Difficulties In Emotion Regulation Scale Subscales Research Articles

Psychological mechanisms and neural correlates of trait mindfulness in emotion regulation: Testing a novel approach to the monitor and acceptance theory

BackgroundThe ongoing mental health crisis warrants investigations to understand why trait mindfulness is associated with beneficial mental health outcomes. This study examined attention monitoring and acceptance as psychological mechanisms underlying the relationship between trait mindfulness and emotion regulation and connectivity between the dorsolateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC) as a potential neural mechanism. MethodsA cross-sectional study was conducted with 501 adult participants (age range: 17–79, M = 31, SD = 11.3) representing the general population. To assess emotion regulation and trait mindfulness, participants completed the Difficulties in Emotion Regulation Scale (DERS) and Five Facets Mindfulness Questionnaire (FFMQ). Resting-state functional MRI was acquired in a subsample of 20 participants to explore the role of dlPFC-PCC functional connectivity. ResultsHigher levels of acceptance, as measured using the Non-judging and Non-reactivity subscales of the FFMQ, were significantly associated with fewer overall emotion regulation difficulties and predicted all emotion regulation subscales. In contrast, higher levels of attention monitoring, measured using the Observe subscale, predicted only three DERS subscales and with mixed effects: higher emotional awareness and clarity, but greater difficulties in goal-directed behaviour. The interaction between monitoring and acceptance was not significant, and no correlation was found between these variables and dlPFC-PCC functional connectivity. ConclusionsThese findings challenge previous theories that argue that attention monitoring is crucial for effective emotion regulation. Instead, we conclude that acceptance is the key psychological mechanism, indicating that the traditional focus on attention monitoring in mindfulness training may be less effective than a primary emphasis on acceptance. This study provides a critical review of past research, highlighting issues with operationalising acceptance, and offers recommendations for future studies and practical implications for developing mindfulness interventions.

Emotional Dysregulation and Temperament-Character Traits in Adolescents With Functional Neurological Symptom Disorder (Conversion Disorder).

The purpose of this study was to evaluate emotion dysregulation and temperament-character traits in adolescents with functional neurological symptom disorder (FNSD). Forty adolescents with FNSD and 40 healthy adolescents were evaluated by a semiconstructed diagnosis interview, Temperament and Character Inventory (TCI), Difficulties in Emotion Regulation Scale (DERS), Regulation of Emotions Questionnaire (REQ), and Children's Somatization Inventory-24 (CSI-24). The external and internal dysfunctional emotion regulation scores of REQ, all subscales of DERS, except the awareness subscale, and CSI-24 scores were significantly higher in FNSD patients compared with healthy controls. There were significant differences between the groups in terms of harm avoidance and reward dependence subscale scores of TCI. Multiple logistic regression analysis showed that the external dysfunctional emotion regulation strategy, somatization, and reward dependence are significant predictors of FNSD. Our results provide evidence that adolescents with FNSD experience emotional dysregulation and that the differential value of some temperament-character traits in the diagnosis of FNSD.

Emotion dysregulation in young people with borderline personality disorder: One pattern or distinct subgroups?

Emotion dysregulation is a key feature of borderline personality disorder (BPD). Given the heterogeneity of BPD and emotion regulation, this study sought to define subgroups among a sample of young people with BPD based on their pattern of emotion regulation abilities. Baseline data from the Monitoring Outcomes of BPD in Youth (MOBY) clinical trial were used, in which 137 young people (Mage = 19.1, SDage = 2.8; 81% female) completed the self-report Difficulties in Emotion Regulation Scale (DERS), as a measure of emotion regulation abilities. Latent profile analysis (LPA) was conducted to identify subgroups, based upon response patterns on the six DERS subscales. Subsequent analysis of variance and logistic regression models were used to characterize the identified subgroups. LPA revealed three subgroups. A "low and unaware" (n = 22) subgroup, reporting the least emotion dysregulation, apart from high emotional unawareness. A "moderate and accepting" subgroup (n = 59), reporting high emotional acceptance within its own pattern, and moderate emotion dysregulation compared with the other subgroups. A "high and aware" subgroup (n = 56), reporting the highest level of emotion dysregulation, but with high emotional awareness. Some demographic, psychopathology, and functioning characteristics were associated with subgroup membership. The identification of distinct subgroups highlights the importance of considering the level of emotional awareness in the context of other regulatory abilities and suggests that therapies should not take a "one-size-fits-all" approach to emotion dysregulation. Future research should seek to replicate the identified subgroups given the relatively small sample size in the current study. In addition, examining the stability of subgroup membership and the influence upon treatment outcome will be interesting avenues for further exploration. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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.

