Relationships between cognitive emotion regulation strategies with depression and anxiety

doi:10.4236/ojpsych.2011.13015

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Open Journal of Psychiatry, 2011, 1, 106-109

doi:10.4236/ojpsych.2011.13015 Published Online October 2011 (http://www.SciRP.org/journal/OJPsych/

OJPsych

Published Online October 2011 in SciRes. http://www.scirp.org/journal/OJPsych

Relationships between cognitive emotion regulation strategies

with depression and anxiety

Majid Pourfaraj Omran

Islamic Azad University, Behshahr Branch, Behshahr, Iran.

Email: [email protected]

Received 20 August 2011; revised 16 September 2011; accepted 10 October 2011.

ABSTRACT

In current study firstly, psychometric properties of

Cognitive Emotion Regulation Questionnaire (CERQ)

in an Iranian sample were examined. The result of

factor analysis, subscales correlations, internal con-

sistency and test-retest coefficients showed good psy-

chometric properties of CERQ in Iran. Secondly, rela -

tionships between cognitive emotion regulation stra-

tegies with depression and anxiety were studied by

multiple regression analysis. The result showed that

catastrophizing, self-blame and rumination were re-

lated with high level of anxiety and depression and

refocusing, positive r e appraisal and planning subscales

rel ated with low level of anxiety and depression.

Keywords: Cognitive Emotion Regulation; Depression;

Anxiety

1. INTRODUCTION

Emotion regulation includes a wide range of conscious

and unconscious physiological, behavioral, and cogni-

tive strategies that are used to reduce, maintain, or in-

crease an emotion [1]. Cognitive emotion regulation

(CER) involves the cognitive way of handling the intake

of emotionally arousing information [2,3]. A relatively

new scale, the Cognitive Emotion Regulation Question-

naire (CERQ), was developed to assess cognitive coping

to stressful life events. This questionnaire includes nine

cognitive strategies: self-blame, referring to thoughts of

putting the blame of what person has experienced on

her/himself; other-blame, referring to thoughts of putting

the blame of what person has experienced on the envi-

ronment or another person; rumination, referring to

thinking about the feelings and thoughts associated with

the negative event; catastrophizing, referring to thoughts

of explicitly emphasizing the terror of what person has

experienced; putting into Persp ective, referring to down-

grading the importance of the event; positive refocusing,

referring to thinking about positive experiences instead

of thinking about the actual event; positive reappraisal,

referring to thoughts of giving the event a positive mean-

ing in terms of personal growth; acceptance, referring to

thoughts of resigning person to what has happened and

planning, referring to thinking about what steps to take

and how to handle the negative event [4].

The CERQ has been included in an increasing number

of studies in various countries focusing on relationships

between cognitive processes and mental health. Despite

some variation across studies, cognitive strategies such as

self-blame, rumination, catastrophizing and positive reap-

praisal (inversely) have consistently been associated

with negative emotions like depression, anxiety, stress

and anger [4-9].

In this research for obtain more knowledge about cross

cultural difference about CER and its role in anxiety and

depression, firstly, psychometric properties of CERQ in

an Iranian sample was studied and then relationship be-

tween CER with anxiety and depression was examined.

2. METHOD

2.1. Subjects

Four hundred eighty four undergraduate students (265 ma-

les) with randomize cluster sampling were selected from

various departments of Shiraz University. The age of the

samples ranged from 18 to 32 years with a mean of 22.14

(SD = 4.02).

2.2. Instruments

2.2.1. Cogni tive Emotion Re gul a ti o n Q uestionnaire

(CERQ)

The CERQ was developed in 1999 for measuring the cog-

nitive emotion regulation strategies that subjects use in

response to the experience of stressful life events [6]. The

CERQ is a self-report questionnaire and has 36-item and 9

subscales (i.e., self-blame, other-blame, rumination, cata-

strophizing, putting into perspective, positive refocusing,

positive reappraisal, acceptance and planning). Items are

M. P. Omran / Open Journal of Psychiatry 1 (2011) 106-109 107

measured on a 5-point Likert scale ranging from 1 (al-

most never) to 5 (almost always). The CERQ can be use-

d to measure cognitive strategies that characterize the in-

dividual’s style of responding to stressful events as well as

cognitive strategies that are used in a particular stressful

event or situation, depending on the nature of the ques-

tions under study. In this study was used from questions

about stressful events. Individual subscale scores are ob-

tained by summing up the scores belonging to the par-

ticular subscale (ranging from 4 to 20). The psychometric

properties of the CERQ have been proven to be good

[10,11], with Cronbach’s alpha coefficients in most cases

well over 0.70 and in many cases even over 0.80. Moreover,

the CERQ has been shown to have good factorial validity,

discriminative properties and construct validity [6].

