Prolonged Exposure and Emotion Regulation Skills Training: A Pilot Study Among Veterans with Military Sexual Trauma-Related PTSD and Difficulties with Emotion Regulation

Background: this study was conducted to examine the effectiveness of emotion regulation and distress tolerance skills training on coping strategies, emotion regulation, and perceived stress in prisoners Method:The esearch method of current study was semi experimental method in form of pretest and posttest with the control group.statistical population consisted of 200 prisoners in Fooman Prison in Iran; of individual who had inclusion criteria, 30 members were selected using convenient sampling method then assigned to two experimental and control groups (n=15 in each group). They were match base on education level and age. Experimental group received 12 sessions teaching of emotion regulation and distress tolerance skills, while control group were waiting. Both groups filled in coping responses, emotion regulation, and perceived stress reduction questionnaires at baseline and after treatment. Data were analyzed using SPSS21 Software. Results: Emotion regulation and distress tolerance skill training could affect improvement of coping strategies, emotion regulation, and perceived stress reduction in prisoners (P<0.001). Conclusion: Emotion regulation and distress tolerance skills led to improved emotion regulation, coping strategies, and reduced use of emotion-focused coping strategies and decreased perceived stress in prisoners. So we could introduce this approach for emotion regulation in prisoners.

Objective Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. This study aimed to explore to what extent parental psychological distress contributes to difficulties in emotion regulation, the way parents respond to children’s expression of negative emotions and whether two emotion regulation strategies are mediating mechanisms through which psychological distress affects parental responses. Method A sample of 307 Australian parents with children aged 3 to 10 years completed an online questionnaire that explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression and cognitive reappraisal as emotion regulation strategies, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. Results Parents who reported higher levels of depression, anxiety, and stress reported more frequent use of expressive suppression and less frequent use of cognitive reappraisal as emotion regulation strategies. Mixed findings were noted, with expressive suppression and cognitive reappraisal acting as mediators of depression and stress symptoms but not anxiety. Conclusion The findings highlight the need for targeting overarching factors such as difficulties in parental emotion regulation, not only as intervention for parental psychological distress but also for detection and prevention of maladaptive parenting practices. KEY POINTS What is already known about this topic: (1) Parental emotion socialisation is of key importance to children’s development. (2) Parental emotion regulation is a vital component of adaptive parenting. (3) Psychological distress compromises emotion regulation and functional parenting behaviour. What this topic adds: (1) Maladaptive emotion regulation may be present even at subclinical levels of emotional distress, thus highlighting the need for emotion regulation skills to be addressed preventatively. (2) Emotion regulation skills training in interventions with parents experiencing psychological distress may offer benefit in terms of parenting and child outcomes. (3) Cognitive reappraisal and expressive suppression may be two underlying processes which predict subsequent problems with parental emotion socialisation.

BackgroundPatients with depression struggle with significant emotion regulation difficulties, which adversely affect their psychological well-being and hinder recovery. Traditional therapeutic approaches often fail to adequately address these challenges, leading to a persistent gap in effective mental health care. This research seeks to address this gap by investigating the impact of emotion regulation skills training on patients with depression.AimTo assess the difficulties in emotion regulation among patients with depression and evaluate the impact of an emotion regulation skills training intervention on those with higher levels of emotion regulation difficulties, specifically focusing on increasing the use of adaptive emotion regulation strategies and reducing the use of maladaptive emotion regulation strategies.MethodA quasi-experimental research design was utilized, using three tools: a socio-demographic and Clinical Data structured interview schedule, Difficulties in Emotional Regulation Scale, and Cognitive Emotion Regulation Questionnaire. Eighty patients with depression were recruited to assess those with higher levels of emotion regulation difficulties; out of those with greater difficulties, 30 patients were chosen to participate in the emotion regulation skills training intervention.ResultThe 80 studied subjects' emotion regulation difficulties scores ranged from 158 to 169 (164.5 ± 3.21), and they indicated less use of adaptive cognitive emotion regulation strategies and more use of maladaptive cognitive emotion regulation strategies (56.07 ± 2.67). Regarding the intervention group, the overall mean score of the 30 patients’ emotion regulation difficulties decreased from 167.35 ± 2.21 pre-intervention to 105.85 ± 3.33 post-intervention (p < 0.0001). Cognitive emotion regulation total scores improved markedly from 54.07 ± 1.66 to 35.2 ± 3.46 (p < 0.01).ImplicationHealthcare providers should routinely assess emotion regulation difficulties in patients with depression and integrate personalized treatment plans that target individual emotion regulation difficulties.ConclusionThe findings suggest that the emotion regulation intervention has the potential to improve emotion regulation difficulties and cognitive emotion regulation strategies among patients with depression.

