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Structural equation model of difficulties in emotion regulation subscales and PTSS clusters. Note: Residual variances and covariances among factors are omitted for clarity. All solid lines are significant at p < .05. Dashed lined are non-significant. Estimates are completely standardized
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Prior research has shown that difficulties in emotion regulation is associated with overall levels of posttraumatic stress symptoms (PTSS). However, it is currently unclear which facets of difficulties in emotion regulation (e.g., lack of emotion regulation strategies, impulse control problems, non-acceptance of emotional responses) are associated...
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If the short-term effectiveness or long-term adaptivity of emotion regulation (ER) depends on the specific ER (covert or overt) behaviors that are executed, it is important to know what it is that leads to those (more or less adaptive or maladaptive) behaviors. While, in brief, ER refers to influencing emotions, meta-emotion-regulation (MER) refers...
Citations
... One construct implicated in the development and maintenance of PTSD symptoms following trauma exposure is difficulties in emotion regulation (Ehring & Quack, 2010;McLean & Foa, 2017;Seligowski et al., 2015;Short et al., 2016). Difficulties in emotion regulation are thought to influence the development or maintenance of sleep disturbance in PTSD through multiple pathways (Dolan et al., 2023;Forbes et al., 2020;Hien et al., 2017;Pickett et al., 2016). ...
Objective: Although associations between posttraumatic stress disorder (PTSD) and sleep disturbance are well-established, relatively little work has examined mechanisms that may underlie this association. This study aimed to examine the explanatory role of emotion regulation difficulties and intolerance of uncertainty (IU) in associations between PTSD symptoms and sleep disturbance among a sample of war-exposed Iraqi individuals. Method: We used structural equation modeling in a war-exposed nonclinical sample (N = 617; Mage = 27.63; SD = 4.81; 46.03% females) to model indirect effects from PTSD symptoms to the sleep disturbance via emotion regulation difficulties and IU. Participants completed PTSD symptoms, sleep disturbance, difficulties in emotion regulation, and IU scales. Results: Significant correlations were found between PTSD symptoms and sleep disturbance. Those who reported higher levels of PTSD symptoms also reported higher levels of sleep disturbance. The structural model was an excellent fit to the data (χ² = 166.03; degrees of freedom = 32; comparative fit index = .960; goodness-of-fit index = .954; Tucker–Lewis index = .943; root-mean-square error of approximation = .082), and all hypothesized indirect effects were significant (ps < .001). Conclusion: Findings add to the emerging body of literature examining potential mechanisms that may help to explain the maintenance or even escalation of PTSD-related sleep disturbance. Findings have clinical implications in designing specialized treatments for individuals with PTSD and suggest focusing on emotion regulation difficulties and IU as potential therapeutic targets that putatively underlie PTSD-related sleep disturbance.
... For example, it has been observed that increased emotional regulation predicts decreased levels of anxiety and depression in parents (Solbakken et al., 2021). Regarding aggressive behaviors from their children, parents experience a wide range of unpleasant emotions (Arias-Rivera & Hidalgo, 2020; Cuervo & Rechea, 2010;Desir & Karatekin, 2018;Gabriel et al., 2018;Murphy-Edwards & Van Heugten, 2018), which may lead to a decrease in the use of parental emotional regulation strategies (Rutherford et al., 2015), thus favoring the presence of psychopathology (Aldao et al., 2010;Short et al., 2016). Notably, it has been evidenced that emotional dysregulation acts as a mediator to explain the relationship between victimization and psychological disorders, such as anxiety and depression (Crow et al., 2014;Goldsmith et al., 2013;Jennissen et al., 2016;Poole et al., 2017;Trompeter et al., 2018). ...
... Emotion dysregulation has also been found to be related to poor functional outcomes (e.g., difficulties getting along with others, trouble with work/home activities) in inpatient civilians experiencing PTS (Boyd et al., 2020). In addition to generally poor emotion regulation, lack of EC is positively related to emotional numbing symptoms in those with PTSD, after controlling for neuroticism (Short et al., 2016). EC is specifically important to study in people who have experienced IPV because these individuals are at high risk of developing psychiatric conditions like PTSD, dissociation, depression, and anxiety, all of which have been found to be linked to low EC (Hallion et al., 2018;Powers et al., 2015). ...
