CROSS-cultural adaptation and validation of the Ukrainian version of the difficulties in emotional regulation scale (DERS): testing in adolescents with anorexia nervosa and their parents/guardians

Abstract

Relevance: Emotional dysregulation is often identified in a variety of mental disorders and shows high comorbidity between them. The presence of emotional regulation disorders can be assessed using various tools, but the most popular is the Difficulty in Emotional Regulation Scale (DERS), which is used to assess emotional regulation disorders in different populations, including adults and adolescents, and is widely used both in research and clinical practice. The purpose of the study: to create a Ukrainian-language version of the Difficulties in Emotional Regulation Scale (DERS) and its cross-cultural adaptation among adolescents and adults, with validity assessment and testing in patients with anorexia nervosa and their parents/caregivers. Methods: The study included 58 adolescents with anorexia nervosa and 97 of their parents/guardians who constituted the main study groups, as well as 50 healthy adolescents and 89 of their parents/guardians as a control group. The full version of the 36-item DERS Emotional Regulation Difficulties Scale was used for validation. The study was conducted in compliance with basic bioethical standards. All patients consented to participate in the study, after which a full clinical examination was conducted: demographic data were collected and screening for emotional regulation disorders was performed using the DERS scale. Statistical analysis was performed using the IBM SPSS23 program. Results: The analysis of the data obtained showed high reliability and validity of the Ukrainian version of the Difficulties in Emotional Regulation Scale (DERS) for screening emotional regulation disorders. Calculations of the α-Cronbach's coefficient based on the results of the test and retest (14 days later) confirmed the internal consistency of the DERS (0.7 and 0.7, respectively). The intraclass correlation coefficient was 0.976 (p<0.05) for adolescents and 0.987 (p>0.05) for adults. Student's paired t-test did not reveal significant differences between the test-retest groups (p>0.05). Subsequently, a study to validate the DERS scale was conducted on adolescents with anorexia nervosa and their parents/guardians. Our results of the DERS survey showed significantly higher scores on the total DERS score in patients with anorexia nervosa (143.70±11.170) and their parents/guardians (141.85±11. 006) compared to healthy adolescents (54.23±6.01) and their parents/guardians (47.61±7.87) of the control group, p<0.0001, indicating a high level of emotional regulation disorder in patients with anorexia nervosa and their parents/guardians. Conclusions: The Ukrainian version of the DERS emotional regulation difficulty scale was created and cross-cultural adaptation was performed for further use in the Ukrainian-speaking population. The Ukrainian version of the DERS scale has a sufficient level of reliability that allows it to be used for scientific purposes and in clinical practice.