Roles for Alexithymia, Emotion Dysregulation and Personality Features in Gambling Disorder: A Network Analysis.

Although there is a growing interest in exploring the specific role of both emotional regulation processes and alexithymia in gambling disorder (GD), evidence remains scarce. In order to delve deeper into the complex interactions between these factors, the present study aimed at exploring a network of the core GD-related features, including GD symptomatology and severity, emotion dysregulation, alexithymia, and personality features. The sample included N = 739 treatment-seeking patients with GD (691 men and 48 women), aged 18-78years (mean age = 39.2, SD = 13.2). The DSM-5 diagnostic criteria were assessed in, and the South Oaks Gambling Screen, Difficulties in Emotion Regulation Scale (DERS), and Temperament and Character Inventory-Revised were administered to, participants. A network analysis was conducted to reveal inter-relationships between these elements. Three nodes related to emotion dysregulation showed the most critical position in the whole network of the present study: "lack of emotional awareness", "non-acceptance of emotional responses", and "difficulties engaging in goal-directed behaviors". When analyzing emotional dysregulation using the different DERS subscales, two independent clusters were identified. One cluster encompassed alexithymia dimensions ("lack of awareness" and "lack of clarity"), while the other cluster included all other emotion-dysregulation dimensions. Identification of the emotion-dysregulation- and GD-related features with the highest centrality/linkage may be particularly useful for developing valid measurement tools and precise management plans for individuals with GD.

The Effect of Dialectical Behavioral Therapy on Emotion Dysregulation in Couples.

Background:Divorce rates have increased during the last decade, leading to a greater focus of marital scholars on the importance of understanding couple-maintaining strategies within marital life. Distresses in couples are attributable to difficulties controlling felt, experienced, and expressed emotions; thus, emotion dysregulation is a core stressor in couples with maladaptive responses.Objective:The aim of the study was to evaluate the effect of Dialectical Behaviour Therapy (DBT) on outpatient couples to treat emotion dysregulation.Methods:We recruited 20 couples with marital distress in which partners presented emotion dysregulation. We offered the couples the opportunity to join a couple DBT group at their convenience and based on the immediate availability of treatment slots. We measured the treatment efficacy using psychometric tools (the Difficulties in Emotion Regulation Scale (DERS) and the Dyadic Adjustment Ccale (DAS) at baseline and after DBT therapy.Results:Both male and female partners presented significant improvements in marital adjustment DAS and emotion regulation scores. Female partners showed significantly greater amplitude changes in both scales. Female partners showed significant improvement in most DERS subscales (except the GOALS subscale); on the other hand, male partners showed significant improvements in impulse, awareness, strategies, and clarity subscales. We found significant improvements in most DAS subscales in both sexes; only affectional expression remained unchanged before and after therapy.Conclusion:DBT for couples is an effective approach to treat emotion dysregulation.

Insulin Restriction, Emotion Dysregulation, and Depressive Symptoms in Late Adolescents with Diabetes.

Insulin restriction occurs when an individual takes less insulin than recommended and is a serious concern for those with diabetes. General insulin restriction (IR) and insulin restriction for weight control (IRWC) have not been clearly distinguished in the literature, creating inconsistencies and limited understanding of factors that underlie this behavior. We examined whether these are distinct, and how emotion dysregulation and depressive symptoms relate to both forms of insulin restriction during late adolescence. As part of a larger study, late adolescents (ages 17-18) with type 1 diabetes (N = 236) completed measures of depressive symptoms (Center for Epidemiologic Studies-Depression Scale [CES-D]), facets of Difficulties In Emotion Regulation Scale (DERS), diabetes self-management behaviors, insulin restriction, and hemoglobin A1c (HbA1c). IR and IRWC were not significantly associated with each other. IR was associated with self-management behaviors but not HbA1c, whereas the opposite was true for IRWC. All DERS subscales (M = 10.60-16.73) and CES-D (M = 16.56) were correlated with greater IRWC; CES-D and all but one DERS subscale were correlated with IR. Covariation with CES-D explained associations between DERS and IRWC. CES-D moderated associations with IR, indicating most subscales of the DERS were associated with IR only when CES-D was higher. Emotion dysregulation and depressive symptoms are important correlates of the dangerous behavior of insulin restriction, but function differently when insulin is restricted specifically for weight control versus nonspecified reasons. Future research to understand these underlying processes will be necessary to develop emotion-based theory and evidence-based interventions for this dangerous behavior.

