Profiles of emotion regulation: Understanding regulatory patterns and the implications for posttraumatic stress

Trauma survivors often experience posttraumatic stress (PTS) and report concurrent difficulties with emotion regulation (ER). Although individuals typically use multiple regulatory strategies to manage emotion, no studies yet examine the influence of a constellation of strategies on PTS in a community sample. We assessed six ER strategies and investigated whether specific profiles of ER (i.e. the typical pattern of regulation, determined by how often each strategy is used) were related to PTS. A hierarchical cluster analysis indicated that four distinct profiles were present: Adaptive Regulation, Active Regulation, Detached Regulation, and Maladaptive Regulation. Further analyses revealed that an individual's profile was not related to frequency of past trauma, but had the power to differentiate symptom severity for overall PTS and each symptom cluster of posttraumatic stress disorder. These findings highlight how profiles characterising multiple regulatory strategies offer a more complete understanding of the ways ER can account for PTS.     

Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity

Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable "lack of clarity of emotions." Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.     

A Preliminary Investigation of the Relationship Between Emotion Dysregulation and Partner Violence Perpetration Among Individuals with PTSD and Alcohol Dependence

This study examines the link between emotion dysregulation and intimate partner violence (IPV) among 77 individuals with posttraumatic stress disorder (PTSD) and alcohol dependence. Participants were recruited from a residential substance abuse treatment program as part of the eligibility screening for an institutional review board approved clinical trial examining the efficacy of an exposure-based intervention in individuals dually diagnosed with alcohol dependence and PTSD. Participants reported on PTSD symptoms, alcohol use disorder symptoms, emotion dysregulation, and physical and verbal aggression in their intimate relationships during the past year. Findings demonstrated that difficulties with emotion regulation are associated with physical and verbal IPV perpetration in a clinical sample. Although facets of emotion regulation emerged as significant predictors of IPV in the models, alcohol and PTSD symptom severity did not emerge as predictors of IPV. These findings suggest targeted emotion regulation skills training could benefit substance abusers who engage in IPV and that emotion dysregulation might be an important target for future research aimed at understanding elevated rates of IPV perpetration in mental health samples.     

Mindfulness and Emotion Regulation Difficulties in Generalized Anxiety Disorder: Preliminary Evidence for Independent and Overlapping Contributions

Diminished levels of mindfulness (awareness and acceptance/nonjudgment) and difficulties in emotion regulation have both been proposed to play a role in symptoms of generalized anxiety disorder (GAD); the current studies investigated these relationships in nonclinical and clinical samples. In the first study, among a sample of 395 individuals at an urban commuter campus, self-reports of both emotion regulation difficulties and aspects of mindfulness accounted for unique variance in GAD symptom severity, above and beyond variance shared with depressive and anxious symptoms, as well as variance shared with one another. In the second study, individuals with GAD (n = 16) reported significantly lower levels of mindfulness and significantly higher levels of difficulties in emotion regulation than individuals in a nonanxious control group (n = 16). Results are discussed in terms of directions for future research and potential implications for treatment development.     

Posttraumatic Stress Disorder Symptom Severity and Emotion Regulation in Acute-Care Psychiatric Inpatients: Associations With Suicidality

Posttraumatic stress disorder (PTSD) symptomatology has been positively associated with suicidality (suicidal ideation and attempts), but less is known about factors that might exacerbate that association. The present study examined the main and interactive effects of PTSD symptom severity and difficulties in emotion regulation in association with four suicidality outcomes. Participants included 128 adults in an acute-care psychiatric inpatient setting. Results revealed that PTSD symptom severity was significantly incrementally associated with self-reported suicidal ideation (ß = .30, p = .02). Difficulties in emotion regulation were significantly associated with suicide as the reason for current admission (p = .01). The interactive effect of PTSD symptom severity and difficulties in emotion regulation was significant only for self-reported suicidal ideation (ß = .24, p < .001). Participants with high levels of PTSD symptom severity and difficulties in emotion regulation exhibited the highest level of suicidal ideation. Clinical implications and future directions are discussed.     

