Dysregulation Research Articles

Correlates of Impairment and Growth in Families of Young Autistic Children.

The purpose of this project was to investigate potential correlates of family life impairment in families of young autistic children. This project incorporated measures of specific child and parent challenges in addition to a commonly used unidimensional measure of autism characteristics. In this way, we could assess whether such challenges explain variance in family life impairment, and whether their inclusion diminish associations between autism characteristics and family life impairment. Cross-sectional data were collected from 564 parents of autistic children aged 2 to 5years who participated in a larger online study. Participants completed measures on child characteristics (autism characteristics, emotion dysregulation, speaking ability, flexibility, and sleep problems), parent depression, and family life impairment, using the Family Life Impairment Scale (FLIS). Multiple linear regression models were generated to examine whether any of the independent variables were associated with the four domains of the FLIS. Models controlled for child age and sex, parent education, and single-parent homes. All independent variables were associated with impairment in one or more FLIS domains. None of the primary independent variables were significantly associated with positive growth. More overt characteristics and behaviors (e.g., autism characteristics, reactivity, speaking ability, and flexibility) were associated with impairment in domains that reflected a family's ability to navigate the community. However, sleep challenges and parent and child emotional difficulties were most strongly associated with parent impairment. Findings suggests that families may have different needs across contexts and provide new avenues through which they might be better supported.

Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study.

Less is known about complex posttraumatic stress disorder (CPTSD) than postrraumatic stress disorder (PTSD) in military veterans, yet this population may be at greater risk of the former diagnosis. Executive function impairment has been linked to PTSD treatment outcomes. The current study therefore aimed to explore possible associations between each CPTSD symptom cluster and executive function to understand if similar treatment trajectories might be observed with the disorder. A total of 428 veterans from a national charity responded to a self-report questionnaire which measured CPTSD symptom clusters using the International Trauma Questionnaire, and executive function using the Adult Executive Function Inventory. Single and multiple linear regression models were used to analyse the relationship between CPTSD symptom clusters and executive function, including working memory and inhibition. Each CPTSD symptom cluster was significantly associated with higher executive function impairment, even after controlling for possible mental health confounding variables. Emotion dysregulation was the CPTSD symptom cluster most strongly associated with executive function impairment. This is the first study to explore the relationship between executive function and CPTSD symptom clusters. The study builds on previous findings and suggests that executive function could be relevant to CPTSD treatment trajectories, as is the case with PTSD alone. Future research should further explore such clinical implications.

Validation of the Bipolar Recovery Questionnaire for the Portuguese Population: Recovery and Predictors in People with Bipolar Disorder.

The paradigm in mental health care is progressively moving towards a recovery-focused perspective. Thus, there is a need for validated instruments to measure recovery in bipolar disorder (BD). The Bipolar Recovery Questionnaire (BRQ) is the most used instrument to assess it. The aim of this study was to translate and perform a cross-cultural adaptation of the BRQ to European Portuguese (PT-PT) and to explore further associations of recovery with sociodemographic and emotional regulation, as well as recovery predictors to inform future research and clinical practice. The BRQ was forward-translated and back-translated until a consensus version was found, and a test-retest design was used to assess temporal stability. Participants were recruited in public hospitals and organizations supporting people with BD, either referred by their psychiatrists or psychologists or through self-referral. Eighty-eight individuals diagnosed with BD were recruited to complete a battery of Portuguese-validated self-report questionnaires to assess recovery (BRQ), clinical mood symptoms (Hospital Anxiety and Depression Scale), affect (Positive and Negative Affect Scale), well-being (brief Quality of Life for Bipolar Disorder; Satisfaction with Life Scale) and emotion regulation (Difficulties in Emotion Regulation Scale). The BRQ showed excellent internal consistency with a Cronbach alpha of 0.92, and test-retest exhibited good reliability (r = 0.88). Construct validity was confirmed through/by positive and moderate correlations with quality of life (QoL; r = 0.58) and positive affect (r = 0.52), and negative moderate correlations with depression (r = -0.64), and negative affect (r = -0.55). Both satisfaction with life (β = 0.38, p = 0.010) and recovery (β = 0.34, p = 0.022) impacted quality of life, supporting the BRQ's incremental validity. Depressive symptoms and emotion dysregulation accounted for 51% of its variance. The BRQ is a valid and reliable instrument to measure recovery in people with BD in the Portuguese population and is suitable for both clinical and research contexts.

