1. Introduction
epression and anxiety are among high prevalent disorders and are often chronic conditions affecting 20% of the general population [1]. These disorders are associated with significant personal and social costs and are a risk factor for suicide. Depression and anxiety are two disorders with high comorbidity that lead to a decline in a person’s performance in various fields of education, work, family, etc. [2]. In 2013, Zackey and William introduced an interpersonal emotion regulation model. This model provides a valuable framework for identifying the interpersonal processes of emotion regulation in depressive and anxious people. This model is consistent with the notion that emotion regulation requires a self-regulation that occurs within a social context and often serves a communicative function [12]. This model specifically describes two symmetric processes: Internal/external emotion regulation strategies and interpersonal emotion regulation strategies. Both of these strategies can be response-dependent or non-response-dependent. Interpersonal emotion regulation strategies refer to the process by which one begins social communication to regulate his/her emotional experiences. In contrast, internal-external emotion regulation strategies refer to a process where one regulates others’ emotions to modify own emotions [11]. Both intrapersonal and interpersonal emotion regulation models have strengths and weaknesses. Intrapersonal emotion regulation models are the first model presented in this field and have been used in many studies, but have some limitations. For example, this model emphasizes a simple input-output relationship between stimulus and response. Moreover, it cannot justify some emotional experiences such as aggressive responses or quick reactions caused by fear [8]. In contrast, interpersonal emotion regulation models provide a transdiagnostic perspective by considering the broader social context of one’s behaviors and emotional experience. Considering the effect of social context on emotion regulation and the shortcomings of intrapersonal emotion regulation models, it is necessary to study various aspects of both interpersonal and intrapersonal models to identify effective models in predicting depression and anxiety symptoms. Therefore, in this study, we aim to compare interpersonal and intrapersonal models of emotion regulation in explaining depression and anxiety syndrome.
2. Materials and Methods
This cross-sectional study was conducted in 2019. The study population consist of all students at public universities in Tehran, Iran. Sampling was performed using multi-stage cluster sampling method. For this purpose, first 4 universities were randomly selected. Then, four faculties were randomly selected from each university, and from each faculty 5 classes were randomly selected. Finally, 602 students were selected and data were collected. of 602, 85 questionnaires were returned incomplete and were excluded from the study. Finally, statistical analysis was performed on data from 517 samples. Hierarchical regression analysis was used to compare the emotion regulation models and examine their predictors.
3. Results
Overall, the results showed that emotional disorders such as depression and anxiety are associated with emotion regulation strategies. Cognitive reappraisal, emotional suppression, enhancing positive affect, soothing, nonacceptance of emotional responses, lack of emotional clarity, and limited access to emotion regulation strategies had a significant role in predicting depression and anxiety. The results are shown in Table 1.


SCL-25= Symptom Checklist 25, ERQ= Emotion regulation questionnaire, IERQ= Interpersonal Emotion Regulation Questionnaire, DERS= Difficulties in Emotion Regulation Scale, CR=Cognitive reappraisal, ES=Emotional suppression, PA= Enhancing positive affect, PE= Perspective taking, ST= Soothing, SM= Social modeling, NA= Nonacceptance of emotional responses, NG= Difficulty engaging in goal-directed behavior, IMC= Impulse control difficulties, NAW= Lack of emotional awareness, NS= Limited access to emotion regulation strategies, NC= Lack of emotional clarity.
4. Discussion and conclusion
Consistent with our findings, Skofer et al. in a meta-analysis study showed that maladaptive emotion regulation strategies play an important role in many psychological disorders, including depression and anxiety [17]. Hayes et al. showed that nonacceptance of emotions leads to a avoidance pattern. Avoidance is generally considered to be a maladaptive emotional strategy that reduces negative emotions in the short run but leads to the development and persistence of anxiety disorders in the long run [18]. Sue et al. also showed that avoidance and lack of emotional clarity are associated with symptoms of depression and anxiety [19]. Suppression is also an emotion regulation strategy with long-term negative impact on mental health. Those who use more this strategy are more likely to develop depression and anxiety [20].
Regarding the interpersonal emotion regulation model, the findings of this study showed that enhancing positive affect and soothing had a significant role in predicting depression and anxiety. Perspective taking also had a significant role in predicting anxiety, but social modeling had no role in predicting depression and anxiety symptoms. Interpersonal emotion regulation is a type of self-regulation that occurs in a social context and often has a communicative function. Zackey and William emphasized that any social interaction is effective in initiating emotion regulation processes [12]. The relationship between interpersonal emotion regulation and depression can be explained by the concept of social support. People who perceive greater social support are more likely to share their emotions with others; thereby, reducing their negative emotions. This makes people less likely to use suppression strategies [21]. In general, both interpersonal and intrapersonal emotion regulation models have a role in explaining depression and anxiety syndromes. This indicates the impact of social context on emotion regulation and anxiety and depression disorders.

Ethical Considerations
Compliance with ethical guidelines
This study has ethical approval obtained from the Research Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1398.1095).

Funding
The Vice-Chancellor for Research and Technology of Iran University of Medical Sciences supported this study (Code: 98-4-50-14179). 

Authors contributions
Conceptualization, project administration and funding acquisition: Mozhgan Lotfi; Methodology, investigation, resources, data curation, writing – original draft preparation: All author; Writing – review & editing, supervision: Mahdi Amini.

Conflicts of interest
The authors declare no conflict of interest.

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