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Objective-As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, the aim of the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD).Method-A prospective study investigated whether emotion-regulation skills were associated with AD and whether these skills predicted alcohol use during and after treatment for AD. Participants were 116 individuals treated for AD with cognitive behavioral therapy. Emotion regulation and severity of AD symptoms were assessed by self-report. Alcohol use during treatment was assessed by breathalyzer and urine analysis for ethyl glucuronid; alcohol use during the 3-month follow-up interval was assessed by self-report.Results-Pretreatment emotion-regulation skills predicted alcohol use during treatment, and posttreatment emotion-regulation skills predicted alcohol use at follow-up, even when controlling for other predictors potentially related to emotion regulation. Among a broad range of specific emotion-regulation skills, the ability to tolerate negative emotions was the only skill that negatively predicted subsequent alcohol consumption when controlling for the other skills. Individuals in the AD sample reported significantly more deficits in emotion-regulation skills than did those in a non-clinical control sample, but significantly less than did those in a sample of individuals exclusively meeting criteria for major depressive disorder.Conclusions-Enhancement of general emotion-regulation skills, especially the ability to tolerate negative emotions, appears to be an important target in the treatment of AD. Publisher's Disclaimer:The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/ccp NIH Public Access Author Manuscript J Consult Clin Psychol. Author manuscript; available in PMC 2012 June 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAlcohol dependence (AD) is the most serious form of alcohol-use disorder. AD is associated with intense mental, physical, and functional impairment; high societal costs; and long-term suffering by both the dependent individual and the individual's family members (e.g., Caetano, Nelson, & Cunradi, 2001). However, AD is also fairly widespread, with a 12-month prevalence rate of nearly 4% in the general population (Hasin, Stinson, Ogburn, & Grant, 2007). Despite the development and implementation of several empirically supported treatments, only about 25% of clients have been found to remain abstinent during the first year following treatment terminat...

Despite some yet to be resolved challenges, the concept of emotion regulation has a broad and significant heuristic value for research in mental health.

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Deficits in emotion-regulation skills have widely been shown to be associated with poor emotional adjustment. However, it is still unclear whether these deficits are a cause or a consequence of poor adjustment. The purpose of the present research was to clarify the reciprocal effects between these 2 concepts. In 2 studies (Ns ϭ 446 and 635), self-reports of emotion regulation and emotional adjustment were assessed twice with a 2-week interval. Cross-lagged regression analyses demonstrated that selfreports of emotion regulation predicted subsequent adjustment, over and above the effects of previous adjustment, whereas emotional adjustment did not predict subsequent emotion regulation. Thus, a focus on emotion-regulation skills may be important in the prevention and treatment of affect-related mental health problems.

The current study investigated whether deficits in mindfulness (the awareness, attention, and acceptance of the present moment) can account for variability in borderline personality (BPD) features and characteristic difficulties in emotion regulation, interpersonal effectiveness, and impulsivity. Structural equation modeling and hierarchical regressions were utilized to examine the associations of trait mindfulness with BPD features, interpersonal problem-solving, impulsive and passive emotion-regulation strategies, and neuroticism in a sample of young adults (N = 342). As hypothesized, mindfulness was related inversely to BPD features and core areas of difficulty, and these associations continued even when controlling for neuroticism. Additionally, mindfulness deficits continued to predict borderline features even when interpersonal effectiveness, passive and impulsive emotion-regulation, and neuroticism were controlled. It is concluded that deficits in mindfulness may be integral to BPD features. Difficulties with attention, awareness, and acceptance of internal and external experience appear to explain borderline pathology even when controlling for problems with negative affectivity, behavioral dyscontrol, and emotional and interpersonal dysfunction--which have been described as definitional of this disorder. Thus, attention to mindfulness deficits may enhance clinical formulation of BPD symptomatology, as well as provide a vital component of effective BPD treatment.

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In this comment we highlight critical problems in the estimation of parameters for their hierarchical three-factor model of psychopathy, as assessed with the Hare Psychopathy Checklist, and their interpretation of these factors as causally related to socially deviant behavior. We argue that there is nothing "causal" about a model in which cross-sectional data are used to assert that antisocial tendencies are consequences of other more fundamental psychopathic traits. We present an equally viable model, based on the PCL-R four-factor solution, in which antisocial tendencies play a fundamental role in the construct of psychopathy, consistent with previous research and clinical tradition.