An Examination of the Latent Structure of the Difficulties in Emotion Regulation Scale

The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, Journal of Psychopathology and Behavioral Assessment 26:41?C54, 2004) is a popular multidimensional self-report measure of emotion regulation. The present study sought to examine the latent factor structure of the DERS. An examination of latent factor intercorrelations and a higher-order confirmatory factor analysis (CFA) suggested that the DERS-AWARENESS dimension may not represent the same higher-order emotion regulation construct as the other five DERS dimensions. Furthermore, findings supported the adequacy of a revised five-factor model of the DERS in which the AWARENESS dimension was removed. This revised DERS total scale did not diminish concurrent relations between the DERS and outcomes relevant to the emotion regulation domain (i.e., depression, anxiety, posttraumatic stress symptoms). Implications for the conceptualization and assessment of emotion regulation are discussed.     

Validation of a Brief Version of the Difficulties in Emotion Regulation Scale (DERS-18) in Five Samples

The field of affective clinical science has expanded dramatically over the past several decades (Rottenberg and Gross 2003; Tracy et al. 2014). An important part of this research is understanding emotion regulation and dysregulation, in particular, how individuals differ in their ability to identify, accept, and manage their emotional experiences. One of the most common and widely cited measures of emotion dysregulation is the Difficulties with Emotion Regulation Scale (DERS; Gratz and Roemer 2004), which has been extensively used to facilitate understanding of how emotion dysregulation is associated with psychiatric symptoms, other emotion-related constructs, and treatment progress. While this scale has contributed greatly to our understanding of emotion regulation problems, its length makes its inclusion in brief study protocols difficult, limiting its utility and increasing participant burden. In order to address this issue, we developed a short form version of the DERS (DERS-18) composed of the strongest items from each of the measure’s six subscales from the original DERS publication (Gratz and Roemer 2004), and then validated this measure in five datasets that vary in age and sample type. Our results demonstrate that an 18-item short-form of the DERS exhibits a similar structure as the original 36-item DERS, demonstrates excellent reliability and validity, and performs similarly to the original DERS despite comprising half the items. The DERS-18 has the potential to improve and expand emotion regulation assessment while reducing demands on research participants.     

The effect of the two-chair dialogue intervention on self-compassion - adding an emotional evocative component to a basic Rogerian condition

Objective

How people relate to themselves when facing distress or failure influences general psychological well-being and vulnerability to psychological disorders. The aim of the present study was to explore the effect of an emotionally evocative intervention on self-compassion.

Methods

The data were retrieved from a larger study of Emotion-Focused Therapy (EFT) utilising a multiple baseline design comparing two treatment phases. The baseline phase consisted of 5, 7 or 9 therapy sessions where the therapist solely adhered to Rogerian relational conditions, as prescribed in EFT. A two-chair dialogue intervention was then added for five sessions. The sample consisted of 18 self-critical clients with clinically significant symptoms of depression and/or anxiety. The “Self-Compassion Scale” (SCS) was administered pre, mid and post therapy.

Results

The baseline phase did not lead to significant changes in self-compassion. However, the addition of the two-chair dialogue was associated with a significant increase in self-compassion. This increase was due to reductions in the negative subscales, especially the isolation subscale.

Conclusion

The emotionally evocative two-chair dialogue was associated with a significant change in self-to-self relating, compared to relational conditions alone. The two-chair dialogue, thus, seems to be a promising intervention for promoting healthier self-to-self relating.     

Ressourcenaktivierung bei Patienten

Background

Starting from Klaus Grawe’s draft of a general psychotherapy, the patient’s resources and resource-activating interventions have received increasing attention in empirical research.

Objective

The effectiveness of standardized writing instructions for the activation of patients’ resources before participating in internet chat aftercare groups for psychosomatic patients was examined.

Method

In a randomized controlled trial writing instruction for the activation of patients’ resources was given in 52 out of 102 internet chat aftercare sessions. The effects of this minimal intervention on the patients’ activity and the number of positive emotion words expressed during the chat session were examined. Additionally, the effects on patients’ self-esteem, attachment, orientation, control and well-being after the group sessions were assessed.