The impact of childhood abuse on adult self-esteem and emotional regulation

Introduction The occurrence of traumatic experiences in childhood can lead to a disruption in the development of secure internal representations, with a negative impact on self-esteem [1]. In addition, child victimisation may compromise their emotional regulation skills [2] and it has been shown that individuals with lower self-esteem have less emotional regulation skills [3]. Studies with adults showed that those who suffered several types of abuse during childhood tend to have worse interpersonal relationships [4]. This research has the main goals, to identify the relationship between the impact of childhood abuse on adult self-esteem and emotional regulation, and the relationship between self-esteem and emotional regulation. This is the first study in a Portuguese sample that integrates those variables. Materials and methods The study design is descriptive, observational, and cross-sectional. The sample was composed of 96 Portuguese adults (over 18 years old) (M = 27.95 years, SD = 11.60). The participants answered online to a sociodemographic questionnaire, Portuguese versions of the Childhood Trauma Questionnaire (CTQ) [5], the Difficulties in Emotion Regulation Scale (DERS) [6], and the Rosenberg Self-Esteem Scale (RSES) [7]. The link to the study was disclosed by e-mail and in social networks. The study was conducted in accordance with all the ethical principles. Results We found significant statistical positive correlations between the total score of the CTQ and the total score of the DERS (r = 0.422, p<.001) and the sub-scales of DERS: the not acceptance of emotional responses (r = 0.311, p=.002), difficulties engaging in goal-directed behaviour (r = 0.243, p=.017), impulse control difficulties (r = 0.431, p<.001)), limited access to emotion regulation strategies (r = 0.465, p<.001), and lack of emotional clarity (r = 0.209, p=.041). Furthermore, we observed statistical negative correlations between the total score of RSES and the total score of the CTQ (r=–0.319, p=.002), the total score of the DERS (r=–0.561, p<.001) and the sub-scales of DERS: the not acceptance of emotional responses (r=–0.413, p<.001), difficulties engaging in goal-directed behaviour (r=–0.336, p=.001), impulse control difficulties (r=–0.373, p<.001), limited access to emotion regulation strategies (r=–0.508, p<.001), and lack of emotional clarity (r = −0.542, p<.001). Discussion and conclusions In our study, traumatic experiences in childhood were associated with emotional regulation difficulties in adults, which is corroborated by other studies [2]. Additionally, we found that individuals who were victimised in childhood tend to have a perception of lower self-esteem in adult life. The relationship between child abuse and self-esteem and also between child abuse and the emotional regulation difficulties proves the need to develop psychological intervention aiming to enhance the positive self-esteem and the adaptative emotional skills in adulthood. This research highlights the importance of developing intervention programs in victimised children, to reduce the impact of victimisation on self-esteem and emotional regulation.

The Effect of Computer-based Cognitive Rehabilitation Therapy on Difficulties in Emotion-regulation among Students With Attention Deficit Hyperactivity Disorder

Objective: The aim of the present study is to investigate the effect of computer-based cognitive rehabilitation therapy on difficulties in emotional regulation among students with Attention Deficit Hyperactivity Disorder (ADHD). Methods: Participants were 24 students with ADHD (12 boys and 12 girls) studying in 6-9th grades during 2018-19 at schools located in District 7 of Tehran, Iran. They were selected using a purposive sampling method and based on inclusion/exclusion criteria and then randomly assigned into experimental and control groups. Data collection tool was the Difficulties in Emotion Regulation Scale (DERS) completed at pre-test, post-test, and follow-up phases. Experimental group received computer-based cognitive rehabilitation therapy for 10 weeks (20 sessions, two sessions per week, each for 30 minutes). Data were analyzed using repeated measure ANOVA in SPSS V. 26 software. Results: All subscales of DERS were significantly improved after intervention which had a medium-to-large effect size. Conclusion: Computer-based cognitive rehabilitation therapy can help treat difficulties in emotional regulation and improve performance of students with ADHD.

