Choosing to Avoid the Positive? Emotion Regulation Strategy Choice in Depression

Individuals with Major Depressive Disorder (MDD) are more likely than non-depressed individuals to use emotion regulation strategies that decrease pleasant emotions (e.g., distraction from positive stimuli) and increase unpleasant emotions (e.g., negative rumination). If such strategies are actively chosen, these choices may partly reflect weaker motivation for pleasant emotions or stronger motivation for unpleasant emotions. Therefore, this investigation tested, for the first time, whether such strategies are actively chosen, even when alternatives are available. In Study 1, using a behavioral task, MDD participants (N=38) were more likely than healthy controls (N=39) to choose to use distraction over positive rumination in response to pleasant stimuli, resulting in reductions in pleasant affect. When instructed to choose the strategy that would make them feel better, however, MDD participants did not differ from controls in their strategy choices. In Study 2, using Ecological Momentary Assessments, MDD participants (N=58) were more likely than controls (N=62) to use distraction from pleasant emotions and to use negative rumination in daily life. This pattern of strategy use was predicted by stronger motivation for unpleasant emotions among MDD participants, compared to controls. Stronger motivation for unpleasant emotions in daily life also predicted increases in unpleasant affect and decreases in pleasant affect. Findings suggest that compared to non-depressed individuals, people with MDD are more likely to choose emotion regulation strategies that decrease pleasant emotions.