Élaboration verbale d’émotions discrètes dépressogènes et sévérité de la dépression

La dépression est associée à d’importants déficits de régulation émotionnelle. La fréquence ou l’intensité (quantité) de tristesse, d’hostilité dirigée contre soi, de honte, de culpabilité et de mépris ont été associées empiriquement à la dépression. Afin de mieux comprendre la régulation émotionnelle dans la dépression, il importe de se pencher également sur la qualité de l’expérience affective, qui renvoie notamment à la notion de mentalisation (c.-à-d. la capacité à rendre mental et élaborer ses émotions). Cette étude visait à examiner les associations entre les aspects quantitatif et qualitatif de la régulation d’émotions spécifiques et la sévérité des symptômes dépressifs. Un échantillon de 62 participants (18 à 60 ans, 73 % de femmes) faisant une demande de soins psychologiques a complété l’entrevue évaluant la dépression de Hamilton ainsi qu’une entrevue semi-dirigée recueillant des expériences relationnelles teintées d’émotions. L’entrevue émotionnelle a été cotée par deux juges avec la Grille de l’Élaboration Verbale de l’Affect, qui évalue la qualité d’émotions spécifiques dans le discours. Des corrélations ont été effectuées afin d’évaluer les associations entre les variables d’intérêt. Une régression hiérarchique a été menée afin d’évaluer la contribution unique d’affects spécifiques dans la prédiction de la sévérité de la dépression. La sévérité des symptômes dépressifs est associée à une plus grande quantité d’hostilité dirigée contre soi (0,35**) et de désir (0,27*), et négativement associée à la quantité d’amour pour les autres (−0,40**) et à la qualité de la mentalisation de la tristesse (−0,27*). Seule la quantité d’hostilité dirigée contre soi et d’amour pour les autres, ainsi que l’âge, présentent une variance unique significative dans l’explication de la dépression. La sévérité de la dépression semble associée à des déficits dans les aspects quantitatif et qualitatif de la régulation émotionnelle. Psychoanalytic and emotion theories have emphasized the important role affective processes play in depression. Discrete emotions such as sadness, hostility turned against the self, shame, guilt and contempt have been empirically associated with the depressive experience. However, research on affect has been mostly focused on the identification of the presence of emotions (their intensity or frequency), without considering the quality of the affective experience. To get a complete picture of affect regulation processes in depression, we must also look at the quality of the elaboration and mentalization of affects. The present study explores the relationship between the regulation and mentalization of distinct affect categories and the severity of depressive symptoms. The level of verbal elaboration/mentalization of discrete affects (quality of emotions) and the proportion of these specific affects in verbal expression (quantity of emotions) will serve as measures of affect regulation. We conceptualize depression as presenting deficits in the regulation of both the quantity and the quality of specific affects, specifically sadness and hostility turned against the self. To test this hypothesis, 62 participants were recruited at an outpatient hospital clinic and at a university psychology clinic. Among them were 45 women (73%) and mean age was 34 years (range 18–60). Thirteen suffered from a current major depressive episode ( n = 13). Twenty-five had been diagnosed with at least one Axis I disorder (40%) while 18 had at least one Axis II disorder (29%). After completing a series of questionnaires, participants took part in an affect-focused RAP interview in which they described relationship episodes that had evoked the basic emotions of sadness, among others. The quality of affect mentalization was examined with the Grille de l’Élaboration Verbale de l’Affect (GEVA), an observer-rated measure designed to be used on verbal transcripts, and the measure of affect content (MAC), which identifies the specific category of verbalized affect (e.g. sadness). Depressive symptoms were assessed with the Hamilton rating scale for depression. Correlations and hierarchical regression analysis were conducted. The severity of depressive symptoms was correlated with a higher proportion of hostility turned against the self (0.35**) and desire (0.27*) and negatively associated with the proportion of love of others (−0.40**) and the level of mentalization of sadness (−0.27*). A hierarchical regression analysis was computed to assess the unique contribution of these affects on the prediction of depression severity, over and above the potential confounding variables of sex, age and level of education. Results indicate that the quantity of hostility turned against the self and love of others, as well as age, predict 26% of the variance of the severity of depressive symptoms. Only the quantity of hostility directed against the self, of love for others and age presented a significant unique variance in the explanation of depressive symptoms. These results seem to indicate that the severity of depression is associated with deficits in both the quantity and quality of the regulation of discrete emotions. As expected, depression severity was associated with a higher proportion of hostility turned against the self and lower levels of mentalization of sadness. However, the associations between depression severity, more desire and fewer mentions of love of others was unexpected. These findings could be explained as an increase in longing and by feelings of social isolation associated with the severity of depression.

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