Emotion Regulation Skills Training Research Articles

Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting

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

Emotion Regulation Training in a First-Year Experience Course: A Qualitative Analysis of Students’ Experiences

ABSTRACT The transition to college is a stressful time that can present many emotional challenges and demands. One way to help ease this transition is through the implementation of emotion regulation skills training in first-year experience courses. However, little is known about how students who receive such instruction implement emotion regulation, and what challenges and difficulties they face in doing so. In the present study, first-semester college students (N= 24) who were enrolled in a first-year experience course and received emotion regulation traitning and reported on their experiences regulating their emotions in their everyday lives. Results of thematic analysis revealed six themes in the experience of emotion regulation: emotion regulation as an effortful process, the impact of regulatory goals on regulatory success, the role of timing, emotional awareness, affective forecasting, and regulatory clarity. Findings highlight the challenges that first-semester college students experience while attempting to regulate their emotions during emotional situations, and may aid counseling psychologists understanding of the transition to college with respect to emotion regulation skill development. Further, findings suggest that implementing emotion regulation training in first-year experience courses can provide a meaningful training ground for the development of emotion regulation during the first semester of college.

The effect of emotion regulation training on family relationships of hyperactive children.

INTRODUCTION:One of the psychiatric disorders related to childhood is attention deficit hyperactivity disorder that can negatively affect the family interactions of these children. Parents of these children, especially the mother as the main caregiver, need comprehensive training to make a positive difference in their attitudes and behaviors with these children. The purpose of this study was to investigate the effect of emotion regulation training on family relationships in hyperactive children.METHODS:This was a randomized clinical trial study with a control group performed on eighty mothers of hyperactive children who were selected randomly. The intervention group members attended emotion regulation skills training sessions for one session of 90 min each week for 8 weeks. During the training course in the intervention group, the control group did not receive any training. Data collection tools included demographic information questionnaires, Mother–Child Relationship Evaluation, and Rahim Organizational Conflict Inventory-II. Data analysis was performed by descriptive statistics and the analysis of covariance.RESULTS:The mean scores of the mother–child relationship in the intervention group showed a significant improvement in the subscales of acceptance, overprotection, facilitation, and rejection (P < 0.0001). The results of this research also showed improvements in all the five communication styles of integrating, avoiding, compromising, obliging (P < 0.0001), and dominating (P < 0.012) between spouses.CONCLUSION:It seems that the emotion regulation training approach in mothers with hyperactive children improved both the mother–child relationship and the interactive spousal styles and can be considered by the managers of treatment and rehabilitation field as an adjunctive therapy for the families of these children.

Emotion Regulation via the Autonomic Nervous System in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): Replication and Extension.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity, as well as executive dysfunction. Recent work underlines the importance in understanding the role of emotion reactivity and regulatory deficits in the context of the disorder. One study (i.e., Musser et al. 2011) utilized a positive and negative emotion induction and suppression task, as well as indexes of autonomic nervous system reactivity, to examine emotional functioning in youth with ADHD. This study revealed inflexible parasympathetic-based regulation across emotion conditions among youth with ADHD compared to typically developing youth. The present study sought to replicate and extend these findings to a clinically recruited, diverse sample, while also examining sympathetic functioning. Two hundred fifty-nine participants (160 youth with ADHD), aged 5 to 13, completed the task utilized in Musser et al. 2011, while indexes of parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., pre-ejection period [PEP] and electrodermal activity [EDA]) reactivity were obtained. ADHD was associated with significantly elevated parasympathetic (i.e., augmented RSA) and sympathetic (as indexed by EDA) reactivity. Overall, results replicate and extend Musser et al. 2011, revealing sympathetic-linked disruptions in emotion reactivity and parasympathetic-linked disruptions in emotion regulation among youth with ADHD. Future studies of behavioral therapies for ADHD should consider the efficacy of adding an emotion regulation skills training component.

Emotion regulation group skills training for adolescents and parents: A pilot study of an add-on treatment in a clinical setting.

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

An Emotion Regulation Skills Training Intervention for Individuals With Multiple Sclerosis (MS) and Their Caregivers

An Emotion Regulation Skills Training Intervention for Individuals With Multiple Sclerosis (MS) and Their Caregivers

Integrating eating disorder and weight gain prevention: a pilot and feasibility trial of INSPIRE.

