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Suicidal behaviors are increasingly prevalent among college students. Although emotion dysregulation is theorized to increase suicide risk, research supporting this relationship is mixed. Engagement in self-damaging behaviors may play a role in the relationship between emotion dysregulation and suicide risk, theoretically by increasing one's capability of engaging in suicidal behaviors. Such behaviors may interact with emotion dysregulation to predict suicide risk. Alternatively, engaging in self-damaging behaviors may mediate the emotion dysregulation-suicide risk relationship. We examined the potential moderating and mediating roles of engagement in multiple self-damaging behaviors in the relationship between emotion dysregulation and suicide risk among college students. Participants were 181 undergraduate students who reported a history of self-damaging behaviors (i.e., non-suicidal self-injury, alcohol misuse, drug misuse, disordered eating), overall emotion dysregulation, and suicide risk. Findings revealed an interactive effect of emotion dysregulation and self-damaging behaviors on suicide risk, with engagement in more forms of self-damaging behaviors conferring higher risk for suicide, particularly in the context of greater emotion dysregulation. The model testing self-damaging behaviors as a mediator was also significant, such that greater emotion dysregulation had an indirect effect on elevated suicide risk via number of self-damaging behaviors. These findings help clarify associations among emotion dysregulation, self-damaging behaviors, and suicide risk, and have implications for specific targets of intervention and for the prevention of suicide by college students.

Borderline personality disorder (BPD) is characterized by both emotion regulation (ER) and interpersonal difficulties. Although the link between ER difficulties and interpersonal problems in BPD is well documented, less work has examined the directionality of these associations. The present study examined the temporal relationship between ER difficulties and interpersonal problems among individuals with BPD features in daily life. Participants were 173 undergraduate students who completed daily questionnaires for 2 weeks. Participants were prompted to identify their most stressful events each day and report their use of maladaptive ER strategies (i.e., expressive suppression, worry/rumination, and avoidance) and interpersonal conflict behaviors (i.e., argue, hit someone/throw things). BPD features were associated with greater interpersonal conflict and ER difficulties. Unexpectedly, maladaptive ER strategy use did not predict next-day interpersonal conflict. Interpersonal conflict significantly predicted next-day maladaptive ER strategy use; however, this association was weaker among those with elevated BPD features. Implications of these findings for treatment are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background Adherence to COVID-19 social distancing guidelines varies across individuals. Purpose This study examined the relations of pseudoscientific and just world beliefs, generalized and institutional trust, and political party affiliation to adherence to COVID-19 social distancing guidelines over three months, as well as the explanatory role of COVID-19 risk perceptions in these relations. Methods A U.S. nationwide sample of 430 adults (49.8% women; mean age = 40.72) completed a prospective online study, including an initial assessment (between March 27 and April 5, 2020), a 1 month follow-up (between April 27 and May 21, 2020), and a 3 month follow-up (between June 26 and July 15, 2020). We hypothesized that greater pseudoscientific and just world beliefs, lower governmental, institutional, and dispositional trust, and Republican Party affiliation would be associated with lower initial adherence to social distancing and greater reductions in social distancing over time and that COVID-19 risk perceptions would account for significant variance in these relations. Results Results revealed unique associations of lower governmental trust, greater COVID-19 pseudoscientific beliefs, and greater trust in the Centers for Disease Control and Prevention (CDC) to lower initial adherence to social distancing. Whereas greater COVID-19 risk perceptions and CDC trust were associated with less steep declines in social distancing over time, both Republican (vs. Democratic) Party affiliation and greater COVID-19 pseudoscientific beliefs were associated with steeper declines in social distancing over time (relations accounted for by lower COVID-19 risk perceptions). Conclusions Results highlight the utility of public health interventions aimed at improving scientific literacy and emphasizing bipartisan support for social distancing guidelines.

Emotion dysregulation is associated with increased risk for suicidal thoughts and behaviors (STBs) and nonsuicidal self-injury (NSSI). However, research in this area has focused almost exclusively on dysregulation stemming from negative emotions. The present study aimed to address this gap in the literature by examining the associations between the specific domains of positive emotion dysregulation and both STBs and NSSI. Participants included 397 trauma-exposed community adults (Mage = 35.95; 57.7% female; 76.8% White). Results demonstrated significant associations between positive emotion dysregulation and both STBs and NSSI. In particular, higher levels of nonacceptance of positive emotions were found to be significantly related to risk for STBs (versus no risk), higher severity of STBs, and history of NSSI (versus no history). Findings suggest positive emotion dysregulation may play an important role in the etiology and treatment of both STBs and NSSI among trauma-exposed individuals.

Background Borderline personality disorder (BPD) is associated with emotional dysfunction and interpersonal sensitivity. Yet, little work has characterized how BPD features predicts emotional reactivity and emotion regulation behaviors in response to interpersonal stress relative to other forms of stress. Methods Participants were 152 university students who completed baseline measures of BPD features and complied with two-week daily diary procedures assessing daily emotion regulation strategy use in response to social and non-social stressors. Results Generalized estimating equations revealed that BPD features predicted greater negative and positive emotions in response to daily stressors, and interacted with type of stressor in predicting urges and behaviors. Elevated BPD features was associated with greater urges for dysfunctional emotion regulatory behaviors and fewer functional emotion regulatory behaviors to a greater extent in response to social (versus non-social) stressors. Limitations This study was limited by its focus on past-day retrospective recall. Further, the student sample limits the generalizability of these findings. Conclusions These findings suggest that individuals with elevated BPD features may have less functional emotion regulation in social contexts.

Objective Although research has established a link between posttraumatic stress disorder (PTSD) symptoms and suicidal thoughts and behaviors (STBs), little is known about factors that may accentuate this relation. This study evaluated the influences of negative and positive emotion dysregulation on the association between PTSD symptoms and STBs among veterans. Methods Four-hundred and sixty-five trauma-exposed military veterans in the community (Mage = 38.00, 71.4% male, 69.5% White) completed online questionnaires. Results Negative emotion dysregulation did not moderate the relation between PTSD symptoms and STBs. Results showed significant interactive effects of PTSD symptoms and positive emotion dysregulation on STBs, such that PTSD symptoms were more strongly related to STBs at high (vs. low) levels of positive emotion dysregulation. This effect was sustained across domains of positive emotion dysregulation. Conclusions Findings suggest a potential need to consider positive emotion dysregulation in the assessment and treatment of STBs among veterans with PTSD symptoms.

