A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms

This study examined the relationship between posttraumatic stress (PTS) symptoms and particular aspects of emotion regulation difficulties among trauma-exposed individuals. Participants were an ethnically diverse sample of 108 undergraduates from an urban university. PTS symptom severity was found to be associated with lack of emotional acceptance, difficulty engaging in goal-directed behavior when upset, impulse-control difficulties, limited access to effective emotion regulation strategies, and lack of emotional clarity. Further, overall difficulties in emotion regulation were associated with PTS symptom severity, controlling for negative affect. Finally, individuals exhibiting PTS symptoms indicative of a PTSD diagnosis reported greater difficulties with emotion regulation than those reporting PTS symptoms at a subthreshold level. The implications of these findings for research and treatment are discussed.     

Posttraumatic stress, difficulties in emotion regulation, and coping-oriented marijuana use

In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M(age) = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.     

Emotion regulation mediates the effects of temperament traits and posttraumatic stress disorder symptoms on affect in motor vehicle accident survivors

ObjectivesThe aim of the present study was to investigate the associations among temperament traits postulated by the Regulative Theory of Temperament (RTT), posttraumatic stress disorder symptoms (PTSD symptoms), emotion regulation strategies, and affect in the 280 motor vehicle survivors (MVA).MethodsTemperament was measured with the Formal Characteristics of Behaviour–Temperament Inventory (FCB-TI), the level of posttraumatic stress disorder symptoms was assessed by the PTSD Clinical Inventory (PTSD-C), emotion regulation was tested with the Polish adaptation of the Inventory of Cognitive Affect Regulation Strategies (ICARUS), and affect was evaluated by the Polish version of the Positive and Negative Affect Scale (PANAS).ResultsGreater emotional reactivity was associated with grater negative affect (also by maladaptive regulation) and lower positive affect whereas greater activity was linked to grater positive affect (also via adaptive regulation). Furthermore, greater PTSD symptoms were related to greater negative affect (also through maladaptive regulation) and lower positive affect. However, PTSD symptoms were not linked to adaptive regulation strategies.ConclusionThe findings significantly extends our current knowledge on the associations among temperament traits, PTSD symptoms, emotion regulation strategies, and affect in the motor vehicle survivors.     

The associations between adult attachment,posttraumatic symptoms,and posttraumatic growth

Background and Objectives: Individual differences after trauma vary considerably and can range from posttraumatic stress disorder (PTSD) to posttraumatic growth (PTG). Current theoretical models cannot fully explain this variability. Therefore, we integrated attachment theory with Ehlers and Clark's model of PTSD to understand whether attachment style is associated with negative appraisals of a traumatic event(s), posttraumatic stress symptoms (PTS), and PTG. Our aim was to test this integrated model PTSD in an analog sample who had experienced at least one traumatic event. Design: We used structural equation modeling to test the association of adult attachment and posttraumatic cognitions (self and world/others) with PTS and PTG using a cross-sectional, correlational design. Methods: The sample comprised 393 university staff and students (Range_Age= 18–49, 85% females) who completed online measures. Results: Attachment anxiety and negative posttraumatic self-cognitions were positively associated. Negative posttraumatic self-cognitions were positively associated with PTS. Attachment anxiety had an indirect effect (via negative posttraumatic self-cognitions) on PTS, whereas attachment avoidance predicted more negative posttraumatic world cognitions and lower perceived PTG. Conclusions: The study highlights the importance of considering how attachment styles influence posttraumatic emotion regulation and cognitive processing of the trauma to determine posttraumatic mental health.     

