Kim L. Gratz

Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale

Given recent attention to emotion regulation as a potentially unifying function of diverse symptom presentations, there is a need for comprehensive measures that adequately assess difficulties in emotion regulation among adults. This paper (a) proposes an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state; and (b) begins to explore the factor structure and psychometric properties of a new measure, the Difficulties in Emotion Regulation Scale (DERS). Two samples of undergraduate students completed questionnaire packets. Preliminary findings suggest that the DERS has high internal consistency, good test–retest reliability, and adequate construct and predictive validity.

Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory

Deliberate self-harm has recently begun to receive more systematic attention from clinical researchers. However, there remains a general lack of consensus as to how to define and measure this important clinical construct. There is still no standardized, empirically validated measure of deliberate self-harm, making it more difficult for research in this area to advance. The present paper provides an integrative, conceptual definition of deliberate self-harm as well as preliminary psychometric data on a newly developed measure of self-harm, the Deliberate Self-Harm Inventory (DSHI). One hundred and fifty participants from undergraduate psychology courses completed research packets consisting of the DSHI and other measures, and 93 of these participants completed the DSHI again after an interval of 2–4 weeks (M = 3.3 weeks). Preliminary findings indicate that the DSHI has high internal consistency; adequate construct, convergent, and discriminant validity; and adequate test-retest reliability.

Risk Factors for Deliberate Self‐Harm Among College Students

This self-report study examined the risk factors for deliberate self-harm among college students. Results indicated that insecure attachment, childhood separation, emotional neglect, sexual abuse, and dissociation were significant predictors of self-harm. Substantial gender differences in the risk factors for self-harm behavior were also revealed. Suggestions for future research are provided.

An experimental investigation of emotion dysregulation in borderline personality disorder.

Despite the prominent role of emotion dysregulation in theoretical accounts of borderline personality disorder (BPD), few studies have examined emotion dysregulation in BPD. This study extends extant research by providing an experimental investigation of emotion dysregulation among outpatients with BPD. Specifically, this study modified an experimental measure of distress tolerance to examine differences between outpatients with BPD (n = 17) and those without a personality disorder (n = 18) in 2 aspects of emotion dysregulation: (a) the unwillingness to experience emotional distress in order to pursue goal-directed behavior and (b) the inability to engage in goal-directed behavior when distressed. As hypothesized, BPD participants were less willing to experience distress in order to pursue goal-directed behavior. However, BPD participants did not evidence greater difficulties engaging in goal-directed behavior when distressed. Results highlight directions for future research and suggest that particular aspects of emotion dysregulation may be more or less relevant to BPD.

Risk Factors for Deliberate Self-Harm Among Female College Students: The Role and Interaction of Childhood Maltreatment, Emotional Inexpressivity, and Affect Intensity/Reactivity

Despite the clinical importance of deliberate self-harm, research on the risk factors for self-harm among nonclinical populations has been limited. This study examined the role of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity in the self-harm behavior of 249 female college students. Childhood maltreatment and low positive affect intensity/reactivity reliably distinguished women with frequent self-harm from women with no history of self-harm, as did the combination of greater maltreatment, greater inexpressivity, and higher levels of affect intensity/reactivity (global and negative). Among women with a history of self-harm, emotional inexpressivity was associated with more frequent self-harm, as was the combination of greater maltreatment, greater inexpressivity, and lower levels of positive affect intensity/reactivity.

The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety, and somatization.

This study examined the relationships between experiential avoidance in general (and thought suppression in particular), posttraumatic stress symptom severity, and symptoms of depression, anxiety, and somatization among a sample of individuals exposed to multiple potentially traumatic events. Although experiential avoidance was not associated with severity of posttraumatic stress symptoms beyond their shared relationship with general psychiatric symptom severity, it was associated with symptoms of depression, anxiety, and somatization when controlling for posttraumatic stress symptom severity. Thought suppression, on the other hand, was associated with severity of posttraumatic stress symptoms when controlling for their shared relationship with general psychiatric symptom severity. No significant relationships were found between thought suppression and the presence of depression, anxiety, and somatization symptoms when controlling for posttraumatic stress symptom severity. Results suggest the importance of separately examining the influence of different forms of experiential avoidance on posttraumatic psychopathology.