Posttraumatic stress disorder (PTSD) is highly prevalent, with recent evidence suggesting that 8.30%, or approximately 27 million Americans according to the recent U.S. Census data (2018), will develop PTSD in their lifetime (Kilpatrick et al., 2013). Unsurprisingly, PTSD is both widely researched and a key consideration in clinical practice. One important clinical and empirically-established correlate of PTSD is engagement in reckless and self-destructive behaviors (RSDBs; Lusk, Sadeh, Wolf, & Miller, 2017; Tull, Weiss, & McDermott, 2015; Weiss, Tull, Sullivan, Dixon-Gordon, & Gratz, 2015). Among theoretical explanations for the PTSD-RSDB link, the disinhibition viewpoint indicates that individuals with PTSD may have difficulties inhibiting rewarding RSDBs (Casada & Roache, 2005); the emotion dysregulation perspective indicates that individuals engage in RSDBs to reduce the negative affect or increase the blunted positive affect characteristic of PTSD (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004); and the cognitive explanation suggests the trauma’s effects on decreasing attention span and information processing capacity may increase the likelihood of impulsive RSDBs (Ben-Zur & Zeidner, 2009). Of clinical salience, engagement in RSDBs among trauma-exposed samples has a detrimental impact on physical and mental health outcomes. For instance, in a study of veterans receiving treatment for PTSD, a significant number of deaths were related to RSDBs such as substance misuse and suicide (Drescher, Rosen, Burling, & Foy, 2003). Additionally, another study found that engagement in RSDBs was associated with greater psychological, emotional, and behavioral problems (Contractor, Weiss, Dranger, Ruggero, & Armour, 2017). With this empirical, theoretical, and clinically-significant foundation, the E2 symptom assessing posttrauma RSDBs was added to the DSM-5 PTSD diagnostic criteria (American Psychiatric Association, 2013). However, the lack of a comprehensive (yet brief) validated screening measure to assess E2 poses a barrier to its measurement and consideration in treatment. In fact, existing assessments of PTSD’s E2 criterion lack clinical utility and empirical support in a number of ways. First, the assessment of PTSD’s E2 criterion in adults has relied either on a single-item (E2 symptom) included in PTSD assessments or requires a time-intensive battery of multiple distinct measures of a range of specific RSDBs (e.g., substance use, aggressive behaviors). With evidence supporting the co-occurrence of RSDBs (Cooper, 2002) representing an underlying unified latent factor (Shaw, Wagner, Arnett, & Aber, 1992; Weiss, Tull, Dixon-Gordon, & Gratz, 2016), using multiple RSDB measures may have less utility than a measure assessing a unified RSDB construct. Second, one could use existing comprehensive risky behavior measures such as the Risky Impulsive and Self-Destructive Questionnaire (Sadeh & Baskin-Sommers, 2017), the Risky Behaviors Questionnaire (Weiss et al., 2016), and the Risk-Taking Behavior Scale (Pat-Horenczyk et al., 2007). However, these are lengthy (e.g., 38, 29, and 87 items), assess more than just frequency of engaging in RSDBs (e.g., functionality of RSDBs), and/or are restricted to a specific developmental period (e.g., adolescence). Further, these measures do not include items to specifically examine posttrauma manifestations of RSDBs, a necessary criterion for evaluating PTSD’s E2. Indeed, while the types of RSDBs may be similar among trauma-exposed and non-trauma-exposed samples, there is a demonstrated uniqueness in the presentation, function, and course of RSDBs among trauma-exposed populations. For instance, trauma-exposed individuals may functionally engage in RSDBs as an emotion regulation strategy to cope with PTSD symptoms/distress (Marshall-Berenz, Vujanovic, & MacPherson, 2011; Weiss et al., 2015; Weiss, Tull, Viana, Anestis, & Gratz, 2012), implying their onset after trauma/PTSD symptoms. Given the aforementioned limitations of existing measures, we need a comprehensive (yet brief enough to ensure clinical utility) and validated screening measure to examine the unidimensional E2 criterion. We developed the Posttrauma Risky Behaviors Questionnaire (PRBQ) to assess extent of engagement in posttrauma RSDBs and examined its factor structure, reliability, and validity (content, convergent, construct, incremental) in a trauma-exposed community sample recruited via Amazon’s MTurk platform. We further replicated this factor structure and examined its validity (construct and convergent) with a different trauma-exposed sample of college students (Hinkin, 1998; Holmbeck & Devine, 2009). We hypothesized good psychometric properties and ability to represent distinct RSDBs as a unidimensional construct.

Borderline personality disorder (BPD) symptoms and suicidal behaviors are prevalent among undergraduate students. Although rumination contributes to self-destructive behaviors in BPD, less research examines the role of rumination in distinct suicidal outcomes among individuals with BPD features instead focusing more on self-destructive behaviors as a latent variable. The present study examined the main and interactive effects of BPD features and two forms of rumination (brooding and anger) in the prediction of suicide-related outcomes (ideation and attempts) among college students. Participants (

Although researchers have identified a number of factors that may motivate individuals to engage in nonsuicidal self-injury (NSSI), few studies have examined whether motives for NSSI differ as a function of psychiatric diagnosis. Therefore, the goal of the present study was to examine motives for lifetime NSSI among individuals with a history of psychiatric disorders associated with elevated rates of NSSI: depressive disorders and posttraumatic stress disorder (PTSD). Young adults (N = 139) with a history of NSSI completed several diagnostic interviews and questionnaires, including a measure of lifetime NSSI motives. Results demonstrated that participants with (vs. without) a lifetime depressive disorder reported significantly lower levels of interpersonal influence motives for NSSI, and participants with (vs. without) lifetime PTSD reported significantly higher levels of emotional relief and feeling generation motives. Further, results revealed a significant interaction between lifetime depressive disorders and PTSD for interpersonal communication motives; specifically, whereas participants with lifetime diagnoses of both a depressive disorder and PTSD did not differ significantly in reported interpersonal communication motives from participants with neither diagnosis, those with lifetime PTSD but without a lifetime depressive disorder reported significantly higher levels of interpersonal communication motives than those without either diagnosis. Results suggest that a history of depression and PTSD (alone and in combination) may be associated with different motives for NSSI.