Assessing the mediating relationships between psychological factors in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome

This study aims to investigate the predictive and mediating relationships between emotion dysregulation, internalizing disorders, family functionality, loneliness preference, and executive functions (EF) in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome (ADHD + CDS). This study included 176 children and adolescents (92 boys, 84 girls) who were diagnosed with ADHD + CDS according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist, between ages 8 -12 (M = 10, SD = 1.52) with a convenience sampling method. The solitude scale for children, difficulties in emotion dysregulation scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, Family assessment device, and CNS Vital Signs test were used. The results showed that difficulty in emotion regulation, preference for loneliness, internalizing disorders and CDS symptom severity did not have a mediating effect between family functionality and EF. Still, emotion dysregulation mediates the relationship between EF and internalizing disorders by itself and through loneliness preference. Also, preference for loneliness and emotion dysregulation had a mediating effect between family functionality and internalizing disorders. Finally, it was found that the effect of emotion regulation difficulty, loneliness preference, and internalizing disorders had a mediating role between CDS symptom severity and family functionality. In conclusion, the information obtained from this study on the etiology of CDS may guide future studies.

Applicability and Psychometric Properties of General Mental Health Assessment Tools in Autistic People: A Systematic Review.

In recent years, there has been a proliferation of instruments for assessing mental health (MH) among autistic people. This study aimed to review the psychometric properties of broadband instruments used to assess MH problems among autistic people. In accordance with the PRISMA guidelines (PROSPERO: CRD42022316571) we searched the APA PsycINFO via Ovid, Ovid MEDLINE, Ovid Embase and the Web of Science via Clarivate databases from 1980 to March 2022, with an updated search in January 2024, to identify very recent empirical studies. Independent reviewers evaluated the titles and abstracts of the retrieved records (n = 11,577) and full-text articles (n = 1000). Data were extracted from eligible studies, and the quality of the included papers was appraised. In all, 164empirical articles reporting on 35 instruments were included. The review showed variable evidence of reliability and validity of the various instruments. Among the instruments reported in more than one study, the Aberrant Behavior Checklist had consistently good or excellent psychometric evidence. The reliability and validity of other instruments, including: the Developmental Behavior Checklist, Emotion Dysregulation Inventory, Eyberg Child Behavior Inventory, Autism Spectrum Disorder-Comorbid for Children Scale, and Psychopathology in Autism Checklist, were less documented. There is a need for a greater evidence-base for MH assessment tools for autistic people.

Emotional dysregulation moderates the relation between perceived stress and emotional eating in adolescent military dependents.

Adolescent children of US service members (i.e., military-dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating. Difficulties with adaptively responding to stress and aversive emotions may play an important role in emotional eating. This study examined emotion dysregulation as a potential moderator of the association between perceived stress and emotional eating in adolescent military dependents. Participants were military-dependent youth (N = 163, 57.7% female, Mage = 14.5 ± 1.6, MBMI-z = 1.9 ± 0.4) at risk for adult binge-eating disorder and high weight enrolled in a randomized controlled prevention trial. Prior to intervention, participants completed questionnaires assessing perceived stress and emotional eating. Parents completed a questionnaire assessing their adolescent's emotion dysregulation. Moderation analyses were conducted using the PROCESS macro in SPSS and adjusted for theoretically relevant sociodemographic covariates. The interaction between adolescent perceived stress and emotion dysregulation (parent-reported about the adolescent) in relation to adolescent emotional eating was found to be significant, such that higher emotion dysregulation magnified the association between perceived stress and emotional eating (p = .010). Examination of simple slopes indicated that associations between perceived stress and emotional eating were strongest for youth with above-average emotion dysregulation, and non-significant for youth with average or below-average emotion dysregulation. Findings suggest that greater emotion dysregulation may increase risk for emotional eating in response to stress among military-dependent youth at risk for binge-eating disorder or high weight. Improving emotion regulation skills may be a useful target for eating disorder prevention among youth who are at risk for emotional eating. Prior research has shown that adolescent military dependents are at increased risk for eating disorders and high weight. The current study found that emotion dysregulation moderated the relationship between perceived stress and emotional eating among military-dependent youth. There may be clinical utility in intervening on emotion regulation for adolescent dependents at particular risk for emotional eating and subsequent eating disorders.

