Deficits In Regulation Research Articles

Impaired regulation of emotional distractors during working memory load in schizophrenia

Schizophrenia (SZ) patients exhibit deficits in emotion regulation that affect their daily functioning. There is evidence that the prefrontal cortex plays an important role in emotion regulation. However, it remains unclear how this brain region is involved in emotion regulation deficits in SZ, and how such deficits impact performance on cognitively demanding tasks.We examined how happy and fearful emotional distractors impact performance on working memory (WM) tasks of varying difficulty (0-back, 2-back), and brain activity using fMRI. Participants were 20 patients with SZ and 20 healthy controls (HC) matched on age, sex, race, and IQ.A significant 3-way interaction showed that SZ patients had lower performance compared to HC when exposed to fearful and happy distractors, but only during the 2-back task. Second-level fMRI between-group analysis revealed that compared to SZ patients, HC showed significantly greater increase in brain activity with WM load in the left IFG (BA 45) when exposed to fearful distractors. Less brain activity in this region was also associated with reduction in SZ patients' performance during higher WM load and the presence of fearful distractors.SZ patients had difficulty in performing a WM task when regulating emotions, and they failed to show the emotion-specific modulation of the left IFG observed in HC. These results suggest that SZ patients have difficulty with emotion regulation demands during effortful cognitive tasks. This also provides us with potential insight on how emotion regulation could be rehabilitated in SZ using cognitive training.

Does getting stigma under the skin make it thinner? Emotion regulation as a stress-contingent mediator of stigma and mental health.

Emotion regulation deficits may link stigma to poor mental health, yet existing studies rely on self-reported stigma and do not consider contextual factors. In the present research, we examined associations among cultural stigma (i.e., objective devaluation of others' status), emotion regulation deficits, and poor mental health. In Study 1, we created an index of cultural stigma by asking members of the general public and stigma experts to indicate desired social distance towards 93 stigmatized attributes. In Study 2, emotion regulation deficits mediated the association between cultural stigma and adverse mental health outcomes, including depressive symptoms and alcohol use problems, among individuals endorsing diverse stigmatized identities. The indirect effect of cultural stigma, via emotion regulation, on these outcomes was stronger among those reporting more life stress. These findings highlight the adverse impact of cultural stigma on mental health and its role in potentiating stigmatized individuals' susceptibility to general life stress.

Facets of Emotion Regulation and Posttraumatic Stress: An Indirect Effect via Peritraumatic Dissociation.

Research suggests important associations between emotion regulation difficulties and posttraumatic stress disorder (PTSD) symptomology, with prospective studies indicating that emotion regulation difficulties may lead to increased PTSD symptoms. Peritraumatic dissociation is considered an important and consistent predictor of PTSD symptoms. The present study examines whether peritraumatic dissociation accounts for associations between facets of emotion regulation difficulties and PTSD symptoms. Adult women with a history of sexual victimization participated in an interview to assess past-month PTSD symptoms and self-report questionnaires to assess peritraumatic dissociation and emotion regulation difficulties. Results showed a partial indirect effect of three facets of emotion regulation difficulties (i.e., nonacceptance of negative emotional responses, limited access to emotion regulation strategies perceived as effective in the context of distress, and impulse control difficulties when experiencing negative emotions) on PTSD symptoms through peritraumatic dissociation. Reverse indirect effects models were also explored. The present study offers preliminary evidence that peritraumatic dissociation by traumatized individuals may signal the presence of specific emotion regulation deficits, which may indicate increased risk of heightened PTSD severity.

Emotional experience of early traumatic experiences and relationship-specific attachment styles in alcohol-dependent patients

Three standardized instruments were used on this clinical sample of 70 patients in inpatient psychotherapy: (1) Scales for Experiencing Emotions (SEE), (2) Childhood Trauma Questionnaire (CTQ), (3) Relationship-Specific Attachment Scales for Adults (RASA). The results showed that traumatic experiences in childhood and adolescence as well as relationship-specific attachment styles were indeed associated with deficits in emotional experience and regulation. Especially emotional abuse was associated with deficits in emotional experience. An insecure attachment style was associated with a lower level of acceptance of emotions, a lower level of self-control, and dysfunctional emotion regulation. In particular, the attachment style to the mother seems to be important. These results suggest that a distinction of alcohol-addicted patients, with respect to attachment styles and traumatic experiences in childhood and adolescent, seems to be important in order to define specific interventions to improve the ability to regulate emotions.