Sexual Harassment and Posttraumatic Stress Symptoms among Asian and White Women

Sexual harassment is a prevalent problem that has been associated with negative psychological and physical health outcomes. Although sexual harassment has been linked to posttraumatic stress (PTS) symptoms, little is known about how PTS symptoms that arose from sexual harassment experiences might be associated with psychological and physical health. This study examined the associations among sexual harassment, PTS symptoms, and psychological and physical well-being in a sample of Asian and White women. In addition, given the lack of research on sexual harassment among Asian women, we investigated the moderating role of ethnicity. Results indicated that greater sexual harassment frequency and PTS symptom severity predicted more depression, overall psychological distress, and physical symptoms. PTS symptom severity and ethnicity moderated the relationship between sexual harassment frequency and physical symptoms. We discuss the implications of these findings and directions for further research.     

The Effects of Anxiety and Depressive Symptoms on Daily Positive Emotion Regulation

Individuals with anxiety and depressive symptoms exhibit disturbances in positive emotion regulation, which may hinder full recovery. By comparison, individuals with strong beliefs regarding their capacity to “savor” or maintain positive emotions (i.e., savoring beliefs) display more adaptive positive emotion regulation. The present daily diary study explores three momentary processes involved in positive emotion regulation, namely positive emotion reactivity, regulatory goals, and regulatory effectiveness, and examines the comparative effects of baseline anxiety and depressive symptoms versus savoring beliefs on such processes in real-life contexts. A sample of 164 nonclinical undergraduates provided baseline measures of anxiety and depressive symptom severity and savoring beliefs prior to completing 14 daily assessments of positive emotions and emotion regulatory responses to daily positive events. Results indicated that higher baseline anxiety and depressive symptom severity were associated with decreased positive emotion reactivity and increased down-regulation of positive emotions; higher baseline savoring beliefs were associated with increased positive emotion reactivity, decreased down-regulation and increased up-regulation of positive emotions. Potential clinical implications are discussed.     

Tolerating Distress After Trauma: Differential Associations Between Distress Tolerance and Posttraumatic Stress Symptoms

Distress tolerance has been implicated in disorders of emotional regulation, such as eating disorders and borderline personality disorder; however, much less attention has been given to distress tolerance in the context of posttraumatic stress (PTS). Several conceptual linkages between distress tolerance and PTS exist. Low distress tolerance may increase negative appraisals, reducing an individual’s propensity to deal with distressing mental symptoms immediately after a trauma. Relatedly, a perceived inability to cope with the distress brought on by trauma-related memories and cues may engender maladaptive coping strategies. The few published studies examining the relationship between distress tolerance and PTS have demonstrated that lower distress tolerance was associated with increased PTS symptomatology, including increased avoidance, hyperarousal, and re-experiencing. The current study sought to replicate and extend the emerging empirical base by examining the relationship between distress tolerance and the four distinct PTS symptom clusters, while controlling for time since the index trauma and depressive symptoms. Results indicated that distress tolerance accounted for significant unique variance in re-experiencing and avoidance but not negative emotionality and hyperarousal symptoms. There was also a strong positive association between the number of traumas endorsed by participants, depression, and PTS symptoms. Findings suggest that distress tolerance is associated with PTS, lending further support to the putative relationship between PTS and distress tolerance. Accordingly, developing treatment protocols designed to increase distress tolerance in individuals affected by PTS may reduce symptom severity and increase coping abilities.     

The indirect effects of emotion regulation on the association between attachment style,depression, and meaning made among undergraduates who experienced stressful events

Undergraduates frequently report exposure to stressful life events which may negatively impact mental health. The current study examined associations among attachment style, depression, and meaning made, and tested both direct effects and indirect effects through emotion regulation difficulties. Undergraduates (N?=?336) who reported having experienced stressful and/or potentially traumatic events completed measures through an online survey. More than half of participants (64%) were female, with a mean age of 19.26 years. In both models, higher attachment anxiety and higher attachment avoidance were significantly associated with greater difficulties with accessing emotion regulation strategies, which in turn were related to higher depression symptom severity and lower meaning made. Lack of emotional awareness also partially explained the associations between attachment avoidance and outcomes in both models. Difficulties in engaging in goal-directed behavior partially explained the associations between attachment anxiety and meaning made, but not depression symptom severity. Our results suggest certain emotion regulation strategies may be key mechanisms through which individuals with high attachment anxiety or avoidance may reduce the potential negative mental health impact that stressful life events may have.     

