Emotion dysregulation and parent emotion socialization in mothers with and without borderline pathology

BackgroundMothers with borderline personality disorder face unique challenges in parenting, as borderline symptoms have been shown to negatively affect parent-child relationships. These challenges can lead to non-supportive reactions to children’s negative emotions, a form of parent emotion socialization (PES) that has been linked to negative outcomes in children. Given the inherent emotional arousal evoked by parenting, emotion dysregulation likely influences the type of PES parents utilize. However, no studies have specifically examined how emotion dysregulation affects PES in mothers with borderline pathology. Against this background, this study aims to (1) investigate the link between maternal emotion dysregulation and PES strategies and (2) assess if emotion dysregulation mediates the relationship between borderline pathology and PES.MethodsThe study sample was comprised of 148 mothers (Mage = 34.92). Of these mothers, 53 had significant borderline features. Emotion regulation was evaluated using the Difficulties in Emotion Regulation Scale – Short Form and PES was assessed using the Coping with Children’s Negative Emotion Scale. Significant borderline features were determined using the Personality Assessment Inventory Borderline Scale. As a part of aim 1, bivariate correlations were conducted to examine relationships between emotion dysregulation and two PES strategies: supportive and non-supportive. The moderating role of emotion dysregulation on the relationships between borderline features and supportive and non-supportive PES was assessed using two moderation models.ResultsResults from the first aim revealed a small, negative correlation between emotion dysregulation and supportive PES and a medium, positive correlation between emotion dysregulation and non-supportive PES. Emotion dysregulation was found to be a significant moderator of the relationship between borderline pathology and non-supportive PES.ConclusionsThe current study significantly contributes to the literature by further elucidating the relationship between maternal borderline pathology and PES and its underlying mechanisms.

Construct validity of a short, self report instrument assessing emotional dysregulation

Literature mainly focuses on the role of dysregulation of negative emotions whereas the topic of dysregulation of positive emotions has been widely neglected. This study aims to explore levels of dysregulation of positive emotions across community, clinical and forensic samples. The Difficulties in Emotion Regulation Scale – Positive (DERS-Positive) was administered to a total sample of 1044 participants, divided in 497 community participants (Mage = 39.18 years), 464 forensic individuals (Mage = 39.36 years), and 83 individuals diagnosed with Bipolar disorder (Mage = 47.26 years). The Difficulties in Emotion Regulation Scale (DERS) and the Toronto Alexithymia Scale (TAS-20) were administered to a subsample of community participants (n = 105). Confirmatory Factor Analyses supported the three-factor structure of the DERS- Positive in both clinical and non-clinical samples. Correlations between DERS-Positive, DERS and TAS-20 scores indicated a good construct validity of the DERS- Positive. We found that the three groups significantly differed from each other on DERS-Positive total scores. Individuals with Bipolar disorders showed higher levels of dysregulation of positive emotions compared to both offenders and community participants. Offenders scored higher on the DERS- Positive compared to community participants. Dysregulation of positive emotions is an often overlooked yet relevant construct that may account for maladaptive behavior and psychopathology.

Objective: The Difficulties in Emotion Regulation Scale (DERS) is a widely used self-report measure of subjective emotion ability, as defined by a prominent clinically derived model of emotion regulation (Gratz and Roemer, 2004). Although the DERS is often used in treatment and research settings for adults with emotional (i.e., anxiety, mood, obsessive-compulsive, or trauma-related) disorders, its psychometric properties are not well-characterized in this population.Method: We examined the psychometric properties of the DERS and three popular short forms (DERS-16; DERS-18; and DERS-SF) in a large (N = 427) sample of treatment-seeking adults with one or more DSM-5 emotional disorders.Results: For the original DERS, internal consistency was strong for all subscales except Awareness. A bifactor structure consisting of one general emotion dysregulation factor and five uncorrelated specific factors corresponding to the original DERS subscales (excluding Awareness) provided the best fit. A series of structural equation models (SEMs) demonstrated unique incremental contributions of the general factor and several specific factors to explaining concurrent clinical severity. The general factor and one specific factor (Goals) also prospectively predicted treatment outcome following a naturalistic course of outpatient cognitive-behavioral therapy (CBT) in a subset of participants (n = 202) for whom discharge data were available. Specifically, more severe emotion dysregulation at intake predicted better CBT response, while more severe impairment in goal-directed activity when distressed predicted worse CBT response. All three short forms showed a robust bifactor structure and good internal consistency and convergent validity vis-à-vis the original measure, albeit with a slight decrement in incremental utility (1–3% less variance explained in clinical severity).Conclusion: With the Awareness items excluded, the DERS showed good internal consistency and a robust bifactor latent structure. The general factor and several specific factors incrementally and prospectively predicted clinical severity and treatment outcome, which suggests that the DERS may have clinical and predictive utility in treatment-seeking adults with emotional disorders. Additional research is needed to establish convergent and discriminant validity in this population. The use of a short form in lieu of the full DERS may be sufficient for many general clinical and research purposes, particularly when participant burden is a concern.

