Exploration of the role of emotion regulation in anxiety, depression and fear of falling in older adults

This Thesis follows the portfolio format and a brief overview is given here. Chapter one is a systematic review of the literature on the relationship between emotion regulation, anxiety and depression in older adults. Chapter two is a research journal which explores the relationship between fear of falling and emotion regulation in community dwelling older adults. The systematic review is written up for publication in the Journal of Affective Disorders. The research article is written up for publication in Aging and Mental Health. Their respective style guidelines were followed. Purpose The aim of the thesis was to explore the relationship between emotion regulation and psychological distress in older adults. The aim of the systematic review was to explore the relationship between self-reported emotion regulation, anxiety and depression in older adults. The empirical study aimed to look at the relationship between fear of falling, a common type of psychological distress in older adults, and emotion regulation. It also aimed to look at the relationship between fear of falling related avoidance behaviour and emotion regulation. Methods The literature was systematically searched for research which has explored the relationship between emotion regulation, anxiety and depression in older adults. The papers which met the inclusion criteria were rated according to predetermined quality criteria. An overview of the results and implications were discussed. The empirical research used a cross-sectional design to examine the research hypothesis. Older adults completed self-report measures of emotion regulation, fear of falling, fear-related avoidance behaviour, anxiety and depression. Correlational analysis explored the relationship between the study variables. A linear regression model examined the unique contribution of emotion regulation to fear of falling after controlling for age, falls history, anxiety and depression. Results 12 studies met the inclusion criteria for the systematic review. The most prevalent relationship explored was that between rumination and depression with consistent evidence that higher levels of rumination were related to higher levels of depressive symptoms. Common methodological limitations were the lack of valid and reliable emotion regulation measures for older adults, non-random sampling, and failure to control for important confounding factors. Within the empirical research, a significant relationship between emotion regulation and fear of falling was found. There was also a significant relationship between emotion regulation and fear of falling avoidance behaviour. After controlling for age, number of falls, depression and anxiety, emotion regulation was no longer significantly associated with fear of falling. Depression was the only modifiable variable that retained a significant association to fear of falling