Posttraumatic Stress Disorder and Emotion‐Focused Coping Among Disaster Mental Health Counselors

The authors surveyed 235 disaster mental health counselors (DMHCs) for levels of posttraumatic stress disorder (PTSD) symptom severity. A correlational design was used to examine the roles of adult attachment security, emotion regulation, and mindfulness in predicting PTSD symptoms among this group. Each of the 3 predictors was negatively correlated with PTSD symptom severity, and data supported a mediating role for emotion regulation. Results may inform DMHCs, other counselors, and individuals who train or deploy DMHCs.     

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.     

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.     

Facets of Emotion Regulation and Emotional Disorder Symptom Dimensions: Differential Associations and Incremental Validity in a Large Clinical Sample

A growing literature suggests robust associations between dimensions of emotion regulation and emotional disorder psychopathology. However, limited research has investigated associations of emotion regulation dimensions across several emotional disorders (transdiagnostic associations), or the incremental validity of emotion regulation versus the higher-order construct of neuroticism. The current study used exploratory structural equation modeling and a large clinical sample (N = 1,138) to: (a) develop a multidimensional emotion regulation measurement model, (b) evaluate the differential associations between latent emotion regulation dimensions and five latent emotional disorder symptom dimensions (social anxiety, depression, agoraphobia/panic, obsessions/compulsions, generalized worry), and (c) determine the incremental contribution of emotion regulation in predicting symptom dimensions beyond neuroticism. The best-fitting measurement model of emotion regulation included four dimensions: Problematic Responses, Poor Recognition/Clarity, Negative Thinking, and Emotional Inhibition/Suppression. Although many zero-order associations between the four latent emotion regulation dimensions and five latent symptom dimensions were significant, few associations remained significant in a structural regression model that included neuroticism. Specifically, Negative Thinking and Problematic Responses incrementally predicted depression symptoms, while Emotional Inhibition/Suppression predicted both social anxiety and depression symptoms. Associations between neuroticism and the emotional disorder dimensions were similar regardless of whether the emotion regulation dimensions were held constant. These results suggest that self-reported emotion regulation dimensions are associated with the severity and expression of a range of emotional disorder symptoms, but that some emotion regulation dimensions have limited incremental validity after accounting for general emotional reactivity. Studies of emotion regulation should assess neuroticism as a key covariate.     

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

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

Difficulties in emotion regulation differentiate depressive and obsessive–compulsive symptoms and their co-occurrence

Background and Objectives: Depressive and obsessive–compulsive (OC) symptoms are frequently comorbid, and the combination of these may result in additional impairment compared to the difficulties of experiencing one of these symptom groups. Emotion regulation difficulties underlie many forms of psychopathology symptoms, and this study examined whether aspects of emotion regulation could differentiate clinical levels of depressive and OC symptoms, and their co-occurrence. Design and Method: College students (N?=?199; M_age?=?19.47 years; 59.8% female) were grouped based on the presence of clinical levels of OC and depressive symptoms. Using a multinomial logistic regression approach, differences in odds ratios for emotion regulation difficulties were examined. Results: The co-occurring clinical-symptom group was differentiated from the single clinical-symptom groups on several aspects of emotion regulation. Impulse-control difficulties and limited access to emotion regulation strategies differentiated clinical levels of depressive from OC symptoms. Conclusions: This study highlights the importance of conducting a nuanced emotion assessment to best inform prevention and treatment of depressive and OC symptoms, and their comorbidity.     