OBJECTIVES. Posttraumatic stress disorder (PTSD) often co-occurs with substance use (SU). Although there has been independent research on subgroups of participants based on their PTSD or SU responses, rarely are PTSD-SU typologies examined consistent with a precision medicine approach (and corresponding person-centered statistical approaches). The current study examined the nature and construct validity (covariates of depression, physical aggression, verbal aggression, anger, hostility, reckless and self-destructive behaviors [RSDB]) of the best-fitting latent class solution in categorizing participants based on PTSD (PTSD Checklist for DSM-5) and alcohol/drug use responses (Alcohol Use and Disorders Identification Test Alcohol Consumption Questions, Drug Abuse Screening Test). METHODS. The sample included 375 trauma-exposed participants recruited from Amazon’s Mechanical Turk online labor market. RESULTS. Latent class analyses indicated an optimal three-class solution (Low PTSD/SU, Moderate PTSD/Drug and High Alcohol, High PTSD/SU). Multinomial logistic regressions indicated that depression (OR = 1.22) and frequency of RSDBs (OR = 1.20) were significant predictors of the Moderate PTSD/Drug and High Alcohol Class versus the Low PTSD/SU Class. Depression (OR = 1.55) and frequency of RSDBs (OR = 1.19) were significant predictors of the High PTSD/SU Class versus the Low PTSD/SU Class. Only depression (OR = 1.27) was a significant predictor of the High PTSD/SU Class versus the Moderate PTSD/Drug and High Alcohol Class. CONCLUSIONS. Results provide construct validity support for three meaningful latent classes with unique relations with depression and RSDBs. These findings improve our understanding of heterogeneous PTSD-SU comorbidity patterns and highlight acknowledgment of such subtyping (subgrouping) in considering differential treatment options, treatment effectiveness, and resource allocation.

Suicide is a leading cause of death in the US, with suicide rates increasing annually. Passive screening of suicidal ideation is vital to provide referrals to at-risk individuals. We study to what degree smartphone-based communication, in particular, text messages, could be leveraged for passively screening for suicidal ideation. We analyze the screening ability of texts sent in different time periods prior to reported ideation, namely, texts from specific weeks only versus accumulative over several weeks. Our approach involves performing comprehensive feature engineering and identifying influential features to train machine learning models. With just the prior week of texts, we were able to predict the existence of suicidal ideation with AUC = 0.88, F1 = 0.84, accuracy = 0.81, sensitivity = 0.94, and specificity = 0.68. The most influential features include word frequencies of words in the car, clothing, affection, confusion, driving, real estate, and journalism categories. This research, demonstrating the potential of text messages to screen for suicidal ideation, will guide the development of screening technologies.

Borderline personality disorder (BPD) and depression are characterized by negative emotionality, yet BPD is also theorized to be linked with emotional variability. The present study extends past work to a larger time scale and notes the degree to which stress-related emotional responses are variable or persistent across stressors using novel analytic models. Participants (N = 164) were undergraduate students who completed daily assessments of negative emotional responses to interpersonal stressors for 2 weeks. BPD and depression were associated with greater negative emotional intensity and greater emotional variability in response to nonsocial stressors. Only BPD features were associated with greater emotional variability in response to social stressors. This study is limited by its reliance on self-report in a nonclinical sample and limited within-person assessments. Data point to distinct constellations of emotional dysfunction in BPD and depression. Pending replication, these data may inform targeting of emotional dysfunction in treatment.

Background A fast-growing body of research provides support for the role of positive emotion dysregulation in the etiology and maintenance of a wide range of psychiatric difficulties and clinically relevant behaviors. However, this work has exclusively relied on the subjective assessment of positive emotion dysregulation. Advancing research, the current study examined associations between physiological and subjective indices of positive emotional responding in the laboratory. Specifically, we explored the relation of the Difficulties in Emotion Regulation Scale – Positive (Weiss, Gratz, & Lavender, 2015) to resting heart rate variability (HRV) at high and low state positive affect intensity. Methods Participants were 122 individuals recruited from college and community settings (Mage = 23.39, 84.4% female, 68.0% White). Results Findings indicated a positive relation between positive emotion dysregulation and resting HRV at high state positive affect and a negative relation between positive emotion dysregulation and resting HRV at low state positive affect. Conclusions Results extend our understanding of the associations among subjective and physiological indices of positive emotional processes. These findings have key implications for the conduct of research on positive emotion dysregulation.

Although once considered a defining feature of borderline personality disorder, research has found high rates of NSSI among individuals with other psychiatric disorders, particularly posttraumatic stress disorder (PTSD) and depressive disorders. A recent study from our research team found that lifetime PTSD and depressive disorders were associated with unique self-reported NSSI motives. Given well-established limitations of assessing motives via self-report measures, the present study sought to extend this line of research by using a novel laboratory measure of the implicit NSSI-relief association to examine NSSI emotional relief motives.A subset of participants from our previous study (Findings indicated that individuals with lifetime PTSD evidenced stronger NSSI-relief associations than those without PTSD. Further, this main effect was qualified by a PTSD by depressive disorder interaction, such that stronger NSSI-relief associations were found among individuals with lifetime PTSD but no lifetime depressive disorder than among individuals without a history of either PTSD or a depressive disorder.Results highlight the importance of investigating NSSI motives associated with different symptom profiles using a multi-method approach.

