Difficulties In Emotion Regulation Scale Scores Research Articles

Predictors of polysubstance use in patients with severe alcohol use disorder: the role of reward craving

BackgroundDifferent craving typologies (i.e., reward, relief, obsessive) have been identified in alcohol use disorder (AUD) but have been less investigated in specific populations like AUD patients with polysubstance use (PSU). The role of dysfunctional personality traits and reward pathways has been reported in both AUD and PSU. We hypothesized that patients with AUD-PSU might show a prevalent reward craving, alongside specific sociodemographic, clinical, and personality features, and aimed at investigating differences in 423 severe AUD outpatients with and without PSU. MethodsOne hundred fifteen patients (27.1% of the sample, 67% males, 42 ± 11.6 years old) displayed PSU. Sociodemographic, clinical features and psychopathological/personality dimensions were assessed through: Craving Typologies Questionnaire (CTQ); Obsessive–Compulsive Drinking Scale (OCDS); UPPS-P Impulsive Behavior Scale (S-UPPS-P); Difficulties in Emotion Regulation Scale (DERS). A binomial logistic regression explored factors associated with PSU. ResultsWe found higher CTQ ‘reward’ scores (p < 0.001) in AUD-PSU patients, and a significant association between reward craving and PSU through logistic regression (OR:1.13; p = 0.005). Earlier AUD onset (p < 0.001), greater rates of binge drinking (p = 0.029), more legal problems (p = 0.015), but no significantly higher S-UPPS-S and DERS scores, were detected in AUD-PSU patients. ConclusionsReward craving was associated with increased risk for PSU in severe AUD patients. Given AUD-PSU participants greater severity and detrimental treatment responses imputed to PSU, identifying prevalent craving types among risk factors for PSU in AUD may help to implement therapeutic strategies. Addressing neurobiological and behavioral mechanisms through combined psychotherapies, pharmacological and neuromodulation treatments could support tailored interventions with better long-term outcome.

Clinical improvement of teens participating in a dbt skills training

IntroductionDialectical behavioural therapy (DBT) developed by Linehan has been shown to be widely effective in improving emotional regulation capacity in patients diagnosed with borderline personality disorder in adults and adolescents, but also for other profiles of emotional dysregulation, even in the general non-clinical population through emotional regulation skills training programs in schools.ObjectivesThe objective was to describe psychopathological characteristics and to evaluate clinical outcome variables (self-harm, suicide attempts, admissions and emotional regulation difficulties) in young patients who participated in the DBT skills training group carried out by the child and adolescent psychiatry team of Hospital del Mar (Barcelona) between February 2020 and April 2022.MethodsProspective longitudinal study with two evaluations (before starting the group and after finishing it). The clinical variables were evaluated by reviewing the medical records, and the improvement in emotional regulation difficulties was evaluated through the Difficulties in Emotion Regulation Scale (DERS) adaptation to adolescents before and after the intervention.ResultsA total of 36 participants have been referred and assessed to participate in the previously mentioned emotional regulation program. The mean age was 15.6 years (14-17 years old). 100% of the participants were female. All of them met criteria for BPD according to the SCID-II questionnaire; but only 23 patients (63.9%) had BPD as their main diagnosis. 63.9% (n=23) presented psychiatric comorbidities, being 27.8% (n= 10) ADHD, 30.6% (n= 11) substance use disorder and 47.2% (n= 17) eating disorders,77.8% (n=28) had presented self-injurious behaviour, 52% (n=18) had committed a suicide attempt, requiring hospital admission in 36.2% (n=13) at some point in their lives before the therapy group. In the three months after the end of the group, admissions were reduced to 17% (n=6), suicide attempts to 14.8% (n=5) and non-suicidal self-injurious behaviours to 27.8% (n=10).The mean score of all participants on the DERS scale was 129.91 points before participating in the DBT skills group and 105 points right after the group finished. Higher scores translate into greater emotional regulation difficulties.ConclusionsThe reduction in DERS scores, self-injurious behaviours, suicide attempts, and admissions was notable for all participants. It remains to add the results of the groups currently in operation and perform the statistical analysis of all the results. It is necessary to continue studying and testing the benefits of DBT both in the clinical adolescent population and in the general child and adolescent population in order to generalize the promising results observed in our sample. At Hospital del Mar, we will continue to expand the DBT program so that more children and adolescents with emotional dysregulation can benefit.Disclosure of InterestNone Declared

