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Bekh Bradley - One of the best experts on this subject based on the ideXlab platform.
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developmental timing of trauma exposure and Emotion Dysregulation in adulthood are there sensitive periods when trauma is most harmful
Journal of Affective Disorders, 2018Co-Authors: Abigail Powers, Erin C Dunn, Kristen Nishimi, Stephanie H Gomez, Bekh BradleyAbstract:Abstract Background This study aimed to determine whether there were sensitive periods when a first exposure to trauma was most associated with Emotion Dysregulation symptoms in adulthood. Methods Adult participants came from a public urban hospital in Atlanta, GA (n = 1944). Lifetime trauma exposure was assessed using the Traumatic Events Inventory (TEI). Multiple linear regression models were used to assess the association between the developmental timing of first trauma exposure, classified as early childhood (ages 0–5), middle childhood (ages 6–10), adolescence (ages 11–18), and adulthood (ages 19+), on adult Emotion Dysregulation symptoms, measured using the abbreviated Emotion Dysregulation Scale. Results Participants exposed to trauma at any age had higher Emotion Dysregulation scores than their unexposed peers. However, participants first exposed to child maltreatment or interpersonal violence during middle childhood had higher Emotion Dysregulation scores relative to those first exposed during other developmental stages; these developmental timing differences were detected even after controlling for sociodemographic factors, exposure to other trauma, and frequency of exposure to trauma. Further, after controlling for current psychiatric symptoms, the effect of other interpersonal trauma exposure in middle childhood was diminished and first exposure to other interpersonal violence in early childhood was associated with significantly lower Emotion Dysregulation symptoms. Limitations Limitations of this study include the use of retrospective reports and absence of complete information about trauma severity or duration. Conclusion These findings should be replicated in other population-based samples with prospective designs to confirm the importance of developmental timing of trauma on later Emotion Dysregulation.
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a genome wide association study of Emotion Dysregulation evidence for interleukin 2 receptor alpha
Journal of Psychiatric Research, 2016Co-Authors: Abigail Powers, Lynn M Almli, Alicia K Smith, Adriana Lori, Jen Leveille, Kerry J Ressler, Tanja Jovanovic, Bekh BradleyAbstract:Emotion Dysregulation has been implicated as a risk factor for many psychiatric conditions. Therefore, examining genetic risk associated with Emotion Dysregulation could help inform cross-disorder risk more generally. A genome-wide association study (GWAS) of Emotion Dysregulation using single nucleotide polymorphism (SNP) array technology was conducted in a highly traumatized, minority, urban sample (N = 2600, males = 774). Post-hoc analyses examined associations between SNPs identified in the GWAS and current depression, posttraumatic stress disorder (PTSD), and history of suicide attempt. Methylation quantitative trait loci were identified and gene set enrichment analyses were used to broadly determine biological processes involved with these SNPs. Among males, SNP rs6602398, located within the interleukin receptor 2A gene, IL2RA, was significantly associated with Emotion Dysregulation (p = 1.1 × 10−8). Logistic regression analyses revealed this SNP was significantly associated with depression (Exp(B) = 2.67, p < 0.001) and PTSD (Exp(B) = 2.07, p < 0.01). This SNP was associated with differential DNA methylation (p < 0.05) suggesting it may be functionally active. Finally, through gene set enrichment analyses, ten psychiatric disease pathways (adjusted p < 0.01) and the calcium signaling pathway (adjusted p = 0.008) were significantly associated with Emotion Dysregulation. We found initial evidence for an association between Emotion Dysregulation and genetic risk loci that have already been implicated in medical disorders that have high comorbidity with psychiatric disorders. Our results provide further evidence that Emotion Dysregulation can be understood as a potential psychiatric cross-disorder risk factor, and that sex differences across these phenotypes may be critical. Continued research into genetic and biological risk associated with Emotion Dysregulation is needed.