The emotion regulation model of attachment:An emotion‐specific approach

This research applies the emotion regulation (ER) model of attachment to the regulation of specific emotions, namely sadness and anger, in early adolescents. The study investigates how attachment and accompanying ER strategies relate to both internalizing and externalizing problems. Two separate cross‐sectional studies (N = 197 and N = 310) supported different associations between attachment and ER (i.e., dysregulation and suppression). For attachment avoidance, associations with ER strategies seem to depend on the specific type of emotion involved, whereas attachment anxiety related to dysregulation irrespective of the type of emotions. Furthermore, Study 2 found that attachment anxiety and avoidance are associated with internalizing and externalizing problems via different ER strategies. Discussion focuses on the dynamics involved in associations between attachment, ER, and psychological problems.     

Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Posttraumatic Stress in Combat Veterans With Insomnia

Daytime and nighttime symptoms of posttraumatic stress disorder (PTSD) are common among combat veterans and military service members. However, there is a great deal of heterogeneity in how symptoms are expressed. Clarifying the heterogeneity of daytime and nighttime PTSD symptoms through exploratory clustering may generate hypotheses regarding ways to optimally match evidence-based treatments to PTSD symptom profiles. We used mixture modeling to reveal clusters based on 6 daytime and nighttime symptoms of 154 combat veterans with insomnia and varying levels of PTSD symptoms. Three clusters with increasing symptom severity were identified (n1 = 50, n2 = 70, n3 = 34). These results suggest that, among veterans with insomnia, PTSD symptoms tend to exist on a continuum of severity, rather than as a categorical PTSD diagnosis. Hypotheses regarding possible targeted treatment strategies for veterans within each identified cluster, as well as ways to generalize these methods to other groups within the military, are discussed.     

Posttraumatic Stress Related to Hyperglycemia: Prevalence in Adults with Type I Diabetes

Prevalence of hyperglycemia-related posttraumatic stress (PTS) was assessed in 239 adults with type 1 diabetes using the posttraumatic stress diagnostic scale (PDS; Foa, Posttraumatic stress diagnostic scale manual, National Computer Systems, Inc., Minneapolis, 1995) by an anonymous online survey. Additionally, this study aimed to identify variables related to hyperglycemia-related PTS. Over 30 % of participants reported symptoms consistent with PTSD related to hyperglycemia with standard PDS scoring, and 10 % with more conservative scoring. Hierarchical multiple regression analyses indicated that diabetes self-management behavior and perceived helplessness about hyperglycemia predicted PTSD with standard scoring. Perceived death threat, self-management behavior, helplessness about hyperglycemia, and severity of hypoglycemia in past month predicted PTSD using more conservative scoring. Perceived helplessness, hypoglycemia severity, perceived death-threat, HbA1c, and self-management behavior predicted PTS severity. When fear, helplessness, and perceived death-threat were combined to represent an overall cognitive appraisal factor, this variable was the strongest predictor of PTSD and PTS severity. Scores for PTSD symptom clusters appeared similar to data on hypoglycemia-related PTS.     

Establishment and replication of emotion regulation profiles: implications for psychological health

Background and Objectives: A promising method of capturing the complex nature of emotion regulation is to assess composite profiles of regulation (i.e., default pattern of regulation across multiple strategies). However, it remains unclear whether regulatory profiles demonstrate consistency across samples and in relation to mental health. Design: Two studies are presented here. Both utilized a cross-sectional design, and the second study presents a replication of the first. Method: Both studies utilized self-report data from independent undergraduate samples to perform latent profile analyses of emotion regulation use. Results: Studies 1 and 2 demonstrated evidence for four replicable regulatory profiles: Adaptive, Accepting (with or without Suppression), Non-accepting, and Maladaptive. Profiles were also related to symptoms of depression and anxiety, such that those consistently relying on adaptive strategies reported lower symptoms than those relying more heavily on maladaptive strategies. Conclusions: These findings clarify previous work which tied regulatory profiles to psychological health by extending a person-centered approach to understanding the ways in which individuals regulate their emotions.     

