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Emotion Dysregulation and Negative Affect: Association With Psychiatric Symptoms [CME]

J Clin Psychiatry 2011;72(5):685-691
10.4088/JCP.10m06409blu

Objective: A growing body of research focuses on the development and correlates of emotion dysregulation, or deficits in the ability to regulate intense and shifting emotional states. Current models of psychopathology have incorporated the construct of emotion dysregulation, suggesting its unique and interactive contributions, along with childhood disruptive experiences and negative affect, in producing symptomatic distress. Some researchers have suggested that emotion dysregulation is simply a variant of high negative affect. The aim of this study was to assess the construct and incremental validity of self-reported emotion dysregulation over and above childhood trauma and negative affect in predicting a range of psychopathology.

Method: Five hundred thirty individuals aged 18 to 77 years (62% female) were recruited from the waiting areas of the general medical and obstetric/gynecologic clinics in an urban public hospital in Atlanta, Georgia. Participants completed a battery of self-report measures obtained by interview, including the Childhood Trauma Questionnaire, the Positive and Negative Affect Schedule, and the Emotion Dysregulation Scale. Regression analyses examined the unique and incremental associations of these self-report measurements of childhood traumatic experiences, negative affect, and emotion dysregulation with concurrent structured interview–based measurements of psychiatric distress and history of self-destructive behaviors. These measures included the Clinician-Administered PTSD Scale, the Alcohol Use Disorders Identification Test, the Short Drug Abuse Screening Test, the Beck Depression Inventory, and the Global Adaptive Functioning Scale from the Longitudinal Interval Follow-Up Evaluation. The presented data were collected between 2005 and 2009.

Results: Regression models including age, gender, childhood trauma, negative affect, and emotion dysregulation were significantly (P .001) associated with each of the study’s criterion variables, accounting for large portions of the variance in posttraumatic stress symptoms (R2 = 0.21), alcohol and drug abuse (R2 = 0.28 and 0.21, respectively), depression (R2 = 0.55), adaptive functioning (R2 = 0.14), and suicide history (omnibus χ2 = 74.80, P < .001). Emotion dysregulation added statistically significant (P < .01) incremental validity to each regression model (β = 0.25, 0.34, 0.35, 0.34, and –0.18, and Wald = 24.43, respectively).

Conclusions: Results support the conceptualization of emotion dysregulation as a distinct and clinically meaningful construct associated with psychiatric distress that is not reducible to negative affect. Emotion dysregulation is a key component in a range of psychiatric symptoms and disorders and a core target for psychopharmacologic and psychosocial treatment interventions.

J Clin Psychiatry 2011;72(5):685–691

Submitted: July 12, 2010; accepted August 20, 2010 (doi:10.4088/JCP.10m06409blu).

Corresponding author: Jared A. DeFife, PhD, Laboratory of Personality and Psychopathology, Department of Psychology, Emory University, 36 Eagle Row, Ste 415, Atlanta, GA 30322 (jdefife@emory.edu).