The current study adapted evidence-based prevention programs to promote positive health behaviors among racially and ethnically diverse young adult women. Two successful programs (The Body Project and the Healthy Weight Intervention) were integrated to evaluate their feasibility, acceptability, and preliminary efficacy in reducing risk for both eating pathology and weight gain. Intervention features extended the previous prevention efforts by emphasizing broad appearance ideals to enhance relevancy for women of color and incorporating distress tolerance and emotion regulation skills training. Individuals were excluded if they met criteria for an eating disorder diagnosis and/or obesity, as this was a prevention project. 27 young adult women participated (M age = 18.59; SD = 1.01). The following racial/ethnic groups were represented: 48.1% White, 25.9% Asian, 22.2% Black, and 3.7% Latina. After each meeting, participants completed satisfaction measures and therapists assessed intervention feasibility. Participants also completed comprehensive questionnaires at pretest (baseline), posttest (8 weeks), and 4-week follow-up. Descriptive statistics and content analyses of open-ended questions indicated that the intervention was both acceptable and feasible. Hierarchical linear models evaluating within-subject change over time indicated reductions in several risk factors that were sustained at follow-up: eating pathology, appearance dissatisfaction, thin-ideal internalization, restrained eating, negative affect, emotion dysregulation, and fat intake. BMI did not change from pretest to posttest; however, BMI increased from posttest to follow-up (mean weight increase = 0.34kg). Results suggest that a prevention program designed to be more culturally sensitive is feasible and acceptable. Findings provide preliminary support for reducing the risk of eating pathology and promoting positive health behaviors. Time series with intervention, Level IV. ClinicalTrails.gov ID: NCT03317587.

"Violence is Everywhere": Childhood Polyvictimization, Perceptions of the Prevalence of Victimization, and Posttraumatic Stress Symptoms.

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

Prediction of verbal and physical aggression among young adults: A path analysis of alexithymia, impulsivity, and aggression

Alexithymia is a personality construct characterized by difficulties in identifying and describing emotions. Previous research has identified a positive association between alexithymia and aggression, and impulsivity may account for some of that association. This study tested a path model of associations between alexithymia, five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking), and verbal and physical aggression in a sample of 503 undergraduate students. Alexithymia had significant positive associations with all facets of impulsivity except for sensation seeking. Negative urgency and (lack of) premeditation mediated the relationship between alexithymia and verbal aggression. Positive urgency, negative urgency, and (lack of) premeditation mediated the relationship between alexithymia and physical aggression. Positive urgency also moderated the relationship between alexithymia and both forms of aggression, increasing the strength of those associations. These results highlight the role of emotion dysregulation in the context of aggression and support the use emotion regulation skills training in anger and aggression management programs.

Relationship between Alcohol Use Disorder and Cognitive Reappraisal Among Youth Seeking Help in Rehabilitation Centers in Kiambu County, Kenya

Alcohol is a widely used and abused substance globally. Deficits in cognitive reappraisal ability are assumed to mark the onset, maintenance, and relapse to alcohol use disorder. Alcohol may therefore be a means to escape from and self-medicate painful inner emotional states. The purpose of this study was to explore the relationship between and alcohol use disorder and cognitive reappraisal among youth seeking help in rehabilitation centers in Kiambu county. To establish any such relationships, this study utilised the Emotion Regulation Questionnaire (ERQ), and the Alcohol Use Disorder Identification Test (AUDIT). Data was collected from 33 (23Males/10Females) youths between 15-35 years seeking help in three rehabilitation centers for alcohol abuse. These youths were compared to a similar group of 33 (20 Females/13Males) youths who had never used alcohol, or any other substance of abuse, and 12 (8 Females/4 Males) others who had stayed alcohol free for at least three years after rehabilitation or quitting alcohol. Correlation research design was found appropriate for this study. A Pearson’s correlation coefficient indicated a negative and significant correlation between AUD and reappraisal, showing that inability to utilise reappraisal is related to AUD. Integrating adaptive emotion regulation skills training, and especially the use of cognitive reappraisal in healthcare and rehabilitation settings, it seems, may lead to higher success rates in rehabilitation.

Emotion dysregulation and eating disorders-Associations with diagnostic presentation and key symptoms.

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

The influence of psychosocial factors in veteran adjustment to civilian life.

Although most veterans have a successful transition to civilian life when they leave the military, some struggle to cope and adjust to the demands and challenges of civilian life. This study explores how a variety of psychosocial factors influence veteran adjustment to civilian life in Scotland, UK, and which of these factors predict a poor adjustment. One hundredand fifty-four veterans across Scotland completed a set of questionnaires that measured veteran adjustment difficulty, quality of life, mental health, stigma, self-stigma, attitude towards help-seeking, likelihood of help-seeking, experiential avoidance, reappraisal and suppression. Veteran adjustment difficulty and quality of life were significantly correlated to a number of psychosocial factors. Mental health, experiential avoidance and cognitive reappraisal were found to be predictors of veteran adjustment difficulty, and experiential avoidance and cognitive reappraisal partially mediated the relationship between mental health and veteran adjustment, with experiential avoidance being the stronger mediator. Our findings suggest that early assessment of experiential avoidance and cognitive reappraisal and the provision of relevant emotion regulation skills training could potentially reduce the veteran's need for more complex (and costly) psychological interventions in the future. Implications for veterans, as well as the services and professionals involved with veteran transition and health care are discussed.