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the mediating role of Emotion Dysregulation and depression on the relationship between childhood trauma exposure and Emotional eating
Appetite, 2015Co-Authors: Abigail Powers, Kerry J Ressler, Vasiliki Michopoulos, Carla J Moore, Stephanie Villarreal, Bekh BradleyAbstract:Exposure to childhood adversity is implicated in the etiology of adverse health outcomes, including depression, posttraumatic stress disorder (PTSD), and obesity. The relationship between childhood trauma and obesity may be related to the association of childhood trauma and risk for Emotional eating. One pathway between trauma exposure, psychopathology, and Emotional eating may be through Emotion Dysregulation and depression. The current study was undertaken to characterize demographic, environmental, and psychological risk factors for Emotional eating in a primarily African American, low socioeconomic status (SES), inner-city population (N = 1110). Emotional eating was measured using the Dutch Eating Behavioral Questionnaire and the Emotional Dysregulation Scale was used to assess Emotion regulation. The Beck Depression Inventory and the modified PTSD Symptom Scale were used to assess depression and PTSD, respectively. Higher levels of Emotional eating were associated with body mass index, income, childhood and adulthood trauma exposure, depressive and PTSD symptoms, negative affect and Emotion Dysregulation. Childhood Emotional abuse was the most associated with Emotional eating in adulthood. Hierarchical linear regression and mediation analyses indicated that the association between childhood trauma exposure (and Emotional abuse specifically) and Emotional eating was fully mediated by depression symptoms and Emotion Dysregulation, with Emotional Dysregulation contributing more to the mediation effect. Together these findings support a model in which obesity and related adverse health outcomes in stress- and trauma-exposed populations may be directly related to self-regulatory coping strategies accompanying Emotion Dysregulation. Our data suggest that Emotion Dysregulation is a viable therapeutic target for Emotional eating in at-risk populations.
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ptsd Emotion Dysregulation and dissociative symptoms in a highly traumatized sample
Journal of Psychiatric Research, 2015Co-Authors: Abigail Powers, Dorthie Cross, Negar Fani, Bekh BradleyAbstract:Exposure to multiple traumas has been shown to result in many negative mental health outcomes, including posttraumatic stress disorder (PTSD). Dissociation, which involves disruptions in memory, identity, and perceptions, may be a component of PTSD, particularly among individuals who have experienced childhood trauma. Emotion regulation difficulties are also strongly associated with childhood trauma and Emotion Dysregulation may be a particularly important factor to consider in the development and maintenance of dissociative symptoms. The goal of the present study was to determine whether Emotion Dysregulation mediated the relationship between PTSD symptoms and dissociation in a sample of 154 (80% female, 97% African-American) adults recruited from a public, urban hospital. PTSD was measured using the Clinician Administered PTSD Scale, Emotion Dysregulation was measured using the Difficulties in Emotion Regulation Scale, and dissociation was measured using the Multiscale Dissociation Inventory. A linear regression analysis showed that both PTSD and Emotion Dysregulation were statistically significant predictors of dissociation even after controlling for trauma exposure. Alexithymia and an inability to use Emotion regulation strategies in particular were predictive of dissociation above and beyond other predictor variables. Using bootstrapping techniques, we found that overall Emotion dyregulation partially mediated the effect of PTSD symptoms on dissociative symptoms. Our results suggest that Emotion Dysregulation may be important in understanding the relation between PTSD and dissociative symptoms. Treatment approaches may consider a focus on training in Emotional understanding and the development of adaptive regulation strategies as a way to address dissociative symptoms in PTSD patients.
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Emotion Dysregulation as a mediator between childhood Emotional abuse and current depression in a low income african american sample
Child Abuse & Neglect, 2014Co-Authors: Thomas Crow, Dorthie Cross, Abigail Powers, Bekh BradleyAbstract:Abuse and neglect in childhood are well-established risk factors for later psychopathology. Past research has suggested that childhood Emotional abuse may be particularly harmful to psychological development. The current cross-sectional study employed multiple regression techniques to assess the effects of childhood trauma on adulthood depression and Emotion Dysregulation in a large sample of mostly low-income African Americans recruited in an urban hospital. Bootstrap analyses were used to test Emotion Dysregulation as a potential mediator between Emotional abuse in childhood and current depression. Childhood Emotional abuse significantly predicted depressive symptoms even when accounting for all other childhood trauma types, and we found support for a complementary mediation of this relationship by Emotion Dysregulation. Our findings highlight the importance of Emotion Dysregulation and childhood Emotional abuse in relation to adult depression. Moving forward, clinicians should consider the particular importance of Emotional abuse in the development of depression, and future research should seek to identify mechanisms through which Emotional abuse increases risk for depression and Emotion Dysregulation.