Results

Patients reported higher levels of self-esteem, orientation, control and well-being after chat sessions with a resource-activating intervention. No differences between intervention and control groups were detected on the text-based variables activity and number of positive emotion words.

Conclusions

Standardized minimal interventions for the activation of patients’ resources seem to be promising for enhancing the effectiveness of therapeutic Internet chat groups.     

Acute aerobic exercise helps overcome emotion regulation deficits

Although colloquial wisdom and some studies suggest an association between regular aerobic exercise and emotional well-being, the nature of this link remains poorly understood. We hypothesised that aerobic exercise may change the way people respond to their emotions. Specifically, we tested whether individuals experiencing difficulties with emotion regulation would benefit from a previous session of exercise and show swifter recovery than their counterparts who did not exercise. Participants (N?=?80) completed measures of emotion response tendencies, mood, and anxiety, and were randomly assigned to either stretch or jog for 30?minutes. All participants then underwent the same negative and positive mood inductions, and reported their emotional responses. Analyses showed that more perceived difficulty generating regulatory strategies and engaging in goal-directed behaviours after the negative mood induction predicted more intense and persistent negative affect in response to the stressor, as would be expected. Interactions revealed that aerobic exercise attenuated these effects. Moderate aerobic exercise may help attenuate negative emotions for participants initially experiencing regulatory difficulties. This study contributes to the literature on aerobic exercise’s therapeutic effects with experimental data, specifically in the realm of emotional processing.     

Helping or Hovering? The Effects of Helicopter Parenting on College Students’ Well-Being

Parental involvement is related to many positive child outcomes, but if not developmentally appropriate, it can be associated with higher levels of child anxiety and depression. Few studies have examined the effects of over-controlling parenting, or “helicopter parenting,” in college students. Some studies have found that college students of over-controlling parents report feeling less satisfied with family life and have lower levels of psychological well-being. This study examined self-determination theory as the potential underlying mechanism explaining this relationship. College students (N = 297) completed measures of helicopter parenting, autonomy supportive parenting, depression, anxiety, satisfaction with life, and basic psychological needs satisfaction. Students who reported having over-controlling parents reported significantly higher levels of depression and less satisfaction with life. Furthermore, the negative effects of helicopter parenting on college students’ well-being were largely explained by the perceived violation of students’ basic psychological needs for autonomy and competence.     

Perceptual-motor learning benefits from increased stress and anxiety

The purpose of this study was to manipulate psychological stress and anxiety to investigate effects on ensuing perceptual-motor learning. Thirty-six participants attended two experimental sessions separated by 24 h. In the first session, participants were randomized to either a mental arithmetic task known to increase stress and anxiety levels or a control condition and subsequently completed training on a speeded precision pinch task. Learning of the pinch task was assessed at the second session. Those exposed to the high stress-anxiety mental arithmetic task prior to training reported elevated levels of both stress and anxiety and demonstrated shorter movement times and improved retention of movement accuracy and movement variability. Response execution processes appear to benefit from elevated states of stress and anxiety immediately prior to training even when elicited by an unrelated task.     

We Can Make It Better: “We” Moderates the Relationship Between a Compromising Style in Interpersonal Conflict and Well-Being

Compromising is considered a useful strategy for solving interpersonal conflicts. However, compromising, which includes accommodating and sacrificing, may also lead to anxiety and depression. Therefore, the current study focused on a moderating mechanism between compromising and psychological health. Based on self-expansion theory, we hypothesized that the more individuals have a relational focus (i.e., a greater use of “we”) while narrating their compromising experiences, the better psychological health they will experience. Two hundred sixty-one participants from National Taiwan University (mean age = 20.40, 53.26 % male, 46.74 % female), wrote about an experience of conflict with their parents and completed a package of questionnaires to measure their conflict management style and psychological health. The frequency of the “we” pronoun was considered an index of relational focus. As predicted, the results from a hierarchical multiple regression demonstrated that “we” moderated the effect of compromising style on well-being. Specifically, the relationship between compromising and psychological well-being were strengthened for individuals who had more relational focus. Thus, although a compromising style helps solve interpersonal conflicts, it does not necessarily increase individuals’ well-being. How individuals anchor their experiences are more important.     