Intimate partner violence (IPV) is a chronic, traumatic stressor related to posttraumatic stress (PTS), depression, and anxiety. As psychological symptoms are exacerbated in those with poor emotional clarity, the present study evaluates the relationship between emotional clarity and PTS, dissociation, depression, and worry in women who experienced at least one instance of physical IPV (n = 88). Hierarchical regression analyses, controlling for childhood trauma, IPV abuse severity, and IPV-related brain injury, found that lack of emotional clarity was significantly related to greater PTS, dissociative experiences, depression, and worry. Results suggest that emotional clarity may be a relevant therapeutic target for individuals with a history of IPV and psychological distress.
... Fizke et al. found that activating insecure attachment representations could significantly reduce mentalizing capacities, causing an individual to fail to perceive others' emotions (12). Studies on defects in the emotional processing of people with developmental trauma indicate that the severity of the trauma strongly and positively correlates with emotional awareness (the ability to perceive and pay attention to others' emotional experiences), emotional acceptance (the ability to experience negative emotions without invoking secondary negative emotions), emotional transparency (the ability to understand others' emotional experiences) and impulse control (the degree of behavioral control during emotional distress) (13)(14)(15)(16). ...
Objective
Traumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model.
Method
This study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure.
Results
Signs of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms.
Conclusion
In this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.
... Generally, emotion regulation difficulties have been highlighted as important components in overall PTSD symptomatology (Cloitre, 1998;Cloitre et al., 2002;Tull et al., 2007;van der Kolk, 1996); however, there have been very few studies examining PTSD symptom clusters and emotion regulation difficulties, most of which utilized previous Diagnostic and Statistical Manual of Mental Disorders (DSM) criterion rather than the updated DSM-5 criteria (Short et al., 2016). Furthermore, previous research examined this effect in civilian samples, leaving the examination of the relationship between difficulties with emotion regulation and PTSD clusters in the U.S. Military unknown. ...
Treatment and research centered on trauma-related mental health issues have largely focused on posttraumatic stress disorder (PTSD); however, moral injury is another important mental health concern requiring attention. There is a paucity of research examining how PTSD and moral injury affect emotion regulation. The current investigation examined how PTSD clusters and moral injury subtypes were uniquely associated with difficulties with emotion regulation. Participants consisted of 253 previously deployed military personnel who were recruited online. To be included in the study, participants had to verify that they had served in the U.S. Military, had been deployed as part of their military service, and endorsed elevated levels of symptoms associated with PTSD and/or moral injury. A hierarchical linear regression was conducted to examine the association between PTSD symptom clusters, moral injury subtypes, and difficulties with emotion regulation. Results indicated that alterations in arousal and reactivity was the only PTSD symptom cluster associated with difficulties with emotion regulation. Self-transgressions was the only facet of moral injury significantly associated with difficulties with emotion regulation. This is the first study to examine the association between emotion dysregulation, PTSD symptom clusters, and moral injury in previously deployed U.S. Military.
... First, no studies to our knowledge have accounted for PTSD symptom heterogeneity when examining the role of emotion dysregulation in the PTSD-RSDB relationship. Indeed, PTSD symptom clusters have found to differentially associate with clinical outcomes (Contractor et al., 2014(Contractor et al., , 2018 including different RSDBs (e.g., Weiss, Schick, et al., 2019;Weiss, Walsh, et al., 2019) and facets of emotion dysregulation (O'Bryan et al., 2015;Short et al., 2016). Thus, research on the potential role of emotion dysregulation in the relations between nuanced PTSD symptom clusters and posttrauma RSDBs could inform trauma treatment, as emotion dysregulation is likely to cause and/or maintain PTSD symptomatology and may differentially associate with each PTSD symptom cluster (Short et al., 2016). ...