Acute, Chronic, and Everyday Physical Pain in Borderline Personality Disorder.

Physical pain is an underrecognized area of dysregulation among those with borderline personality disorder (BPD). Disturbances are observed within the experience of acute, chronic, and everyday physical pain experiences for people with BPD. We aimed to synthesize research findings on multiple areas of dysregulation in BPD in order to highlight potential mechanisms underlying the association between BPD and physical pain dysregulation. Potential biological mechanisms include altered neural responses to painful stimuli within cognitive-affective regions of the brain, as well as potentially low basal levels of endogenous opioids. Emotion dysregulation broadly mediates dysregulation of physical pain. Certain psychological experiences may attenuate acute physical pain, such as dissociation, whereas others, such as negative affect, may exacerbate it. Social challenges between patients with BPD and healthcare providers may hinder appropriate treatment of chronic pain. Dysregulated physical pain is common in BPD and important in shaping health outcomes including elevated BPD symptoms, chronic pain conditions, and risk for problematic substance use.

Clinical outcomes for sexual and gender minority adolescents in a dialectical behaviour therapy programme.

Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people. This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK). Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms. SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions. These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.

Adults with both bipolar disorder and ADHD

ADHD and bipolar disorder (BP) commonly coexist, and both share key symptoms, depending on affective state and emotional dysregulation. The overlap poses diagnostic challenges and may lead to underdiagnoses. Comorbid cases exhibit worsened symptom burden, increased psychiatric morbidity, admissions, and suicide attempts. Treating BP before ADHD is recommended. Stimulant use combined with mood stabilisers may be effective and relatively safe; however, this review finds that well-designed randomised controlled studies in the area is warranted.

Filling the void: boredom’s associations with hoarding symptom severity

In hoarding disorder, features including attentional difficulties and emotion dysregulation can contribute to the core symptoms of clutter, difficulties discarding, and excessive acquisition. Boredom is a negative feeling state that shares a high level of overlap with associated features of hoarding, including inattention, depressive symptoms, and impulsivity, and has been implicated in compulsive buying behaviors. Boredom may be a particularly relevant factor in compulsive hoarding; however, this relationship remains significantly under-researched. The present studies aimed to thoroughly investigate associations between boredom and hoarding severity using diverse methodologies. Study 1 (N = 253) replicated, in an online community sample, previously reported positive associations between hoarding severity and recent state boredom while statistically controlling for potentially confounding variables (e.g., depression, indecisiveness), and extended these findings to include boredom proneness. In Study 2, individuals with elevated hoarding symptoms (n = 56) and a history of hoarding problems (n = 43) reported higher levels of recent state and trait boredom than controls (n = 61). Additionally, boredom was associated with performance on simulated acquiring and discarding tasks. Finally, Studies 3a (N = 144) and 3b (N = 146) attempted the first experimental tests of induced boredom on acquiring and discarding behaviors. Although results were mixed and preclude causal conclusions, exploratory analyses revealed that individuals reporting higher in-the-moment boredom took more (p = .008) and discarded fewer (p = .021) items on the simulated tasks. Overall, results suggest that boredom may have crucial implications in hoarding symptom severity.

