Abstract
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.