Selection and implementation of emotion regulation strategies in major depressive disorder: An integrative review

- There is a large literature on emotion regulation (ER) in major depression (MDD).
- MDD is linked to aberrant habitual use of ER strategies based on self-reports.
- People with MDD can often effectively implement ER strategies under instruction.
- More laboratory and naturalistic emotion regulation research is needed.

Emotion regulation (ER), broadly defined, has been implicated in mental health, including major depressive disorder (MDD). We review empirical studies examining selection and implementation of ER strategies in adults with current or past MDD. We focus on eight strategies (rumination, distraction, cognitive reappraisal, suppression, acceptance, savoring, positive rumination, dampening), organizing the review by research design: (1) self-reported habitual use (i.e., trait) of ER strategies, (2) spontaneous use of ER strategies in laboratory settings, (3) experimentally instructed ER strategies, and (4) use of ER strategies in naturalistic settings. Reviewed findings suggest that MDD is associated with unskillful selection of ER strategies-indexed by self-reported habitual use of ER strategies-but not impaired abilities to implement them; in fact, those with current MDD and MDD in remission show intact abilities to implement many ER strategies when instructed to do so. Additionally, the vast majority of research examines trait ER, while there is a dearth of laboratory and naturalistic studies using MDD samples. There are also discrepant findings on habitual use of ER strategies assessed by self-reports and spontaneous use of ER strategies in the lab. We discuss implications of reviewed findings and five areas for future research in emotion dysregulation in MDD.