父母情绪调节困难对流动儿童对立违抗症状的影响:亲子冲突解决方式和儿童情绪调节的作用

本研究以来自北京10所小学的369名有对立违抗(Oppositional Defiant Disorder, ODD)症状的流动儿童及父母、349名无ODD症状的对照组流动儿童及父母为被试进行了问卷施测,探究了父母情绪调节困难对流动儿童对立违抗症状的影响,并进一步探讨了亲子冲突解决方式和儿童情绪调节(情绪调节与情绪消极和不稳)在其中所起的作用。经过分析发现:(1)ODD症状流动儿童的父母情绪调节、亲子冲突解决方式、儿童情绪调节显著差于对照组儿童;(2)总体上,父母情绪调节困难、亲子冲突解决方式和儿童ODD症状之间两两相关显著,而儿童情绪调节与这几个变量相关不显著;(3)父母情绪调节困难能显著正向预测流动儿童ODD症状,并进一步通过亲子冲突解决方式对流动儿童ODD症状产生影响;(4)儿童情绪调节(儿童情绪调节与儿童情绪消极和不稳)仅在父母情绪调节困难对儿童ODD症状的直接影响中起着显著的调节作用,对亲子冲突解决方式所起的中介作用并无调节作用。在对有ODD症状的流动儿童进行干预时,不仅要培养儿童自身的情绪调节能力,也应提升父母的情绪调节能力并改善亲子冲突解决方式。     

The Unique Relationship of Emotion Regulation and Alexithymia in Predicting Somatization Versus PTSD Symptoms

Posttraumatic stress disorder (PTSD) has received considerable attention in the field of trauma studies. Yet trauma survivors suffer from other psychological and physical symptoms including somatic complaints, or somatization. The extent to which the same emotional processes that predict PTSD are implicated in somatization has remained relatively unexamined. We contend that emotion regulation difficulties and alexithymia are also implicated in somatization, and the way in which these factors interact differentially place one at risk for somatization or PTSD. Regression analyses revealed that emotion regulation difficulties were more highly correlated with somatization for individuals who also reported greater alexithymia. This interaction was not observed for PTSD symptoms where both alexithymia and emotion regulation difficulties uniquely predicted PTSD symptoms.     

Emotion Regulation of Events Central to Identity and Their Relationship With Concurrent and Prospective Depressive Symptoms

Dispositional emotion regulation is related to the severity and maintenance of depressive symptoms. However, whether emotion regulation specific to an event highly central for an individual’s identity is predictive of depressive symptoms has not been examined. Nonclinical participants (N = 220) reported the extent to which they employed a selection of emotion regulation strategies when recalling low- and high-centrality events. Dispositional emotion regulation and depressive symptoms were also assessed. A 7-week follow-up was conducted. High-centrality events were associated with more emotion regulation efforts. Greater brooding and expressive suppression in relation to high-centrality memories predicted concurrent depressive symptoms after controlling for event valence and dispostional emotion regulation. Effects were absent for low-centrality memories. Emotion regulation in response to high-centrality memories did not predict depressive symptoms at follow-up beyond baseline depressive symptoms. Overall, the findings showed that maladaptive emotion regulation in response to memories of high-centrality events is important for explaining depressive symptomatology.     

Sex differences in the indirect effects of cognitive processes on anxiety through emotion regulation difficulties

Drawing on a gender roles theory of emotion regulation, we examined the specific facets of emotion regulation difficulties through which higher-order cognitive abilities may be related to anxiety. Participants (N = 225) completed self-report measures of emotion regulation difficulties and anxiety, and were administered neuropsychological tests assessing abstract reasoning and inhibition. PROCESS (Hayes, 2012) was used to estimate the direct and indirect effects of both inhibition and abstract reasoning on anxiety symptoms, with six dimensions of emotion regulation difficulties serving as multiple mediators operating in parallel. Results suggest that the relation between higher-order cognitive abilities and anxiety operate through distinct, sex-dependent emotion dysregulation mechanisms. For females, higher levels of inhibition and abstract thinking were associated with poorer clarity of emotions, which in turn, was associated with higher levels of anxiety symptoms. As such, over-attentiveness to, or over-analysis of, emotions may be particularly detrimental among females who have relatively higher abstract reasoning abilities. For males, higher inhibition was associated with greater perceived effectiveness in regulating negative emotions, which in turn, was associated with lower levels of anxiety symptoms. This finding suggests that mood regulation expectancies may be particularly important in understanding the pathogenesis of anxiety in males.