BackgroundEmotion regulation difficulties appear to play a role in the development and maintenance of several eating disorders. This pilot study aimed at examining whether a short add-on group skills training in emotion regulation for young adults with different eating disorders was feasible in a psychiatric clinical setting. We also investigated if the treatment increased knowledge of emotions, and decreased self-reported difficulties with emotion regulation, alexithymia, symptoms of eating disorder, anxiety and depression, as well as clinical impairment.MethodsSix skills training groups were piloted with a total of 29 participants (M = 21.41 years, SD = 1.92). The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired samples t-test was used to compare differences between before-and-after measures.ResultsThe primary outcomes measures difficulties in emotion regulation (p < 0.001) and alexithymia (p < 0.001) showed significant improvement after treatment. The total eating disorder score (p = 0.009) was also significantly reduced, as was clinical impairment (p < 0.001). Acceptance/valued direction, identifying primary emotions and learning about secondary emotions was rated as especially helpful.ConclusionsThis preliminary pilot study showed that group training targeting emotion regulation skills was feasible and appreciated by participants, as well as being potentially promising as an adjunctive treatment for different eating disorders. Further controlled studies are needed.Trial registrationThe study was retrospectively registered NCT04148014 on October 30th 2019.

Difficulties with emotion regulation have been identified as an underlying mechanism in mental health. This pilot study aimed at examining whether group skills training in emotion regulation for adolescents and parents as an add-on intervention was feasible in an outpatient child and adolescent psychiatric clinic. We also investigated if the treatment increased knowledge and awareness of emotions and their functions, increased emotion regulation skills and decreased self-reported symptoms of anxiety and depression. Six skills training groups were piloted with a total of 20 adolescents and 21 adults. The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired-samples t test was used to compare differences between before-and-after measures for adolescents and parents separately. The primary outcome measure, Difficulties in Emotion Regulation Scale, showed significant improvement after treatment for both adolescents and parents. For adolescents, measures of alexithymia were significantly reduced. Also, emotional awareness was significantly increased. Measures of depression and anxiety did not change. In conclusion, group skills training as an add-on treatment can be feasible and effective but further studies are needed.

Evaluation of the Effectiveness of Dialectical Behavior Therapy based on Emotion Regulation Skills Training on Impulsivity and Cognitive Emotion Regulation in Type 1 Bipolar Patients

BACKGROUND: Hypertension is a common chronic disease that is affected by several factors. The aim of this study is to evaluate the effectiveness of emotion regulation skills training on blood pressure control and quality of life (QOL) in patients with hypertension. METHODS: The present study was a quasi-experimental design with pre-test and post-test evaluations to compare the experimental group with a control group. 60 patients with high blood pressure who received medical treatment and referred to the health centers and clinics affiliated to Isfahan University of Medical Sciences, Isfahan, Iran were randomly selected and assigned to either the experimental group (30 patients) or the control group (30 patients). The experimental group received eight training sessions (two 2-hour sessions weekly) on emotional regulation. In each group, the blood pressure was measured before and after the intervention. Data for the QOL were collected using the 36-Item Short Form Health Survey (SF-36). RESULTS: The findings showed that in the post-test evaluation, systolic blood pressure (SBP) of the patients in the experimental group was reduced in comparison to the control group (P ≤ 0.050). In addition, in the experimental group compared to the control group, the QOL in the patients increased after the intervention. However, the diastolic blood pressure (DBP) did not show a significant difference. CONCLUSION: Emotion regulation skills training was effective in patients with hypertension. It is suggested that the emotion regulation skills training be considered along with medical treatments.

Sexual minority young adults (SMYAs) experience discrimination and have high cannabis use prevalence. Discrimination may be associated with cannabis use, including hazardous use and co-use with tobacco, depending on emotion regulation and gender. Fall 2020 survey data assessed discrimination, use frequency of emotion regulation strategies (i.e., cognitive reappraisal, expressive suppression), current cannabis use, hazardous use, and cannabis-tobacco dual use among SMYAs (age 18-34) in 6 United States metropolitan areas (women: n=450, M age =24.1, SD=4.7, 69.6% bisexual, 18.2% lesbian/gay, 12.2% other; men: n=254, M age=24.7, SD=4.5, 33.5% bisexual, 54.3% gay, 12.2% other). Multivariable logistic regression examined the moderating roles of cognitive reappraisal and expressive suppression on associations of discrimination with cannabis use outcomes, stratified by gender and adjusted for age, race and ethnicity, and employment. Among SMYA women, 89.5% experienced any discrimination; 53.1% reported current cannabis use, of whom 49.4% and 47.7% reported hazardous use and cannabis-tobacco dual use, respectively. Adjusting for sociodemographics, experiencing greater discrimination was associated with greater odds of hazardous cannabis use (aOR=1.08, 95% CI [1.02, 1.15]) and cannabis-tobacco dual use (aOR=1.04, 95% CI [1.01, 1.08]) among SMYA women with greater use of expressive suppression. Among SMYA men, 83.9% experienced any discrimination; 49.2% reported current cannabis use, of whom 55.2% and 44.0% reported hazardous use and cannabis-tobacco dual use. Discrimination and emotion regulation were unrelated to cannabis use outcomes among men. Conclusions: Given high rates of discrimination experiences among SMYAs, emotion regulation skills training may empower SMYAs, particularly women, to cope with discrimination without using cannabis.