2.2.2. Beck Depression Inventory II (BDI-II)

The BDI-II, second edition of BDI, is a 21-item measure

that is widely used to assess cognitive, affective, somatic,

and behavioral symptoms of depression. Scores on the

BDI have range from 0 (no symptoms) to 63 (very se-

vere symptoms). The psychometric properties of the

scale are supported [12]. In Iran the psychometric prop-

erties of a Persian-language version of the this inventory

examined with compared mean item scores on the BDI-

II-Persian with those on the English-language version

administered to North American college students [13]. In

this study assessed internal consistency and test- retest reli-

ability and its concurrent validity against a measure of

negative automatic thoughts in depression, the Automa-

tic Thoughts Questionnaire [14]. They also examined the

factor structure of the BDI-II-Persian through comparing

the fit of various proposed models to the data using con-

firmatory factor analysis. The BDI-II-Persian had high

internal consistency (Cronbach’s alpha = 0.87) and ac-

ceptable test-retest reliability (r = 0.74). The instrument

correlated strongly with the Automatic Thoughts Ques-

tionnaire. In factor analysis, models with strongly corre-

lated affective-cognitive and somatic-vegetative factors

provided a better fit than models with one global factor.

2.2.3. State-Trait A nxiety In ventory (STAI)

The STAI is a 40-item self-report measure of general an-

xiety. The first 20 items assess state anxiety, or how the

participant feels ‘right now;’ the second 20 items assess

trait anxiety, or how the participant feels ‘generally.’ The

STAI has high reliability and validity [15]. Mahram [16]

in his study about standardization STAI in Iran reported

this inventory has good psychometric properties in Iran.

2.3. Procedure

The instruments were administered during or after regular

class hours. Before the administration, instructions about

procedure of responding to inventories were given to the

participants.

3. RESULT

3.1. Factor Structure

The factorial structure of the Persian version of the CERQ

was investigated with an exploratory principal components

(PCA) followed by varimax rotation. Items were in-

cluded on a factor if the loading was 0.40 or higher. This

analysis revealed nine factors with eigenvalues greater

than 1, accounting for 76% of the total variance. The

results of factor analyses were summarized in Table 1.

Table 1. Factor structure of CERQ.

Factors and items Loading

Self-blame

I feel that I am the one to blame for it 0.68

I feel that I am the one who is responsible for what has

happened 0.71

I think about the mistakes I have made in this matter 0.64

I think that basically the cause must lie within myself 0.75

Other-blame

I feel that others are to blame for it 0.72

I feel that others are responsible for what has happened 0.64

I think about the mistakes others have made in this matter 0.59

I feel that basically the cause lies with others 0.61

Rumination

I often think about how I feel about what I have experi-

enced 0.69

I am preoccupied with what I think and feel about what I

have experienced 0.78

I want to understand why I feel the way I do about what I

have experienced 0.66

I dwell upon the feelings the situation has evoked in me 0.63

Catastrophizing

I often think that what I have experienced is much worse

than what others have experienced 0.77

I keep thinking about how terrible it is what I have experi-

enced 0.71

I often think that what I have experienced is the worst tha

can happen to a person 0.72

I continually think how horrible the situation has been 0.75

Refocus on planning

I think of what I can do best 0.69

I think about how I can best cope with the situation 0.73

I think about how to change the situation 0.65

I think about a plan of what I can do best 0.79

Positive reappraisal

I think I can learn something from the situation 0.58

I think that I can become a stronger person as a result o

what has happened 0.66

I think that the situation also has its positive sides 0.71

I look for the positive sides to the matter 0.75

Putting into perspective

I think that it all could have been much worse 0.56

I think that other people go through much worse experi-

ences 0.69

I think that it hasn’t been too bad compared to other things 0.71

I tell myself that there are worse things in life 0.67

Acceptance

I think that I have to accept that this has happened 0.70

I think that I have to accept the situation 0.64

I think that I cannot change anything about it 0.71

I think that I must learn to live with it 0.57

Positive refocusing

I think of nicer things than what I have experienced 0.70

I think of pleasant things that have nothing to do with it 0.68

I think of something nice instead of what has happened 0.59

I think about pleasant experiences 0.65

M. P. Omran / Open Journal of Psychiatry 1 (2011) 106-109

108

3.2. Reliability

Internal consistency (Cronbach’s alpha), and test-retest

coefficients for with 3 weeks interval (N = 30; one class

of original sample) was computed for each CERQ sub-

scale .The result was shown in Table 2.

3.3. Subscales Correlations

Correlations between subscales were summarized in

Ta ble 3. The correlation matrix shows that the correla-

tions among subscales that are conceptually inverse (e.g.

Self-blame vs. other-blame, catastrophizing vs. positive

reappraisal and putting into perspective) are significantly

negative but subscales that are conceptually near (e.g.

putting into perspective, positive refocusing, positive

reappraisal and acceptance) are significantly positive.

OJPsych

3.4. Relationships between CER with Depression

and Anxiety

For investigation relationships between CER with de-

pression and anxiety was used from BDI-II and STAI.