Narcissistic Implications in Gambling Disorder: The Mediating Role of Emotion Dysregulation.

Gambling Disorder (GD) is a complex psychopathology involving a numbers of cognitive, behavioral, emotional and neurobiological determinants. Previous research suggests that GD may frequently co-occur with Narcissistic Personality Disorder. However, there is still a lack of study investigating Pathological Narcissism (PN) in both its vulnerable and grandiose facets among clinical population. Moreover, emotional dysregulation is commonly thought to underlie GD albeit research on this topic remains poor. The present study aims to investigate the role of both vulnerable and grandiose narcissism in relation to GD as well as the mediator role played by emotion dysregulation in such link. We administered to a sample of addicted gamblers (n=74) and a sample of heathy controls (n=105), the South Oaks Gambling Screen (SOGS), the Pathological Narcissism Inventory (PNI) and the Difficulties in Emotion Regulation Scale (DERS). Differences across groups emerged on the scores obtained on the PNI and DERS. Moreover, we found positive associations between SOGS scores and both PNI and DERS. Also, strategic addicted gamblers showed higher levels of vulnerable narcissism compared to others. Finally, emotion dysregulation difficulties appeared to fully mediate the relationship between grandiose narcissism and GD severity. Grandiose and vulnerable narcissism appear important variables involved in GD. Also, emotion regulation deficits seem to account for GD and to explain the pathways by which grandiose narcissism leads to GD. Clinical implications and future directions are discussed.

Are Drinking Motives Universal? Characteristics of Motive Types in Alcohol-Dependent Men from Two Diverse Populations.

Since alcohol use disorders are among the most prevalent and destructive mental disorders, it is critical to address factors contributing to their development and maintenance. Drinking motives are relevant driving factors for consumption. Identifying groups of drinkers with similar motivations may help to specialize intervention components and make treatment more effective and efficient. We aimed to identify and describe distinct motive types of drinkers in dependent males from two diverse cultures (Uganda and Germany) and to explore potential differences and similarities in addiction-related measures. Moreover, we investigated specific links between motive types and childhood maltreatment, traumatic experiences, and symptoms of comorbid psychopathologies. To determine distinct drinking motive types, we conducted latent class analyses concerning drinking motives (Drinking Motive Scale) in samples of treatment-seeking alcohol-dependent men (N = 75). Subsequently we compared the identified motive types concerning their alcohol consumption and alcohol-related symptoms (Alcohol Use Disorders Identification Test), history of childhood maltreatment (Childhood Trauma Questionnaire), trauma exposure (Violence, War and Abduction Exposure Scale), psychopathology (Posttraumatic Stress Diagnostic Scale, Depression-section of the Hopkins Symptom Checklist, and Brief Symptom Inventory) and deficits in emotion regulation (Difficulties in Emotion Regulation Scale). We found two congruent drinking motive types in both contexts. Reward-oriented drinking motives like the generation of positive feelings and enhancing performance were endorsed almost equally by both motive types, whereas high relief motive endorsement characterized one group, but not the other. The relief motive type drank to overcome aversive feelings, withdrawal, and daily hassles and was characterized by higher adversity in general. Emotional maltreatment in childhood and psychopathological symptoms were reported to a significantly greater extent by relief drinkers (effect sizes of comparisons ranging from r = 0.25 to r = 0.48). However, the motive types did not differ significantly on alcohol consumption or alcohol-related symptoms and traumatic experiences apart from childhood maltreatment. The chronology of addiction development and patterns of drinking motivation seem to be similar across cultures, i.e., that motive targeting interventions might be applicable cross-culturally. Addressing comorbid symptomatology should be a key treatment component for relief drinkers, whereas finding alternatives for the creation of positive feelings and ways to counteract boredom and inactivity should be a general treatment element.

Emotional dysregulation is a primary symptom in adult Attention-Deficit/Hyperactivity Disorder (ADHD)

