Carlo Garofalo

Understanding the connection between self-esteem and aggression: The mediating role of emotion dysregulation.

The purpose of the present study was to extend previous knowledge concerning the link between self-esteem and aggression by examining the mediating role of emotion dysregulation among offenders and community participants. A sample of 153 incarcerated violent offenders and a community sample of 197 individuals completed self-report measures of self-esteem level, emotion dysregulation, and trait aggression. Offenders reported lower levels of self-esteem than community participants, as well as greater levels of emotional nonacceptance and hostility. Bootstrapping analyses were performed to test whether emotion dysregulation mediated the association between self-esteem level and aggression. In the offender sample, mediation models were significant for three of the four aspects of trait aggression that were considered. Emotion dysregulation fully mediated the links that low self-esteem had with physical aggression, anger, and hostility. The same pattern (with the addition of full mediation for verbal aggression) was confirmed in the community sample. Our findings suggest that emotion dysregulation may play an important role in the connection between low self-esteem and aggression. Alternative models of the associations among these variables were tested and discussed. As a whole, the present results are consistent with those of other studies and suggest that it may be beneficial to include emotion regulation modules as part of prevention and treatment programs for violent offenders.

Alexithymia, emotion dysregulation, impulsivity and aggression: a multiple mediation model

There is a need to better understand the antecedent of aggressive behaviors in order to tailor treatments and reduce the associated damage to the others and the self. Possible mechanisms underlying aggression are poor emotional awareness and emotion dysregulation, as well as impulsivity. Here, we examined the relationships among alexithymia, emotion dysregulation, impulsivity and aggression, comparing a mixed psychiatric sample (N=257) and a community sample (N=617). The clinical sample reported greater levels of alexithymia, emotion dysregulation, trait impulsivity and aggression, than the community sample. Furthermore, in the community sample, emotion dysregulation and impulsivity mediated the relationship (i.e., accounted for the shared variance) between alexithymia and aggression. In the clinical sample, only emotion dysregulation explained the alexithymia-aggression link. In particular, specific dimensions of the emotion dysregulation (i.e., Negative Urgency) and impulsivity constructs (i.e., cognitive and motor impulsivity) played a unique role in explaining these associations. Finally, controlling for depressive symptoms reduced some of the findings involving impulsivity to nonsignificant results. Overall, our findings add to the extant literature attesting to the relevance of alexithymia and emotion dysregulation for understanding aggression, and providing concrete recommendation for the treatment and prevention of aggressive tendencies.

Mindfulness moderates the relationship between aggression and Antisocial Personality Disorder traits: Preliminary investigation with an offender sample

INTRODUCTIONnPoor mentalizing has been described as a characteristic of Antisocial Personality Disorder (ASPD), along with the well-established role of aggressiveness. In the current study, we tested this hypothesis focusing on a specific aspect of mentalization (i.e., mindfulness).nnnMETHODnWe explored the unique and joint contribution of aggression dimensions and mindfulness facets to ASPD traits in an offender sample (N=83).nnnRESULTSnMindfulness deficits were associated with ASPD traits, and a significant unique association emerged between difficulties in acting with awareness and ASPD traits. Likewise, physical aggression confirmed its association with ASPD traits. Moderation analyses revealed that mindfulness interacted with aggression in predicting ASPD. Specifically, at low levels of mindfulness, the association between aggression and ASPD dropped to nonsignificance.nnnCONCLUSIONSnResults suggest that fostering self-mentalizing is a relevant treatment target when treating offenders with ASPD.

Alcohol misuse in psychiatric patients and nonclinical individuals: The role of emotion dysregulation and impulsivity

Abstract Notwithstanding the relevance of both emotion dysregulation and impulsivity to alcohol misuse, there is a dearth of study addressing their reciprocal interaction. The first aim of this study was to confirm the role played by difficulties in emotion regulation and trait impulsivity in explaining maladaptive alcohol use, comparing a mixed psychiatric sample (Nu2009=u2009130; 64.4% males; mean ageu2009=u200943.30 years, SDu2009=u200911.83) with community-dwelling individuals (Nu2009=u2009307; 54.3% males; mean ageu2009=u200936.01 years, SDu2009=u200911.88). Results corroborate this hypothesis, with emotion dysregulation and impulsiveness showing their significant association with alcohol misuse, and with levels of all these three components being significantly higher in the clinical sample. This study also extended extant research by explicating the hypothesised indirect effect of emotion dysregulation on alcohol misuse, through the effect of trait impulsivity. Results are also consistent with this latter hypothesis, with trait impulsivity accounting for the association between emotion dysregulation and alcohol misuse, albeit partially. As a whole, findings of this study highlight the potential utility of prevention and intervention efforts targeting emotion dysregulation and impulsivity in reducing alcohol misuse.

Emotion dysregulation and hypersexuality: Review and clinical implications

ABSTRACT There is a long and varied history of research on hypersexuality, but no consensus on either etiology or therapeutic interventions. In an effort to advance understanding of hypersexuality, we review the largely separate literatures on hypersexuality and emotion dysregulation, which has recently been suggested to be a critical factor in the development and maintenance of mental health problems. Unfortunately, there is also a lack of consensus on the various primary and intervening factors involved in development of emotion regulation or emotion dysregulation. First, we review theories and empirical evidence to try to explain how emotion dysregulation could contribute to the onset of hypersexuality or other inappropriate sexual behavior. Next, an attachment-theory perspective is used to develop a common etiological model for both emotion dysregulation and hypersexuality. Finally, we address the issue of hypersexual behavior in the context of couple relationships, taking an interpersonal perspective on emotion and emotion regulation. We refer to different age categories, ranging from adolescence to elderly, as emotion regulation skills are likely to change throughout the lifespan.