... Indeed, PTSD symptom clusters have found to differentially associate with clinical outcomes (Contractor et al., 2014(Contractor et al., , 2018 including different RSDBs (e.g., Weiss, Schick, et al., 2019;Weiss, Walsh, et al., 2019) and facets of emotion dysregulation (O'Bryan et al., 2015;Short et al., 2016). Thus, research on the potential role of emotion dysregulation in the relations between nuanced PTSD symptom clusters and posttrauma RSDBs could inform trauma treatment, as emotion dysregulation is likely to cause and/or maintain PTSD symptomatology and may differentially associate with each PTSD symptom cluster (Short et al., 2016). Second, most studies that have examined the link between emotion dysregulation and an overall measure of posttrauma RSDBs have been limited to clinical samples characterized by substance use disorder (SUD; Raudales et al., 2020a). ...
... Addressing these limitations, we examined the role of emotion dysregulation in associations between the four heterogeneous PTSD symptom clusters (intrusions, avoidance, NACM, AAR) and an overall measure of posttrauma RSDBs in a trauma-exposed community sample. We hypothesized that all PTSD symptom cluster severities would be significantly and positively associated with emotion dysregulation (Paulus et al., 2019;Short et al., 2016) and posttrauma RSDBs (Semiatin et al., 2017). Further, we expected that emotion dysregulation would be significantly and positively associated with posttrauma RSDBs (Weiss, Schick, et al., 2019). ...
Objectives:
Emotion dysregulation theoretically and empirically explains the link between posttraumatic stress disorder (PTSD) and posttrauma reckless and self-destructive behaviors (RSDBs).
Method:
The current study uniquely examined the role of emotion dysregulation in the association between the four heterogeneous PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]) and an overall measure of posttrauma RSDBs. Trauma-exposed participants (n = 411) completed self-report measures assessing PTSD symptoms (PTSD Checklist for DSM-5), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), and engagement in RSDBs (Posttrauma Risky Behaviors Questionnaire).
Results:
Direct and indirect effects were examined using PROCESS Model 4. The bias-corrected bootstrap revealed a significant indirect effect of emotion dysregulation in posttrauma RSDBs' relation with PTSD's intrusions (B = -.13, SE = .04, 95% CI [-.23, -.06]), avoidance (B =.15, SE =.07, 95% CI [.04, .33]), NACM (B =.17, SE =.05, 95% CI [.09, .27]), and AAR (B =.14, SE =.05, 95% CI [.05, .27]).
Conclusions:
Emotion dysregulation explained associations between the severity of each PTSD symptom cluster and overall posttrauma RSDBs. PTSD treatments targeting emotion dysregulation may help to reduce posttrauma RSDBs for trauma-exposed individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Our findings are consistent with previous studies that found increased PTSD symptom severity to be associated with increased emotion dysregulation (Ehring & Quack, 2010;Tull et al., 2007;Weiss et al., 2012). Previous research has yielded inconsistent results on the associations between PTSD severity and ER domains: Some studies reported positive associations between PTSD severity and all ER domains (Ehring & Quack, 2010;Frewen et al., 2012), whereas others did not find an association between PTSD symptom severity and the ER subscales emotional awareness (Hallion et al., 2018;Short et al., 2016;Tull et al., 2007), goals (Jones et al., 2018), or clarity (Weiss et al., 2012). Importantly, none of these studies examined a Veteran population. ...
Objective:
This study examined trauma frequency, alcohol use, and posttraumatic stress disorder (PTSD) symptoms as predictors of emotion regulation (ER) difficulties among post-9/11 Veterans.
Method:
Seventy-four Veterans (95.5% male; mean age = 40; 45.9% Caucasian) completed questionnaires on demographics, PTSD symptoms, ER, trauma frequency, and drinking.