Objective This study examined the presence of posttraumatic stress disorder (PTSD) as a predictor of treatment response to dialectical behavior therapy (DBT) across the primary outcomes of interest within DBT (i.e., borderline personality disorder [BPD] symptoms, deliberate self-harm, emotion regulation [ER] difficulties) and PTSD symptoms. Method Participants (N = 56) were consecutive admissions to an outpatient DBT clinic that completed diagnostic interviews at intake and self-report outcome measures at intake and every 3 months throughout the treatment. Results Patients with (vs. without) a PTSD diagnosis did not report greater clinical severity at intake on most outcome measures, with the exception of PTSD symptom severity and, among older patients only, ER difficulties. The presence of a PTSD diagnosis was not associated with poorer treatment response to DBT. Instead, PTSD was associated with better response on the measure of BPD symptom severity. Conclusions The results suggest that patients with PTSD can benefit from DBT.

Existing literature indicates a theoretical and empirical relation between engagement in reckless behaviors and posttraumatic stress disorder (PTSD). Thus, the DSM-5 revision of the PTSD nosology added a new “reckless or self-destructive behavior” (RSDB) symptom (Criterion E2). The current study applied a network analytic approach to examine the item-level relations among a range of reckless behaviors and PTSD symptom clusters. Participants were recruited from Amazon's Mechanical Turk (N = 417), and network analysis was conducted with 20 variables: six PTSD symptom clusters, corresponding to the hybrid model of PTSD (Armour et al., 2015) and excluding the externalizing behavior cluster (Community 1), and 14 items related to reckless behavior (Community 2). The results showed that the network associations were strongest within each construct (i.e., within PTSD and within reckless behaviors), although several bridge connections (i.e., between PTSD clusters and reckless behaviors) were identified. Most reckless behavior items had direct associations with one or more PTSD symptom clusters. The present findings support the existence of close relations between a variety of reckless behaviors and PTSD symptom clusters beyond their relations with DSM Criterion E2. The results provide testable hypotheses about the associations between specific reckless behaviors and PTSD symptom clusters, which may inform future research.

Background Research over the past two decades supports emotion regulation as a transdiagnostic factor related to the etiology, maintenance, and treatment of a wide range of psychiatric difficulties and risky behaviors. However, prior investigations are limited by their focus on difficulties regulating negative (but not positive) emotions. Further, research has not accounted for the heterogeneity in difficulties regulating emotions. Methods Participants were 210 female victims of domestic violence (DV; M age = 36.14, 48.6% African American) who completed measures assessing emotion regulation (Difficulties in Emotion Regulation Scale; Difficulties in Emotion Regulation Scale – Positive), posttraumatic stress disorder (PTSD; Posttraumatic Stress Diagnostic Scale), depression (Center for Epidemiologic Studies-Depression Scale), alcohol misuse (Alcohol Use Disorder Identification Test) and drug misuse (Drug Abuse Screening Test). Latent profile analysis was utilized to identify subgroups of DV-victimized women who were similar in endorsed difficulties in regulating negative and positive emotions. Differences in psychiatric difficulties (i.e., PTSD and depressive symptom severity) and risky behaviors (i.e., alcohol and drug misuse) were examined across these classes. Results Three classes of DV-victimized women differentiated by levels of difficulties regulating negative and positive emotions were identified. Greater psychiatric difficulties were found among classes defined by higher levels of difficulties regulating emotions, regardless of emotion valence. Risky behaviors were more prevalent among the class defined by higher levels of difficulties regulating both negative and positive emotions. Limitations Although results add to the literature on difficulties regulating emotions and their correlates, findings must be interpreted in light of limitations present including use of a cross-sectional and correlation design, reliance on self-report measures, and assessment of a select sample of women victims of DV. Conclusions Results highlight the potential importance of tailoring interventions accounting for the heterogeneity in negative and positive emotion regulation dimensions among DV-victimized women.

Despite the prevalence of anger management programs in correctional settings, there is mixed support for their effectiveness, and little is known about who benefits most. This preliminary study aim...

Recent attention has focused on the role of interpersonal emotion regulation (IER) in the development and maintenance of a range of forms of psychopathology, including anxiety, depression, and borderline personality disorder (BPD). Despite the relevance of IER in psychopathology, few measures exist to characterize patterns of maladaptive IER. Our aim was to (1) develop a measure of maladaptive IER, (2) begin to explore the factor structure of this new measure, the difficulties in interpersonal regulation of emotions (DIRE), and (3) examine its association with symptoms of psychopathology. In Study 1, 853 Mechanical Turk workers completed the DIRE and measures of psychopathology symptoms. We identified two factors each in the IER and intrapersonal emotion regulation scales. In Study 2, 142 undergraduate students completed the DIRE and daily measures of emotion regulation and coping for 14 days. Preliminary findings suggest that the DIRE has adequate internal consistency and construct and predictive validity. This measure has the potential to supplement future efforts in assessing IER in psychopathology.

This study examined the effects of avoidance- versus acceptance-oriented emotion regulation instructions among individuals with borderline personality disorder (BPD; n = 48), major depressive disorder (MDD; n = 54), and non-psychiatric controls (NPC; n = 50) using ecological momentary assessment. Participants were randomly assigned to either accept or avoid negative emotions, and monitored their moods, urges, and distress tolerance several times per day over 6 days. Avoidance instructions resulted in reduced negative affect and urges for maladaptive behaviors uniquely among BPD participants. Together with past research, and consistent with treatment approaches emphasizing the short-term use of skills to avoid or distract from emotions (e.g., DBT; Linehan, 1993b, 2015), these findings suggest that avoidance of negative emotions may have temporary benefits for individuals with BPD. Acceptance-oriented strategies may take longer or may require more extensive training to be beneficial for emotional functioning in everyday life in BPD.

