Matthew T. Tull

Evidence of Broad Deficits in Emotion Regulation Associated with Chronic Worry and Generalized Anxiety Disorder

This study examined the relationship between emotion regulation deficits and GAD-related outcomes in an analogue sample. Consistent with hypotheses, general emotion dysregulation was associated with reports of chronic worry and with analogue GAD status. Also, specific regulation deficits, including deficits in emotional clarity, acceptance of emotions, ability to engage in goal directed behaviors when distressed, impulse control, and access to effective regulation strategies, were associated with worry and analogue GAD above and beyond variance contributed by negative affectivity. These findings provide additional preliminary evidence for an emotion regulation deficit model of GAD and are discussed in terms of clinical implications and directions for future research.

Factors Associated with Co-Occurring Borderline Personality Disorder Among Inner-City Substance Users: the Roles of Childhood Maltreatment, Negative Affect Intensity/Reactivity, and Emotion Dysregulation

The co-occurrence of borderline personality disorder (BPD) among individuals with substance use disorders is a common and clinically relevant phenomenon in need of further empirical investigation. The present study adds to the extant literature on the factors associated with co-occurring BPD among substance users, examining the relationships between childhood maltreatment (in the form of sexual, physical, and emotional abuse and emotional and physical neglect), negative affect intensity/reactivity, emotion dysregulation, and BPD pathology (both diagnostic status and symptom count) among a sample of 76 inner-city treatment-seeking substance users. Emotion dysregulation was expected to mediate the relationships between childhood maltreatment and negative affect intensity/reactivity (and their interaction) and BPD pathology. Results indicate that the presence of a BPD diagnosis was associated with higher levels of both childhood maltreatment and negative affect intensity/reactivity. However, only childhood maltreatment emerged as a unique predictor of BPD diagnostic status. Conversely, both childhood maltreatment and negative affect intensity/reactivity accounted for unique variance in the number of endorsed BPD symptoms. Moreover, emotion dysregulation fully mediated the relationships between maltreatment and negative affect intensity/reactivity and BPD symptom count, as well as the relationship between emotional abuse in particular and BPD diagnostic status. Contrary to hypotheses, results provided no support for the interaction between maltreatment and negative affect intensity/reactivity in the prediction of BPD pathology (diagnosis or symptom count), above and beyond the main effects of these factors.

Exploring the relationship between childhood maltreatment and intimate partner abuse: gender differences in the mediating role of emotion dysregulation

Despite evidence that childhood maltreatment is associated with increased risk for intimate partner abuse perpetration, the mechanisms underlying this relationship remain unclear. Given literature suggesting that violent behaviors may serve an emotion regulating function, this study examined the mediating role of emotion dysregulation in the relationship between childhood maltreatment and intimate partner abuse perpetration among 341 male and female undergraduates. However, given evidence of gender differences in the underlying mechanisms of intimate partner abuse, emotion dysregulation was expected to be more relevant to the perpetration of partner abuse among men. Consistent with hypotheses, emotion dysregulation mediated the relationship between childhood maltreatment and intimate partner abuse among men; conversely, emotion dysregulation was not associated with partner abuse among women.

The role of emotional inexpressivity and experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and aggressive behavior among men exposed to interpersonal violence

Abstract Posttraumatic stress disorder (PTSD) has been found to be associated with aggressive behavior. Recent evidence suggests that the ways in which individuals respond to their emotions may account for this relationship. In particular, to the extent that aggressive behaviors serve an emotion regulatory function, responding to emotions with avoidance (i.e., experiential avoidance) or the active suppression of emotional expression may heighten emotion dysregulation, increasing the risk for aggressive behavior as individuals attempt to regulate that dysregulated state. This study examined whether these two ways of responding to emotions account for the relationship between PTSD symptom severity and self-reported engagement in aggressive behavior among a diverse sample of 113 men with past exposure to interpersonal violence. Experiential avoidance and emotional inexpressivity each accounted for a significant amount of unique variance in aggressive behavior, above and beyond PTSD symptom severity and trait anger. Clinical and research implications of findings are discussed.

Alternative Explanations of Emotional Numbing of Posttraumatic Stress Disorder: An Examination of Hyperarousal and Experiential Avoidance

The mechanisms that underlie the emotional numbing symptoms associated with PTSD are not well understood. Studies of Vietnam combat veterans have demonstrated that hyperarousal symptoms predict emotional numbing symptoms more strongly than do other symptoms of PTSD. This study sought to extend these findings through the self-report of 170 female sexual assault survivors. The study also examined whether the relationship between hyperarousal and emotional numbing symptoms was the result of the relationship of each of these to another variable, the tendency to engage in experiential avoidance. Results were consistent with and extended previous findings. Hyperarousal symptoms were also found to predict emotional numbing symptoms above and beyond experiential avoidance, as well as all other symptoms of PTSD.

