Difficulties In Emotion Regulation Scale Research Articles

EFFECT OF ANIMAL-ASSISTED THERAPY ON DEPRESSION, MEMORY, ATTENTION, AND EMOTION REGULATION

Introduction: The mere presence of a dog in a therapeutic setup is known to bring about more positive outcomes when incorporated in therapy, dogs can bring about multifarious benefits which are not entirely tapped upon. Aim: This research aimed to study the effect of animal-assisted therapy (AAT), with therapy dogs, on depressive symptoms, emotional regulation, memory and attention of individuals. Method: A pretest-posttest quasi-experimental research design was used. Psychology Experiment Building Language (PEBL) for memory and attention, Difficulty in Emotion Regulation Scale (DERS) and Hamilton Depression Rating Scale (HDRS) were used for pre and post-testing 1 week before and post the intervention. Results: The findings reveal a positive impact of AAT on the given domains of memory, attention, emotion regulation and depressive symptoms, in the experimental group. No significant changes were obtained for the control group. Discussion: The results help validate the module of AAT to improve an individual’s cognitive functioning and alleviate depressive and emotional dysregulations. Further implications are discussed.

Difficulties in Emotion Regulation: Are They the Preventable Cause of Suicide, Impulsivity, and Aggression in Schizophrenia and Bipolar Disorder?

Difficulties in emotion regulation have begun to be seen as the source of psychopathologies. It is one of the underlying factors of patients' suicidality, impulsivity, and aggression. This study aims to determine the difficulties in emotion regulation in schizophrenia (SZ) and bipolar disorder (BD) patients and their relationship with suicidality, aggression, and impulsivity. It also emphasizes the importance of emotion regulation in these patients. 52 healthy individuals, 58 BD, and 55 SZ patients in remission were included in the study. The participants were informed before the study, and their written consent was obtained. Suicide Probability Scale (SPS), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale (BIS-11), and Buss-Perry Aggression Questionnaire (BPAQ) were administered to all three groups. DERS scores of patients with BD and SZ were higher than healthy individuals. SPS scores of patients with BD and SZ were higher than healthy individuals. The motor and total scores of the Barratt Impulsivity Scale (BIS-11) were higher in patients with BD than in patients with SZ and healthy individuals. According to Spearman correlation analysis, a significant positive relationship was found between all subscales of DERS and all subscales of SPS; physical aggression, anger, and hostility subscales of BPAQ; attention and motor subscales of BIS-11. Suicidality may increase in patients with schizophrenia and bipolar disorder who have difficulty in emotion regulation. Determining the difficulties of emotion regulation may contribute to the presumption and prevention of suicides in BD and SZ patients with a high risk of death by suicide.

Effect of emotion dysregulation and emotion regulation strategies on evaluative conditioning

Evaluative conditioning (EC) appears when a neutral conditioned stimulus (CS) is repeatedly paired with a positive or negative unconditioned stimulus (US). Most studies on EC have focused on the influence of procedural factors (e.g., number of presentations) and awareness, while emotional factors have been understudied. However, literature shows that emotional processes could be involved. In this paper, we assume that, upon appraisal, the US elicits a particular emotion that is then paired with the CS. In this perspective, the ability to regulate emotions could modulate how individuals pay attention to stimuli, appraise them, and, more generally, use them. For these reasons, emotion regulation could be an interindividual moderator of the EC. To test this assumption, we explore whether (i) emotional dysregulation and (ii) emotional regulation strategies moderate EC effects. We conducted an integrative analysis (n = 236) based on two studies using the Difficulties in Emotion Regulation Scale and an observational study using the Emotion Regulation Questionnaire (n = 128). Higher levels of emotional dysregulation were associated with less positive conditioning. Furthermore, the reappraisal strategy was associated with higher positive conditioning. Therefore, people differ in how they are conditioned (particularly positively conditioned), and part of it is because of emotion regulation differences. This contribution opens several new questions for the EC field to understand more precisely when and where these emotional processes are involved.

Quality of life in the older adults: The protective role of self-efficacy in adequate coping in patients with chronic diseases.