Borderline personality disorder (BPD) is a disorder characterized by emotion regulation (ER) difficulties. Although research indicates that patterns of ER differ across racial groups, few studies have examined the role of race in the ER-BPD association. This study sought to address this gap. Participants in this study identified as either East Asian, White, or Black, and were recruited from sites in Western Canada and the Southern United States. Two samples were included in this study: (a) 194 university students who self-reported BPD features and (b) 88 adults from the community who underwent diagnostic interviews and had a BPD diagnosis. All participants self-reported ER difficulties. Results revealed that race moderated the link between some aspects of ER difficulties and BPD. For instance, relations between (a) nonacceptance of emotions and BPD affect instability, (b) limited access to ER strategies and BPD identity disturbance, and (c) low emotional awareness and BPD diagnosis were stronger among White (vs. Black or East Asian) participants. Implications of these findings for the diagnosis and treatment of BPD across racial groups are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background : Despite theories that negative reinforcement in the form of relief from negative emotions maintains nonsuicidal self-injury (NSSI), no studies have examined the extent to which specific emotional consequences of NSSI predict the maintenance of NSSI over time or explain the greater risk for NSSI found among individuals with borderline personality disorder (BPD) pathology. This study examined whether specific emotional consequences of NSSI relate to the continuance of NSSI behavior over a 12-month period and explain the relation of baseline BPD pathology to future NSSI. Methods : Participants with a history of recent repeated NSSI (N = 84) completed baseline measures of BPD pathology, NSSI, and the emotional antecedents and consequences of NSSI, including self-conscious emotions, undifferentiated negative affect, anger, emptiness, sadness, and anxiety; follow-up data on NSSI were collected every three months for one year. Results : Of the emotional consequences of NSSI examined here, only self-conscious emotions significantly predicted the presence and frequency of NSSI during the 12-month follow-up period. Likewise, whereas BPD pathology was not directly associated with later NSSI, both overall BPD pathology and the specific BPD feature of identity problems were indirectly related to the presence of 12-month NSSI through the greater frequency of post-NSSI self-conscious emotions. Limitations : Emotional consequences of NSSI were assessed using a retrospective self-report measure. Only frequency, and not intensity, of emotions before and after NSSI were assessed. Conclusions : Results suggest a distinct role of post-NSSI self-conscious emotions in the maintenance of NSSI among individuals with and without BPD pathology.

Although parent emotion socialization and child temperament are theorized to interact in the prediction of borderline personality disorder (BPD) features, few studies have directly examined these relationships. The present study examined whether parental emotion socialization interacted with behavioral ratings and physiological indicators of emotional vulnerability in the prediction of BPD features among preadolescent children. Participants were 125 children (10–12 years; 55% female) and their parents recruited from the community. Parents and children reported on children’s BPD features and parents completed a measure of supportive and non-supportive emotion socialization. Children’s emotional vulnerability was assessed based on parent-rated negativity/lability and emotion regulation skills and children’s respiratory sinus arrhythmia (RSA) and skin conductance level (SCL) reactivity to a social stressor. Several significant interactions of parent supportive reactions, non-supportive reactions, and child emotional reactivity emerged. Children were lowest in BPD features when parents were high in supportive reactions and/or low in non-supportive reactions and the child was low in emotional vulnerability (e.g., low negativity/lability, good emotion regulation skills, or low SCL reactivity to stress). These findings suggest that specific emotion socialization factors in interaction with children’s emotional reactivity may predict risk for BPD features in preadolescence. Future research is needed to replicate these findings and examine whether this interaction prospectively predicts trajectories of BPD features.

Objective Emotion dysregulation is a transdiagnostic construct with relevance to a wide range of mental health outcomes. A growing literature highlights the contribution of positive emotion dysregulation to mental health outcomes. However, there remains limited understanding of the interplay of negative and positive emotion dysregulation on mental health outcomes. To address this limitation, the current study examined whether the association of positive emotion dysregulation to the mental health outcomes of posttraumatic stress disorder (PTSD), depression, and alcohol and drug misuse was attenuated by negative emotion dysregulation. Method Participants were 373 trauma-exposed individuals recruited from Amazon's MTurk (Mage = 35.74 years; 57.1% female; 75.9% White). Results Both negative and positive emotion dysregulation were positively related to PTSD, depression, and alcohol and drug misuse. Moderation analyses showed that negative emotion dysregulation did not attenuate the relations between positive emotion dysregulation and PTSD, depression, and alcohol and drug misuse. Discussion These findings suggest that the relation of positive emotion dysregulation to mental health outcomes may not be dependent on negative emotion dysregulation, supporting the utility of both negative and positive emotion dysregulation in identifying and treating mental health outcomes in trauma-exposed individuals. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Theories of borderline personality disorder (BPD) highlight the central role of emotional dysfunction in this disorder, with a particular emphasis on emotional reactivity and emotion regulation (ER) difficulties. However, research on emotion-related difficulties in BPD has produced mixed results, often related to the particular indices of emotional responding used in the studies. As such, the specific nature of emotional dysfunction in BPD, as well as the extent to which subjective emotion-related difficulties map onto corresponding physiological deficits, remains unclear. This study examined both subjective and physiological indices of emotional reactivity and ER difficulties in response to a social rejection emotion induction (relative to a neutral emotion induction) across three groups of participants: self-harming young adults with BPD, self-harming young adults without BPD, and clinical controls with no self-harm history or BPD. Consistent with the hypotheses, results revealed a lack of convergence between subjective and physiological indices of emotional reactivity and ER difficulties among participants with BPD. Whereas participants with BPD reported both greater emotional reactivity and greater ER difficulties in response to the negative emotion induction than participants without self-harm or BPD, there were no significant differences in physiological indices of emotional reactivity or ER between participants with BPD and either of the control groups. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

OBJECTIVES Emotion dysregulation is a transdiagnostic factor central to the etiology and treatment of various clinical difficulties. Yet, research in this area has focused almost exclusively on emotion dysregulation stemming from negative emotions. The current study confirmed the factor structure of the Difficulties in Emotion Regulation Scale-Positive (DERS-P) and further examined its reliability and validity. METHOD Participants in Study 1 were 229 college students (M age = 19.37 years; 66.8% female; 67.2% White). Participants in Study 2 were 353 trauma-exposed community individuals ( M age = 35.77 years; 57.8% female; 71.2% White). RESULTS Findings supported the three-factor structure of the DERS-P. Mean levels of the DERS-P scales demonstrated convergent and discriminant validity and differentiated individuals with (vs. without) probable posttraumatic stress disorder, depression, alcohol use, and drug use disorders. CONCLUSIONS Findings provide additional support for the factor structure, reliability, and validity of the DERS-P, thereby adding to its clinical utility.