Measuring Teacher Talk and the Behavior of Autistic Students in Preschool Through Third-Grade Special Education Mathematics Activities

Abstract Objectives Teacher talk provides the medium for teaching and learning. However, there has been little emphasis on conceptualizing and measuring teacher talk within specific contexts and populations or the influence that child behavior has on teacher talk. We described and investigated varying models of teacher talk directed individually toward autistic students within 96 special education mathematics activities drawn from larger mathematics lessons. We also examined child behavior within mathematics contexts measured through observation and via teacher report. Methods Our participants included 39 preschool–third-grade teachers across 14 districts in California and their 66 autistic students (Mage = 6.74 years, SD = 2.04). We utilized archival video observations from the start of the school year collected as part of a longitudinal study examining a classroom-based intervention for autistic students. Results Our findings provide support for a five-factor model of teacher talk (instructional talk, questioning techniques, responsive language, directive language, and foundational talk) and shed light upon teachers’ overuse of directive language to direct or redirect autistic students’ behavior relative to the other talk dimensions. We also documented a significant positive association between teachers’ use of non-task-related directives and student emotion dysregulation. Conclusions This detailed evaluation of teacher talk provides a promising means for gauging the quality of instructional talk and the experiences of elementary-aged autistic students within special education mathematics contexts. Tailoring professional development for educators that centers on understanding developmental characteristics associated with autism and highlighting teacher talk as a targeted intervention is an area for further study.

Parenting and Emotional and Behavioral Difficulties in a General Population Sample of Adolescents: The Mediating Role of Emotional Dysregulation

Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.

Modeling the associations between emotion regulation, suicide crisis syndrome and suicidal behavior: Results in community and clinical samples.

Emotion Regulation (ER) and Suicide Crisis Syndrome (SCS) are psychological processes involved in suicide. Within ER, both the use of rumination and dysfunctional emotion beliefs are associated with suicide. SCS, a pre-suicidal mental state involving cognitive and affective dysregulation, is related to short-term suicide risk. Here, we first examined associations between ER (beliefs about the uncontrollability of emotions and rumination), SCS and suicide behavior, and second, we test a multistep model in which ER factors are linked to suicide behavior through SCS. We conducted two cross-sectional studies to address this issue by self-reports. Study 1 used a community sample (N = 421). Study 2 used a clinical sample (N = 70). Results from both studies showed that beliefs about the uncontrollability of emotions and rumination were associated with higher levels of SCS symptoms and suicide behavior, and that SCS was associated with suicide behavior. In addition, path analyses showed that uncontrollability beliefs were linked to rumination, which in turn was associated with SCS, and this variable mediated the association between ER factors and suicide ideation (in both community and clinical samples) and suicide attempts (in the community sample). As we expected, in both samples, uncontrollability of emotions and rumination were positively related with SCS and suicide behavior. We emphasize the importance of addressing uncontrollability beliefs and rumination in suicide prevention.

Development of a self-report screening instrument for emotional dysregulation: the Reactivity, Intensity, Polarity and Stability questionnaire, screening version (RIPoSt-SV)

BackgroundEmotional dysregulation (ED) refers to the inability to manage emotional experiences or expressions hindering goal-oriented behavior. Moderate impairment on at least two domains among temper control, affective lability, and emotional over-reactivity has been proposed to identify ED in adults with attention-deficit/hyperactivity disorder (ADHD). No screening measure designed for use in diverse psychiatric samples exists. We aimed to develop a self-report screening tool for ED based on the 40-item version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-40). Methods150 adult outpatients with non-psychotic conditions were enrolled between February and July 2023 at the Second Psychiatry Unit of Pisa University Hospital. Clinically significant ED (CSED) was defined based on the previously suggested approach for ADHD. Differences between patients with and without CSED were tested. To develop our screening instrument, a decision tree algorithm was trained by hyperparameter tuning through 5-fold cross-validation in 120 subjects and tested on the remaining 30. Results75 subjects met criteria for CSED (50 %). CSED was associated with lower age and higher prevalence of psychiatric conditions, including minor mood disorders, ADHD, cannabis use disorders, and eating disorders. We identified a decision tree consisting of six items from RIPoSt-40 that effectively detected CSED, with accuracy, sensitivity, specificity, positive and negative predictive values of 80 % or higher in both the training and testing sets. LimitationsTertiary-level; no consensus on criteria; sample size. ConclusionThe screening version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-SV) demonstrates promise as a valuable tool for ED screening in clinical settings.

The role of specific emotion dysregulation facets in the association between child violence exposure and psychopathology.