EMOTION DYSREGULATION AFFECTS FUNCTIONALITY IN MAJOR DEPRESSIVE DISORDER

Purpose: Mood disorders are recurrent chronic mental illnesses known to affect functionality. In this study, it was aimed to compare coping strategies and emotion regulation difficulties in depression and bipolar disorder and observe the effects of coping strategies and emotion regulation on functionality.&#x0D; Methods: 31 patients with bipolar disorder (BD), 29 with major depressive disorder (MDD), and 27 healthy controls (HC) were included in the study. Participants completed the Coping Strategies Inventory (COPE), Bipolar Disorder Functioning Questionnaire (BDFQ), Difficulties in Emotion Regulation Scale (DERS), Hamilton Depression Scale (HAM-D), and Young Mania Rating Scale (YMRS).&#x0D; Results: In the BD group, a positive significant correlation was found between COPE-M and DERS scores, and a negative significant correlation was found between COPE-M and BDFQ. In the MDD group, a positive significant correlation was found between COPE-A and BDFQ scores, and a negative significant correlation was found between DERS and BDFQ. BDFQ was statistically significantly predicted positively by COPE-A and negatively by DERS.&#x0D; Conclusion: It was thought that emotion dysregulation may predispose to depressive symptomatology and negatively affect clinical course and functionality. Addressing emotion regulation difficulties and increasing the use of adaptive coping strategies in therapeutic interventions contribute to the improvement of functionality as well as clinical improvement.

Difficulties in emotion regulation and ad libitum smoking topography: A secondary analysis

IntroductionDespite the well-known linkages between poor emotion regulation and subjective smoking motives, little is known about the role of emotion regulation in predicting smoking reinforcement behavior. This study examined the relation between difficulties in emotion regulation and puff velocity data, a behavioral index of smoking reinforcement, in adult daily cigarette smokers. MethodThe current study was a secondary analysis of data collected from non-treatment seeking daily smokers (N = 124). Participants completed the Difficulties in Emotion Regulation Scale (DERS) followed by an ad libitum smoking period during which puff topography data was collected via a handheld puffing device. Puff velocity served as our puff topography index and was examined at the average and puff-to-puff level using regression and multi-level models, respectively. ResultsRegression analyses showed no significant association between DERS scores and average puff velocity. In contrast, multi-level modeling found a significant quadratic time × DERS effect at the puff-to-puff level, such that those with greater emotion regulation difficulties inhaled more quickly at the initiation of the cigarette, whereas those with lower emotion regulation difficulties evidenced consistent puffing over the course of the cigarette. DiscussionSmokers with greater difficulties in emotion regulation appear to smoke in a way that maximizes delivery of nicotine, perhaps to self-regulate distress. One’s style of puffing may reflect a possible behavioral marker of negative reinforcement smoking, especially in the context of emotional distress. ImplicationsThis study was the first to explore the relationship between difficulties in emotion regulation and a behavioral measure of smoking reinforcement.