Paul A Pilkonis - One of the best experts on this subject based on the ideXlab platform.
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psychometric properties of the Emotion Dysregulation inventory in a nationally representative sample of youth
Journal of Clinical Child and Adolescent Psychology, 2020Co-Authors: Carla A Mazefsky, Paul A PilkonisAbstract:Objective: The Emotion Dysregulation Inventory (EDI) is an informant questionnaire developed based on the Patient-Reported Outcomes Measurement Information System (PROMIS®) Scientific Standards and refined through factor analyses and item response theory (IRT) analyses. Although it was developed to improve measurement of Emotion Dysregulation in youth with autism spectrum disorder, Emotion Dysregulation has transdiagnostic significance. Therefore, the aim of this study was to evaluate the EDI's psychometric properties and to establish IRT-based scores for a general population of youth.Methods: Data were collected from a sample of 1000 caregivers of 6- to 17-year-old youth matched to the US census on age, gender, race/ethnicity, years of education, and region. Confirmatory factor analyses and IRT analyses using the two-parameter graded response model were performed to evaluate the EDI's structure and psychometric properties.Results: Analyses supported the original two-factor structure of the EDI, reflecting factors for Reactivity and Dysphoria. Simulations of computerized adaptive testing supported use of the same items for a Reactivity short form as those that emerged as most informative in the original autism psychometric analyses. IRT co-calibration with commonly used measures of Emotion regulation and irritability in child clinical or community samples indicated the EDI scales provide more information across a wider range of Emotion Dysregulation. Validity was supported by moderate correlations with measures of related constructs and expected known-group differences.Conclusions: The EDI is an efficient and precise measure of Emotion Dysregulation for use in general community and clinical samples as well as samples of youth with ASD.
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the Emotion Dysregulation inventory psychometric properties and item response theory calibration in an autism spectrum disorder sample
Autism Research, 2018Co-Authors: Carla A Mazefsky, Lan Yu, Susan W White, Matthew Siegel, Paul A PilkonisAbstract:Individuals with autism spectrum disorder (ASD) often present with prominent Emotion Dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS®) to capture observable indicators of poor Emotion regulation. Caregivers of 1,755 youth with ASD completed 66 candidate EDI items, and the final 30 items were selected based on classical test theory and item response theory (IRT) analyses. The analyses identified two factors: 1) Reactivity, characterized by intense, rapidly escalating, sustained, and poorly regulated negative Emotional reactions, and 2) Dysphoria, characterized by anhedonia, sadness, and nervousness. The final items did not show differential item functioning (DIF) based on gender, age, intellectual ability, or verbal ability. Because the final items were calibrated using IRT, even a small number of items offers high precision, minimizing respondent burden. IRT co-calibration of the EDI with related measures demonstrated its superiority in assessing the severity of Emotion Dysregulation with as few as seven items. Validity of the EDI was supported by expert review, its association with related constructs (e.g., anxiety and depression symptoms, aggression), higher scores in psychiatric inpatients with ASD compared to a community ASD sample, and demonstration of test-retest stability and sensitivity to change. In sum, the EDI provides an efficient and sensitive method to measure Emotion Dysregulation for clinical assessment, monitoring, and research in youth with ASD of any level of cognitive or verbal ability.
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the Emotion Dysregulation inventory psychometric properties and item response theory calibration in an autism spectrum disorder sample
Autism Research, 2018Co-Authors: Carla A Mazefsky, Susan W White, Matthew Siegel, Paul A PilkonisAbstract:Individuals with autism spectrum disorder (ASD) often present with prominent Emotion Dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS® ) to capture observable indicators of poor Emotion regulation. Caregivers of 1,755 youth with ASD completed 66 candidate EDI items, and the final 30 items were selected based on classical test theory and item response theory (IRT) analyses. The analyses identified two factors: (a) Reactivity, characterized by intense, rapidly escalating, sustained, and poorly regulated negative Emotional reactions, and (b) Dysphoria, characterized by anhedonia, sadness, and nervousness. The final items did not show differential item functioning (DIF) based on gender, age, intellectual ability, or verbal ability. Because the final items were calibrated using IRT, even a small number of items offers high precision, minimizing respondent burden. IRT co-calibration of the EDI with related measures demonstrated its superiority in assessing the severity of Emotion Dysregulation with as few as seven items. Validity of the EDI was supported by expert review, its association with related constructs (e.g., anxiety and depression symptoms, aggression), higher scores in psychiatric inpatients with ASD compared to a community ASD sample, and demonstration of test-retest stability and sensitivity to change. In sum, the EDI provides an efficient and sensitive method to measure Emotion Dysregulation for clinical assessment, monitoring, and research in youth with ASD of any level of cognitive or verbal ability. Autism Res 2018, 11: 928-941. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This paper describes a new measure of poor Emotional control called the Emotion Dysregulation Inventory (EDI). Caregivers of 1,755 youth with ASD completed candidate items, and advanced statistical techniques were applied to identify the best final items. The EDI is unique because it captures common Emotional problems in ASD and is appropriate for both nonverbal and verbal youth. It is an efficient and sensitive measure for use in clinical assessments, monitoring, and research with youth with ASD.