BackgroundClinical observations suggest that adults have more diverse deficits than children with Attention Deficit/Hyperactivity Disorder (ADHD). These seem to entail difficulties with emotionality, self-concept and emotion regulation in particular, along with the cardinal symptoms of inattention, impulsivity, and hyperactivity for adult patients. Here, we probed a model that explicitly distinguished positive and negative affect, problems with self-concept and emotion regulation skills as distinct but correlating factors with the symptom domains of inattention, hyperactivity, and impulsivity. MethodsParticipants were 213 newly diagnosed adults with ADHD (62.9% male, mean age 33.5 years). Symptoms were assessed via self-report on the Conners’ Adult ADHD Rating Scales, a modified version of the Positive and Negative Affect Scale and the Emotion Regulation Skill Questionnaire. A confirmatory factor analysis with the R package lavaan, using a robust Maximum Likelihood estimator (MLR) for non-normal data, was conducted to test our new non-hierarchical 7-factor model. ResultsAll calculated model-fit statistics revealed good model-fit (χ2/df ratio = 2.03, robust RMSEA = .07). The SRMR in our model reached .089, indicating an acceptable model fit. Factor loadings on the postulated factors had salient loadings ≥ .31 except for one item on the hyperactivity factor. Latent factor associations were especially salient between emotional dysregulation and problems with self-concept, and also partially with impulsivity/emotional lability. LimitationsThe three models of ADHD and emotion regulation as suggested by Shaw et al. (2014) could not be disentangled in this study, though the overall results support the model with shared neurocognitive deficits. Further, we did not separately analyze ADHD with or without comorbid disorders. As our sample of clinical cases with ADHD is highly comorbid (47.9%), other disorders than ADHD might account for the emotion regulation deficits, though a sensitivity analysis revealed no such differences. ConclusionsOur model adequately characterizes the relations between and among clinically and therapeutically relevant symptoms in adult ADHD, thus potentially informing future therapeutic interventions by targeting the successful and flexible use of adaptive emotion regulation skills.

Type D Personality and Alexithymia: Common Characteristics of Two Different Constructs. Implications for Research and Clinical Practice.

In the last few decades, particular attention has been paid to the role of personality specific traits that can affect the loss of health, i.e., Type D personality and Alexithymia. They have been conceptualized in a different period, this means that they are different both for their theoretical positions and their empirical studies. Some authors have speculated that there is a potential conceptual overlap between Type D personality and alexithymia constructs but there is a shortcoming in the literature. The aim of the study was to examine the potential overlap between the constructs of type D personality and alexithymia, replicating previous two studies, to extend these findings to Italian population. The participants were 247 Italian adults (males = 43%), recruited in primary health care practices of Palermo. All participants did not have chronic diseases during tests administration. They ranged in age from 35 to 69 years old (M = 52.34 years, SD = 9.76). Participants were administered Type D Personality Scale (DS-14) and Toronto Alexithymia Scale (TAS-20). A series of confirmatory factor analyses was performed to evaluate the factorial structure underlying the TAS-20 and DS-14 items. Globally results showed that alexithymia and type D personality are distinct constructs, but they are also strictly positively related with each other. Negative affectivity (NA) was highly correlated with Difficulties in identifying feelings and Difficulties in describing feelings, while Social inhibition (SI) was highly correlated with Difficulties in describing feelings. These results are consistent with those of other studies conducted in this area. Future research should consider evaluating the relationship between a deficit of affect regulation and type D personality to improve the effectiveness of interventions of health cure.

Examining latent classes of smartphone users: Relations with psychopathology and problematic smartphone use

Little is known about how people use their smartphones, and whether usage patterns are related to psychopathology and problematic smartphone use. We sampled 296 college students, and administered self-report scales to assess frequency of using various smartphone features, and problematic smartphone use. We also assessed psychopathology constructs (ruminative thinking and emotion regulation deficits), and demographics (age and gender) as potential covariates of smartphone use patterns. Using latent class analysis, we identified two distinct classes of smartphone feature use, with one class representing especially heavy use (particularly that of social networking, audio and visual entertainment, and image- and video-taking), and the other class involving light use (particularly that of social networking, audio entertainment and image- and video-taking). Higher levels of rumination, and higher levels of cognitive reappraisal as an emotion regulation strategy, were related to the heavy use class. The heavy use class scored higher on all problematic smartphone use outcome variables. Results aid in understanding the nature and relation of smartphone usage patterns to psychopathology and problematic smartphone usage.

Effects of Withdrawal from Chronic Intermittent Ethanol Exposure on Sleep Characteristics of Female and Male Mice.