Background: Deficits in emotion regulation skills are possible factors maintaining major depressive disorder (MDD). Therefore, the aim of the study was to test whether integrating a systematic emotion regulation training (ERT) enhances the efficacy of routine inpatient cognitive behavioral therapy (CBT) for MDD. Methods: In a prospective randomized controlled trial, 432 inpatients meeting criteria for MDD were assigned to receive either routine CBT or CBT enriched with an intense emotion regulation skills training (CBT-ERT). Results: Participants in the CBT-ERT condition demonstrated a significantly greater reduction in depression (response rates - CBT: 75.5%, CBT-ERT: 84.9%; remission rates - CBT: 51.1%, CBT-ERT: 65.1%). Moreover, CBT-ERT participants demonstrated a significantly greater reduction of negative affect, as well as a greater increase of well-being and emotion regulation skills particularly relevant for mental health. Conclusions: Integrating strategies that target emotion regulation skills improves the efficacy of CBT for MDD.

Efforts to identify targets that could be instrumental for child abuse prevention programs have often implicated stress as a key risk factor. However, existing research has not adequately considered the role of emotion dysregulation and frustration intolerance in predicting parents’ risk to engage in parent-child aggression (PCA). In addition, research in this field continues to focus heavily on mothers, with limited attention to fathers. Thus, the current study investigated whether perceived stress and distress, emotion dysregulation, and frustration intolerance independently predicted risk of PCA in a sample of 81 couples; moreover, the study evaluated whether emotion regulation or frustration tolerance mediated or moderated the association between stress and PCA risk. Findings indicated that each of the risk factors uniquely predicted PCA risk after controlling for demographic factors; neither emotion dysregulation nor frustration intolerance moderated the association between stress and PCA risk but emotion regulation did partially mediate this association. No significant differences in the pattern of these relationships were observed between mothers and fathers. Future research directions are discussed, including methodological considerations as well as evaluating how emotion regulation skills training and improved parental frustration tolerance may prevent parent-child aggression.

Childhood polyvictimization is related to a heightened risk for mental health and functional problems in young adulthood, including posttraumatic stress symptoms, but little research has examined how perceptions of the prevalence of victimization may contribute to specific symptoms of posttraumatic stress. The primary aims of the current study were to (a) evaluate the accuracy of young adults' beliefs about the prevalence of multiple types of childhood victimization and (b) determine how inaccurate appraisals of victimization prevalence are associated with posttraumatic stress symptoms. College students (n = 369) drawn from two geographic regions of the United States responded to an online survey assessing their experiences of childhood victimization, perceptions about the prevalence of victimization, emotion regulation skills, and mental health. Childhood polyvictimization was significantly and positively related to distorted appraisals of the prevalence of victimization overall (r = .26, p < .001), and emotion regulation was associated with symptoms of posttraumatic stress in all domains. Distorted perceptions of the prevalence of victimization were linked to higher symptoms of hyperarousal, but not to higher symptoms of reexperiencing, avoidance, or negative mood/cognition. Results suggest that emotion regulation skills training is likely to be beneficial for many individuals experiencing posttraumatic stress, and intervention around perceptions of the prevalence of victimization may be useful for addressing symptoms of hyperarousal.