Cigarette smoking is associated with difficulties in the use of reappraisal for emotion regulation

BackgroundNegative emotions can promote smoking relapse during a quit attempt. The use of cognitive reappraisal to self-regulate these emotions may therefore aid smoking cessation. Determining whether smokers exhibit difficulties in the use of reappraisal, and which factors are associated with such difficulties, may aid smoking cessations. Methods50 smokers and 50 non-smokers completed an online reappraisal task in which they either reappraised or naturally experienced emotions induced by negatively- and neutrally-valenced images that presented situations in either the 1st-person or 3rd-person perspective. Participants also completed the Difficulties in Emotion Regulation Scale (DERS). ResultsCompared to non-smokers, smokers were less successful in using reappraisal to self-regulate emotions elicited by negatively-valenced images (but not neutrally-valenced images). Importantly, this effect was only true for images that were presented in the 1st-person (but not 3rd-person) perspective. Contrary to predictions, there were no group differences in DERS scores. ConclusionsThis study provides the first evidence that smokers experience difficulties in the use of reappraisal, particularly in situations that appear to be happening to themselves. Because the use of this regulation technique may help smokers to quit, improving smokers’ abilities to use reappraisal, particularly during negatively-valenced situations that directly influence the smoker, may aid smoking cessation.

Mindfulness, mood symptom tendencies and quality of life in bipolar disorder: An examination of the mediating influence of emotion regulation difficulties

BackgroundThe aim of this cross-sectional study was to investigate dispositional mindfulness and its association with depression and manic tendencies, and subjective life quality in bipolar disorder (BD). Furthermore, this study sought to examine the potential mediating effects of emotion regulation difficulties on these relationships. MethodTwenty-eight healthy controls (HC) and 66 clinically stable outpatients with a DSM-IV-TR diagnosis of BD completed the Mindfulness Attention Awareness Scale (MAAS), Difficulties in Emotion Regulation Scale (DERS), Seven Up (7 Up) Seven Down (7 Down) and the Quality of Life in Bipolar Disorder Questionnaire (QoL.BD). These variables were compared between groups and entered into a series of mediation analyzes using PROCESS in the BD group only. ResultsLower MAAS scores were detected amongst the BD patients compared to HCs. Lower MAAS scores in BD patients predicted higher 7 Up, 7 Down and lower QoL.BD scores. For the 7 Down and QoL.BD, the associations were completely mediated by DERS scores, with difficulties in strategy use and emotional clarity mediating the association between mindfulness and depressive tendencies and quality of life, respectively. No significant direct or indirect effects were detected for the 7 Up model. LimitationsThe cross-sectional design precludes causal inference. The MAAS conceptualises mindfulness as unidimensional. Self-report scales of depressive and manic tendencies utilised. ConclusionsThis study detected a significant association between dispositional mindfulness and depressive tendencies and life quality in BD, and found that these associations were influenced by emotion regulation difficulties. These findings encourage further investigation of mindfulness-based interventions in BD.

Emotion Regulation and Self-Harm Among Forensic Psychiatric Patients.

Emotion regulation has been specifically linked to both non-suicidal self-injury (NSSI) and attempted suicide. It is also known that self-harm is disproportionally higher (30–68.4%) in forensic samples than in the general population, yet knowledge about the association between emotion regulation and self-harm in forensic settings is scarce. The purpose of this study was to describe emotion regulation in a sample of forensic psychiatric patients, to explore dimensions and levels of emotion regulation between forensic psychiatric patients with and without self-harm, and to explore associations between forensic psychiatric patients’ self-reported emotion regulation and self-reported functions of NSSI. A cohort of forensic psychiatric inpatients (N=98) was consecutively recruited during 2016–2020 from a high-security forensic psychiatric clinic in Sweden. Data were collected through the self-report measures Difficulties in Emotion Regulation Scale (DERS) and Inventory of Statements About Self-injury (ISAS). In relation to the first aim, median total and subscales scores for DERS were reported. Results showed a statistically significant difference in emotion regulation between participants with and without self-harm (p=0.004), with a medium effect size (Cohen’s d=0.65) for the DERS total scale. The DERS subscales returned large differences for Impulse (p=0.001, d=0.86), Goals (p=0.014, d=0.58), and Strategies (p=0.012, d=0.54) between participants with and without self-harm. Finally, DERS scores were correlated with both the interpersonal (rs=0.531, p<0.001, n=43) and intrapersonal factors (rs=0.503, p<0.001, n=43) of NSSI as reported on the ISAS. Participants with self-harm (NSSI and/or suicide attempts) demonstrated significantly more difficulties with emotion regulation than those without self-harm. Emotion dysregulation was associated with both interpersonal and intrapersonal functions of NSSI in the participants. We suggest further studies on forensic psychiatric patients’ maladaptive behaviors that focus on substance abuse, self-harm, and aggressive behaviors in relation to the regulation and expression of emotion.