The result of multiple regression analyses (Table 4) that

were performed with depression and anxiety scales as

dependent variables and the CERQ as independent vari-

ables shows both regression models were significant (p <

0.001) and explained 0.42 and 0.45 percentage for the

prediction of depression and anxiety, respectively. Catas-

trophizing, self-blame and rumination subscales were stro-

ngest predictors of anxiety and depression and related

with high level of anxiety and depression, but refocusing,

positive reappraisal and planning subscales related with

low level of anxiety and depression.

Table 2. Means, standard deviations and reliability of CERQ.

Test-retestα Mean (SD) Subscales

0.61 0.69 10.44 (3.52) Self-blame

0.66 0.77 7.64 (1.65) Other-blame

0.59 0.76 11.21 (4.02) Rumination

0.60 0.68 8.09 (2.45) Catastrophizing

0.65 0.80 10.61 (3.63) Planning

0.57 0.75 9.89 (3.95) Positive reappraisal

0.69 0.70 10.9 6 (2.98) Putting into perspective

0.66 0.72 8.65 (3.31) Acceptance

0.62 0.79 9.55 (3.01) Positive refocusing

Table 3. Correlations between CERQ subscales.

CERQ subscales 1 2 3 4 5 6 7 8

1. Self-blame

2. Acceptance 0.21**

3. Rumination 0.17** 0.27***

4. Positive refocusing 0.08 0.24*** 0.05

5. Planning 0.40*** 0.28*** 0.33*** 0.18**

6. Positive reappraisal 0.22** 0.31*** 0.16** 0.41*** 0.44***

7. Putting into perspective 0.18** 0.27*** 0.06 0.36*** 0.38*** 0.41***

8. Catastrophizing 0.20** 0.05 0.46*** –0.07 0.03 –0.11* –0.13*

9. Other-blame –0.13* –0.02 0.25*** 0.03 0.05 –0.02 0.03 0.36***

*p < 0.05; **p < 0.01; ***p < 0.001.

4. DISCUSSION

Table 4. Relationships between CER strategies with depression

and anxiety (multiple regression analysis)’.

The aim of this study was determination psychometric

properties of the CERQ in Iran and relationship between

CER with anxiety and depression. For study of validity

factor analysis, criterion validity and subscales correla-

tions were used. Factor analysis of CERQ yielded nine

factors that are labeled as: self-blame, other-blame, ru-

mination, catastrophizing, putting into perspective, posi-

tive refocusing, positive reappraisal, acceptance and pla-

nning. Low to moderate negative correlations among

subscales that are conceptually in versus with together

and positive correlations among subscales that are con-

ceptually near together could show fit construct validity

of this questionnaire.

STAI(Beta) BDI-II(Beta) Subscales

0.20**

0.26***

1. Self-blame

0.01

0.04

2. Acceptance

0.31***

0.23***

3. Rumination

–0.24***

–0.26***

4. Positive refocusing

–0.11*

–0.16**

5. Planning

–0.08

–0.06

6. Positive reappraisal

–0.15**

–0.12*

7. Putting into perspective

0.41***

0.32***

8.Catastrophizing

0.02

0.45***

0.06

0.42***

9. Other-blame

BDI-II = Beck Depression Inventory II; STAI = State-trait Anxiety Inven-

tory; *p < 0.05; **p < 0.01; ***p < 0.001. The result of internal consistency (Cronbach’s alpha) and

M. P. Omran / Open Journal of Psychiatry 1 (2011) 106-109 109

test-retest coefficients shows good reliability of CERQ.

Totally, these results are comparable with result of Gar-

nefski and Kraaij [4]. Accordingly, this study showed

that CERQ has fit psychometric properties and could be

used for clinical and investigative purposes in Iran.

The result of multiple regression analysis about rela-

tionship between CER strategies with depression and an-

xiety showed that CER strategies explained relatively

high amount variances of depression and anxiety. Catas-

trophizing, self-blame and rumination subscales were

related with high level of anxiety and depression, also

refocusing, positive reappraisal and planning subscales

related with low level of anxiety and depression. This

result is similar to the result of Garnefski and Kraaij [4].

The results suggest that self-blame is related to the re-

porting of symptoms of depression and anxiety. This find-

ing confirms other studies showing that an attributional

style of putting the blame of what you have experienced on

yourself is related to depression and other measures of

ill-health [17].

The results also showed a strong impact style of rumi-

nation in symptoms of depression and anxiety, fitting in

with the results of Nolen-Hoeksema et al. [18] who sho-

wed that a ruminative coping style tended to be associ-

ated with higher levels of depression. The present study

adds that rumination is also an important predictor of

symptoms of depression and anxiety.

In this article for study relationship between CER

strategies with depression and anxiety was used from

normal group. For future similar study in this field is

suggested using from clinical groups for reach to more

firm evident about relationship between CER and psych-

opathology.

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