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Emotion Dysregulation as a maintenance factor of borderline personality disorder features
Comprehensive Psychiatry, 2014Co-Authors: Stephanie D Stepp, Lori N Scott, Jennifer Q Morse, Kimberly A Nolf, Michael N Hallquist, Paul A PilkonisAbstract:We examined within-individual changes in Emotion Dysregulation over the course of one year as a maintenance factor of borderline personality disorder (BPD) features. We evaluated the extent to which (1) BPD symptom severity at baseline predicted within-individual changes in Emotion Dysregulation and (2) within-individual changes in Emotion Dysregulation predicted four BPD features at 12-month follow-up: affective instability, identity disturbances, negative relationships, and impulsivity. The specificity of Emotion Dysregulation as a maintaining mechanism of BPD features was examined by controlling for a competing intervening variable, interpersonal conflict. BPD symptoms at baseline predicted overall level and increasing Emotion Dysregulation. Additionally, increasing Emotion Dysregulation predicted all four BPD features at 12-month follow-up after controlling for BPD symptoms at baseline. Further, overall level of Emotion Dysregulation mediated the association between BPD symptom severity at baseline and both affective instability and identity disturbance at 12-month follow-up, consistent with the notion of Emotion Dysregulation as a maintenance factor. Future research on the malleability of Emotion Dysregulation in laboratory paradigms and its effects on short-term changes in BPD features is needed to inform interventions.
Kim L Gratz - One of the best experts on this subject based on the ideXlab platform.
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the role of Emotion Dysregulation in the presence associated difficulties and treatment of borderline personality disorder
Personality Disorders: Theory Research and Treatment, 2016Co-Authors: Kim L Gratz, Kelly E Moore, Matthew T TullAbstract:Theory and research identify Emotion Dysregulation as one of the primary mechanisms underlying borderline personality disorder (BPD) and related pathology. Yet, despite the extensive research documenting an association between Emotion Dysregulation and BPD, many questions regarding the precise role of Emotion Dysregulation in the development and treatment of BPD and its associated difficulties remain unanswered. This paper reviews the extant literature on the role of Emotion Dysregulation in BPD and its associated difficulties, as well as the treatment of BPD-related pathology, and identifies important next steps for future research in this area. In particular, this review highlights the need for further research examining: (a) the dimensions of Emotion Dysregulation that are unique to BPD, (b) the role and nature of interpersonal (vs. intrapersonal) Emotion regulation in BPD, (c) the role of Emotion Dysregulation in the physical (vs. mental) health problems associated with BPD, and (d) the role of Emotion regulation in efficacious treatments for BPD. Such research has the potential to elucidate the precise Emotion regulation deficits that are most relevant (and central) to BPD, the active ingredients and mechanisms of change in current efficacious treatments for BPD, and the most effective and efficient targets for integrative treatments for this population. (PsycINFO Database Record
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the pursuit of death versus escape from negative affect an examination of the nature of the relationship between Emotion Dysregulation and both suicidal behavior and non suicidal self injury
Comprehensive Psychiatry, 2014Co-Authors: Michael D Anestis, Evan M Kleiman, Matthew T Tull, Jason M Lavender, Kim L GratzAbstract:Across three studies, we tested a model in which the relationship between Emotion Dysregulation and suicidal behavior is accounted for by non-suicidal self-injury (NSSI). Whereas some models posit that suicide attempts serve as an escape from acute aversive states, our model proposes that NSSI accounts for the relationship between Emotion Dysregulation and suicide attempts. To test our model, we recruited two large nonclinical samples of adults and a clinical sample of adults seeking inpatient treatment for substance use disorders. To increase generalizability, we used four different measures of Emotion Dysregulation across the three studies: broad Emotion regulation, distress tolerance, negative urgency, and grit (i.e., the persistent, passionate pursuit of long-term goals). Results were largely supportive of our hypothesized model, revealing significant indirect effects of Emotion Dysregulation on suicide attempts through NSSI in all three samples. Specifically, NSSI fully mediated the relationship between Emotion Dysregulation and suicide attempts in three of six analyses, and partially mediated this relation in the other three. Overall, findings are supportive of an Emotion regulation model of NSSI and suggest that the relation between certain aspects of Emotion Dysregulation and suicide attempts may be indirect through NSSI.