A lowered and heightened synchrony between the mother’s and infant’s nonverbal behavior predicts adverse infant development. We know that maternal depressive symptoms predict lowered and heightened mother-infant gaze synchrony, but it is unclear whether maternal emotion dysregulation is related to mother-infant gaze synchrony. This cross-sectional study examined whether maternal emotion dysregulation in mothers with mood disorders is significantly related to mother-infant gaze synchrony. We also tested whether maternal emotion dysregulation is relatively more important than maternal depressive symptoms in predicting mother-infant gaze synchrony, and whether maternal emotion dysregulation mediates the relation between maternal depressive symptoms and mother-infant gaze synchrony. We observed 68 mothers and their 4- to 9-month-old infants in the Still-Face paradigm during two play interactions, before and after social stress was induced. The mothers’ and infants’ gaze behaviors were coded using microanalysis with the Maternal Regulatory Scoring System and Infant Regulatory Scoring System, respectively. The degree of mother-infant gaze synchrony was computed using time-series analysis. Maternal emotion dysregulation was measured by the Difficulties in Emotion Regulation Scale; depressive symptoms were assessed using the Beck Depression Inventory. Greater maternal emotion dysregulation was significantly related to heightened mother-infant gaze synchrony. The overall effect of maternal emotion dysregulation on mother-infant gaze synchrony was relatively more important than the effect of maternal depressive symptoms in the five tested models. Maternal emotion dysregulation fully mediated the relation between maternal depressive symptoms and mother-infant gaze synchrony. Our findings suggest that the effect of the mother’s depressive symptoms on the mother-infant gaze synchrony may be mediated by the mother’s emotion dysregulation.

A heightened synchrony between the mother's and infant's facial affect predicts adverse infant development. We know that maternal psychopathology is related to mother-infant facial affect synchrony, but it is unclear how maternal psychopathology is transmitted to mother-infant synchrony. One pathway might be maternal emotion dysregulation. We examined (a) whether maternal emotion dysregulation is positively related to facial affect synchrony and (b) whether maternal emotion dysregulation mediates the effect of maternal psychopathology on mother-infant facial affect synchrony. We observed 68 mothers with mood disorders and their 4- to 9-month-old infants in the Still-Face paradigm during two play interactions. The mother's and infant's facial affect were rated from high negative to high positive, and the degree of synchrony between the mother's and infant's facial affect was computed with a time-series analysis. Emotion dysregulation was measured with the Difficulties in Emotion Regulation Scale, and psychopathology was assessed with the Symptom Checklist-90-Revised. Higher maternal emotion dysregulation was significantly associated with higher facial affect synchrony; emotion dysregulation fully mediated the effect of maternal psychopathology on facial affect synchrony. Our findings demonstrate that maternal emotion dysregulation rather than maternal psychopathology per se places mothers and infants at risk for heightened facial affect synchrony.