Which emotional regulatory strategy makes Chinese adolescents happier? A longitudinal study

Growing interest in emotion regulation is reflected in the studies of cognitive and social development. However, the extant studies mainly highlight how emotion regulation develops based on a western value system. This study utilised a longitudinal design to examine the development of emotion regulation and explored the contributions of different regulatory strategies to emotion experience regarding the early adolescent development period in a Chinese population. A total of 303 Chinese adolescents (age range = 10–14 years) were followed up in a three‐phase longitudinal study for 3 years. In each phase of the study, participants completed Adolescents Emotion Regulation Questionnaire and Daily Emotion Scale. Results of hierarchical linear regressions revealed that Chinese adolescents reported more down‐regulation. Down‐regulation is more effective than up‐regulation in enhancing desirable emotion experience and reducing undesirable emotion experience during adolescents' development. Also, the adaptive functions of emotional regulatory strategies in Chinese background were discussed.     

An examination of the roles of trauma exposure and posttraumatic stress disorder on emotion regulation strategies of Operation Iraqi Freedom,Operation Enduring Freedom,and Operation New Dawn veterans

Theories of posttraumatic stress disorder (PTSD) implicate emotional processes, including difficulties utilizing adaptive emotion regulation strategies, as critical to the etiology and maintenance of PTSD. Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (OIF/OEF/OND) veterans report high levels of combat exposure and PTSD. We aimed to extend findings suggesting that emotion regulation difficulties are a function of PTSD, rather than combat trauma exposure or common comorbidities, to OIF/OEF/OND veterans, in order to inform models of PTSD risk and recovery that can be applied to returning veterans. We tested differences in emotion regulation, measured with the Difficulties in Emotion Regulation Scale and Emotion Regulation Questionnaire, among trauma-exposed veterans with (n = 24) or without PTSD (n = 22) and healthy civilian comparison participants (n = 27) using multivariate analyses of covariance, adjusting for major depressive disorder, anxiety disorders, and demographic variables (age, sex, and ethnicity). Veterans with PTSD reported more use of expressive suppression and more difficulties with emotion regulation than veterans without PTSD and healthy comparison participants. Groups did not differ on cognitive reappraisal. Findings suggest the key role of PTSD above and beyond trauma exposure, depression, and anxiety in specific aspects of emotion dysregulation among OIF/OEF/OND veterans. Interventions that help veterans expand and diversify their emotion regulation skills may serve as helpful adjunctive treatments for PTSD among OIF/OEF/OND veterans.     

Negative cognitive emotion regulation as a predictor of adolescent heart rate variability and entropy under social stress

ABSTRACT

Background and Objectives: Negative cognitive emotion regulation (ER) strategies are particularly important within the framework of anxiety problems amongst youths and how they cope with stressful events. The aim of this study was to examine the associations between both negative and positive ER style and cardiac regulation under stressful conditions.

Design: Eighty-nine adolescents (M?=?13.31 years, SD?=?0.68, 44.94% girls) were exposed to a socially relevant stress induction protocol.

Methods: Participants’ emotion regulation strategies were assessed and their cardiac function was recorded.

Results: A negative ER style predicted heart rate (HR) entropy at the stressful stage after controlling for anxiety scores. In addition, heart rate variability reactivity and recovery and HR entropy recovery were larger (p?<?.05) in the low negative ER style group (n?=?16) than in the high negative ER style group (n?=?23).

Conclusions: Results suggest that individuals with a highly negative ER style have diminished autonomic flexibility.     

Child Maltreatment,Emotion Regulation,and Posttraumatic Stress: The Impact of Emotional Abuse

This study examined the relationship of emotion regulation to multiple forms of child abuse and subsequent posttraumatic stress. Particular consideration was given to emotional abuse, which has received less attention in the literature. Results from a survey of 912 female college students revealed that women who reported a history of sexual, physical, or emotional abuse endorsed greater emotion regulation difficulties compared to women without abuse histories. Notably, emotional abuse was the strongest predictor of emotion deregulation. Mediation analyses indicated that emotion dysregulation partially explained the relationship between physical and emotional abuse and symptoms of posttraumatic stress, suggesting that intervention efforts aimed at improving emotion regulation strategies might be beneficial in decreasing posttraumatic stress among women with child maltreatment histories.     