Sleep disruptions are an important consequence of alcohol use disorders. There is a dearth of preclinical studies examining sex differences in sleep patterns associated with ethanol (EtOH) dependence despite documented sex differences in alcohol-related behaviors and withdrawal symptoms. The purpose of this study was to investigate the effects of chronic intermittent EtOH on sleep characteristics in female and male mice. Female and male C57BL6/J mice had access to EtOH/water 2-bottle choice (2BC) 2h/d for 3weeks followed by exposure to EtOH vapor (vapor-2BC) or air for 5 cycles of 4days. An additional group never experienced EtOH (naïve). Mice were implanted with electroencephalographic (EEG) electrodes, and vigilance states were recorded across 24hours on the fourth day of withdrawal. The amounts of wakefulness, slow-wave sleep (SWS), and rapid eye movement sleep were calculated, and spectral analysis was performed by fast Fourier transformation. Overall, vapor-2BC mice showed a decrease in the amount of SWS 4days into withdrawal as well as a decrease in the power density of slow waves, indicating disruptions in both the amount and quality of sleep in EtOH-dependent mice. This was associated with a decrease in duration and an increase in number of SWS episodes in males and an increase in latency to sleep in females. Our results revealed overall deficits in sleep regulation in EtOH-dependent mice of both sexes. Female mice appeared to be more affected with regard to the triggering of sleep, while male mice appeared more sensitive to disruptions in the maintenance of sleep.

An Electrophysiological Study of Cognitive and Emotion Processing in Type I Chiari Malformation.

Type I Chiari malformation (CMI) is a neurological condition in which the cerebellar tonsils descend into the cervical spinal subarachnoid space resulting in cervico-medullary compression. Early case-control investigations have indicated cognitive deficits in the areas of attention, memory, processing speed, and visuospatial function. The present study further examined cognitive and emotional processing deficits associated with CMI using a dual-task paradigm. Nineteen CMI patients were recruited during pre-surgical consultation and 19 matched control participants identified emotional expressions in separate single and asynchronous dual-task designs. To extend earlier behavioral studies of cognitive effects in CMI, we recorded event-related potentials (ERPs) in the dual-task design. Though response times were slower for CMI patients across the two tasks, behavioral and ERP analyses indicated that patients did not differ from matched controls in the ability to allocate attentional resources between the two tasks. P1 ERP component analyses provided no indication of an emotional arousal deficit in our CMI sample while P3 ERP component analyses suggested a CMI-related deficit in emotional regulation. P3 analysis also yielded evidence for a frontalization of neurophysiological activity in CMI patients. Pain and related depression and anxiety factors accounted for CMI deficits in single-task, but not dual-task, response times. Results are consistent with a dysfunctional fronto-parietal attentional network resulting from either the indirect effects of chronic pain or the direct effects of CMI pathophysiology stemming from cervico-medullary compression.

A Randomized Controlled Pilot Trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) is an intervention for children aged 7 to 13 targeting high negative emotion, emotional reactivity, and emotion regulation deficits common across emotional disorders. Our objective was to collect pilot randomized controlled trial (RCT) data on the efficacy of the UP-C, comparing UP-C with an active, anxiety-focused intervention. Participants were 47 children with at least one primary anxiety disorder; approximately one half had elevated depression symptoms. Participants received either UP-C or the anxiety-focused control treatment. No condition-related differences were found with respect to diagnostic remission and anxiety symptoms. However, differences in favor of UP-C were observed with respect to treatment response at follow-up, depression symptoms, sadness dysregulation, and cognitive reappraisal. Results provide preliminary evidence that the UP-C may be at least as efficacious in treating anxiety as well-supported anxiety-specific treatment protocols and may produce greater gains in certain emotion reactivity and regulation variables.

Physiological Emotion Regulation in Children with ADHD with and without Comorbid Internalizing Disorders: a Preliminary Study

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience deficits in emotion regulation that can be measured physiologically under environmental stress conditions by examining respiratory sinus arrhythmia (RSA), a marker of parasympathetic nervous system (PNS) withdrawal. The current pilot study examined the impact of comorbid internalizing disorders and comorbid Oppositional Defiant Disorder (ODD) on emotion regulation in children with ADHD by measuring RSA as an indicator of dysregulated emotional reactivity. Twenty-four 7–10 year old children with ADHD participated in the current study. Children completed a 5-min resting attending baseline while electrocardiogram data (ECG) were recorded to examine baseline RSA. Children then completed a stress inducing, blocked goal, Card Sorting Task to measure RSA reactivity to stress. Results revealed a significant effect of internalizing disorder status on RSA difference score, F (1, 18) = 5.83, p = .03, η2 = .25. Children in the comorbid internalizing disorder group had a significantly greater decrease in RSA from the baseline time period to the card sorting task. There was no significant effect of ODD diagnostic status on RSA difference score, p > .05. The results of this preliminary study suggest that among children with ADHD, the presence of a comorbid internalizing disorder predicts greater withdrawal of the PNS. These findings represent an important step in understanding autonomic functioning of children with ADHD and comorbid disorders.