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the relative and unique contributions of Emotion Dysregulation and impulsivity to posttraumatic stress disorder among substance dependent inpatients
Drug and Alcohol Dependence, 2013Co-Authors: Nicole H Weiss, Matthew T Tull, Michael D Anestis, Kim L GratzAbstract:BACKGROUND: Despite elevated rates of posttraumatic stress disorder (PTSD) among substance use disorder (SUD) patients, as well as the clinical relevance of this co-occurrence, few studies have examined psychological factors associated with a PTSD-SUD diagnosis. Two factors worth investigating are Emotion Dysregulation and impulsivity, both of which are associated with PTSD and SUDs. Therefore, this study examined associations between PTSD and facets of Emotion Dysregulation and impulsivity within a sample of trauma-exposed SUD inpatients. METHODS: Participants were an ethnically diverse sample of 205 SUD patients in residential substance abuse treatment. Patients were administered diagnostic interviews and completed a series of questionnaires. RESULTS: Patients with PTSD (n=58) reported significantly higher levels of negative urgency (i.e., the tendency to engage in impulsive behaviors when experiencing negative affect) and lower sensation seeking, as well as higher levels of Emotion Dysregulation and the specific dimensions of lack of Emotional acceptance, difficulties engaging in goal-directed behavior when upset, difficulties controlling impulsive behaviors when distressed, limited access to effective Emotion regulation strategies, and lack of Emotional clarity. Further, overall Emotion Dysregulation emerged as a significant predictor of PTSD status, accounting for unique variance in PTSD status above and beyond facets of impulsivity (as well as other relevant covariates). CONCLUSIONS: Results suggest that Emotion Dysregulation may contribute to the development, maintenance, and/or exacerbation of PTSD and highlight the potential clinical utility of targeting Emotion Dysregulation among SUD patients with PTSD. Language: en
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impulsive behaviors as an Emotion regulation strategy examining associations between ptsd Emotion Dysregulation and impulsive behaviors among substance dependent inpatients
Journal of Anxiety Disorders, 2012Co-Authors: Nicole H Weiss, Matthew T Tull, Andres G Viana, Michael D Anestis, Kim L GratzAbstract:Recent investigations have demonstrated that posttraumatic stress disorder (PTSD) is associated with a range of impulsive behaviors (e.g., risky sexual behavior and antisocial behavior). The purpose of the present study was to extend extant research by exploring whether Emotion Dysregulation explains the association between PTSD and impulsive behaviors. Participants were an ethnically diverse sample of 206 substance use disorder (SUD) patients in residential substance abuse treatment. Results demonstrated an association between PTSD and impulsive behaviors, with SUD patients with PTSD reporting significantly more impulsive behaviors than SUD patients without PTSD (in general and when controlling for relevant covariates). Further, Emotion Dysregulation was found to fully mediate the relationship between PTSD and impulsive behaviors. Results highlight the relevance of Emotion Dysregulation to impulsive behaviors and suggest that treatments targeting Emotion Dysregulation may be useful in reducing impulsive behaviors among SUD patients with PTSD.