Anxiety sensitivity: A unique predictor of dropout among inner-city heroin and crack/cocaine users in residential substance use treatment

The present study examined the extent to which anxiety sensitivity (AS) at treatment entry was related to prospective treatment dropout among 182 crack/cocaine and/or heroin-dependent patients in a substance use residential treatment facility in Northeast Washington, DC. Results indicated that AS incrementally and prospectively predicted treatment dropout after controlling for the variance accounted for by demographics and other drug use variables, legal obligation to treatment (i.e., court-ordered vs. self-referred), alcohol use frequency, and depressive symptoms. Findings are discussed in relation to the role of AS in treatment dropout and substance use problems more generally.

Effects of trauma exposure on anger, aggression, and violence in a nonclinical sample of men.

This study assessed the impact of traumatic exposure and posttraumatic stress disorder (PTSD) symptoms on anger, aggression, and violence among civilian male college students. Results suggest that civilian men who have been exposed to a potentially traumatic event (PTE) and report symptoms of PTSD indicate more trait anger, more internal anger and hostility, and more aggression and violence than men who do not report symptoms of PTSD. Results are contrasted to those found in clinical samples of male veterans with PTSD and discussed in terms of understanding and treating anger and aggression in nonclinical, trauma-exposed populations.

The Role of Negative Affect Intensity and the Fear of Emotions in Posttraumatic Stress Symptom Severity Among Victims of Childhood Interpersonal Violence

Heightened negative affect (NA) intensity and the tendency to negatively evaluate emotions may be associated with the development and maintenance of posttraumatic stress symptoms. However, the specific role of these vulnerabilities has yet to be explored. Thus, this study was conducted to examine the influence of NA intensity and the fear of emotions in posttraumatic symptom severity among 102 childhood interpersonal violence victims. Fear of emotions significantly predicted posttraumatic symptom severity above and beyond NA intensity and NA. Findings suggest that posttraumatic outcomes may not be influenced by an underlying vulnerability of heightened NA intensity, but instead, are affected by the extent to which emotional responses are negatively evaluated. Results are discussed in terms of their implications for interventions and future research on posttraumatic responding.

Extending Extant Models of the Pathogenesis of Borderline Personality Disorder to Childhood Borderline Personality Symptoms: The Roles of Affective Dysfunction, Disinhibition, and Self-and Emotion-Regulation Deficits

Although research has been conducted on the course, consequences, and correlates of borderline personality disorder (BPD), little is known about its emergence in childhood, and no studies have examined the extent to which theoretical models of the pathogenesis of BPD in adults are applicable to the correlates of borderline personality symptoms in children. The goal of this study was to examine the interrelationships between two BPD-relevant personality traits (affective dysfunction and disinhibition), self- and emotion-regulation deficits, and childhood borderline personality symptoms among 263 children aged 9 to 13. We predicted that affective dysfunction, disinhibition, and their interaction would be associated with childhood borderline personality symptoms, and that self- and emotion-regulation deficits would mediate these relationships. Results provided support for the roles of both affective dysfunction and disinhibition (in the form of sensation seeking) in childhood borderline personality symptoms, as well as their hypothesized interaction. Further, both self- and emotion-regulation deficits partially mediated the relationship between affective dysfunction and childhood borderline personality symptoms. Finally, results provided evidence of different gender-based pathways to childhood borderline personality symptoms, suggesting that models of BPD among adults are more relevant to understanding the factors associated with borderline personality symptoms among girls than boys.

Extending an Anxiety Sensitivity Model of Uncued Panic Attack Frequency and Symptom Severity: The Role of Emotion Dysregulation

Models of panic disorder are primarily cognitive in nature, and the role of emotion regulation has not been extensively examined. This study investigates the extent to which emotion dysregulation predicts uncued panic attack frequency and symptom severity above and beyond anxiety sensitivity (AS). Participants were 77 undergraduate students reporting a recent history of uncued panic attacks. Emotion dysregulation was not found to significantly predict past year panic attack frequency above and beyond AS dimensions (fear of respiratory symptoms, publicly observable anxiety reactions, cardiovascular symptoms, and cognitive dyscontrol). Fear of respiratory symptoms emerged as the only significant predictor of panic attack frequency. However, emotion dysregulation did significantly predict panic symptom severity above and beyond AS dimensions. Results offer preliminary evidence of the differential influence of emotion dysregulation and AS on panic-related variables and suggest the need to examine emotion dysregulation as it pertains to the development and maintenance of panic-related psychopathology.