Emotion dysregulation seems involved in the development, maintenance, and outcome of eating disorders (EDs). The present study aimed to differentiate patients with EDs from a comparison group on emotion dysregulation, and to examine emotion dysregulation in relation to ED diagnostic presentation and ED symptoms. Participants, patients with EDs (N = 999) and a student comparison group (N = 252), completed the Difficulties in Emotion Regulation Scale and the Eating Disorder Examination Questionnaire. Patients were compared to the comparison group and compared by diagnosis regarding emotion dysregulation, and unique associations between emotion dysregulation aspects and ED symptoms were examined. Patients reported greater general emotion dysregulation than the comparison group, especially poorer emotional awareness and clarity. There were very few diagnostic differences. In both patients and the comparison group, limited access to emotion regulation strategies was associated with cognitive ED symptoms, and presence of binge eating in the comparison group. In patients, poor emotional awareness and emotional non-acceptance were additionally associated with cognitive symptoms, and difficulties in impulse control and emotional non-acceptance were associated with binge eating. Emotion dysregulation is an important transdiagnostic characteristic of ED. Results suggest interventions that enhance emotional awareness and acceptance, as well as emotion regulation skills training, in both ED treatment and prevention.

This pilot study examined the effects of dialectical behavior therapy (DBT) emotion regulation (ER) skills training for borderline personality disorder (BPD). To date, studies have yet to reveal whether specific DBT skill modules uniquely improve ER problems - one of the putative factors considered to underlie clinical problems in BPD. This preliminary examination aimed to characterize the effect sizes of DBT-ER compared to DBT interpersonal effectiveness (DBT-IE) skills training. Women with BPD (N = 19) were randomized to 6-weeks of DBT-ER, DBT-IE, or a control group. BPD symptoms, emotion regulation, and other BPD-relevant outcomes were assessed using self-report and laboratory-based measures. The DBT-ER group demonstrated large effect sizes for improved self-reported reactivity to an emotional stressor, generation of active rather than passive solutions to interpersonal problems, as well as self-reported distress tolerance, mindfulness, and BPD symptoms following treatment. At follow-up, DBT-ER training was also associated with large improvements in ER, social problem solving, and depression. Similarly large effect sizes, however, were sometimes also achieved in the DBT-IE and control condition. Significant condition x time interactions were detected for non-suicidal self-injury and mindfulness, with significant improvements occurring only in the DBT-ER group, whereas such interactions were not detected for other outcomes. These findings, although preliminary, can stimulate future research examining the specificity of DBT skills.

While Veterans in general are no more dangerous than the civilian population, Veterans with posttraumatic stress disorder (PTSD) have stronger associations with anger and hostility and certain forms of aggression, such as intimate partner violence, than civilians with PTSD. This is alarming because up to 21% of Veterans seeking Veterans Affairs (VA) health care are diagnosed with PTSD. Emotion regulation difficulties (emotion dysregulation) are also related to increased PTSD symptom severity and may play a role in aggressive behavior. Because the predominant form of aggression in PTSD appears to be the impulsive subtype, the authors sought to clarify the relationship between PTSD, emotion dysregulation, and impulsive aggression. We examined how emotion dysregulation influenced impulsive aggression in a Veteran sample (N = 479) seeking treatment for trauma sequelae. All Veterans completed measures that assessed demographic information, emotion dysregulation, aggression frequency and subtype, and PTSD symptoms. Men generally reported more aggression than women. The emotion dysregulation, aggression, and PTSD measures were significantly correlated. Two cross-sectional mediation models showed emotion dysregulation fully accounted for the relationship between PTSD and impulsive aggression (indirect path for men: b = .07, SE = .026, bias-correct and accelerated confidence interval [BCa CI] = [0.02, 0.13]; indirect path for women: b = .08, SE = .022, BCa CI = [0.05, 0.13]). PTSD can increase negative emotions yet does not always lead to aggressive behaviors. The ability to regulate emotions may be pivotal to inhibiting aggression in those with PTSD. PTSD interventions may benefit from augmentation with emotion regulation skills training.

Background: Emotional adjustment skills have recently been proposed as a new framework in the prevention of addiction in students. The purpose of this study was to determine the effectiveness of training emotional regulation skills on reducing addiction ability in high school male students. Methods: The statistical population of the present quasi-experimental study with a pre-test, post-test design and a control group was male high school students in Tabriz District 3 in the academic year 2018-2019. Accordingly, using the cluster sampling method, the students of one school were selected as the statistical sample and those with higher than the average score (above 21) were selected randomly and divided into the experimental (n=25) and control (n=25) groups. The experimental group was subjected to Emotional regulation skills training for 8 sessions, each session lasting 90 minutes for two months. During this period, the control group received no intervention. Theoretical Addiction Questionnaire was used for data collection. Covariance analysis was used to analyze the results. Results: Data analysis showed that training of emotional regulation skills has an impact on reducing the addiction of talented students. Conclusion: Training emotional regulation skills has an impact on reducing the addiction of talented students. emotion regulation skills training can also be used as a coping approach in adolescent education that should be targeted by reference groups, such as counselors, school coaches, and social planners.