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the relationship between Emotion Dysregulation and deliberate self harm among inpatients with substance use disorders
Cognitive Therapy and Research, 2010Co-Authors: Kim L Gratz, Matthew T TullAbstract:Despite the emphasis on the role of Emotion Dysregulation in deliberate self-harm (DSH), no studies have examined this association among patients with substance use disorders (SUD). This study examined if Emotion Dysregulation is heightened among SUD inpatients with (vs. without) DSH, and if the association between DSH and Emotion Dysregulation remains significant when controlling for their shared association with risk factors for both, including borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), childhood abuse, and substance use severity. Findings indicate heightened Emotion Dysregulation among SUD patients with (vs. without) DSH, and provide evidence of a unique association between Emotion Dysregulation and DSH when controlling for BPD, PTSD, childhood abuse, and substance use severity. Findings also highlight the particular relevance of three dimensions of Emotion Dysregulation to DSH among SUD patients: limited access to effective Emotion regulation strategies, difficulties engaging in goal-directed behaviors when distressed, and Emotional nonacceptance.
Michael D Anestis - One of the best experts on this subject based on the ideXlab platform.
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the role of Emotion Dysregulation in suicide as considered through the ideation to action framework
Current opinion in psychology, 2015Co-Authors: Keyne C Law, Lauren R Khazem, Michael D AnestisAbstract:Research supports a model in which Emotionally dysregulated individuals are more likely to think about suicide and experience proximal risk factors for suicidal ideation (e.g., thwarted belongingness, perceived burdensomeness). The drive to escape aversive affective sensations inherent in Emotion Dysregulation, however, serves as an obstacle to the capability for suicide. As such, although Emotionally dysregulated individuals die by suicide at an elevated rate, the transition from ideation to attempt appears better explained by the tendency of Emotionally dysregulated individuals to engage in painful and/or provocative behaviors (e.g., NSSI) capable of elevating the capability for suicide. The relationship between Emotion Dysregulation and suicide is thus robust but nuanced.
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the pursuit of death versus escape from negative affect an examination of the nature of the relationship between Emotion Dysregulation and both suicidal behavior and non suicidal self injury
Comprehensive Psychiatry, 2014Co-Authors: Michael D Anestis, Evan M Kleiman, Matthew T Tull, Jason M Lavender, Kim L GratzAbstract:Across three studies, we tested a model in which the relationship between Emotion Dysregulation and suicidal behavior is accounted for by non-suicidal self-injury (NSSI). Whereas some models posit that suicide attempts serve as an escape from acute aversive states, our model proposes that NSSI accounts for the relationship between Emotion Dysregulation and suicide attempts. To test our model, we recruited two large nonclinical samples of adults and a clinical sample of adults seeking inpatient treatment for substance use disorders. To increase generalizability, we used four different measures of Emotion Dysregulation across the three studies: broad Emotion regulation, distress tolerance, negative urgency, and grit (i.e., the persistent, passionate pursuit of long-term goals). Results were largely supportive of our hypothesized model, revealing significant indirect effects of Emotion Dysregulation on suicide attempts through NSSI in all three samples. Specifically, NSSI fully mediated the relationship between Emotion Dysregulation and suicide attempts in three of six analyses, and partially mediated this relation in the other three. Overall, findings are supportive of an Emotion regulation model of NSSI and suggest that the relation between certain aspects of Emotion Dysregulation and suicide attempts may be indirect through NSSI.
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the relative and unique contributions of Emotion Dysregulation and impulsivity to posttraumatic stress disorder among substance dependent inpatients
