Lizabeth Roemer

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.

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.

Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial

Generalized anxiety disorder (GAD) is a chronic anxiety disorder, associated with comorbidity and impairment in quality of life, for which improved psychosocial treatments are needed. GAD is also associated with reactivity to and avoidance of internal experiences. The current study examined the efficacy of an acceptance-based behavioral therapy aimed at increasing acceptance of internal experiences and encouraging action in valued domains for GAD. Clients were randomly assigned to immediate (n = 15) or delayed (n = 16) treatment. Acceptance-based behavior therapy led to statistically significant reductions in clinician-rated and self-reported GAD symptoms that were maintained at 3- and 9-month follow-up assessments; significant reductions in depressive symptoms were also observed. At posttreatment assessment 78% of treated participants no longer met criteria for GAD and 77% achieved high end-state functioning; these proportions stayed constant or increased over time. As predicted, treatment was associated with decreases in experiential avoidance and increases in mindfulness.

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.

Fear and Avoidance of Internal Experiences in GAD: Preliminary Tests of a Conceptual Model

The tendency to fear and avoid internal experiences may be an important characteristic of individuals with generalized anxiety disorder (GAD). We review here theory and research suggesting that individuals with GAD may be experientially avoidant, and present preliminary evidence to support this model. Findings from both a non-clinical and clinical sample suggest that worry and generalized anxiety disorder may be associated with a tendency to try to avoid or control (versus accept) internal experiences, as well as a tendency to fear losing control over one’s own emotional responses (particularly anxiety). The clinical implications of these findings, along with directions for future research, are discussed.

A preliminary investigation of the effects of experimentally induced mindfulness on emotional responding to film clips.

Despite encouraging preliminary findings regarding the efficacy of mindfulness and acceptance-based treatments for a range of psychological presentations, we have yet to elucidate mechanisms of action within these treatments. One mechanism through which mindfulness may reduce psychological symptoms and promote functioning is enhancing emotional responding and regulation. In this study, we used multimodal assessment to examine the effects of a brief mindfulness intervention in a laboratory setting on emotional experiences and regulation in response to distressing, positive, and affectively mixed film clips. Although there were no condition (mindfulness vs. control) effects on reports of emotional response or difficulties in regulation after the distressing film clip, participants in the mindfulness condition reported significantly greater positive affect in response to the positive film. Additionally, participants in the mindfulness condition reported more adaptive regulation (approaching significance, medium to large effect size) in response to the affectively mixed clip and significantly less negative affect immediately after this clip, although not after a recovery period. No significant differences emerged between conditions on physiological measures (skin conductance and heart rate) throughout the study.

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.

Increases in retrospective accounts of war-zone exposure over time: the role of PTSD symptom severity.

Retrospective reports of the frequency of war-zone exposure are commonly used as objective indices in studies investigating the mental health consequences of exposure to such stressors. To explore the temporal stability of these types of reports, we obtained frequency estimates of exposure to war-zone stressors at two time points from 460 U.S. soldiers who had served in the peace-keeping mission in Somalia. On average, soldiers demonstrated a significant increase in their frequency reports from initial (postdeployment) to subsequent (follow-up) assessment. Severity of posttraumatic symptomatology was uniquely associated with this change, indicating a possible systematic bias in which severity of symptoms leads to increased reports of stressor frequency. The implications of these findings for research in the field of traumatic stress are discussed.

Emotion regulation in unipolar depression: The effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect

This study examined the effects of emotional suppression and acceptance in a depressed sample. Sixty participants with diagnoses of unipolar depression completed a questionnaire packet and participated in an experiment. The experiment utilized two conditions to explore correlates of the spontaneous use of emotion regulation strategies and the effects of an experimental manipulation of acceptance and suppression. Results demonstrated that suppression produced short-term reductions in sadness. Notably, anxiety about the experience of depressed mood influenced the efficacy of emotional suppression with findings showing that suppression was no longer effective at moderate and higher levels of anxiety about the experience of depressed mood. Implications of study findings for understanding emotion dysregulation in depressive disorders and the treatment of depression are discussed.