Efficacy of Dialectical Behavioral Therapy for Emotion Dysregulation in Patients with Dual Diagnosis of Borderline Personality Disorder and Substance Use Disorder

Background: The published evidence supports the efficacy of dialectical behavioral therapy (DBT) to treat patients with borderline personality disorder and particular emphasis on emotion dysregulation as a psychopathological construct. Aim: To assess the efficacy of DBT for improving emotion dysregulation among patients with dual diagnosis of borderline personality disorder and substance use disorder. Methods: We recruited 40 patients meeting DSM-5 criteria for borderline personality disorder and substance use disorder and assigned them to one of two groups of 20 participants each. One group underwent DBT therapy and the other group followed a treatment-as-usual (TAU) protocol over one year. We used the scores of the difficulties in emotion regulation scale (DERS) at baseline, immediately after therapy, and 4 months after therapy to assess emotion dysregulation. Results: We found significant improvements (p&lt;0.05) in the DBT group after therapy that were maintained at least for 4 months afterwards based on the DERS scores (including subscale scores). More patients dropped out of the treatment in the TAU group than in the DBT group. Conclusion: DBT is a potentially efficacious psychological intervention to treat emotion dysregulation in patients with borderline personality disorder and substance use disorder.

Self-Projected Protection Order Violations across Contexts, History, and Emotion Regulation: A Brief Report

The effectiveness of protection orders (PO) from abuse vary by objective and subjective metrics, including victims’ perceptions and legal outcomes. It is unclear how defendants perceive PO violations and evaluate decisions to violate POs. This study examined how context, emotion regulation, and adverse childhood experiences (ACEs) were related to the decision to violate a PO. A general community sample (N = 300) recruited via Amazon Mechanical Turk completed a demographics questionnaire, Difficulties in Emotion Regulation Scale (DERS), ACEs Questionnaire, and a study-specific vignette and measure asking their projected likelihood of verbally/physically violating the PO. The context in each vignette was randomized to include control (providing information about the PO and ex-partner), custody (alluding to child custody disputes), or significant other conditions (introducing the complainant’s new partner). PO context was not significantly related to projected physical or verbal violations. DERS and ACEs were significantly associated with projected total and physical violations in all contexts. DERS scores were also associated with verbal violations. Certain violation types were related to endorsement of specific ACEs items: self-reported sexual abuse and household abuse were each associated with projected total and physical PO violations. Preliminary data suggest that emotion regulation and ACEs may be more noteworthy than the situation in which the PO was issued. Given the impact of ACEs on emotion dysregulation and offending behavior (e.g. domestic violence), research is needed on effective early interventions and to determine when/where POs may fail to prevent future harm.

Problematic internet gaming in adolescents, and its relationship with emotional regulation and perceived social support

Technological developments and the increased use of the internet have created some risks for adolescents, including problematic internet gaming (PIG). The aim of this study is to investigate the role of age, gender, emotional dysregulation and perceived social support in PIG. The study was conducted with 1,291 adolescents. Participants completed the game addiction scale (GAS), difficulties in emotion regulation scale (DERS), and multidimensional scale of perceived social support (MSPSS) under the observation of their teachers. According to the results of the GAS, participants were divided into two groups: those with PIG and those without PIG. The effect of age, gender, DERS scores, and MSPSS scores on PIG was investigated using stepwise logistic regression analysis. The mean age of participants was 14.7 years and the frequency of PIG was 13.5% (n = 144). The frequency of PIG was significantly higher in males than in females. The results showed that male gender, high emotional dysregulation and low perceived social support were significantly associated with PIG. The present study indicate that PIG is highly observed in adolescents, especially in males, and as in other behavioral addictions, emotional dysregulation and perceived social support can play an important role in PIG.