African Americans living in low-income urban environments are disproportionately exposed to violence compared to other racial groups. Child exposure to community violence is linked to adverse psychological outcomes, including externalizing and internalizing behaviors. Emotion dysregulation may be one psychological process through which externalizing and internalizing behaviors develop in the context of childhood violence exposure. However, limited research exists on how different aspects of emotion dysregulation are affected by community violence exposure in children. The present study examined whether violence exposure was indirectly associated with externalizing and internalizing behaviors via facets of emotion dysregulation in a sample of 94 African American mother-child dyads. Mothers and children completed measures to assess child community violence exposure, externalizing and internalizing behaviors, and emotion dysregulation (anger, sadness, and worry dysregulation). Results indicated that maternal report of child community violence exposure was indirectly associated with externalizing behaviors via anger dysregulation and internalizing behaviors via worry dysregulation. Child report of community violence exposure was also indirectly associated with externalizing behavior via anger dysregulation; however, there were no significant associations with internalizing behavior. These findings suggest that certain components of emotion dysregulation serve as an indirect pathway of influence for community violence exposure on child behavior, and the pathways differ between externalizing and internalizing behavior outcomes. Emotion dysregulation may serve as an important potential treatment target in reducing long-term risks associated with violence exposure in urban communities of color. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Emotion Beliefs Questionnaire: Psychometric properties, norms, and links to affective outcomes

BackgroundThe Emotion Beliefs Questionnaire was recently developed to measure beliefs about the controllability and usefulness of negative and positive emotions. These are beliefs that have been theorised to be influential for emotion regulation and psychological outcomes. However, to date there are few studies utilising large, representative samples to examine the EBQ's psychometric properties and affective correlates. Our aim was to fill this gap by examining the EBQ's psychometric properties and exploring associations between emotion beliefs, emotion regulation, and affective disorder symptoms. MethodsA sample of 1175 adults recruited from the general population in the United States completed measures of emotion beliefs, emotion regulation, and affective disorder symptoms. ResultsConfirmatory factor analyses supported the EBQ's intended subscale structure, where controllability and usefulness beliefs were separated by valence. This structure was invariant across gender, age, and education categories. The EBQ correlated in expected ways with other measures, demonstrating good validity, and had good to excellent levels of internal consistency reliability. LimitationsThis study used a non-clinical sample that was predominantly White. Future work should utilise clinical and cross-cultural samples to maximise generalisability of findings. ConclusionsOur findings indicate that the EBQ is a psychometrically sound tool for measuring the multidimensional emotion belief construct. The EBQ may have clinical utility in the conceptualisation, assessment, and treatment of maladaptive emotion beliefs. Furthermore, our results highlight the importance of considering the potential influence of maladaptive emotion beliefs in emotion dysregulation and affective disorder symptoms.

Adverse childhood experiences and insecure attachment: The indirect effects of dissociation and emotion regulation difficulties.

Difficulties with dissociation and emotion regulation are well-documented reactions to early adverse childhood experiences (ACEs). Although findings identify dissociation and emotion dysregulation as explaining the relationship between various forms of ACEs and adult psychopathology, less is known about their combined effect in the relationship between ACEs and insecure attachment in adulthood. This study examined the indirect effects of dissociation and emotion regulation difficulties in the relationship between early adverse experiences and insecure attachment traits. Participants (N = 260) completed an online questionnaire measuring ACEs, dissociation, emotion regulation difficulties, and anxious and avoidant attachment. Results indicated that, after controlling for mental health treatment, dissociation and emotion regulation difficulties explained the relationship between ACEs and insecure (anxious and avoidant) attachment. Emotion regulation difficulties were not a significant predictor of avoidant attachment. Findings provide support for greater research on mediating factors in the maintenance of insecure attachment across development and potential implications of dissociation and emotion regulation in clinical and nonclinical populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Undoing mothers' avoidant coping with children's negative emotion: A randomized controlled trial of relational savoring.