Difficulties in emotion regulation are one of the core features of borderline personality disorder (BPD). Individuals with BPD also report higher levels of experiential avoidance (EA) compared to controls. These constructs have never been studied concomitantly in adolescents. First, given the conceptual similarity of difficulties in emotion regulation and EA, the authors sought to determine whether EA provides incremental validity, above emotion dysregulation, in its association with borderline features. Second, EA was explored as a mediator in the relation between difficulties in emotion regulation and borderline features. The sample included 208 adolescents recruited from an inpatient psychiatric unit (M(age) = 15.96, SD = 1.39; females = 60.1%). Borderline personality features were assessed using the self-report Borderline Personality Features Scale for Children (Crick, Murray-Close, & Woods, 2005). EA was assessed using the Avoidance and Fusion Questionnaire for Youth (Greco, Lambert, & Baer, 2008), and difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004). Greater borderline personality features were associated with significantly higher levels of EA and difficulties in emotion regulation. Hierarchical regression analyses showed that EA made a small, but significant, incremental and independent contribution to borderline features when added to a model already including difficulties in emotion regulation. In addition, EA partially mediated the relation between difficulties in emotion regulation and borderline features. EA and emotion regulation are both important targets of treatments aimed at decreasing borderline personality features in adolescents.

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.

In the study, the mediating roles of emotional dysregulation and cognitive flexibility in the relationship between self-compassion and forgiveness scores of university students were examined. The study group of the research consists of a total of 662 university students, 424 women (64%) and 238 men (36%) continuing their education at Mersin University. "Self-compassion Scale - Short Form", "Heartland Forgiveness Scale", “Difficulties in Emotion Regulation Scale - Short Form" and "Cognitive Flexibility Scale" were used as data collection tools, and IBM SPSS Statistics 20 and Lisrel 8.71 statistical programs were used in the analysis of the data. As a result of the analysis of the research, it was revealed that there was a positive and significant relationship between self-compassion and forgiveness and cognitive flexibility, and a negative significant relationship between self-compassion and emotional dysregulation. It was concluded that there is a positive and significant relationship between forgiveness and cognitive flexibility, a significant negative relationship between forgiveness and emotional dysregulation, a negative significant relationship between emotional dysregulation and cognitive flexibility. Emotional dysregulation and cognitive flexibility have partial mediating roles in the relationship between self-compassion and forgiveness. The results of the research were discussed within the limits of the literature, and suggestions were given for the researcher and experts in this field.

In order to assess the relationships among borderline personality disorder features, non-suicidal self-injury (NSSI) and emotion dysregulation, 122 community-dwelling Italian adolescents were administered by the Italian translations of the Borderline Personality Features Scale for Children-11, the Deliberate Self-Harm Inventory and the Difficulties in Emotion Regulation Scale (DERS). Regression models showed that both Deliberate Self-Harm Inventory (DSHI) and DERS scores significantly predicted Borderline Personality Features Scale for Children-11 total score; moreover, the DSHI total score significantly predicted the DERS total score. Our findings suggest that borderline personality features in adolescence are moderately, albeit significantly related to NSSI, and that emotion dysregulation does not completely account for the association between borderline personality features and NSSI, although it seems to explain a non-trivial proportion of this relationship. Copyright © 2016 John Wiley & Sons, Ltd.

Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation

A widely used measure of emotion dysregulation, the Difficulties in Emotion Regulation Scale (DERS), may insufficiently cover a number of potentially important aspects of emotional dysregulation. A new measure of emotional dysregulation, the Emotional Dysregulation Questionnaire (EDQ) was therefore developed based upon an eight-factor model of the construct. The DERS and the EDQ were administered to a community sample (N=362; 183 female, 179 male), along with a number of measures of psychopathology associated with emotional dysregulation. The capacity of the EDQ and the DERS to account for the emotional dysregulation associated with these different types of psychopathology was then compared. In several of the psychopathologies examined, the EDQ could account for more variation than the DERS, suggesting that it more comprehensively assessed the emotion regulation deficits associated with these issues. Results suggest the EDQ possesses several advantages relative to the DERS, allowing for a more comprehensive and accurate assessment of emotional dysregulation. Emotional dysregulation is a common component of many psychological disorders. The Difficulties in Emotion Regulation Scale is one of the primary self-report measures used to asses these difficulties, however, concerns exist that it may not comprehensively assess the construct of emotional dysregulation. A new self-report measure of comparable length, the Emotional Dysregulation Questionnaire has been developed, with this new measure possessing several advantages relative to the DERS with regard to the assessment of emotional dysregulation. The use of this measure in clinical practice may more accurately identify the emotion regulation deficits present in clients.