The purpose of the present study was to establish the association between self-efficacy, perception of disease, emotional regulation, and fatigue and the health-related quality of life in older adults living in the departments of Cesar and Atlántico in Colombia and who have been diagnosed with a chronic disease. The participants were 325 older adults of both sexes, with literacy and no presence of cognitive impairment in the Mini-Mental State Examination (MMSE); A non-probabilistic sampling was carried out. We used the MOS-SF-36 questionnaire, the Brief Illness Perception Questionnaire scale for measuring the perception of disease, the Stanford Patient Education Research Center's Chronic Disease Self self-efficacy questionnaire for chronic patients, the Difficulties in Emotional Regulation Scale, and the Fatigue Severity Questionnaire as measurement instruments. The design was non-experimental cross-sectional with a correlational scope. The results indicate that self-efficacy, disease perception, emotional regulation and severity of fatigue are variables that could impact the physical function of quality of life, confirming that self-efficacy would work as a factor that decreases the probability that a participant score low on this dimension of quality of life. On the other hand, both the perception of the disease and the severity of fatigue were identified as factors that probably negatively influence quality of life.

Emotional Regulation Underlies Gender Differences in Pathological Eating Behavior Styles of Bariatric Surgery Candidates

Almost a third of bariatric surgery patients present suboptimal weight loss or important weight regain in the first five postoperative years. While the reasons underlying this are not fully understood, it is known that pathological eating styles (such as emotional or binge eating) can thwart efforts to maintain weight loss. However, detailed characterization and understanding of these eating styles have yet to be achieved. In particular, research on gender differences in pathological eating styles and psychiatric symptoms before bariatric surgery is lacking. To characterize gender differences in eating styles and their association with clinical symptoms, we prospectively enrolled 110 bariatric surgery candidates, collecting eating styles and clinical scores. Women displayed a higher frequency of emotional eating as compared to men (x2 = 9.07, p = 0.003), while men showed a higher frequency of quantitative eating behavioral style (x2 = 4.58, p = 0.044). Binge eating style was associated with higher Difficulties in Emotion Regulation Scale (DERS), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) scores (p < 0.05). Emotional eating style was associated with higher HAM-D and HAM-A scores (p < 0.05). The present findings highlight the importance of understanding the role of gender differences in emotion regulation processes involved in the development and maintenance of pathological eating styles in bariatric surgery candidates. This paves the way to gender- and symptoms-specific interventions on eating behaviors to improve surgery long-term outcomes.

The Psychometric Properties of the International Trauma Questionnaire in Taiwan.

Complex post-traumatic stress disorder was often present after chronic traumatic events. The diagnostic criteria of complex post-traumatic disorder consisted of both post-traumatic stress disorder and disturbance in self-organization. People with complex post-traumatic disorder often exposed to chronic stress. It might not be as significant as the major traumatic event as survivors with post-traumatic stress disorder had experienced. Therefore, the impact of complex post-traumatic stress disorder was often ignored. It is critical to identify the at-risk individuals with complex post-traumatic disorder in community. We planned to investigate the psychometrics of the International Trauma Questionnaire for assessing complex post-traumatic stress disorder symptoms in Taiwan. One hundred twenty-one individuals were enrolled and they completed 8 self-report scales, including International Trauma Questionnaire, Childhood Trauma Questionnaire Short Form, Beck Depression Inventory-II, Beck Anxiety Inventory, the Chinese version of the Post-traumatic Stress Disorder Checklist for DSM-5, Difficulties in Emotional Regulation Scale, Rosenberg Self-Esteem Scale, and the Interpersonal Relationship Scale. The psychometric of International Trauma Questionnaire was examined by bivariate correlation analysis, independent t-test, and factor analysis. The study showed International Trauma Questionnaire had good reliability and validity and corresponded with previous studies. The result of confirmatory factor analysis supported the structure of complex post-traumatic stress disorder criteria in International Classification of Diseases-11. The 2-factor second-order model was the best-fitting model. The 6 symptom domains of complex post-traumatic stress disorder were also significantly correlated with depressive and anxiety symptoms. It suggests that the Chinese version of International Trauma Questionnaire could be used for screening at-risk groups and future works for mental public health in Taiwan.

Assessing the Psychometric Properties of the Persian Version of Brief-mentalized Affectivity Scale