Some mothers report using avoidant coping strategies (minimizing, punishing) in response to their young children's negative emotion, an aspect of insensitive parenting that places children at risk for emotional or behavioral dysregulation (Fabes et al., 2001) and insecure attachment (De Wolff & van Ijzendoorn, 1997). In prior work, an in-home attachment-based relational savoring (RS) intervention, administered over a month's time, positively affected maternal emotion and sensitive behavior with young children (Borelli et al., 2023); further, a one-time online RS protocol had greater impacts on emotion and relationship satisfaction for mothers with greater attachment avoidance (Burkhart et al., 2015). However, we do not yet know whether a brief, laboratory intervention impacts highly avoidant mothers' behavior with their children and not just their self-reports of satisfaction. Here, we examine whether mothers' endorsement of avoidant coping strategies moderates the effect of an RS versus active control intervention on mothers' use of emotion-coaching during an emotionally charged conversation with their child. Mothers (N = 122; Mage = 33.42, SD = 5.40) and their preschoolers (Mage = 41.80 months, SD = 4.65; 48.4% female) from diverse backgrounds (41% Latina, 40% White [non-Latina]; 42% under $60,000 annual income) participated. The interaction between condition and level of avoidant coping on mothers' emotion-coaching behaviors was significant. Mothers high in avoidant coping (top quartile) displayed better emotion-coaching during the emotion conversation if they had been in the RS condition. Savoring may be a valuable tool to promote effective emotion-coaching among parents most prone to avoid their children's negative emotion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implication of Social Rejection in Cognitive Bias Modification Interpretation Training in Adolescents With Eating Disorders.

Difficulties in interpersonal relationships intensify negative emotions and act as risk and maintenance factors for eating pathology in eating disorders. Rejection sensitivity refers to the tendency to react sensitively to a rejection. Patients with eating disorders experience difficulties in interpersonal relationships because of their high sensitivity to rejection. Cognitive bias modification interpretation (CBM-I) is a treatment developed to correct interpretation bias for social and emotional stimuli. In this review, we searched for research characteristics and trends through a systematic literature analysis of CBM-I for eating disorders. Five papers that met the selection and exclusion criteria were included in the final literature review and analyzed according to detailed topics (participant characteristics, design, and results). The literature supports the efficacy of the CBM-I in reducing negative interpretation bias and eating disorder psychopathology in patients with eating disorders. CBM-I targets emotional dysregulation in adolescent patients with eating disorders and serves as an additional strengthening psychotherapy to alleviate eating disorder symptoms. The current findings highlight the potential of CBM-I as an individualized adjunctive treatment for adolescents with eating disorders and social functioning problems.

DIFFERENCES BETWEEN GRANDIOSE AND VULNERABLE NARCISSISM: SELF-ESTEEM, EMOTION DYSREGULATION, AND INTERPERSONAL RELATIONSHIP

Introduction – Narcissism is most often associated with someone arrogant, domineering, and conceited which is captured in the term grandiose narcissism. However, it is agreed that there are two different dimensions of narcissism which are grandiose narcissism and vulnerable narcissism. Manifestations of the two dimensions are differently affecting one’s self-esteem and interpersonal relationships. Methods – The researcher used several journals and literature discussing grandiose and vulnerable narcissism including assessment, self-esteem, emotion dysregulation, difficulties in interpersonal relationships, and parenting about grandiose and vulnerable narcissism. Results – Narcissism is an effort to protect one’s self-concept which is characterized by an intense need for validation and admiration that pushes them to seek self-enhancements. There are two types of narcissism which are grandiose and vulnerable narcissism. Vulnerable narcissism is associated with lower self-esteem than grandiose narcissism and in turn, has a more positive association with difficulties in regulating negative emotions than grandiose narcissism. Discuss – The assessment of grandiose narcissism is less of a challenge because of the overt presentation of grandiosity. On the other hand, the assessment of vulnerable narcissism is tricky. The entitlement is usually hidden in these individuals with the overt presentation being fearful, cautious, and easily threatened. Conclusion – Vulnerable narcissists tend to develop social avoidance to cope with their vulnerabilities in a relationship, while grandiose narcissist tends to say positive things about themselves. Keywords: grandiose, narcissism, self-esteem, emotion dysregulation, interpersonal relationship.