Main and Interactive Effects of Mental Contamination and Tolerance of Negative Emotions in Relation to Posttraumatic Stress Symptoms Following Sexual Trauma

Mental contamination, an internal sense of dirtiness that originates in the absence of physical contact with a stimulus, has been implicated in the exacerbation of posttraumatic stress (PTS) symptoms following sexual trauma. In addition, evidence suggests that associations between PTS-related risk factors and PTS symptoms may depend on the degree to which one can tolerate experiencing negative emotions. To better understand the association between mental contamination and PTS symptoms, we examined main and interactive effects of mental contamination and tolerance of negative emotions in relation to PTS symptoms, including specific symptom clusters, in a community sample of women who experienced sexual trauma (N?=?101). Tolerance of negative emotions moderated the association between mental contamination and PTS symptoms (total symptom severity, intrusion cluster, and cognitive/mood alterations cluster). These results indicate that difficulties tolerating negative emotions may be a necessary condition for mental contamination to relate to PTS symptoms following sexual trauma.     

Can functional emotion regulation protect children's mental health from war trauma? A Palestinian study

Effective emotion regulation (ER) is expected to protect mental health in traumatic stress. We first analysed the protective (moderator) function of different ER strategies and the associations between ER and mental health. Second, we tested gender differences in the protective function of ER and the associations between ER strategies and mental health. Participants were 482 Palestinian children (girls 49.4%; 10–13 years, M = 11.29, SD = .68) whose ER was assessed by the Emotion Regulation Questionnaire and mental health by post‐traumatic stress (Children's Impact Event Scale), depressive, and psychological distress (Strengths and Difficulties Questionnaire) symptoms, and by psychosocial well‐being (Mental Health Continuum‐Short Form). War trauma involved 42 events. Results showed, first, that none of the ER strategies could protect a child's mental health from negative impact of war trauma, but self‐focused ER was associated with low depressive symptoms, and other‐facilitated ER with high psychological well‐being. However, controlling of emotions formed a comprehensive risk for children's mental health. Second, gender differences were found in the protective role of ER, as self‐focused and distractive ER formed a vulnerability among boys. The results are discussed in the context of emotional and regulative demands of war and life‐threat.     

The relation between emotion regulation choice and posttraumatic growth

ABSTRACT

Previous research has examined emotion regulation (ER) and trauma in the context of psychopathology, yet little research has examined ER in posttraumatic growth (PTG), the experience of positive psychological change following a traumatic event. ER typically involves decreasing negative affect by engaging (e.g. reappraisal) or disengaging (e.g. distraction) with emotional content. To investigate how ER may support PTG, participants who experienced a traumatic event in the past 6 months completed a PTG questionnaire and an ER choice task in which they down regulated their negative emotion in response to negative pictures of varying intensity by choosing to distract or reappraise. Latent growth curve analyses revealed that an increase in reappraisal choice from low to high subjective stimulus intensity predicted higher PTG, suggesting that individuals who chose reappraisal more as intensity increased reported higher PTG. Findings suggest that reappraisal of negative stimuli following a traumatic event may be a key component of PTG.     

A Preliminary Examination of Thought Suppression,Emotion Regulation,and Coping in a Trauma-Exposed Sample

Attempts to modulate negative emotional and cognitive symptoms of posttraumatic stress disorder (PTSD) may be related to psychopathology. Trauma-exposed undergraduates, 31 reporting severe PTSD symptoms (PTSD group) and 34 without PTSD symptoms (non-PTSD group), completed measures of PTSD, depression, anxiety, thought control, emotion regulation, and coping. The PTSD group had greater psychopathology and overall modulation strategy use than the non-PTSD group. Thought suppression, emotion suppression, and avoidant coping strategies were positively related to psychopathology, whereas emotion reappraisal and approach coping strategies were either not related or weakly negatively related. Hierarchical multiple regressions with psychopathologic variables as criteria and modulation strategies as predictors indicated significant models in all cases. Generally, thought suppression was the only significant independent predictor of psychopathology.     