Distress tolerance and mindfulness mediate relations between depression and anxiety sensitivity with problematic smartphone use

Excessive, problematic smartphone use (PSU) has demonstrated relationships with depression and anxiety severity across studies. However, less is known about psychopathology-related variables that may mediate relations between depression/anxiety with PSU – especially variables involving emotional regulation processes. We recruited 261 college students for a repeated-measures web survey, administered self-report measures of depression, anxiety sensitivity, distress tolerance, mindfulness, smartphone use frequency, and PSU; one month later, participants completed these measures again. We tested a model where depression severity and anxiety sensitivity predicted distress tolerance and mindfulness, in turn predicting smartphone use frequency, and one-month PSU severity, adjusting for age and sex. Distress tolerance and mindfulness were inversely associated with levels of PSU. Distress tolerance mediated relations between anxiety sensitivity and levels of PSU. Mindfulness mediated relations between both depression and anxiety sensitivity with PSU severity. Results are discussed in the context of emotion regulation theory and compensatory internet use theory, with clinical implications for emotion regulation skills training and mindfulness in offsetting PSU.

The Effectiveness of Emotion Regulation Skills Training on Anxiety and Emotional Regulation Strategies in Adolescent Students

The Effectiveness of Emotion Regulation Skills Training on Anxiety and Emotional Regulation Strategies in Adolescent Students

Predicting Parent-Child Aggression Risk in Mothers and Fathers: Role of Emotion Regulation and Frustration Tolerance

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

The Emotional Resources Group: The development of a brief emotion regulation skills training programme for secondary care

The Emotional Resources Group: The development of a brief emotion regulation skills training programme for secondary care

A Preliminary Pilot Study Comparing Dialectical Behavior Therapy Emotion Regulation Skills with Interpersonal Effectiveness Skills and a Control Group Treatment

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

The Relationship Between Emotion Dysregulation and Impulsive Aggression in Veterans With Posttraumatic Stress Disorder Symptoms.

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

Difficulties in emotion regulation are associated with panic symptom severity following a quit attempt among cannabis dependent veterans

Background and Objectives: Prior research suggests that difficulties in emotion regulation are associated with elevations in panic symptoms. The present study aimed to extend this work by prospectively examining the relation between difficulties in emotion regulation and panic symptoms over the course of a self-guided cannabis cessation attempt. Design and Method: One hundred and four cannabis-dependent military veterans participated in the study. Difficulties in emotion regulation and panic symptoms were assessed at baseline and at each week during a four-week cessation attempt for a total of five time-points. Results: Fewer difficulties in emotion regulation were associated with a greater reduction in panic symptoms during the self-guided cannabis cessation period. Results remained significant after statistically adjusting for mean substance use (i.e., cannabis, alcohol, and tobacco) during the study period. Conclusions: Results are discussed in terms of integrating adaptive emotion regulation skills training into existing evidence-based treatments for cannabis dependence.

Reducing symptoms of major depressive disorder through a systematic training of general emotion regulation skills: protocol of a randomized controlled trial

BackgroundMajor Depressive Disorder is one of the most challenging mental health problems of our time. Although effective psychotherapeutic treatments are available, many patients fail to demonstrate clinically significant improvements. Difficulties in emotion regulation have been identified as putative risk and maintaining factors for Major Depressive Disorder. Systematically enhancing adaptive emotion regulation skills should thus help reduce depressive symptom severity. However, at this point, no study has systematically evaluated effects of increasing adaptive emotion regulation skills application on symptoms of Major Depressive Disorder. In the intended study, we aim to evaluate stand-alone effects of a group-based training explicitly and exclusively targeting general emotion regulation skills on depressive symptom severity and assess whether this training augments the outcome of subsequent individual cognitive behavioral therapy for depression.Methods/DesignIn the evaluation of the Affect Regulation Training, we will conduct a prospective randomized-controlled trial. Effects of the Affect Regulation Training on depressive symptom severity and outcomes of subsequent individual therapy for depression will be compared with an active, common factor based treatment and a waitlist control condition. The study sample will include 120 outpatients meeting criteria for Major Depressive Disorder. Depressive symptom severity as assessed by the Hamilton Rating Scale will serve as our primary study outcome. Secondary outcomes will include further indicators of mental health and changes in adaptive emotion regulation skills application. All outcomes will be assessed at intake and at 10 points in time over the course of the 15-month study period. Measures will include self-reports, observer ratings, momentary ecological assessments, and will be complemented in subsamples by experimental investigations and the analysis of hair steroids.DiscussionIf findings should support the hypothesis that enhancing regulation skills reduces symptom severity in Major Depressive Disorder, systematic emotion regulation skills training can enhance the efficacy and efficiency of current treatments for this severe and highly prevalent disorder.Trial registrationThis study is registered with ClinicalTrials.gov, number NCT01330485.