Emotion regulation difficulties as common and unique predictors of impulsive behaviors in university students

Objectives Researchers examined associations between specific forms of emotion dysregulation and numerous behavioral manifestations of impulsivity (i.e., problematic alcohol use, drug use, risky sexual activity, binge eating, non-suicidal self-injury). Participants: Participants were 238 undergraduate students (69% female). Method: Emotion dysregulation was assessed using the Difficulties in Emotion Regulation Scale (DERS). Path models examined each DERS subscale on its own, and all DERS subscales together, as predictors of all impulsive behaviors. Results: Lack of emotional clarity predicted the largest number of impulsive behaviors, both on its own and after controlling for other forms of emotion dysregulation. Non-acceptance of emotions and difficulties achieving goals when upset also related to several impulsive behaviors. Conclusions: Certain emotion regulation difficulties, particularly poor emotional clarity, may represent specific mechanisms that lead to maladaptive impulsive behaviors. Findings provide useful information for incorporating specific emotion regulation skills in harm prevention programs and treatments for university students.

Exploring emotion regulation as a mediator of the relationship between resilience and distress in cancer.

Distress in patients with cancer is a significant problem that affects up to 32% of patients. Yet research indicates that 35% of cancer patients do maintain high levels of well-being. Resilience is one psychological factor implicated as being protective against distress; however, the mechanisms for this relationship are currently unknown. The present study aimed to explore emotion regulation as a potential mediator of the relationship between resilience and distress. A cross-sectional survey examining emotional regulation, resilience, and distress was completed by 227 patients from two hospitals with heterogeneous cancer types. Measures included the Difficulties in Emotion Regulation Scale (DERS), the Connor Davidson Resilience Scale, and the Depression, Anxiety, Stress Scale. Difficulties in emotion regulation and resilience explained 33.2% of the variance in distress. Resilience had a significant direct effect on distress, accounting for 15.8% of the variance. However, this effect was no longer significant when difficulties in emotion regulation were controlled for. The indirect effect through difficulties in emotion regulation was significant, b=0.009, 95% CI [-0.013,-0.007], suggesting that the effect of resilience on distress was fully mediated by emotion regulation. Parallel mediation analyses also examined the differential effects of the six DERS subscales on the relationship between resilience and distress. These findings suggest that emotion regulation is an important mediator of resilience in cancer. Hence, in patients with cancer, difficulties in emotion regulation (and the DERS specifically) might be a useful focus for screening for patients at risk of distress.

Dimensions of emotion dysregulation associated with problem video gaming

Background and Purpose: Emotion dysregulation is characterised by difficulties monitoring, understanding, and accepting uncomfortable emotions and may lead some individuals to attempt to attenuate or escape emotional experiences by engaging in distracting activities, such as video gaming. Preliminary findings suggest that some dimensions of emotion dysregulation may be related to problem video gaming, but these findings are not generalisable to the general English-speaking population. The purpose of the current study was to determine whether dimensions of emotion regulation were associated with problem video gaming in a sample of self-reported video gamers from the general English-speaking adult population.Method: Self-identified adult video game players (N = 928) completed an online survey including the Problem Video Game Playing Scale (PVP) and the Difficulties in Emotion Regulation Scale (DERS).Results: A sequential regression analysis revealed age and gender as statistically significantly predictors of problem gaming in the full sample, as well as two dimensions of emotion dysregulation: (1) difficulties with impulse control; and (2) perceived limited access to emotion regulation strategies. A second sequential regression analysis was conducted to explore if gender moderated the relationship between any DERS subscales and problem gaming, and no significant moderations were found.Conclusions: This study represents the first examination of emotion dysregulation and problem gaming in English-speaking adults and expands upon existing evidence supporting associations between specific dimensions of emotion dysregulation and problem video gaming.

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.