Objectives Despite the increasing importance of emotion regulation, there are limited scales for its assessment. Mentalized affectivity theory proposes a novel perspective on emotion regulation. This study aims to investigate the psychometric properties of the Persian version of briefmentalized affectivity scale (B-MAS). Methods This is a descriptive psychometrics study. Participants were 414 students from Tarbiat Modares University, Tehran University, and Shahid Beheshti University in the academic year 2022-2023, who were selected by a convenience sampling method. They completed the Persian versions of B-MAS, ten-item personality inventory (TIPI), satisfaction with life scale (SWLS), Beck anxiety inventory (BAI), and difficulties in emotion regulation scale (DERS). Construct validity was evaluated using confirmatory factor analysis (CFA). Convergent and divergent validity were assessed by the Pearson correlation test. Internal consistency (using Cronbach’s α), test re-test reliability, and composite reliability were also evaluated. Results The CFA results confirmed the three-factor solution (identifying, processing, and expressing) and showed the good fit of the model. The significant correlation of the Persian B-MAS score with the BAI, TIPI, SWLS, and DER scores confirmed its convergent and divergent validity. Cronbach’s α for the three factors was from 0.86 to 0.88. Test re-test reliability for the three factors was from 0.75 to 0.80. Composite reliability was from 0.79 to 0.82. Conclusion The Persian version of B-MAS with three subscales has acceptable validity (construct, convergent, divergent) and reliability for psychological studies on the Iranian population.

Emotion Regulation Is Associated with Anxiety, Depression and Stress in Adults with Cerebral Palsy

Emotion regulation difficulties are associated with many neurological conditions and negatively impact daily function. Yet little is known about emotion regulation in adults with cerebral palsy (CP). Our aim was to investigate emotion regulation in adults with CP and its relationship with condition-related and/or socio-demographic factors. In a cross-sectional study of adults with CP, participants completed a survey containing the Difficulties in Emotion Regulation Scale (DERS), Depression Anxiety and Stress Scale-21 (DASS-21), and socio-demographic and condition-related questions. Descriptive statistics, chi-squared and Mann-Whitney tests were performed. Of the 42 adults with CP (x31.5 years, SD13.5) that were tested, 38 had within normal limits DERS total scores; however, a significantly higher proportion of participants experienced elevated scores (i.e., more difficulties with emotion regulation) than would be expected in the general population across five of the six DERs subdomains. Moderate-extremely severe depression and anxiety symptoms were reported by 33% and 60% of participants, respectively. The DERS total scores for participants with elevated depression, anxiety, and stress scores were significantly higher than the DERS totals score for those without elevated depression, anxiety, and stress scores. DERS and DASS-21 scores did not differ significantly by condition-related nor socio-demographic characteristics. In conclusion, emotion regulation difficulties were associated with elevated symptoms of depression and anxiety, which were overrepresented in the adults with CP participating in this study.

Factorial Structure of the Emotional Beliefs Questionnaire: Testing Measurement Invariance and Competitive Models

The role of metacognitive beliefs towards positive and negative emotions has been stressed by several theoretical models. The Emotion Belief Questionnaire (EBQ) has been developed to assess these metacognitive beliefs. We administrated the Italian version of the EBQ, the Difficulties in Emotion Regulation Scale (DERS), the DERS-Positive and the short form of the Depression Anxiety Stress Scale (DASS-21) to a sample of Italian adults. (N = 516). Structural Equation Modelling testing the factorial structure of EBQ evidenced a good fit in the four-factor model compared to the three-factor model and model with two second order variables. The EBQ showed invariance across sex, and significant associations with validating variables. These results demonstrate the goodness of the four-factor structure for the EBQ and support its use for assessment of metacognition beliefs towards emotions.

Psychometric properties of an Arabic translation of the brief version of the difficulty in emotion regulation scale (DERS-16)

BackgroundThe current study aimed to examine the psychometric properties of an Arabic translation of the short form of the Difficulty in Emotion Regulation Scale (DERS-16) in an Arabic-speaking population-based adult sample in Lebanon. In particular, the factorial structure, composite reliability, convergent validity and gender invariance were investigated.MethodsA total of 411 Lebanese adult participants (mean age of 32.86 ± 11.98 years, 75.4% females) took part of this cross-sectional web-based study. The forward and backward translation method was applied.ResultsFindings revealed good internal consistency of the Arabic DERS-16 total scale and five subscales (McDonald’s ω ranging from 0.81 to 0.95). Confirmatory factor analyses confirmed the five-factor solution of the scale and demonstrated strong measurement invariance across gender at the configural, metric, and scalar levels. No significant differences were found in all DERS-16 domains between men and women participants. Finally, the DERS-16 scores and sub-scores showed strong correlations with the Borderline Personality Questionnaire (r > .40), thus indicating its convergent validity.ConclusionOverall, the present findings suggest that the Arabic version of the DERS-16 may be a reliable and valid self-report measure that assesses ER difficulties as a multidimensional construct. Making the Arabic version of the DERS-16 available will hopefully strengthen its utilization for clinical and research purposes to benefit the millions of Arabic-speaking people worldwide.