Emotion regulation difficulties of patients with bipolar disorder and first-degree relatives

Objective: Difficulty in emotion regulation is the deficiency to regulate an individual's emotional response to a negative stimulus. Our aim is to investigate the effect of emotion regulation difficulty on the process and function of bipolar disorder (BD). Methods: 64 patients with BD, 64 patient’s first-degree relatives and 66 healthy controls were included in the study, which were followed in Mersin University Research and Practice Hospital Outpatient Clinic of Psychiatry. Sociodemographic Information Form and Difficulties in Emotion Regulation Scale (DERS) were filled to all participants. In addition; SCID-I, Short Form-36 (SF-36), Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale were filled to the patient group. Statistical analyses were performed with SPSS 21.0 computer program. Results: DERS scores in patients’ group were found to have significantly higher scores than patient’s relatives and healthy controls (p0.05). Another finding that who score high scores on DERS receive lower scores on SF-36. In depressed patients, there was a significant positive correlation between HDRS scores and DERS scores. Discussion: In our study, it was shown that difficulty of emotion regulation negatively affected the functioning and disease course of BD patients and there is a positive correlation between difficulty in emotion regulation and impairment in functioning in depressive episodes

Differences in emotion regulation difficulties among adults and adolescents across eating disorder diagnoses.

Although much empirical attention has been devoted to emotion regulation (ER) in individuals with eating disorders, little is known about ER across a wide age range and among different ED subtypes. The current study sought to examine ER in a sample of eating disorder patients. A total of 364 adults and adolescents with anorexia nervosa restricting subtype (AN-R), anorexia nervosa binge/purge subtype (AN-BP), or bulimia nervosa (BN) were assessed with the Difficulties in Emotion Regulation Scale (DERS). Older ages were associated with higher DERS total, nonacceptance, goals, and impulsivity scores. When controlling for age, patients with BN and AN-BP had higher overall DERS scores than those with AN, and there were some differences among diagnostic subtypes on specific facets of ER. These results indicate that treatments for emotion dysregulation may be applied across eating disorder diagnoses and ages, and inform how these strategies apply to different diagnostic groups.

Suicide attempts and emotion regulation in psychiatric outpatients

BackgroundSuicidal behavior has been associated with maladaptive strategies for emotion regulation; however, limited research has explored this association after controlling for diagnosis. This study aims to explore this connection across diagnoses. We hypothesized that patients who reported greater difficulty with emotion regulation would be more likely to have made suicide attempts. MethodParticipants included 1046 psychiatric outpatients. Diagnoses and information about suicide history were determined using semi-structured interviews. Patients also completed the Difficulties in Emotion Regulation Scale (DERS). Analyses were conducted to determine the relationships between emotion regulation difficulties and lifetime suicide attempts. ResultsEmotion regulation difficulties did not independently predict suicidal behavior. After controlling for the contribution of emotion dysregulation on lifetime suicide attempts, diagnoses of borderline personality disorder and posttraumatic stress disorder were the only disorders independently associated with a history of suicidal behavior. LimitationsThe generalizability of our findings may be limited based on the sample's demographic characteristics and low base rate of suicide attempts. This study was cross-sectional in nature; therefore, the predictive capacity of either DERS scores or psychiatric diagnoses in terms of future suicidal behavior could not be determined. ConclusionsThe independent effect of emotion dysregulation on suicidal behavior was negated after controlling for psychiatric diagnosis. Individuals with certain disorders tend to make suicide attempts for reasons that are distinct from emotion dysregulation, whereas emotion dysregulation may be at the core of suicidality for individuals with other clinical presentations.

