Effects of Cognitive Reappraisal Training on Psychological Resilience, Depression Symptoms, and Emotional State

Purpose: Cognitive reappraisal can improve mental state by reinterpreting events and thoughts. This study investigated the effects of a five-day cognitive reappraisal training program on mental resilience, depression level, and emotional state in 63 Chinese individuals with depressive disorder. Patients and Methods: This pre–post intervention study recruited participants through verified online depression support groups. Training was conducted daily over five consecutive days (each session lasting 60 minutes). A total of 63 individuals participated (age range 16– 42 years, M=24, SD=5), including 26 males and 37 females. Based on baseline SDS scores, 27.0% met criteria for minor depression, 31.7% for moderate depression, and 41.3% for major depression. A 5-day intervention comprising daily 30– 40-minute sessions of cognitive reappraisal training using IAPS images was implemented. Patient-generated reappraisal strategies were collected as written responses and systematically coded by researchers for analysis. Participants completed the Reappraisal Inventiveness Test (RIT), Brief Resilience Scale (BRS), Self-Rating Depression Scale (SDS), and Positive and Negative Affect Scale (PANAS) before training, on day 2 and day 5 during training, and 10 days post-training. Data were analyzed using SPSS 27.0, including paired-sample t-tests, Wilcoxon signed-rank tests, Spearman correlation, and independent-sample t-tests with Bonferroni correction. Results: Cognitive reappraisal ability (CR1: mean increase from 2.349 to 3.365, P < 0.05), mental resilience (mean increase from 12.333 to 13.540, P < 0.05), and emotional state improved during training (ES: mean increase from 29.825 to 40.095, P < 0.05), while depression level declined, though changes in depression were not statistically significant. Improvements persisted to 10 days after training, albeit slightly diminished. Cognitive reappraisal ability correlated positively with mental resilience ( P < 0.05) and negatively with depression level ( P < 0.05). The strategy of “humor interpretation” significantly enhanced mental resilience and reduced depression ( P < 0.05), while “generating positive aspects” only significantly enhanced mental resilience ( P < 0.05). The differences in emotional state across strategies were not significant. Demographic analyses indicated a larger reduction in depression levels among younger participants (16– 25 years)( P < 0.05) and those with minor depression (p< 0.01), while gender and regional differences were nonsignificant. Conclusion: Cognitive reappraisal training can improve mental well-being in the short-term in individuals with depressive disorder. Extended training may enhance these effects. Keywords: reappraisal, depressive disorder, mental health, emotion, pre-post intervention