This study examined the main and interactive effects of MDD and lifetime nonsuicidal self-injury (NSSI) on current suicide risk and past suicide attempts. We predicted that individuals with a history of NSSI and current MDD would be at greater suicide risk than those with either risk factor alone. An interaction between lifetime MDD and NSSI was hypothesized for past suicide attempts. 204 substance dependent inpatients completed self-report measures and a diagnostic interview. Patients with both a history of NSSI and current MDD, relative to all other groups, had the greatest suicide risk. No support was found for the lifetime MDD by NSSI interaction. Conclusion: Findings suggest the relevance of both NSSI and MDD in suicide risk.

Emotion dysregulation has been theorized to either directly or indirectly drive many of the symptoms associated with borderline personality disorder. In this chapter, several current controversies in this body of work are reviewed. The chapter presents the role of emotion dysregulation in theories of the development and maintenance of borderline personality disorder. Further, it reviews the state of research on emotional responding in borderline personality disorder, focusing on any evidence of emotional sensitivity, reactivity, and time course. Building on this review, the chapter summarizes recent advances in the study of difficulties in emotion regulation capacities and strategies in the context of this disorder. In addition, it outlines the links between emotion dysregulation and other problems in borderline personality disorder. Finally, this chapter highlights the limitations and future directions in this line of work.

BACKGROUND: Alcohol use is highly prevalent and linked to a wide range of negative outcomes among college students. Although emotion dysregulation has been theoretically and empirically linked to alcohol use, few studies have examined emotion dysregulation stemming from positive emotions. OBJECTIVE: The goal of the current study was to extend extant research by using daily diary methods to examine the potentially moderating role of difficulties regulating positive emotions in the daily relation between positive affect and alcohol use to cope with social and non-social stressors. METHODS: Participants were 165 college students (M age = 20.04; 55.2% male) who completed a baseline questionnaire assessing difficulties regulating positive emotions and responded to questions regarding state positive emotions and alcohol use once a day for 14 days. RESULTS: Difficulties regulating positive emotions moderated the daily relation between positive affect stemming from social stressors and alcohol use to cope with social stressors, such that positive affect stemming from social stressors predicted alcohol use to cope with social stressors among college students with high (but not low) levels of difficulties regulating positive emotions. CONCLUSIONS: Findings underscore the potential utility of targeting difficulties regulating positive emotions in treatments aimed at reducing alcohol use to cope with social stressors among college students.

The co-occurrence of posttraumatic stress disorder (PTSD) and substance use is clinically-relevant. Emotion dysregulation is one factor that has been shown to underlie this association. However, literature in this area has been limited in its exclusive focus on emotion dysregulation stemming from negative emotions. The goal of the current study was to extend prior research by exploring the role of difficulties regulating positive emotions in the associations between PTSD symptom severity and both alcohol use and problems from drug use. Participants were 463 trauma-exposed individuals recruited from Amazon's MTurk (M age = 35.66 years; 55.7% female; 76.6% White). PTSD symptom severity, difficulties regulating positive emotions, alcohol use, and problems from drug use demonstrated significant positive zero-order correlations. Further, difficulties regulating positive emotions were found to account for the associations between PTSD symptom severity and both alcohol use and problems from drug use. Our results suggest the potential utility of addressing difficulties regulating positive emotions in interventions aimed at reducing substance use and abuse among individuals with PTSD.

BackgroundAlthough Dialectical Behaviour Therapy (DBT) is an evidence-based psychosocial treatment for borderline personality disorder (BPD), the demand for it exceeds available resources. The commonly researched 12-month version of DBT is lengthy; this can pose a barrier to its adoption in many health care settings. Further, there are no data on the optimal length of psychotherapy for BPD. The aim of this study is to examine the clinical and cost-effectiveness of 6 versus 12months of DBT for chronically suicidal individuals with BPD. A second aim of this study is to determine which patients are as likely to benefit from shorter treatment as from longer treatment.Methods/designPowered for non-inferiority testing, this two-site single-blind trial involves the random assignment of 240 patients diagnosed with BPD to 6 or 12months of standard DBT. The primary outcome is the frequency of suicidal or non-suicidal self-injurious episodes. Secondary outcomes include healthcare utilization, psychiatric and emotional symptoms, general and social functioning, and health status. Cost-effectiveness outcomes will include the cost of providing each treatment as well as health care and societal costs (e.g., missed work days and lost productivity). Assessments are scheduled at pretreatment and at 3-month intervals until 24months.DiscussionThis is the first study to directly examine the dose-effect of psychotherapy for chronically suicidal individuals diagnosed with BPD. Examining both clinical and cost effectiveness in 6 versus 12months of DBT will produce answers to the question of how much treatment is good enough. Information from this study will help to guide decisions about the allocation of scarce treatment resources and recommendations about the benefits of briefer treatment.Trial registrationNCT02387736 . Registered February 20, 2015.

Within the United States, risky sexual behavior (RSB) is the primary mode of HIV transmission. The role of emotion dysregulation in RSB has received growing attention over the past decade. However, this literature has been limited in its focus on emotion dysregulation stemming from negative (but not positive) emotions. The goal of the current study was to extend research by examining the relative and unique contributions of dimensions of difficulties regulating positive emotions (i.e., nonacceptance of positive emotions [Accept], difficulties controlling impulsive behaviors when experiencing positive emotions [Impulse], and difficulties engaging in goal-directed behaviors when experiencing positive emotions [Goals]) to RSB. Participants were 386 trauma-exposed individuals recruited from Amazon’s MTurk (M age = 35.85 years; 57.5% female; 76.4% White). At the bivariate level, dimensions of difficulties regulating positive emotions were significantly positively associated with sexual risk taking with uncommitted partners, impulsive sex behaviors, and intent to engage in risky sexual behaviors (with the exception of Goals to sexual risk taking with uncommitted partners), and significantly negatively associated with risky sex acts. Regarding the unique contributions of difficulties regulating positive emotions to RSB, (a) Accept was significantly positively associated with impulsive sexual behaviors and intent to engage in risky sexual behaviors; (b) Impulse was significantly positively associated with risky anal sex acts; and (c) Goals was significantly negatively associated with risky anal sex acts. Findings suggest the potential utility of targeting difficulties regulating positive emotions in treatments aimed at reducing RSB.

