Time in remission from depression predicts cognitive-affective regulation dynamics in everyday life.

Abstract

Introduction: Impairment in affect regulation continues even after remission from depression. However, little is known about whether difficulties in affect regulation persist or improve as time in remission grows and how they manifest in everyday life. With the aim of addressing this gap, we hypothesized that greater time in remission would correspond with more positive affect and perceived regulatory success, and with less negative affect, perseverative cognition, and momentary impulsivity. An exploratory aim was to determine whether executive dysfunction would mediate relationships between time in remission and regulatory outcomes.

Method: A sample of 42 young adults with remitted major depressive disorder completed ecological momentary assessments, which included measures of positive and negative affect, perseverative cognition (rumination and worry), perceived regulatory success, and momentary impulsivity multiple times per day across the assessment period. Each person's mean level and variability of these constructs was computed and time in remission was calculated using a semi-structured clinical interview.

Results: Regression analyses indicated that a shorter time in remission predicted higher levels of negative affect, perseverative cognition, and momentary impulsivity and less perceived success with regulating affect in everyday life (ps < .05). Shorter time in remission also predicted more variability in perseverative cognition and positive and negative affect.

Discussion: Although cognitive-affective processes often are conceptualized as traits, our data indicate that these measures are dynamic, fluctuating across the course of a week. Several of these processes also appear to attenuate and stabilize as depressive episodes become more distal. These findings have important clinical implications, suggesting that remitted individuals may continue to benefit from interventions to reduce impulsive and perseverative cognitive-behavioral patterns and improve regulation success and affective stability. Interventions may have particular utility earlier in remission when these skills may be more impaired, with the goal of restoring functioning and reducing the likelihood of relapse.