Results:
Positive correlations were observed between PTSD symptom severity and ER difficulties (r = .6, p < .001) and drinking behavior and emotion dysregulation (r = .25, p < .05). PTSD symptoms above the clinical cutoff resulted in significantly higher ER difficulties than subclinical symptoms, t(66) = -2.975, p < .01). Linear regressions revealed that PTSD accounted for 37% of the variance in ER difficulties, F(1, 66) = 37.34, p < .05. Cluster C was the only significant predictor of Difficulties in Emotion Regulation Scale (DERS) total scores (B = 1.40, p < .05). Regression analyses on DERS subscales were also examined. Both PTSD Checklist-Specific (PCL-S) total and Cluster C significantly predicted the subscales of nonacceptance (PCL-S total, B = .30, p < .001; Cluster C, B = .45, p < .05) and clarity (PCL-S total, B = .12, p < .05; Cluster C, B = .31, p < .05). PCL-S total predicted strategies (PCL-S total, B = .43, p < .01). PCL-S total was the only significant predictor of the DERS subscales of goals (B = .21, p < .001) and impulse (B = .27, p < .001). There were no significant predictors for the subscale of awareness.
Conclusion:
The findings will aid the development of targeted intervention strategies in Veterans. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Viewing emotion regulation as a complex, heterogeneous operation, Gratz and Roemer (2004) suggest six dimensions in which difficulties can occur: impulse control, emotional clarity, goal-directed behavior, emotional awareness, acceptance of emotional responses, and access to emotion regulation strategies. With respect to impulse control, in terms of successful inhibition of inappropriate or impulsive behaviors (Gratz & Roemer, 2004), a relation with arousal can be drawn, as impulsiveness influences the emotional modulation of response inhibition (Benvenuti et al., 2015) and can be seen in diseases like, e.g., posttraumatic stress disorder (PTSD- Short et al., 2016). Emotional clarity, defined as the extent to which an individual is clear about the emotions he or she is currently experiencing (Gratz & Roemer, 2004), was shown to predict arousal discrimination ability (Nielsen, 2004). ...
... Emotional clarity, defined as the extent to which an individual is clear about the emotions he or she is currently experiencing (Gratz & Roemer, 2004), was shown to predict arousal discrimination ability (Nielsen, 2004). Problems with emotional clarity can be found in diseases that involve abnormal physiological arousal like, for example, depression and social anxiety (see e.g., APA, 2013; but also Short et al., 2016;Vine & Aldao, 2014). In this context, alexithymia and its different types are associated with malfunctioning arousal processing like hypo-or hyperreactivity to emotional stimuli and problems in interpreting these physiological reactions (e.g., Larsen et al., 2003). ...
Subjective emotional arousal in typically developing adults was investigated in an explorative study. 177 participants (20–70 years) rated facial expressions and words for self-experienced arousal and perceived intensity, and completed the Difficulties in Emotion Regulation scale and the Hospital Anxiety and Depression scale (HADS-D). Exclusion criteria were psychiatric or neurological diseases, or clinically relevant scores in the HADS-D. Arousal regarding faces and words was significantly predicted by emotional clarity. Separate analyses showed following significant results: arousal regarding faces and arousal regarding words constantly predicted each other; negative faces were predicted by age and intensity; neutral faces by gender and impulse control; positive faces by gender and intensity; negative words by emotional clarity; and neutral words by gender. Males showed higher arousal scores than females regarding neutral faces and neutral words; for the other arousal scores, no explicit group differences were shown. Cluster analysis yielded three distinguished emotional characteristics groups: “emotional difficulties disposition group” (mainly females; highest emotion regulation difficulties, depression and anxiety scores; by trend highest arousal), “low emotional awareness group” (exclusively males; lowest awareness regarding currently experienced emotions; by trend intermediate arousal), and a “low emotional difficulties group” (exclusively females; lowest values throughout). No age effect was shown. Results suggest that arousal elicited by facial expressions and words are specialized parts of a greater emotional processing system and that typically developing adults show some kind of stable, modality-unspecific dispositional baseline of emotional arousal. Emotional awareness and clarity, and impulse control probably are trait aspects of emotion regulation that influence emotional arousal in typically developing adults and can be regarded as aspects of meta-emotion. Different emotional personality styles were shown between as well as within gender groups.
