Difficulties in Emotion Regulation Scale
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Emotion regulation is a key process aimed to answer flexibly to environmental requests and challenges in a vital way for adaptation. It is a multidimensional process that comprehends monitoring, evaluation, and behavioral modification of psychophysical states (Thompson and Calkins 1996). Research has shown that individuals differ in their habitual use of emotion regulation strategies, and that these differences have consequences for multiple domains of psychological adjustment (Balzarotti et al. 2016). However, in relevant clinical condition, the capacity to regulate emotions appears to be critically compromised (Garofalo and Velotti 2015).
The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004) is a self-report measure that evaluates individuals’ levels of difficulties in regulating emotions. The instrument presents 36-item on a 5-point Likert scale of frequency (from 1 = almost never, to 5 = almost always). DERS provides a total scoring of overall difficulties where higher scores correspond to greater difficulties, and other six different subscales: (a) nonacceptance of emotional responses, (b) difficulty engaging in goal-directed behavior when distressed, (c) impulse control difficulties when distressed, (d) lack of awareness of emotions, (e) limited access to strategies for regulation, (f) lack of emotional clarity. These dimensions were obtained through exploratory factor analysis in a sample of 357 university students. Research supported the scale’s adequate construct and predictive validity and good test-retest reliability over a period of 4–8 weeks (ρI = 0.88; Gratz and Roemer 2004).
The DERS has been translated and validated across a large number of countries (i.e., France, Portugal, Mexico, Netherlands, Argentina, United States, Spain, Australia, Hungary, Turkey, and Italy) in both clinical and nonclinical samples (Medrano and Trógolo 2016).
Generally, most of the studies’ results support the original six-factor structure. However, several studies sustain a different factor structure. Bardeen et al. (2012) confirmed both the 36-item one-factor model and a reduced 30-item one-factor model (i.e., excluding items of the Awareness subscale). They found out good-fit indices for both the correlated five- and six-factor models, and they also discovered a nonsignificant difference between the two models’ fit. Moreover, Fowler and collaborators (2014) found that a five-factor model, excluding the Awareness dimension, and the six-factor model produced equivalent fit indices. These studies highlighted that the Awareness factor could provide a lower contribution to DERS general factor, leading the authors to recommend a five-factor model (without Awareness). Overall, although research has demonstrated the relevance and the utility of DERS in measuring difficulties in emotion regulation, evidence about the best factor structure of the scale are not decisive.
Furthermore, research has linked difficulties in emotion regulation to many behaviors having an emotion regulation dysfunction, including cocaine-dependence (Fox et al. 2007) and deliberate self-harm (Gratz and Roemer 2008). Indeed, recent research confirmed that difficulties in these domains could increase individual proneness to react with aggression to perceived threats or offenses (Garofalo et al. 2016). Also, a review of longitudinal studies regarding adolescents suggested that deficits in emotion regulation constitute an important risk factor for aggressive behaviors (Roll et al. 2012). Yet, DERS scores have been found to be heightened among individuals with high hostility levels (Contardi et al. 2016).
Difficulties in emotion regulation research, using DERS, also demonstrated significant associations with different kind of variables, such as mindfulness (Roemer et al. 2009) and attachment (Velotti and Garofalo 2015). Higher emotion dysregulation, in fact, resulted associated with attachment insecurities and difficulties in impulse control. Velotti and colleagues found that attachment avoidance was related to lacking emotional awareness, and that women’s attachment anxiety was related to greater difficulties in engaging in goal-directed behavior when experiencing distress (Velotti and Garofalo 2015).
Furthermore, theories around personality and personality disorders are increasingly considering the centrality of emotion regulation and its dimensions. Impulsivity as well is recognized as a personality trait underlying the manifestation of diverse symptoms. Although research in this field has mainly regarded borderline personality disorder (Gratz et al. 2006), recent studies supported the association between emotion dysregulation and personality styles across all clusters. To date, research has mostly focused on studying emotional dysregulation in selected PDs, such as borderline (Carpenter and Trull 2013; Linehan et al. 1993), antisocial (Litt et al. 2003), and, to a certain extent, narcissistic (Centifanti et al. 2013), whereas recent findings (Garofalo et al. 2016; Steenkamp et al. 2015) suggest that it can be considered a feature of the whole range of PDs.
Correlates, as demonstrated by Uchida and collaborators (2015), emotion regulation ability varies in relation to intrinsic functional brain architecture, and it can be compromised by psychopathologies or improved by specific trainings. In relation to this, DERS has been used to measure the effects of mindfulness training on diagnosed borderline participants, assessing the improvement of emotion regulation alongside an increasing PFC response detected through fMRI (Ives-Deliperi et al. 2013). Furthermore, DERS has also been used by Paret and collaborators (2016) as a psychometric measure to assess the effects of real-time functional magnetic resonance imaging neurofeedback (NF), a stimulation aimed to enhance amygdala and PFC connectivity in borderline patients. A reduction of scores in DERS’ subscale “lack of emotional awareness” after NF registered training effectiveness. According to these evidence, administered alongside with neuroimaging techniques, DERS constitutes also a crucial instrument to investigate emotion dysregulation’s neural correlates.
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