The Relationship Between Childhood Traumas, Identity Development, Difficulties in Emotion Regulation and Psychopathology

The present study aimed to explore the relationship between traumatic experiences, difficulties in emotion regulation, identity confusion and psychopathology. Six hundred and thirty five university students volunteered to participate to the first step of the study (460 (72.4%) females and 175 (27.6%) males). The mean age was 20.57 (17-29) years. The participants who scored above the group mean (X=44) on the Childhood Trauma Questionnaire- Short Form (CTQ-SF) were invited for a diagnostic interview. A total of 69 participants, consisting of 46 females (66.7%) and 23 males (33.3%), with a mean group age of 20.93 (17-29) years, were included in the second step of the study. All participants completed the General Information Form, the CTQSF, the Difficulties in Emotion Regulation Scale (DERS), the Sense of Identity Assessment Form (SIAF), SCID-I and SCID II. Prevalence of childhood traumas in the study group was 31.3%. Participants who came from low income groups, who were using psychotropic medications, who had family or personal history of self harm behaviour and who attempted suicide had significantly higher CTQ-SF scores. The SIAF scores of the subgroup diagnosed with psychiatric disorders were significantly higher than those of the undiagnosed. However, they did not differ with respect to their CTQ-SF and DERS scores. Results showed that difficulties in emotion regulation played a partial mediating role in the association of childhood traumatic events, in particular emotional abuse, with identity confusion. The present study demonstrated that childhood traumatic events not only have effects on emotion regulation and the development of sense of identity, but also may be associated with self harm behaviours in the later stages of life. For prevention studies, enhancing parenting skills and raising community awareness to this issue would be beneficial.

The relationship between executive functions and emotion regulation in females attending therapeutic community treatment for substance use disorder

BackgroundDifficulties in emotion regulation influence the development of substance use disorder (SUD), its severity, course, treatment outcomes, and relapse. Impaired executive functions (EFs) are common in SUD populations and may relate to emotion dysregulation. The current study tested whether performance on three basic EF tasks (‘working memory’, ‘inhibition’, and ‘task-switching’) and/or inventory-based assessment of EF were related to difficulties in emotion regulation in females attending residential SUD therapeutic community treatment. MethodsCross-sectional design in which participants (N=50, all female) completed a questionnaire battery including the Difficulties in Emotion Regulation Scale (DERS) and Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A) was used. Participants also completed neuropsychological assessment of EF including the Working Memory Index (WMI; Wechsler Adult Intelligence Scale), and measures of inhibition and task-switching (Color-Word Interference Test; Delis-Kaplan Executive Function System). ResultsExecutive dysfunction, as assessed by the Global Executive Composite (GEC; BRIEF-A), and personality disorder indicators (Standardised Assessment of Personality – Abbreviated Scale; SAPAS) were positively correlated with DERS scores. Sequential hierarchical regression indicated that task-switching, GEC, and SAPAS scores statistically predicted DERS scores, while working memory and inhibition did not. Mediation analysis indicated that there was a significant indirect effect of GEC scores and task-switching performance on DERS scores, through SAPAS scores. ConclusionsImpairment of EF, particularly task-switching, is related to difficulties in emotion regulation in a female sample attending residential SUD treatment. Cognitive training interventions that improve task-switching performance may be beneficial in promoting effective emotion regulation and improved SUD treatment outcomes.