Despite prior assumptions about poor prognosis, the surge in research on borderline personality disorder (BPD) over the past several decades shows that it is treatable and can have a good prognosis. Prominent theories of BPD highlight the importance of emotional dysfunction as core to this disorder. However, recent empirical research suggests a more nuanced view of emotional dysfunction in BPD. This research is reviewed in the present article, with a view towards how these laboratory-based findings can influence clinical work with individuals suffering from BPD.

This pilot study examined the effects of dialectical behavior therapy (DBT) emotion regulation (ER) skills training for borderline personality disorder (BPD). To date, studies have yet to reveal whether specific DBT skill modules uniquely improve ER problems - one of the putative factors considered to underlie clinical problems in BPD. This preliminary examination aimed to characterize the effect sizes of DBT-ER compared to DBT interpersonal effectiveness (DBT-IE) skills training. Women with BPD (N = 19) were randomized to 6-weeks of DBT-ER, DBT-IE, or a control group. BPD symptoms, emotion regulation, and other BPD-relevant outcomes were assessed using self-report and laboratory-based measures. The DBT-ER group demonstrated large effect sizes for improved self-reported reactivity to an emotional stressor, generation of active rather than passive solutions to interpersonal problems, as well as self-reported distress tolerance, mindfulness, and BPD symptoms following treatment. At follow-up, DBT-ER training was also associated with large improvements in ER, social problem solving, and depression. Similarly large effect sizes, however, were sometimes also achieved in the DBT-IE and control condition. Significant condition x time interactions were detected for non-suicidal self-injury and mindfulness, with significant improvements occurring only in the DBT-ER group, whereas such interactions were not detected for other outcomes. These findings, although preliminary, can stimulate future research examining the specificity of DBT skills.

Emerging research suggests that two features of emotional contexts (emotion intensity, emotion type) predict spontaneous use of emotion regulation (ER) strategies. However, prior work has not examined the interactive effects of emotion intensity and emotion type on the selection of specific ER strategies. This is a noteworthy omission because in real life, emotional situations are characterized by a combination of emotion intensity and type. We recruited 562 participants and asked them to report their use of 7 ER strategies across self-identified stressful contexts that varied in emotion intensity (moderate, high) and primary emotion elicited (anger, anxiety, sadness). Participants reported using ER strategies to a greater extent in high versus moderate emotionally intense contexts, and in response to sadness (versus anger). Further, high intensity sadness prompted greater use of expressive suppression than other contexts. Our findings underscore the importance of taking into account emotional contextual features as predictors of spontaneous ER.

The transaction of adolescent’s expressed negative affect and parental interpersonal emotion regulation are theoretically implicated in the development of borderline personality disorder (BPD). Although problem solving and support/validation are interpersonal strategies that foster emotion regulation, little is known about whether these strategies are associated with less BPD severity among adolescents. Adolescent girls (age 16; N = 74) and their mothers completed a conflict discussion task, and maternal problem solving, support/validation, and girls’ negative affect were coded. Girls’ BPD symptoms were assessed at four time points. A 3-way interaction of girls’ negative affect, problem solving, and support/validation indicated that girls’ negative affect was only associated with BPD severity in the context of low maternal support/validation and high maternal problem solving. These variables did not predict changes in BPD symptoms over time. Although high negative affect is a risk for BPD severity in adolescent girls, maternal interpersonal emotion regulation strategies moderate this link. Whereas maternal problem solving coupled with low support/validation is associated with a stronger negative affect-BPD relation, maternal problem solving paired with high support/validation is associated with an attenuated relationship.

Emerging research and theory point to the importance of interpersonal emotion regulation processes in intrapersonal and social functioning. The aim of the present review is to present a definitional framework of interpersonal emotion regulation and highlight recent empirical research and novel paradigms in this area. We suggest that future work in this field would benefit from firstly, converging upon a common terminology; secondly, using innovative paradigms to adequately capture the dyadic nature of these processes; and finally, employing context-sensitive views of the adaptive and maladaptive influences of interpersonal emotion regulation across domains. In particular, further research is needed to identify patterns of interpersonal emotion regulation associated with psychopathology that could serve as targets for intervention.

African American women are at heightened risk for intimate partner violence (IPV) and its negative consequences, including health-compromising behaviors. Deliberate self-harm (DSH) is one clinically-relevant behavior that has been understudied among African American women generally and those with exposure to IPV in particular. To date, no studies have examined factors that may account for the relationship between IPV and DSH. Therefore, the goal of the present study was to examine the intercorrelations among IPV (physical, psychological, and sexual), PTSD, and DSH history and versatility, and the potentially mediating role of PTSD symptoms in the IPV-DSH relation. Participants were 197 African American community women currently experiencing IPV. Sixty participants (31%) reported a history of DSH. Among participants who reported DSH, there was an average endorsement of 2.3 unique forms of deliberate self-harm (i.e., DSH versatility). Significant positive associations were detected among physical IPV severity, psychological IPV severity, PTSD symptom severity, and DSH history and versatility. PTSD symptom severity mediated the relationships between physical and psychological IPV severity and DSH history and versatility. Results highlight the relevance of PTSD symptoms to DSH and suggest that treatments targeting PTSD symptoms may be useful in reducing DSH among IPV-exposed African American women.

Despite growing evidence for the efficacy of Gratz and colleagues' emotion regulation group therapy (ERGT) for deliberate self-harm (DSH) among women with borderline personality disorder (BPD), the proposed mechanism of change in this treatment (i.e., emotion regulation) remains largely unexamined. This study examined change in emotion dysregulation as a mediator of the effects of this ERGT on DSH and BPD symptoms, as well as the extent to which change in emotion dysregulation during treatment predicts further improvements in DSH during a 9-month follow-up. Participants included 61 female outpatients with BPD and recent DSH who were randomly assigned to receive this ERGT in addition to their ongoing outpatient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of emotion dysregulation, DSH, and BPD symptoms were administered pre- and post-treatment or -waitlist, and at 9-months post-treatment (for participants in both conditions who received ERGT). Results from a series of mediation analyses provide further support for emotion regulation as a mechanism of change in this treatment. Specifically, results revealed that improvements in emotion dysregulation over the course of treatment mediated the observed reductions in BPD cognitive and affective symptoms during treatment and predicted further improvements in DSH during follow-up.

