG einherzugehen wie sie für Jugendliche mit dem engen Phänotyp (SMD) berichtet wurden; hinsichtlich der REGUL Strategien scheint AD mit spezifischen Beeinträchtigungen assoziiert zu sein.

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