It is widely accepted that stress over a prolonged period of time is a risk factor for psychiatric illness. There are certain strategies, known as adaptive cognitive emotion regulation (CER) strategies, that can help to reduce the effects of stress on mental health. One example of an adaptive CER strategy is positive reappraisal, through which there is a positive meaning associated with a stressor. Other examples include planning, positive refocusing, and putting things into perspective. Conversely, examples of maladaptive CER strategies include self-blame, other-blame, rumination, and catastrophizing. Because using adaptive CER strategies requires intact executive functioning, there was a study done by Sullivan et al. (2023) about whether sleep affects adaptive CER use, therefore affecting mental health outcomes after a stressful experience.
Two main questions were posed in this study: “Is adaptive CER strategy use associated with positive mental health outcomes?” and “Are the mental health benefits of adaptive CER strategy use contingent on good quality sleep?” The researchers used the COVID-19 pandemic as their stressor. They used the Cognitive Emotion Regulation Questionnaire to evaluate CER use, the Pittsburgh Sleep Quality Index questionnaire to assess sleep quality, the Patient Health Questionnaire to measure depression severity, and the Generalized Anxiety Disorder Questionnaire to measure anxiety severity.
They found that with more adaptive CER strategy use, there were lower depression levels. Additionally, better sleep quality was associated with lower depression and anxiety levels. With better sleep quality, there was more use of adaptive CER strategies. However, they found that high sleep quality and adaptive CER strategies each reduce depression levels independently. Sleep quality was not found to influence the effect of adaptive CER use. The same conclusion could not be drawn for anxiety levels, as adaptive CER use was not a significant predictor of anxiety levels after controlling for other factors.
There were several limitations noted in the paper. One of these was the use of subjective reports of emotion regulation techniques and sleep quality. Another limitation was the low socio- demographic diversity in the data. Participants were largely female, white, and well-educated. Another limitation noted in the study was the fact that the pandemic was a complex stressor, and many people were affected by the pandemic in different ways given their own personal circumstances. The findings of this study highlight the importance of sleep quality and use of adaptive CER strategies to reduce depression levels after a stressful event.