Food specific inhibitory control under negative mood in binge-eating disorder: Evidence from a multimethod approach.

Inhibitory control has been discussed as a developmental and maintenance factor in binge-eating disorder (BED). The current study is the first aimed at investigating inhibitory control in a negative mood condition on a psychophysiological and behavioral level in BED with a combination of electroencephalography (EEG) and eye tracking (ET). We conducted a combined EEG and ET study with overweight individuals with BED (BED+, n=24, mean age=31, mean BMI=35 kg/m2 ) and without BED (BED-, n=23, mean age=28, mean BMI=35 kg/m2 ) and a normal-weight (NWC, n=26, mean age 28, mean BMI=22 kg/m2 ) control group. We assessed self-report data regarding impulsivity and emotion regulation as well as the processing of food stimuli under negative mood in an antisaccade task. Main outcome variables comprise event-related potentials (ERP) regarding conflict processing (N2) and performance monitoring (error-related negativity [ERN/Ne]) assessed by EEG and inhibitory control (errors in the first and second saccade) assessed by ET. BED+ patients reported increased impulsivity and higher emotion regulation difficulties compared with the other groups. The eye tracking data revealed impaired inhibitory control in BED+ compared with both control groups. Further, we found preliminary evidence from EEG recordings that conflict processing might be less thorough in the BED+ sample as well as in the NWC sample. In the BED+ sample this might be connected to the inhibitory control deficits on behavioral level. While the BED- sample showed increased conflict processing latencies (N2 latencies), which might indicate a compensation mechanism, the BED+ sample did not show such a mechanism. Performance monitoring (ERN/Ne latencies and amplitudes) was not impaired in the BED+ sample compared with both control samples. Participants with BED reported higher impulsivity and lower emotion regulation capacities. The combined investigation of electrocortical processes and behavior contributes to an advanced understanding of behavioral and electrocortical processes underlying inhibitory control in BED. Inhibitory control and negative mood, probably amplified by emotion regulation deficits, should be addressed further in the investigation and treatment of BED.

The Association among Default Mode Network Functional Connectivity, Mentalization, and Psychopathology in a Nonclinical Sample: An eLORETA Study

Aims: We investigated default mode network (DMN) electroencephalography (EEG) functional connectivity differences between individuals with self-reported high mentalization capability and low psychopathological symptoms, versus participants with mentalization impairments and high psychopathological symptoms. Methods: Forty-nine students (35 women) with a mean age of 22.92 ± 2.53 years were administered the Mentalization Questionnaire (MZQ) and the Symptom Checklist-90-Revised. Five minutes of EEG during resting state were also recorded for each participant. DMN functional connectivity analyses were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). Results: Compared to the individuals with high mentalization capability and lower self-reported psychopathological symptoms, participants with mentalization impairments and high psychopathological symptoms showed a decrease of EEG beta connectivity between: (i) the right and left medial frontal lobe, and (ii) the left medial frontal lobe and the right anterior cingulate cortex. Furthermore, while MZQ total score was positively associated with DMN network connections (i.e., right and left medial frontal lobes), several psychopathological symptoms (i.e., interpersonal sensitivity, depression, and psychoticism) were negatively associated with DMN connectivity. Conclusion: Our results may reflect a top-down emotion regulation deficit which is associated with both internalizing and externalizing behavior problems.

Insula Sensitivity to Unfairness in Alcohol Use Disorder.

Social decision making has recently been evaluated in alcohol use disorder (AUD) using the ultimatum game (UG) task, suggesting a possible deficit in aversive emotion regulation elicited by the unfairness during this task. Despite the relevance to relapse of this possible faulty regulation, the brain correlates of the UG in AUD are unknown. In total, 23 AUD and 27 healthy controls (HC) played three consecutive fMRI runs of the UG, while behavioral and brain responses were recorded. Overall, acceptance rate of unfair offers did not differ between groups, but there was a difference in the rate of behavioral change across runs. We found significant anterior insula (aINS) activation in both groups for both fair and unfair conditions, but only HC showed a trend towards increased activation during unfair vs. fair offers. There were not overall whole-brain between-group significant differences. We found a trend of signal attenuation, instead of an increase, in the aINS for AUD when compared to HC during the third run, which is consistent with our recent findings of selective insula atrophy in AUD. We found differential group temporal dynamics of behavioral response in the UG. The HC group had a low acceptance rate for unfair offers in the first two runs that increased markedly for the third run; whereas the AUD group was consistent in their rejection of unfair offers across the three runs. We found a strong significant decrease in neural response across runs for both groups. This fMRI study of UG in alcohol use disorder found behavioral group differences in acceptance rate across runs, which together with significant BOLD-signal decrease across runs in UG-related regions in both groups, highlights the impairment of strategy in AUD and the effect of repetitive exposure to unfairness in this task.