Relation of emotion regulation and empathy skills with maternal emotion regulation and attachment in children diagnosed with ADHD

Objective: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood neurodevelopmental disorder. Difficulties in the areas of emotion regulation and empathy were found in prior studies. Mother-child attachment is important in the development of emotion regulation and empathy. We aimed to examine the relation emotional regulation and empathy skills in children with ADHD and emotion regulation and attachment properties in their mothers and to compare with healthy controls. Methods: The study group consisted of 61 children (8-12 years old) diagnosed with ADHD. The control group (87 children) comprised patients of other clinics at hospital and was matched for gender and age to the ADHD patients. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was used to diagnose ADHD and allowed comorbidities. We evaluated disorder severity at the time of assessment using the DuPaul Attention Deficit and Hyperactivity Disorder Rating Scale. All patients were treatment-naive. Emotional Regulation Checklist (ERC) and KA-SI empathy scale were used to examine children emotional regulation and empathy. Difficulties in Emotion Regulation Scale (DERS) was used to indicate maternal emotional dysregulation status and Experiences in Close Relationship Scale-II was used to evaluate attachment properties in mothers. Results: Children with ADHD had statistical significant lower scores in the areas of affective empathy, cognitive empathy, total empathy score and emotion regulation and cases had statistical significant higher scores in emotion lability. Mothers of children with ADHD had higher scores in anxious and avoidant attachment styles and all subscales of DERS. The correlation between, ADHD symptoms, KA-SI Empathy, ERC, Attachment Scale, and DERS was evaluated by Pearson’s correlation analysis. Negative correlation was found between both attention deficit and hyperactivity scores of Du Paul scale and affective, cognitive empathy scores of KA-SI Emphatic Tendency Scale and emotion regulation scores of ERC; a positive correlation was determined between attention deficit and hyperactivity scores of Du Paul scale, mothers’ anxious and avoidant attachment and DERS total scores, and emotional lability scores of ERC. Discussion: Mother-child attachment and maternal emotion regulation skills have important roles in the emotion regulation and empathy skills of children. Better understanding of neuropsychologic development process of attachment, empathy and emotion regulation skills and their relations with each other may contribute to the treatment of children with ADHD.

Are Iranian obese women candidate for bariatric surgery different cognitively, emotionally and behaviorally from their normal weight counterparts?

The purpose of the present study was to examine the cognitive, emotional and behavioral differences between obese and normal weight women. The participants consisted of 60 obese women (BMI≥35, Mean age 35.83) who were candidates for bariatric surgery and 60 normal weight women (BMI≤24.90, Mean age 33.38) who were selected through convenient sampling method. The two groups were matched with respect to age and education. Measures included the Young Schema Questionnaire-Short Form, Difficulties in Emotion Regulation Scale (DERS) and the Binge Eating Scale. Independent sample t test and Mann-Whitney U tests were conducted to compare the two groups' scores on early maladaptive schemas, DER and binge eating. Results indicated that obese women candidate for bariatric surgery scored significantly higher on emotional deprivation, mistrust, failure, dependency, enmeshment, self-sacrifice, especially abandonment, social isolation, vulnerability, self-control and subjugation schemas, but not on shame, entitlement, emotional inhibition and unrelenting standards. Obese women also displayed higher scores on three subscales of DERS, i.e., goal, impulse and strategies. BE scores were significantly higher in obese women than normal weight ones. The findings showed that obese women candidates for bariatric surgery suffered from more cognitive, emotional and behavioral vulnerability compared to women with normal weight. Addressing these vulnerabilities among obese women could improve outcomes of weight loss surgeries and cognitive behavioral interventions so that weight regain is minimized and better outcomes are achieved.

Dimensions of Emotion Dysregulation in Bulimia Nervosa

The goal of this study was to examine associations between dimensions of emotion dysregulation and eating disorder (ED) symptoms in bulimia nervosa (BN). This investigation used baseline data from a BN treatment study that included 80 adults (90% women) with full or subthreshold BN. Participants completed the Difficulties in Emotion Regulation Scale (DERS) and the Eating Disorders Examination interview. The Eating Disorders Examination global score was significantly correlated with the DERS total score, as well as several DERS subscales: nonacceptance, impulse and strategies. Further, the DERS goals subscale was found to be uniquely associated with frequency of purging and driven exercise, although none of the subscales were associated with frequency of objective binge eating. Findings indicate that emotion dysregulation is associated with ED symptoms in BN, suggesting the utility of interventions that address emotion regulation skills deficits in the treatment of the disorder.