Cross-Cultural Differences in Driving Styles: A Moderated Mediation Analysis Linking Forgivingness, Emotion Regulation Difficulties, and Driving Styles

Although various factors contributing to driving styles have been studied in recent decades, cultural differences have received little attention. Both emotion regulation difficulties and trait forgivingness have been found to be associated with driving styles, but the role of culture in these associations has not been yet explored. The current study seeks to understand the mediating role of emotion regulation difficulties in the association between trait forgivingness and driving styles and whether this relationship differs in different cultures. To this end, a moderated mediation model was developed and tested among 823 drivers from Israel (n = 287), Turkey (n = 329), and the USA (n = 207). The participants completed the Forgivingness Scale, Multidimensional Driving Style Inventory (MDSI), Difficulties in Emotion Regulation Scale, and background details. The moderated mediation analysis was conducted using model 59 in the PROCESS macro developed by Hayes and Preacher (2013). The results show significant differences in all driving styles between the study groups. In addition, the mediation model for the angry and hostile and the reckless and careless driving styles was found to apply only to certain countries. The study highlights cultural differences and their importance in understanding the association between emotional processes and driving styles and the need to design culturally sensitive interventions.

The relations between parent and toddler emotion regulation

Emotion regulation (ER) develops throughout childhood and contributes to a host of important outcomes, including social functioning, behavior, academic performance, and general health. The toddler years build the foundations for emotion regulation, with parents playing a key role in their children's emotional development. However, there is currently limited knowledge about the relations between parents’ own ER and how this may influence toddler ER. The current study investigated whether parental ER was related to toddler ER using a self-reported measure and observational measures. Data were drawn from Australian parents and their 18–36-month-old children recruited as part of a randomized controlled trial of a parenting program, Tuning in to Toddlers (n = 231). Measures included parent-report on Difficulties in Emotion Regulation Scale (DERS) and direct observation of toddler ER. For a smaller sample of parents, an observation measure of parent ER was also available (n = 73). Moderation analyses revealed that when parents reported more ER difficulties, older toddlers had poorer ER. Younger toddler's ER was not affected by parent-reported difficulties. For the smaller sample of parent observation, those observed to have better ER, also had toddlers that regulated emotions more effectively. The results suggest that parent ER, either in terms of difficulties or skills, has an impact on toddler ER.

The Persian Version of the Difficulties in Emotion Regulation Scale (DERS-18): Psychometric Properties and Its Role in Predicting Aggression in Iranian Adolescents

The Persian Version of the Difficulties in Emotion Regulation Scale (DERS-18): Psychometric Properties and Its Role in Predicting Aggression in Iranian Adolescents

An Examination of the Relationships between Eating-Disorder Symptoms, Difficulties with Emotion Regulation, and Mental Health in People with Binge Eating Disorder.

Eating disorders, such as binge eating disorder, are commonly associated with difficulties with emotion regulation and mental-health complications. However, the relationship between eating-disorder symptoms, difficulties with emotion regulation, and mental health in people with binge eating disorder is unclear. Thus, we investigated associations between eating-disorder symptoms, difficulties with emotion regulation, and mental health in 119 adults with binge eating disorder. Participants were assessed with the Eating Disorder Examination Questionnaire, Loss of Control over Eating Scale, Difficulties in Emotion Regulation Scale, Depression Anxiety and Stress Scale, and the 12-Item Short Form Survey at the pre-treatment phase of a randomized controlled trial. Structural-equation-modelling path analysis was used to investigate relationships between variables. We found that (1) eating-disorder behaviors had a direct association with depression, anxiety, and stress; (2) depression, psychological stress, difficulties with emotion regulation, and eating-disorder psychopathology had a direct association with mental-health-related quality of life; and (3) eating-disorder psychopathology/behaviors and stress had a direct association with difficulties with emotion regulation. Our findings show that depression, stress, difficulties with emotion regulation, and eating-disorder psychopathology were related in important ways to mental-health complications in people with binge eating disorder.