Drug and Alcohol Dependence, 2013Co-Authors: Nicole H Weiss, Matthew T Tull, Michael D Anestis, Kim L GratzAbstract:BACKGROUND: Despite elevated rates of posttraumatic stress disorder (PTSD) among substance use disorder (SUD) patients, as well as the clinical relevance of this co-occurrence, few studies have examined psychological factors associated with a PTSD-SUD diagnosis. Two factors worth investigating are Emotion Dysregulation and impulsivity, both of which are associated with PTSD and SUDs. Therefore, this study examined associations between PTSD and facets of Emotion Dysregulation and impulsivity within a sample of trauma-exposed SUD inpatients. METHODS: Participants were an ethnically diverse sample of 205 SUD patients in residential substance abuse treatment. Patients were administered diagnostic interviews and completed a series of questionnaires. RESULTS: Patients with PTSD (n=58) reported significantly higher levels of negative urgency (i.e., the tendency to engage in impulsive behaviors when experiencing negative affect) and lower sensation seeking, as well as higher levels of Emotion Dysregulation and the specific dimensions of lack of Emotional acceptance, difficulties engaging in goal-directed behavior when upset, difficulties controlling impulsive behaviors when distressed, limited access to effective Emotion regulation strategies, and lack of Emotional clarity. Further, overall Emotion Dysregulation emerged as a significant predictor of PTSD status, accounting for unique variance in PTSD status above and beyond facets of impulsivity (as well as other relevant covariates). CONCLUSIONS: Results suggest that Emotion Dysregulation may contribute to the development, maintenance, and/or exacerbation of PTSD and highlight the potential clinical utility of targeting Emotion Dysregulation among SUD patients with PTSD. Language: en
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impulsive behaviors as an Emotion regulation strategy examining associations between ptsd Emotion Dysregulation and impulsive behaviors among substance dependent inpatients
Journal of Anxiety Disorders, 2012Co-Authors: Nicole H Weiss, Matthew T Tull, Andres G Viana, Michael D Anestis, Kim L GratzAbstract:Recent investigations have demonstrated that posttraumatic stress disorder (PTSD) is associated with a range of impulsive behaviors (e.g., risky sexual behavior and antisocial behavior). The purpose of the present study was to extend extant research by exploring whether Emotion Dysregulation explains the association between PTSD and impulsive behaviors. Participants were an ethnically diverse sample of 206 substance use disorder (SUD) patients in residential substance abuse treatment. Results demonstrated an association between PTSD and impulsive behaviors, with SUD patients with PTSD reporting significantly more impulsive behaviors than SUD patients without PTSD (in general and when controlling for relevant covariates). Further, Emotion Dysregulation was found to fully mediate the relationship between PTSD and impulsive behaviors. Results highlight the relevance of Emotion Dysregulation to impulsive behaviors and suggest that treatments targeting Emotion Dysregulation may be useful in reducing impulsive behaviors among SUD patients with PTSD.
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clarifying the role of Emotion Dysregulation in the interpersonal psychological theory of suicidal behavior in an undergraduate sample
Journal of Psychiatric Research, 2011Co-Authors: Matthew T Tull, Michael D Anestis, Courtney L Bagge, Thomas E JoinerAbstract:The interpersonal-psychological theory of suicidal behavior (IPTS; Joiner, 2005) has been subjected to a number of rigorous investigations and has shown to be a promising lens through which to understand suicide. One area thus far left unstudied with respect to the IPTS is Emotion Dysregulation. The bulk of the work examining the role of Emotion Dysregulation in suicidality has focused on suicidal ideation rather than behavior, with a number of studies reporting that Emotion Dysregulation is predictive of suicidal ideation (e.g., Lynch et al., 2004; Orbach et al., 2007). Studies examining suicide attempts have produced more ambiguous results. One way to clarify the nature of this relationship is to consider the construct of Emotion Dysregulation through an examination of specific subcomponents. In this study, we examined two specific components of Emotion Dysregulation - negative urgency and distress tolerance - and their relationships to all three components of the IPTS, thereby providing clarity for an otherwise poorly understood relationship. Results indicated that Emotionally dysregulated individuals - those with low distress tolerance and high negative urgency - exhibited higher levels of suicidal desire, as indexed by perceived burdensomeness and thwarted belongingness. In contrast, Emotionally dysregulated individuals exhibited lower levels of the acquired capability for suicide and physiological pain tolerance. As such, a complicated but theoretically cogent picture emerged indicating that, although Emotion Dysregulation may drastically increase the likelihood of suicidal desire, it simultaneously serves as a form protection against lethal self-harm.
Carla A Mazefsky - One of the best experts on this subject based on the ideXlab platform.