The Difficulties in Emotion Regulation Scale (DERS) is a measure of emotion regulation that has been extensively used in research and clinical settings, both with adolescents and adults. However, its length has been recognized as an important limitation. In addition, its adequacy as a multidimensional measure and the utility and interpretability of the Awareness subscale has been questioned. The goal of this study is to contribute to the clarification of these issues through the examination of the factor structure and psychometric properties of a short form of the DERS in a large sample of Portuguese adolescents and adults from the community. Two studies were conducted. The first study comprised 1314 adults and the second study comprised 612 adolescents, who completed the DERS-SF and additional measures to assess validity evidence for DERS-SF scores in relation to other relevant variables (self-compassion, attachment orientations, anxiety and depressive symptoms, dispositional mindfulness, perceived stress, emotion suppression, and quality of life). Several models were examined in two studies as well as bifactor model-based psychometric indices. In both studies, bifactor models, particularly the one that excluded the Awareness items, exhibited a good fit to the data. ECV and OmegaH indices suggest a strong general factor of emotion dysregulation and do not support individual use of the Objectives, Strategies, Impulse, and Nonacceptance subscales. The DERS-SF scores correlated with the other measures as expected. Our findings suggest that the Awareness subscale should be excluded when computing the DERS-SF total score and that the total score can be considered essentially unidimensional. This study supports the use of a total score to assess emotion dysregulation but does not support the use of most subscale scores.

Emotion dysregulation during pregnancy may impede women's capacity to navigate increased stressors during this period and may elevate risk for psychosocial impairment, especially for socioeconomically disadvantaged or racially marginalized women. Valid and efficient assessment of emotion dysregulation is needed. We used Item Response Theory (IRT) to examine the Difficulties in Emotion Regulation Scale (DERS) in 248 low income, primarily Latina/x pregnant women, to compare the short forms relative to the full DERS. IRT indicated that the short forms exhibited modest reliability, but also indicated a substantial decrease in information (i.e., reliability) for the short forms compared with the full DERS. IRT indicated that the DERS-16 appeared more reliable (conserve more information) relative to the other short forms, the DERS-SF and DERS-18. Findings suggest that clinicians and researchers use the full DERS when time permits and the DERS-16 when needing a briefer version.

BackgroundContemporary theorists have suggested that impulsivity and emotion dysregulation are two of the core features of BPD. The aim of this study was to evaluate the relationships between Borderline Personality Disorder (BPD) features, impulsivity, and emotion dysregulation in adolescence.Methods1,157 nonclinical adolescents were administered the Borderline Personality Inventory, following which three groups of adolescents with high (high–BPD; n = 29), average (average-BPD; n = 31), and low (low–BPD; n = 31) levels of BPD features were selected. Participants in these three groups were administered the UPPS-P Impulsive Behavior Scale (UPPS-P) and the Difficulties in Emotion Regulation Scale (DERS).ResultsUPPS-P Negative and Positive Urgency scales, as well as the DERS total score, significantly discriminated high-BPD adolescents from both other groups. The differences in UPPS-P Negative and Positive Urgency between high-BPD adolescents and both control groups remained significant when partialing out the variance associated with the DERS; However, when partialing out the variance associated with Positive and Negative Urgency, high-BPD adolescents reported significantly higher DERS scores than only the low-BPD control group (and not the average-BPD group). Finally, although the differences in Positive Urgency between high-BPD adolescents and both control groups remained significant when partialing out the variance associated with Negative Urgency, the between group differences in Negative Urgency did not remain significant when controlling for the variance associated with Positive Urgency.ConclusionsThese findings highlight the relevance of both emotion dysregulation and two dimensions of impulsivity (negative and positive urgency) to BPD features in adolescence, providing evidence for a unique association between BPD features and Positive Urgency in particular. These findings add to the literature in this area, suggesting that the tendency to act rashly in the context of intense positive affect may have unique relevance to BPD features in adolescence.