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

Eating when depressed, anxious, bored, or happy: An examination in treatment-seeking adults with overweight/obesity

Emotions that differ in valence are uniquely associated with eating. In our previous study with an online sample of adults with overweight/obesity, eating in response to depression was the type of emotional eating most closely associated with negative psychosocial correlates (Braden et al., 2018). The current study extended this research by examining associations between emotional eating types (eating in response to depression, anxiety, boredom, happiness) and psychological correlates among treatment-seeking adults. The present study was a secondary analysis of adults (N = 63; 96.8% female) with overweight/obesity and self-identified emotional eating who completed a baseline assessment for a behavioral weight loss intervention. Emotional eating in response to depression (EE-depression), anxiety/anger (EE-anxiety/anger), and boredom (EE-boredom) were assessed with the revised Emotional Eating Scale (EES-R), and positive emotional eating (EE-positive) was assessed with the positive emotions subscale of the Emotional Appetite Questionnaire (EMAQ). The Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9; depressive symptoms) were also administered. Frequencies showed the most endorsed emotional eating type was EE-depression (44.4%; n = 28). Four multiple regression analyses examined associations between emotional eating (EE-depression, EE-anxiety/anger, EE-boredom, and EE-positive) and dependent variables (EDE-Q, BES, DERS, and PHQ-9). Results showed that depression was the emotional eating type most closely related to disordered eating, binge eating, and depressive symptoms. Eating in response to anxiety was closely related to emotion regulation difficulties. Positive emotional eating was related to less depressive symptoms. Exploratory analyses showed that lower levels of positive emotional eating were related to higher depressive symptoms among adults with greater emotion regulation difficulties. Researchers and clinicians may consider tailoring weight loss treatment based on unique emotions that trigger eating.

Electrophysiological changes between patients with suicidal ideation and suicide attempts: An event-related potential study

IntroductionSuicide is recognized as a social problem and the interest in preventive measures to diminish suicide risk is constantly increasing. But scientific research results that distinguish between those who have only suicidal ideation (SI) and those who have a history of Suicidal attempts (SA) are limited. Inhibitory control is regarded as an important ability related to the transition from suicidal ideation to suicide attempts. In event-related potential, patients with dysfunction of inhibitory control demonstrate a reduction in the no-go amplitude.ObjectivesThis study aimed to determine the association between the no-go event-related potential component and suicidal behaviors among suicide attempters and ideators who never attempted suicide.MethodsOverall, 150 patients who visited the emergency room by suicide attempts or patients who visited the psychiatric department with suicidal ideation were recruited and instructed to perform a go/no-go task during electroencephalography recording. The Beck Depression Inventory, Beck Anxiety Inventory, Barratt Impulsivity Scale, Difficulties in Emotional Regulation Scale, and Acquired Capability for Suicide Scale were used. Individuals were divided into two groups: those with suicidal attempts (SA group) and with suicidal ideation (SI group) without SA. The psychological characteristics and event-related potentials of the two groups were compared. Correlation analyses were conducted to test the association between the clinical characteristics and event-related potentials.ResultsThe SA group had significantly decreased no-go P3 amplitudes at all electrodes compared to the SI group. In the correlation analysis between the clinical measurements and event-related potentials in all the participants, no-go P3 amplitudes in whole electrode sites were negatively correlated with the scores of the acquired capability for the suicide scale.ConclusionsThis study revealed that suicide attempters have dysfunction in controlling inhibition compared to suicide ideators reflected in the no-go P3. Our findings suggested that no-go P3 can be a biomarker associated suicide attempts in suicide ideators.Disclosure of InterestNone Declared

Metacognition, emotional dysregulation, psychosocial functioning and subjective well-being after 6 months of CBT treatment in pharmacologically stabilized schizophrenic patients

IntroductionPsychoses represent serious psychiatric disorders in which an individual perceptions, thoughts, mood and behavior are significantly altered. Each person who develops a psychosis lives a unique set of symptoms and experiences that may widely vary depending on life circumstances. Although cognitive behavioral psychotherapy (CBT) for psychosis is recommended by main international guidelines, its effectiveness in real-world is still a subject of controversy.ObjectivesThe aim of this study was to evaluate, in an Italian outpatient clinical setting, eventual improvements induced by a 6 months intensive CBT specific programme focused on metacognition and emotional regulation and its consequences on psychosocial functioning and subjective well-being in pharmacologically stabilized psychotic patients.MethodsEight patients with schizophrenia spectrum disorders (DSM-V), clinically and pharmacologically stabilized, were included in a 6-month program of weekly CBT sessions with focus on metacognition, emotional dysregulation, social functioning and subjective well-being. Patients were assessed with the Metacognitions Questionnaire-30, Difficulties in Emotion Regulation Scale, Heinrichs Quality of Life Scale, The Psychological General Well-Being Index, Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale at baseline and at 3 and 6 months, to verify any improvement on these specific domains and, possibly, on general psychopathology.ResultsIn this study CBT showed to be effective on all domains evaluated, most notably for younger patients with a short history of disease (<5 years). Metacognitive capacity was the dimension with most evident improvements, followed by the ability to modulate emotions and the consequent improvement in psychosocial functioning and perceived subjective well-being. During the 6 months follow-up none of the enrolled patients experienced symptoms exacerbation or psychotic relapses.ConclusionsIn conclusion, the 6-month CBT treatment showed to be effective for stabilized psychotic patients, improving metacognitive functions, emotional regulation, psychosocial functioning, and subjective well-being. In addition, insight, adherence and the therapeutic alliance improved. The absence of psychotic relapses is not attributable with certainty to the effect of CBT since, for this purpose, longer duration studies on larger case series and with RCT methods are required. However, it is plausible that the improvement obtained in disease awareness and adherence may be a facilitating factor in relapse reduction.Disclosure of InterestNone Declared