Evaluation of the relation between emotion regulations of children diagnosed with anxiety disorders and attachment, anxiety sensitivity, emotion regulation of their mothers

Introduction: The information about the etiology of anxiety disorders are still limited however anxiety disorders are prevalent disorders in childhood. In this study it is aimed to evaluate the relation of emotion regulation and anxiety level of children diagnosed with anxiety disorder with attachment and emotion regulation in the children’s mother and it is also aimed to compare the results with healthy controls. Methods: The study group consisted of 64 children (8-12 years old) diagnosed with anxiety disorder and their mothers. The control group (78 children and mothers) comprised patients of other clinics at hospital and was matched for gender and age to the anxious patients. We evaluated disorder severity at the time of assessment using the Screen for Child Anxiety Related Emotional Disorders (SCARED). Emotional Regulation Checklist (ERC) was used to examine children emotional regulation. Difficulties in Emotion Regulation Scale (DERS) was used to indicate maternal emotional dysregulation status, Anxiety Sensitivity Index-3 (ASI-3) was used for anxiety sensitivity in mothers and Experiences in Close Relationship Scale-II was used to evaluate attachment properties in mothers. Results: SCARED child and parent form scores were compared with anxiety sensitivity index, ERC subscales, DERS and ASI with Pearson’s correlation analysis. Positive correlation was found between SCARED child, parent form scores and ERC emotional lability scores, social, physical, cognitive anxiety scores of ASI, maternal anxious attachment and DERS scores and negative correlation was found between SCARED child, parent form scores and ERC emotional regulation scores. There was no relation between SCARED child, parent form scores and maternal avoidant attachment. Conclusion: This is the first study which evaluated the relationship of emotion regulation difficulties of children, who are diagnosed with anxiety disorder, and maternal attachment properties and maternal emotion regulation. The anxiety symptoms may decrease with using cognitive behavioral methods in emotion regulation difficulties of children diagnosed with anxiety disorder.

A Systematic Analysis of Treatment Effects on Depressive Symptom Severity by Level of Coercion.

Few studies examine the effect of interpersonal, regulatory or legal coercion on the treatment of depressive symptoms. This retrospective case-control study compared the recovery rates of 574 adults whose level of coercion was scored on a 0-3 scale from fully voluntary to severe coercion when admitted to the Menninger Clinic between 2009 and 2014. The change in Patient Health Questionnaire-9 (PHQ-9) scores (measuring depression severity) from admission to discharge served as the primary outcome measure. Level of coercion was not associated with a difference in rate of improvement in PHQ-9 score. Greater improvement in PHQ-9 scores was associated with (a) older age, (b) lack of a psychotic spectrum disorder diagnosis, (c) stronger working alliance with treatment team, and (d) less difficulty with emotional regulation [lower Difficulties in Emotion Regulation Scale (DERS) scores]. DERS scores were the most impactful factor. This study suggests that licensure boards can continue to mandate treatment despite concerns that coercion may decrease treatment effectiveness.

Dialectical Behavioural Therapy (DBT)? There is an App for That!!

Introduction Borderline personality disorder (BPD) is a common psychiatric disorder. Although DBT has been proven effective, in the treatment of this disorder, many patients suffering from BPD are resistant to taking part in group psychotherapy, a core aspect of DBT. With Internet use ever rising, online DBT could be an alternative effective treatment for these group of patients. Objectives Understand the barriers in receiving DBT in patients with personality disorder and understand how online DBT could be helpful in improving these patients' symptoms Aim Use online DBT as an alternative method for patients who do not have access to live DBT Method We gave the participants the opportunity to choose the online format or the live sessions for Managing Powerful Emotions program at Personality Disorders Service at Queen's university. On each session, patients were provided with information on a topic, homework sheets and feedback from the therapist. All the participants were assessed by using 'self assessment questionnaire' and Difficulties in Emotion Regulation Scale (DERS). Results The DERS scores among these two groups were not significantly different before the treatment. Statistical analysis showed that both online and live DBT significantly reduced DERS scores in all 6 categories and there was no significant differences in amount of the changes in the scores in the 2 groups. Conclusion Despite the proven efficacy of psychotherapy, there are some barriers, including being resistant to taking part in live sessions, long wait-lists and transportation. With Internet use rising, delivering online psychotherapy might be an alternative method.