Emotion Regulation and Aggression: The Incremental Contribution of Alexithymia, Impulsivity, and Emotion Dysregulation Facets

Objective: Prior research has long emphasized the role of alexithymia and impulsivity to explain aggressive tendencies. Recently, a growing body of research seems to support the relevance of the broader construct of emotion dysregulation to understand aggression. The present study was the first to comprehensively examine the relative contribution of, and the mechanisms linking alexithymia, impulsivity, and emotion dysregulation in predicting aggression dimensions. Method: Male violent offenders (N = 221) and community participants (N = 245) completed multifaceted self-report measures of alexithymia, impulsivity, emotion dysregulation, and aggression. Regression analyses tested the independent contribution of each facet on aggression dimensions. Bootstrap analyses examined the indirect effect of alexithymia on aggression through emotion dysregulation and impulsivity. Results: Offenders reported higher levels of difficulties identifying feelings, emotional nonacceptance, physical aggression, and hostility. Difficulties in identifying and describing feelings, and motor and attentional impulsivity, explained unique variance in physical aggression, anger, and hostility in both samples, and also in verbal aggression among community participants. In both samples, negative urgency and emotional nonacceptance explained additional variance in aggression dimensions above and beyond the influence of alexithymia and impulsivity. Emotion dysregulation and impulsivity mediated the relation between alexithymia and aggression in both samples, with emotion dysregulation demonstrating a relatively stronger effect. Conclusions: Findings emphasize the unique relevance of alexithymia, impulsivity, and emotion dysregulation facets in explaining aggressive tendencies. Clinical implications include the importance of focusing on emotion regulation skills—such as accepting emotions and do not act on them—to reduce aggression tendencies.

Exploring Anger Among Offenders: The Role of Emotion Dysregulation and Alexithymia

This study tests whether specific dimensions of emotion dysregulation predict maladaptive anger expression among offenders from Italy and Australia. In particular, it examines the unique associations among emotion dysregulation dimensions and different aspects of anger expression and control, in both inmates and offenders on parole. Multiple regression analyses reveal that difficulties controlling impulsive behaviour when distressed are related to state anger, trait anger, and chronic anger expression. On the other hand, alexithymia predicts the maladaptive expression of anger inwardly directed. Finally, lack of emotional awareness and limited access to emotion regulation (ER) strategies are negatively related to anger control, suggesting that they may represent useful treatment targets. Interestingly, incarcerated offenders reported significantly higher levels of state anger and lower levels of anger control out (i.e. seeking support from others) than offenders living on parole in the community, highlighting the importance of contextual influences in the emotional life of offenders.

Dissociative Experiences and Psychopathology Among Inmates in Italian and Portuguese Prisons

The association between dissociation and psychopathological symptoms is well established, yet studies with inmates are lacking. If higher rates of dissociation and psychiatric symptoms are reported in inmate samples, it is not clear whether they represent two separate, albeit related, characteristics. We examined the association between dissociation and psychopathological symptoms among 320 Italian subjects (122 inmates and 198 community participants) and a Portuguese inmate sample (n = 67). Then, we tested whether dissociation and psychopathology levels were higher among inmates. Both hypotheses were supported, confirming the relevance of dissociative, paranoid, and psychotic symptoms among inmates, as well as their interrelations. Notably, the group difference in dissociation remained significant after partialing out the variance associated with other psychopathological symptoms. Conversely, only the difference in paranoid symptoms remained—marginally—significant when controlling for the influence of dissociation. This finding suggests that dissociation may have unique relevance for the psychological functioning of inmates.

Gender moderates the relationship between attachment insecurities and emotion dysregulation

The relation between attachment styles and emotion regulation is well documented, and emotion dysregulation is considered characteristic of individuals with insecure attachment styles. Although gender differences in emotion regulation have often been reported, it is not clear whether the association between attachment styles and aspects of emotion dysregulation may vary across gender. A sample of 229 newlywed couples completed the Experiences in Close Relationship–Revised scale and the Difficulties in Emotion Regulation Scale. First, we confirmed previous evidence on the association between attachment insecurities and emotion dysregulation. Indeed, attachment anxiety and avoidance were both related to emotional nonacceptance and lack of emotional clarity. Moreover, attachment anxiety was associated with difficulties in impulse control and limited access to effective emotion regulation strategies, whereas attachment avoidance was uniquely related to lack of emotional awareness. Finally, gender was found to moderate the association that both attachment anxiety and attachment avoidance had with difficulties in pursuing desired goals when experiencing negative emotions. Specifically, among women (but not men), attachment anxiety was associated with greater difficulties in engaging in goal-directed behavior when distressed. Conversely, the association between attachment avoidance and difficulties in pursuing desired goals when distressed was positive for men and negative for women.

Unique Associations Among Emotion Dysregulation Dimensions and Aggressive Tendencies: A Multisite Study

Although problems with emotion regulation (ER) have long been associated with internalizing symptoms, only recently has an ER framework been applied to the study of aggression. Therefore, little is known about the unique and independent associations between specific domains of the ER construct and different kinds of aggressive tendencies. We sought to explore these associations in two independent samples of young adults. Furthermore, we tested whether gender moderated the proposed emotion dysregulation–aggression link. Our results corroborated the association between emotion dysregulation and aggression in both samples. Specifically, the inability to control impulsive behavior when upset (i.e., negative urgency) was uniquely related to physical aggression, verbal aggression, anger, and hostility. Limited access to ER strategies was also significantly associated with overall aggression and hostility. The effect of negative urgency on physical and verbal aggression was stronger among males than females, although only in one sample.