Beliefs about emotion: implications for avoidance-based emotion regulation and psychological health

People’s beliefs about their ability to control their emotions predict a range of important psychological outcomes. It is not clear, however, whether these beliefs are playing a causal role, and if so, why this might be. In the current research, we tested whether avoidance-based emotion regulation explains the link between beliefs and psychological outcomes. In Study 1 (N?=?112), a perceived lack of control over emotions predicted poorer psychological health outcomes (increased self-reported avoidance, lower well-being, and higher levels of clinical symptoms), and avoidance strategies indirectly explained these links between emotion beliefs and psychological health. In Study 2 (N?=?101), we experimentally manipulated participants’ emotion beliefs by leading participants to believe that they struggled (low regulatory self-efficacy) or did not struggle (high regulatory self-efficacy) with controlling their emotions. Participants in the low regulatory self-efficacy condition reported increased intentions to engage in avoidance strategies over the next month and were more likely to avoid seeking psychological help. When asked if they would participate in follow-up studies, these participants were also more likely to display avoidance-based emotion regulation. These findings provide initial evidence for the causal role of emotion beliefs in avoidance-based emotion regulation, and document their impact on psychological health-related outcomes.     

Women's Psychological Experiences in a Narrative Therapy-Based Group: An Analysis of Participants' Writings and Beck Depression Inventory–Second Edition

The purpose of this study was to explore women's experiences in a narrative therapy-based group conducted to help participants re-author their stories. Seven women who were either patients or individuals enrolled in Transition Support for Employment at a psychiatric clinic participated in the meetings, one every fortnight. Each session explored a theme based on narrative therapy techniques such as externalization. The participants wrote their reflections during each session, and completed the Beck Depression Inventory-Second Edition (BDI-II) during the initial and final sessions. An affinity diagram was developed to classify their written reflections into 22 lower categories (e.g., new understanding of self, forward-looking-understanding of life) and 4 upper categories (“Insight,” “Sharing with others,” “Changes with understanding of lives,” “Higher motivation”). The relationship among five lower categories comprising “Insight” was explored, and it became apparent that clarification of participants' own thoughts about social problems functioned as a mediator promoting the process. The largest portion of depressed feelings emerged during the initial session, and four participants had lower scores for BDI-II items such as self-criticism in the final session. The results suggest that the group's purpose was realized. However, future studies should examine participants' feelings more closely, especially during the initial session.     

Intolerance of uncertainty and difficulties in emotion regulation: Proposal for an integrative model of generalized anxiety disorder

Introduction

The Intolerance of Uncertainty Model (IUM) is a well-tested model of generalized anxiety disorder (GAD).

Symptomattributionsstile bei Hypochondrie

Background

Somatic symptom attributions are of central importance in cognitive-behavioral models of the development, maintenance and treatment of hypochondriasis. However, the mode of symptom attribution has rarely been systematically investigated in these patients. Is a somatic mode of symptom attribution indeed specific for hypochondriasis and furthermore, how strongly is it associated with “doctor shopping”, a typical behavioral consequence of hypochondriasis?

Patients and methods

In this study 88 hypochondriacal, 52 depressive and 52 healthy persons were asked to complete the symptom interpretations questionnaire and several standardized symptom questionnaires. They also took part in two structured clinical interviews for the diagnosis of hypochondriasis and various other psychological disorders according to DSM-IV.

Results

Somatic symptom attributions were associated specifically with hypochondriasis, while normalizing attributions characterized persons with low health anxiety. When examined as predictors in multiple regression models, in particular somatic attributions and the total of somatoform complaints predicted the intensity of health anxiety (R ²?=?0.69) and “doctor shopping” (R ²?=?0.48).