... Problems with emotion regulation also impacts stress symptoms, another target of many AAI programs, with different facets of emotion regulation difficulties impacting PTSD symptom clusters differently. Impulse control difficulties are consistently associated with all symptom clusters, whereas a lack of emotion regulation strategies or emotional clarity is uniquely associated with numbing symptoms (Short, Norr, Mathes, Oglesby, & Schmidt, 2016). Emotion regulation strategies have also been differentially linked to PTG and distress, with emotion suppression predicting distress but not PTG, and meaning making positively predicting PTG and negatively predicting distress (Larsen & Berenbaum, 2015). ...
Dolphins have been explicitly linked to psychological healing in children and interactions with marine life have led to greater conservation knowledge and attitudes. The link between dolphins, psychological healing, and education have led to the development of many recreational swim-with-dolphin programs and therapeutic Dolphin Assisted Therapy programs (DAT). Despite the increased number of programs, studies investigating the psychological and educational impact on children are limited. In a series of three studies, this dissertation examined the psychological and educational impacts of children interacting with dolphins in various settings. Study 1 compared swimming with wild dolphins to whale watching and found that dolphins evoked a greater sense of awe, corresponding to increased perceptions of support compared to whales. Study 2 focused on DAT with wild dolphins and found decreases in heart rate, stress, and anxiety across the length of the program, along with increases in comfort and positive affect. Study 3 investigated how recreational interactions with captive dolphins influenced both psychological and educational variables. Study 3 found improvements in emotion regulation skills, knowledge of dolphin welfare and heart rate, but no impact on conservation behaviors or environmental attitudes. Together, the three studies elucidate the differing psychological and educational impacts of diverging dolphin interaction programs on children, indicating that multiple types of dolphin interactions may provide a sense of support and a feeling of calm, as well as imparting knowledge about dolphins.
... O 'Toole, Jensen, Fentz, Zachariae, & Hougaard, 2014;Rusch, Westermann, & Lincoln, 2012;Salovey et al., 2002;Thompson, Boden, & Gotlib, 2017), panic attacks (e.g. De Berardis et al., 2007;, and posttraumatic stress symptoms among trauma-exposed individuals (Doolan, Bryant, Liddell, & Nickerson, 2017;Ehring & Quack, 2010;Short, Norr, Mathes, Oglesby, & Schmidt, 2016;Tull, Barrett, McMillan, & Roemer, 2007). 1 Notwithstanding the well-documented finding that emotional clarity is linearly and inversely associated with a variety of internalising problems, some researchers have recently speculated that very high emotional clarity could also be problematic. Gross and Jazaieri (2014) suggested nonlinear associations between constructs related to emotional experiences (e.g. ...
Low emotional clarity has been a target for psychological interventions due to its association with increased internalising symptoms. However, theory suggests that very high emotional clarity may also lead to increased symptoms, particularly in combination with high levels of neuroticism. As an initial empirical test of this hypothesis, the present study examined curvilinear associations of emotional clarity with internalising symptoms (i.e. dysphoria, social anxiety, panic, traumatic intrusions) and a moderating role of neuroticism/negative affect in the association across two student samples and two clinical samples (total N = 920). Evidence of curvilinear associations and moderation varied across samples, with some supporting evidence in three samples. Specifically, neuroticism/negative affect moderated the curvilinear association of emotional clarity with traumatic intrusions in Clinical Sample 2 as well as the linear association between emotional clarity and dysphoria in Student Sample 2 and Clinical Sample 1. Simple slope analyses indicated that high emotional clarity was not consistently associated with lower symptoms. Also, the hypothesised quadratic effects of emotional clarity were found in Student Sample 2 and Clinical Sample 1 for panic, and in Clinical Sample 1 for dysphoria. Implications and limitations of these findings for conceptualisations of emotional clarity and current treatments were discussed.