Emotion dysregulation in migraine patients: can it be a hallmark the probability of the transformation from episodİc to chronic?

ABSTRACT Objective The main aim of this study was to examine patients with migraine in terms of emotional dysregulation and to evaluate whether the emotion dysregulation is effective on chronicity in migraine. Materials and Methods A total of 85 migraine patients and 61 healthy participants were included in this study. All participants were evaluated using Migraine Disability Scale (MIDAS), Visual Analog Scale (VAS), Depression, Anxiety, and Stress Scale (DASS-21), Difficulties in Emotion Regulation Scale (DERS), Pain Catastrophizing Scale (PCS), and the Discomfort Intolerance Scale (DIS). Then, all results were compared between the migraine patients and healthy individuals. In addition, the migraine patients were separated into three groups as patients without an aura, patients with an aura and patients with chronic migraine and then their results were compared among them. Finally, the predictive markers of chronic migraine were explored using regression analyses. Results Among 85 migraine patients, the mean age was 31.5 (SD = 7.98); 83.5% were women. The total and subscale scores of DERS, PCS, DIS, and DASS-21 were significantly higher in patients than in healthy individuals (p < 0.01). Subscale scores of DERS, DIS, and DASS-21 in the chronic migraine patients were found to be higher than in the other two patient groups (p < 0.01). Logistic regression analysis showed that chronic migraine could be associated with ‘lack of emotional clarity’ (OR = 1.229; p = 0.042), ‘lack of awareness’ (OR = 1.187; p = 0.032), ‘migraine associated disability’ (OR = 1.128; p = 0.033), and ‘stress’ (OR = 1.292; p = 0.027). Conclusion This study results showed that chronic migraine could be associated with the emotional dysregulation. To our knowledge, this study is the preliminary study in the literature and, therefore, new studies with large samples are needed.

A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings

BackgroundDifficulties in emotion regulation (DER) are widely considered to underlie anxiety and depression. Given the prevalence of anxiety and depression in adolescents and the fact that adolescence is a key period for the development of emotion regulation ability, it is important to examine how DER is related to anxiety and depression in adolescents in clinical settings.MethodsIn the present study, we assessed 209 adolescents in clinical settings using the Difficulties in Emotion Regulation Scale (DERS) and the Hospital Anxiety and Depression Scale (HADS) and examined the associations between six components of DER and 14 symptoms of anxiety and depression. We used network analysis, constructed circular and multidimensional scaling (MDS) networks, and calculated network centrality, bridge centrality, and stability of centrality indices.ResultsThe results showed that: (1) The global centrality index shows that the Strategy component (i.e., lack of access to strategies) is the center in the whole network, ranking highest in strength, closeness, betweenness, and expected influence. (2) The MDS network showed a closeness of anxiety and depression symptoms, while Awareness component (i.e., lack of emotional awareness) stayed away from other DER components, but Awareness is close to some depression symptoms. (3) The bridge nodes of three groups, Strategy from DERS, Worry and Relax from anxiety symptoms, and Cheerful and Slow from depression symptoms, had the strongest relationships with the other groups.ConclusionLack of access to strategies remains in the center not only in DER but also in the DER-anxiety-depression network, while lack of awareness is close to depression but not to anxiety. Worrying thoughts and inability to relax are the bridging symptoms for anxiety, while lack of cheerful emotions and slowing down are the bridging symptoms for depression. These findings suggest that making emotion regulation strategies more accessible to patients and reducing these bridging symptoms may yield the greatest rewards for anxiety and depression therapy.