Conclusion

In the cognitive-behavioral treatment of hypochondriasis, patients should be encouraged to test normalizing explanations as alternatives to habitual somatic attributions of somatic disturbances.     

Living (dys)regulated and alienated young masculinity—Young men's embodied experiences of mental disorders and suicidality

Introduction

Mental disorders, such as depression and anxiety with interlinked suicidality, are the leading cause of health-related disability among young men. Knowledge of the interaction between emotional, bodily, social and gendered mental health processes in young men is limited and therefore needed.

Aim

This study aimed to explore young men's lived embodied experiences of mental disorders and suicidality, and to conceptualise these by integrating affective–emotional, physiological, social and gendered processes.

Methods

Semistructured individual interviews were conducted with 13 young men who had sought professional help for mental disorders and suicidality. Grounded theory (GT) was used with a social constructivist perspective.

Results

The results comprise one core category—Living (dys)regulated and alienated young masculinity—with related categories “battling with the emotional body,” “suffering in social silence” and “balancing embodied darkness and distress.” The GT illustrates how young men navigate and manage their embodied and emotional suffering in a context of “regulative” masculine and social norms alongside insufficient social support.

Conclusion

Our results suggest that young men's lived embodied experiences of mental disorders and suicidality can be understood as a dynamic process of internal and external “(dys)regulation and alienation.” The generated GT provides a broad tentative explanation model, contributing to theory development, and serves as a basis for gender-sensitive interventions—in both psychotherapy and physiotherapy—integrating body, mind and the social context.     

The Difficulties in Emotion Regulation Scale: Factor Structure and Association with Nonsuicidal Self-Injury in Adolescent Inpatients

Research suggests that difficulties in emotion regulation are an important correlate of nonsuicidal self-injury (NSSI) in adults. Research examining this link in adolescents is limited by the lack of comprehensive instruments to assess difficulties in emotion regulation. Against this background, the aims of the current study were to (a) confirm the six-factor structure of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, Journal of Psychopathology and Behavioral Assessment, 23(4), 253?C263, 2004) in a sample of adolescent inpatients (N?=?218); (b) explore the relation between different aspects of emotion dysregulation and lifetime NSSI while controlling for psychopathology and sex; and (c) assess the clinical utility of the DERS in detecting lifetime NSSI status. Fit indices obtained through Confirmatory Factor Analysis indicated that the six-factor structure of the DERS fit the data adequately and that most items loaded strongly on their respective latent factor. All six latent factors were significantly correlated with each other, with the exception of lack of emotional awareness and difficulties engaging in goal-directed behavioral when distressed. Regression analyses revealed that only the limited access to emotion regulation strategies subscale accounted for a significant portion of the variance in NSSI when controlling for other aspects of emotion dysregulation, sex, and psychopathology. Receiver Operating Characteristic analysis indicated that the DERS limited access to emotion regulation strategies subscale score has moderate diagnostic accuracy in detecting the presence of NSSI. The optimal cut-off score was 21.5 when detecting NSSI among inpatient adolescents. Results provide further support for the relation between emotion regulation difficulties and NSSI. The DERS appears to be a useful measure of detecting NSSI in clinical samples of adolescents.     

Individual differences in emotion regulation moderate the associations between empathy and affective distress

Individual differences in empathy can have positive and negative psychological outcomes. Yet, individual differences in the processing and regulation of empathy-induced emotion have not been fully explored within this dynamic. This study was designed to explore whether individual differences in emotion regulation strategies moderated the effects of empathy on common forms of affective distress. Eight hundred and forty four participants completed survey measures of trait empathy, emotion regulation strategies, and symptoms of depression, anxiety, and stress. Affective empathy typically predicted greater affective distress, but the effects on depression and anxiety were offset when people were effective at reappraising their emotions. Cognitive empathy predicted lower distress on average, but this beneficial effect on anxiety and stress was absent in those who typically suppressed their emotions. Finally, suppression unexpectedly reduced the depression and stress reported for people high in affective empathy. Individual differences in emotion regulation are an important moderator between empathy and psychological health, and thus a useful target for intervention.     

