An Experience Sampling Study of Psychological Processes and their Relation to Functional Outcome among Individuals with Severe Psychopathology

Background. The functional relations between daily contextual factors, psychological coping and functional outcome among individuals with severe psychopathology are still largely unexamined as compared to other aspects in this population, such as the genetic makeup of these individuals, their performance on cognitive tests, or their retrospective self-reports. Aims and method. To compare the role of cognitive and emotional regulation strategies versus contextual and behavioral regulation strategies in predicting different types of functional outcome after controlling for the occurrence of positive psychotic events and other negative stressors. A group of 31 individuals diagnosed with severe psychopathology from a Program for Assertive Community Treatment (PACT) of the Northern Nevada Adult Mental Health Services (NNAMHS) were recruited for this study. The study design was observational, with the added feature of an experience sampling method; 685 experience sampling moments were gathered during the course of six days. Additional psychological processes were examined in this study such as empathy, perspective taking ability and values. Results The study suggests that the occurrence of positive psychotic symptoms and stressful events had a negative impact on functional outcome, but not after accounting for the role of some contextual and behavioral regulation strategies. More specifically, behavioral regulation strategies such as experiential acceptance and overt avoidance had a superior association with functional outcome than emotional regulation strategies such as cognitive reappraisal. Moreover, data suggests that cognitive reappraisal tended to increase individual's distress, although not after accounting for cognitive suppression and overt avoidance. Finally, due to small sample size and design considerations it was not possible to reliably explore the association between perspective taking, values and functional outcome, however, additional exploratory analysis were conducted in order to test the direction and strength of these associations. Conclusions. Behavioral and contextual regulation strategies seem to have a superior effect on functional outcome as compared to cognitive and emotional regulation strategies among individuals with severe psychopathology that regularly experience psychotic and/or negative experiences.