Anxiety sensitivity and distress tolerance typologies and relations to posttraumatic stress disorder: A cluster analytic approach

A growing literature suggests a relationship between a high anxiety sensitivity (AS; the fear of anxiety and its related consequences)/low distress tolerance (DT; the capacity tolerate internal negative states) profile and posttraumatic stress disorder (PTSD) symptoms. However, specific profiles have not been identified or examined specifically in Veteran samples. Thus, the aims of the present study were to establish empirically derived profiles created from response patterns on the Anxiety Sensitivity Index and Distress Tolerance Scale and to examine associations with PTSD symptom clusters among a sample of combat-exposed Veterans (N = 250). A cluster analytic approach was used to identify AS/DT profiles, and a series of multivariate analyses of variance with post hoc analyses was conducted to examine the relationship between each AS/DT profile and each PTSD symptom cluster. Results indicated a 3-cluster solution including a high AS/low DT “at risk” profile, a low AS/high DT “resilient” profile, and an average AS/DT “intermediate” profile. The at-risk profile was associated with significantly greater symptoms in each PTSD cluster (i.e., hyperarousal, avoidance, re-experiencing) when compared to the other two profiles. The at-risk profile was also associated with greater depressive symptoms and lower self-reported resilience. These findings extend the previous literature by identifying a high AS/low DT “at risk” profile and its associations with PTSD symptoms, underscoring the potential utility in targeting these affect-regulation constructs for clinical intervention.     

Development and Initial Psychometric Evaluation of the Semi-Structured Emotion Regulation Interview

Emotion regulation (ER) strategy use has been identified as a transdiagnostic predictor of the development, maintenance, and recovery from several forms of psychopathology. However, the ER strategy use literature relies primarily on self-report measures that have several important limitations. This article describes the development and initial psychometric evaluation of a novel clinician-administered measure of ER strategy use, the Semi-Structured Emotion Regulation Interview (SERI; Lee, Weathers, &; Sloan, 2016 Lee, D. J., Weathers, F. W., &; Sloan, D. M. (2016). The Semi-Structured Emotion Regulation Interview (SERI). Unpublished instrument. [Google Scholar]). The SERI was developed in a construct validation framework with emphasis on a multistage content validity process. The SERI assesses frequency and efficacy (i.e., proximal change in the targeted emotion) of 9 strategies in regulation of a specified emotion type and intensity (e.g., severe anxiety) during the past 30 days. Undergraduates (N = 68) completed a battery of self-report measures and a subsequent interview. Frequency and efficacy of each strategy was assessed separately with respect to regulation of moderate and severe anxiety and anger. Each of the assessed strategies demonstrated excellent discriminant validity. Associations between SERI and self-report measures of ER strategy use varied by target emotion type and intensity for some strategies, but not others. Implications and suggestions for future research are described.     

Emotion regulation and risk taking: Predicting risky choice in deliberative decision making

Only very recently has research demonstrated that experimentally induced emotion regulation strategies (cognitive reappraisal and expressive suppression) affect risky choice (e.g., Heilman et al., 2010). However, it is unknown whether this effect also operates via habitual use of emotion regulation strategies in risky choice involving deliberative decision making. We investigated the role of habitual use of emotion regulation strategies in risky choice using the “cold” deliberative version of the Columbia Card Task (CCT; Figner et al., 2009). Fifty-three participants completed the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) and—one month later—the CCT and the PANAS. Greater habitual cognitive reappraisal use was related to increased risk taking, accompanied by decreased sensitivity to changes in probability and loss amount. Greater habitual expressive suppression use was related to decreased risk taking. The results show that habitual use of reappraisal and suppression strategies predict risk taking when decisions involve predominantly cognitive-deliberative processes.