Emotion Regulation as a Moderator of Outcomes of Transdiagnostic Group Cognitive-Behavioral Therapy for Emotional Disorders

The aim of this study was to examine the potential moderating effect of baseline emotion regulation skills—cognitive reappraisal and expressive suppression—on the relationship between treatment allocation and treatment outcomes in primary care patients with emotional symptoms. A total of 631 participants completed scales to evaluate emotion regulation, anxiety, depression, functioning, and quality of life (QOL). The moderation analysis was carried out using the SPSS PROCESS macro, version 3.5. Expressive suppression was a significant moderator in the relationship between treatment allocation and treatment outcomes in terms of symptoms of anxiety (b = −0.530, p = .026), depression (b = −0.812, p = .004), and QOL (b = 0.156, p = .048). Cognitive reappraisal acted as a moderator only in terms of QOL (b = 0.217, p = .028). The findings of this study show that participants with higher scores of expressive suppression benefited more from the addition of transdiagnostic cognitive-behavioral therapy to treatment as usual (TAU) in terms of anxiety and depressive symptoms, and QOL. Individuals with higher levels of cognitive reappraisal obtained a greater benefit in terms of QOL from the addition of psychological treatment to TAU. These results underscore the relevant role that emotion regulation skills play in the outcomes of psychological therapy for emotional symptoms.     

The Relationship Between Perceived Parenting Style and Emotion Regulation Abilities in Adulthood

Emotion regulation abilities are very important for psychological and social wellbeing during the whole course of life. By contrast, emotion dysregulation is a significant risk factor for several psychological disorders. According to developmental research, an optimal parenting style, described as warmth and affectionate, promotes the development of an adequate emotion regulation in children and adolescents. However, little research has examined the relationship between parenting style and emotion regulation in adulthood. In the present study, we tested the relationship between perceived experiences with parents, in terms of parental care and parental overprotection, during childhood, and emotion regulation abilities in a sample of adults. One hundred participants completed the Parental Bonding Instruments, the Emotion Regulation Questionnaire, and the Difficulties in Emotion Regulation Scale. Hierarchical multiple regression analyses revealed that perceived parental care was more related to emotion regulation abilities than perceived parental overprotection. In particular, perceived paternal care was strictly linked to several difficulties in emotion regulation. By contrast, perceived maternal care was negatively associated with the use of maladaptive emotion regulation strategies, and a specific emotion dysregulation dimension, that is lack of emotional awareness. In summary, perceived parental care seemed to have a key role to protect individuals from emotion dysregulation. These results demonstrate that parenting styles still exert their influence on emotion regulation abilities also in adulthood. Limitations and directions for future research are discussed.     

The Difficulties in Emotion Regulation Scale Short Form (DERS-SF): Validation and Replication in Adolescent and Adult Samples

Emotion dysregulation often emerges early in development and is a core feature of many psychological conditions. The Difficulties in Emotion Regulation Scale (DERS) is a well validated and widely used self-report measure for assessing emotion regulation problems among adolescents and adults. The DERS has six subscales with five to eight items each (36 total), suggesting multiple questions may assess similar underlying constructs. In an effort to reduce respondent burden and streamline this widely-used instrument, we created a short-form version of the DERS (DERS-SF) using confirmatory factor analysis on data from three adolescent (n?=?257) and two adult samples (n?=?797). Scores on the DERS-SF yielded similar correlation patterns relative to the full measure, ranging from .90 to .98 and reflecting 81–96 % shared variance. This instrument maintains the excellent psychometric properties and retains the total and subscale scores of the original measure with half the items.     

Perceptions on well-being at home of families with people with disabilities: A psycho-environmental perspective

Introduction

Although the home is of major importance in the lives of people with disabilities, few studies address disability in the literature on home and health. Moreover, people with disabilities and their family members’ perceptions of their homes has rarely been explored.