Despite the inclusion of nonsuicidal self-injury disorder (NSSID) in the DSM-5, research on NSSID is limited and no studies have examined the full set of DSM-5 NSSID diagnostic criteria. Thus, this study examined the reliability and validity of a new structured diagnostic interview for NSSID (the Clinician-Administered NSSI Disorder Index; CANDI) and provides information on the clinical characteristics and features of DSM-5 NSSID. Data on the interrater reliability, internal consistency, and construct validity of the CANDI and associated characteristics of NSSID were collected in a community sample of young adults ( N = 107) with recent recurrent NSSI (≥10 lifetime episodes of NSSI, at least one episode in the past year). Participants completed self-report measures of NSSI characteristics, psychopathology, and emotion dysregulation, as well as diagnostic interviews of borderline personality disorder (BPD) and lifetime mood, anxiety, and substance use disorders. The CANDI demonstrated good interrater reliability and adequate internal consistency. Thirty-seven percent of participants met criteria for NSSID. NSSID was associated with greater clinical and diagnostic severity, including greater NSSI versatility, greater emotion dysregulation and psychopathology, and higher rates of BPD, bipolar disorder, posttraumatic stress disorder, social anxiety disorder, and alcohol dependence. Findings provide support for the reliability, validity, and feasibility of the CANDI.

Emotion regulation difficulties have been theoretically and empirically linked to posttraumatic stress disorder (PTSD). Previous research, however, has focused almost exclusively on difficulties regulating negative emotions. In this study, we explored the nature of difficulties regulating positive emotions in PTSD. Participants were women who had experienced domestic violence (N = 210; 48.6% African American; M(age) = 36.14 years). Higher levels of nonacceptance of positive emotions, difficulties engaging in goal-directed behaviors when experiencing positive emotions, and difficulties controlling impulsive behaviors when experiencing positive emotions were related to a higher level of PTSD symptom severity overall and for the intrusion, avoidance/emotional numbing, and hyperarousal clusters, rs = .24–.37. The presence (vs. absence) of a probable PTSD diagnosis was related to greater difficulties engaging in goal-directed behaviors, d = 0.54, and controlling impulsive behaviors, d = 0.34, when experiencing positive emotions. Results suggest the potential utility of assessing and treating difficulties regulating positive emotions among domestic violence–victimized women with PTSD.

Background and objectives Despite strong support for the role of emotional relief in deliberate self-harm (DSH), no research has examined the impact of emotional distress on the strength of the DSH-relief association. Thus, it remains unclear whether the association of DSH with emotional relief is stable across emotional contexts or context-dependent. This study aimed to examine if the implicit DSH-relief association is stronger in the context of emotional distress (relative to a neutral emotional context). Methods Young adult women with (n = 60) and without (n = 60) a history of recent recurrent DSH were randomly assigned to complete a novel version of the Implicit Association Test (IAT) assessing the DSH-relief association at baseline (following an initial neutral emotion induction) and again following either a neutral or negative (i.e., social rejection) emotion induction. Results Consistent with hypotheses, the DSH-relief association was stronger among women with recent recurrent DSH (vs. those without DSH) at baseline. Contrary to hypotheses, however, whereas the DSH-relief association remained stable following both the neutral and negative emotion inductions among participants with DSH, it became stronger across both conditions for participants without DSH. Limitations The use of a community sample of young adult women may limit generalizability to other relevant populations (e.g., clinical populations, young men, adolescents). Additionally, the negative emotion induction may not have been powerful enough to affect the strength of the learned DSH-relief association among individuals with a repeated history of DSH. Conclusions Findings suggest that the repeated use of DSH to bring about emotional relief may engender associations of DSH with relief that are relatively insensitive to emotional context.

This paper reviews current literature on the links between personality pathology and intentional self-harm, including nonsuicidal self-injury (NSSI) and suicidal behaviors. Specifically, this review highlights recent advances stemming from longitudinal, epidemiological, and health registry studies, as well as emerging research on pathological personality traits and intentional self-harm, and integrates current knowledge across dimensional and categorical frameworks to provide recommendations for clinical practice and future research. This review provides strong evidence that personality disorders marked by intense and unstable negative affect, detachment/low extraversion, aggression/hostility, and specific facets of impulsivity may be considered risk factors for suicidal behaviors. Further, there is some evidence of a stronger relation between maladaptive personality traits and suicidal versus non-suicidal intentional self-harm.

Borderline personality disorder (BPD) is associated with higher rates of pain conditions and greater pain impairment. Past research implicates emotional suppression in acute pain tolerance; thus, emotional suppression may contribute to pain interference among those with high BPD features. Participants were 89 university students who completed measures of BPD features, and complied with 2-week daily diary procedures assessing suppression of emotional thoughts associated with social and nonsocial stressors, distress, pain severity, and interference. Multilevel models revealed a BPD × Suppression × Distress interaction, such that suppression in response to social (but not nonsocial) stressors in the context of high distress was related to pain interference when controlling for pain severity among those with high, but not low, BPD features. These findings suggest. that suppression of emotionally relevant thoughts in response to high distress may contribute to the functional impairment from pain among those with high BPD symptoms.

Despite preliminary evidence that individuals with borderline personality disorder (BPD) demonstrate deficits in learning from corrective feedback, no studies have examined the influence of emotional state on these learning deficits in BPD. This laboratory study examined the influence of negative emotions on learning among participants with BPD (n = 17), compared with clinical (past-year mood/anxiety disorder; n = 20) and healthy (n = 23) controls. Participants completed a reinforcement learning task before and after a negative emotion induction. The learning task involved presenting pairs of stimuli with probabilistic feedback in the training phase, and subsequently assessing accuracy for choosing previously rewarded stimuli or avoiding previously punished stimuli. ANOVAs and ANCOVAs revealed no significant between-group differences in overall learning accuracy. However, there was an effect of group in the ANCOVA for postemotion induction high-conflict punishment learning accuracy, with the BPD group showing greater decrements in learning accuracy than controls following the negative emotion induction.