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Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology
Open accessAbstract
Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and "at-risk" remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology.
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“From a mechanistic perspective, ED may mediate the relationship between environmental stressors-such as trauma, neglect, or peer victimization-and later psychiatric outcomes.”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [34]
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“It has been consistently associated with impaired academic performance, interpersonal difficulties, and a higher risk of psychiatric comorbidities [34-36].”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [34]
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“Several studies suggest that early adversity disrupts normative emotion regulation development, increasing vulnerability to depression, anxiety, and behavioral problems [34,35].”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [34]
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“the experience of emotion dysregulation is also positively associated with depressive and anxiety symptom severity.31–33”
From A meta-analysis of emotional regulation outcomes in psychological interventions for youth with depression and anxiety (2021) · cites this paper as [31]
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“and also the link between cumulative adversity in lifetime and depressive symptoms (Abravanel and Sinha, 2015).”
From Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies (2017) · cites this paper as Abravanel and Sinha, 2015
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Self-citation
Metadata
- Authors
- Abravanel, B. T., & Sinha, R.
- Affiliations
- Yale University (US)
- Corresponding author
- Sinha, Rajita
- ORCID
- Sinha, Rajita
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 61
- Pages
- 89-96
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC4308421
- OpenAlex
- W1994490855
- Cited by
- 109
- References
- 83
- Citations by year
- 2026: 11 · 2025: 10 · 2024: 12 · 2023: 14 · 2022: 8 · 2021: 18 · 2020: 13 · 2019: 6 · 2018: 5 · 2017: 8 · 2016: 2 · 2015: 2
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (DK099039)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- cumulative adversity, emotional dysregulation, depressive symptoms, depression risk, life events, mediation, emotion regulation, stress reduction intervention, depression prevention
- MeSH terms
- Adaptation, Psychological, Adult, Depression, Emotions, Female, Humans, Interpersonal Relations, Life Change Events, Male, Personality Inventory, Risk Factors, Social Perception, Young Adult
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