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psychometric properties of the Emotion Dysregulation inventory in a nationally representative sample of youth
Journal of Clinical Child and Adolescent Psychology, 2020Co-Authors: Carla A Mazefsky, Paul A PilkonisAbstract:Objective: The Emotion Dysregulation Inventory (EDI) is an informant questionnaire developed based on the Patient-Reported Outcomes Measurement Information System (PROMIS®) Scientific Standards and refined through factor analyses and item response theory (IRT) analyses. Although it was developed to improve measurement of Emotion Dysregulation in youth with autism spectrum disorder, Emotion Dysregulation has transdiagnostic significance. Therefore, the aim of this study was to evaluate the EDI's psychometric properties and to establish IRT-based scores for a general population of youth.Methods: Data were collected from a sample of 1000 caregivers of 6- to 17-year-old youth matched to the US census on age, gender, race/ethnicity, years of education, and region. Confirmatory factor analyses and IRT analyses using the two-parameter graded response model were performed to evaluate the EDI's structure and psychometric properties.Results: Analyses supported the original two-factor structure of the EDI, reflecting factors for Reactivity and Dysphoria. Simulations of computerized adaptive testing supported use of the same items for a Reactivity short form as those that emerged as most informative in the original autism psychometric analyses. IRT co-calibration with commonly used measures of Emotion regulation and irritability in child clinical or community samples indicated the EDI scales provide more information across a wider range of Emotion Dysregulation. Validity was supported by moderate correlations with measures of related constructs and expected known-group differences.Conclusions: The EDI is an efficient and precise measure of Emotion Dysregulation for use in general community and clinical samples as well as samples of youth with ASD.
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the Emotion Dysregulation inventory psychometric properties and item response theory calibration in an autism spectrum disorder sample
Autism Research, 2018Co-Authors: Carla A Mazefsky, Lan Yu, Susan W White, Matthew Siegel, Paul A PilkonisAbstract:Individuals with autism spectrum disorder (ASD) often present with prominent Emotion Dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS®) to capture observable indicators of poor Emotion regulation. Caregivers of 1,755 youth with ASD completed 66 candidate EDI items, and the final 30 items were selected based on classical test theory and item response theory (IRT) analyses. The analyses identified two factors: 1) Reactivity, characterized by intense, rapidly escalating, sustained, and poorly regulated negative Emotional reactions, and 2) Dysphoria, characterized by anhedonia, sadness, and nervousness. The final items did not show differential item functioning (DIF) based on gender, age, intellectual ability, or verbal ability. Because the final items were calibrated using IRT, even a small number of items offers high precision, minimizing respondent burden. IRT co-calibration of the EDI with related measures demonstrated its superiority in assessing the severity of Emotion Dysregulation with as few as seven items. Validity of the EDI was supported by expert review, its association with related constructs (e.g., anxiety and depression symptoms, aggression), higher scores in psychiatric inpatients with ASD compared to a community ASD sample, and demonstration of test-retest stability and sensitivity to change. In sum, the EDI provides an efficient and sensitive method to measure Emotion Dysregulation for clinical assessment, monitoring, and research in youth with ASD of any level of cognitive or verbal ability.
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the Emotion Dysregulation inventory psychometric properties and item response theory calibration in an autism spectrum disorder sample
Autism Research, 2018Co-Authors: Carla A Mazefsky, Susan W White, Matthew Siegel, Paul A PilkonisAbstract:Individuals with autism spectrum disorder (ASD) often present with prominent Emotion Dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS® ) to capture observable indicators of poor Emotion regulation. Caregivers of 1,755 youth with ASD completed 66 candidate EDI items, and the final 30 items were selected based on classical test theory and item response theory (IRT) analyses. The analyses identified two factors: (a) Reactivity, characterized by intense, rapidly escalating, sustained, and poorly regulated negative Emotional reactions, and (b) Dysphoria, characterized by anhedonia, sadness, and nervousness. The final items did not show differential item functioning (DIF) based on gender, age, intellectual ability, or verbal ability. Because the final items were calibrated using IRT, even a small number of items offers high precision, minimizing respondent burden. IRT co-calibration of the EDI with related measures demonstrated its superiority in assessing the severity of Emotion Dysregulation with as few as seven items. Validity of the EDI was supported by expert review, its association with related constructs (e.g., anxiety and depression symptoms, aggression), higher scores in psychiatric inpatients with ASD compared to a community ASD sample, and demonstration of test-retest stability and sensitivity to change. In sum, the EDI provides an efficient and sensitive method to measure Emotion Dysregulation for clinical assessment, monitoring, and research in youth with ASD of any level of cognitive or verbal ability. Autism Res 2018, 11: 928-941. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This paper describes a new measure of poor Emotional control called the Emotion Dysregulation Inventory (EDI). Caregivers of 1,755 youth with ASD completed candidate items, and advanced statistical techniques were applied to identify the best final items. The EDI is unique because it captures common Emotional problems in ASD and is appropriate for both nonverbal and verbal youth. It is an efficient and sensitive measure for use in clinical assessments, monitoring, and research with youth with ASD.