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March 28, 2026

Unraveling the cycle of depression: Dynamics of state depression, state attachment, and social emotion regulation among psychiatric patients.

Key Points

To explore the dynamic relationships among state depression, state attachment, and social emotion regulation in psychiatric patients.
Utilized experience sampling method to gather data.
Total of 205 diagnosed psychiatric patients participated.
Participants reported on their state depression and attachment three times daily for 10 days.
Data analyzed using dynamic structural equation modeling.
State depression linked to increased social sharing, impacting future depression levels.
Reciprocal cycle found: state attachment anxiety and state depression reinforced each other.
Both state depression and attachment anxiety linked to increased expressive suppression.

Abstract

Attachment and social emotion regulation strategies play crucial roles in social interactions and are associated with the maintenance and exacerbation of depressive symptoms. However, previous studies have relied on retrospective questionnaire surveys, which are susceptible to recall bias and limit the ability to capture dynamic interactions among depression, attachment, and social emotion regulation-particularly in psychiatric patients. Therefore, this study employed the experience sampling method to investigate the dynamic relationships among state depression, state attachment, and social emotion regulation in diagnosed psychiatric patients. Participants (N = 205; Mage = 31.87, SDage = 11.44; 69.8% female) with depression or anxiety disorders provided self-reports of state depression, state attachment (security, anxiety, and avoidance), and social emotion regulation (social sharing and expressive suppression) three times daily over 10 days, resulting in a total of 4,711 momentary assessments. Data were analyzed using dynamic structural equation modeling. The results provided preliminary evidence for two cyclical patterns of depression at the within-person level: (a) State depression was associated with increased social sharing at subsequent measurements, either directly or indirectly via heightened state attachment anxiety at the next time point. In turn, social sharing predicted a momentary reduction in state depression at the next measurement. (b) State attachment anxiety and state depression reinforced each other in a reciprocal cycle. Both were associated with increased expressive suppression at the subsequent measurement. These findings highlight the importance of attachment insecurity and social emotion regulation in maintaining depression, providing empirical support for interventions aimed at breaking the cycle of depression. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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