Affective predictors of the severity and change in eating psychopathology in residential eating disorder treatment: The role of social anxiety

ABSTRACTDespite evidence documenting relationships between eating disorder (ED) psychopathology, depression, and anxiety, little is known regarding how social anxiety is related to ED symptoms in treatment. Therefore this study examined associations between depression, general anxiety, social anxiety, and ED psychopathology at the beginning and end of treatment (EOT) among patients (N = 380) treated in a residential ED program. Participants completed measures of ED psychopathology and affective variables. Higher depression and general anxiety, but not social anxiety, were related to higher ED psychopathology at baseline. However, social anxiety emerged as a unique predictor of ED psychopathology at EOT such that participants with higher social anxiety evidenced less improvement in ED psychopathology. Findings suggest that social anxiety has specific relevance to treatment in EDs, which may reflect shared mechanisms and underlying deficits in emotion regulation.

Restrictive eating is associated with emotion regulation difficulties in a non-clinical sample

ABSTRACTThe relationship between emotion regulation difficulties and restrictive eating has not been established in non-clinical samples. In this study, undergraduates (n = 98) provided information regarding general and specific emotion regulation difficulties on the Difficulties in Emotion Regulation Scale (DERS) and whether they had engaged in recent restrictive eating. Generalized linear models were used to determine if individuals endorsing versus denying recent restrictive eating differed on emotion regulation problems. Results indicated that individuals endorsing restrictive eating had elevated DERS Total (p < .001), Goals (p = .001), Impulse (p < .001), and Strategies (p < .001) scores. Results remained primarily unchanged after controlling for the related construct of dietary restraint. Findings indicate that endorsement of restrictive eating among non-clinical individuals is uniquely associated with emotion regulation deficits, especially those reflecting emotional under-control. Interventions targeting emotion regulation may enhance prevention and treatment of restrictive eating across severity.

Смысловая сфера несовершеннолетних, употребляющих психоактивные вещества

The article presents the results of an empirical study aimed at revealing the features of the semantic sphere in juveniles abusing psychoactive substances. Thirty teenagers aged from 14 to 16 were examined. The main group included minors who use psychoactive substances and undergo rehabilitation at the narcological dispensary. A set of methods for studying the semantic sphere wasused. Based on the results obtained, it is concluded that adolescents who use psychoactive substances show a less developed structure of meanings. In the formation of chemical dependence in adolescence, there is a clear deficit in the sense regulation of activity. Prosocial values in the semantic structure do not occupy leading positions. They are characterized by weak self-understanding and reflectivity, which are combined with increased egocentrism. In juveniles with addictive behavior, positively stained assessments and self-evaluation categories are associated with drug use. This pattern can be considered as a risk factor for further narcotization and inadequate focus on overcoming the existing dependence.

Hoarding disorder and difficulties in emotion regulation

The present study aimed to examine self-reported deficits in emotion regulation (ER) among individuals with hoarding disorder (HD). Seventy-seven adult outpatients with HD and 45 age- and gender-matched healthy control (HC) participants received a diagnostic assessment and completed self-report measures of hoarding severity, depression, and anxiety. In addition, participants completed the Difficulties in Emotion Regulation Scale (DERS), which measures lack of emotional clarity (Clarity), difficulty regulating behavior when distressed (Impulse), difficulty engaging in goal-directed cognition and behavior when distressed (Goals), unwillingness to accept emotional responses (Accept), and lack of access to strategies for feeling better when distressed (Strategies). The HD group scored higher on all DERS subscales than did the HC group; self-reported ER deficits remained evident when controlling for baseline depression, anxiety, and stress. The DERS correlated significantly with hoarding severity in the HD group: acquiring was significantly correlated with DERS Impulse, Strategies, and Accept; saving was significantly correlated with DERS Accept. Correlations remained significant when controlling for depression, anxiety, and stress. Results suggest that HD is characterized by self-reported deficits in ER, and that this relationship is not solely attributable to high levels of depression and anxiety.