The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university.

Despite the theoretical emphasis on the role of emotion dysregulation in deliberate self‐harm (DSH), few studies have examined this relationship. The present study sought to examine the role of emotion dysregulation in DSH by extending the findings of Gratz (2006) regarding the environmental (i.e. childhood maltreatment) and individual (i.e. emotional inexpressivity and affect intensity/reactivity) factors associated with DSH among 249 female undergraduates. Specifically, the present study examined whether emotion dysregulation (a) is associated with DSH above and beyond these other risk factors and (b) mediates the relationship between these risk factors and DSH. Findings indicate that overall emotion dysregulation distinguished women with frequent DSH from those without a history of DSH, adding reliably to the prediction of DSH status above and beyond maltreatment, inexpressivity, and affect intensity/reactivity. Moreover, among self‐harming women, emotion dysregulation accounted for a significant amount of additional variance in DSH frequency and mediated the relationship between emotional inexpressivity and DSH frequency. Results also suggest the particular relevance of two specific dimensions of emotion dysregulation to DSH: limited access to effective emotion regulation strategies and a lack of emotional clarity, each of which reliably improved the prediction of DSH status and accounted for unique variance in DSH frequency among self‐harming women above and beyond the other risk factors in the models. Results suggest the potential utility of teaching self‐harming women more adaptive ways of responding to their emotions, including nonavoidant strategies for modulating emotional arousal and the ability to identify, label, and differentiate among emotional states.

Borderline personality disorder and emotional responding: a review of the research literature

Although problems with emotional functioning are considered central to borderline personality disorder (BPD), it is only recently that studies have begun utilizing laboratory biobehavioral measures (including neuroimaging and psychophysiological measures) to examine emotional responding in BPD. The application of basic science methodologies used in a systematic program of research to investigate clinically relevant phenomena, often called translational research, holds much promise in advancing the assessment and treatment of BPD. In this paper, we begin with an overview of the research on self-reported emotional responding in BPD. Next, we outline the advantages that translational research has over traditional self-report methodology in furthering an understanding of emotional responding in BPD, and review the extant laboratory studies of emotional responding in BPD. Finally, problems commonly encountered when conducting translational research on emotion in BPD are outlined, and solutions to these problems are offered.

Multidimensional Assessment of Emotion Regulation Difficulties in Adolescents Using the Difficulties in Emotion Regulation Scale.

The authors explored the utility of the Difficulties in Emotion Regulation Scale (DERS) in assessing adolescents’ emotion regulation. Adolescents (11-17 years; N = 870) completed the DERS and measures of externalizing and internalizing problems. Confirmatory factor analysis suggested a similar factor structure in the adolescent sample of the authors as demonstrated previously among adults. Furthermore, results indicated no gender bias in ratings of DERS factors on three scales (as evidenced by strong factorial gender invariance) and limited gender bias on the other three scales (as evidenced by metric invariance). Female adolescents scored higher on four of six DERS factors than male adolescents. DERS factors were meaningfully related to adolescents’ externalizing and internalizing problems. Results suggest that scores on the DERS show promising internal consistency and validity in a community sample of adolescents.

The Role of Emotional Responding and Childhood Maltreatment in the Development and Maintenance of Deliberate Self-harm Among Male Undergraduates

Despite recent findings indicating comparable rates of deliberate self-harm across gender (Gratz, Conrad, & Roemer, 2002; Klonsky, Oltmanns, & Turkheimer, 2003; Muehlenkamp & Gutierrez, 2004; Zoroglu et al., 2003), little research has examined the pathogenesis of self-harm among men. Thus, the prese