A Preliminary Experimental Examination of the Effect of Emotion Dysregulation and Impulsivity on Risky Behaviors Among Women With Sexual Assault–Related Posttraumatic Stress Disorder

Abstract

Posttraumatic stress disorder (PTSD) is associated with a wide range of risky behaviors (e.g., substance use and risky sexual behaviors); however, few studies have examined mechanisms that may underlie risky behaviors in this population. The present study utilized a prospective experimental design to examine the effects of emotion dysregulation and impulsivity on risky behaviors across time. Thirty women with sexual assault-related PTSD were randomly assigned to receive emotion modulation, impulsivity reduction, or healthy living (comparison condition) skills trainings. Participants completed measures of emotion dysregulation, impulsivity, and risky behaviors pre-manipulation and one month post-manipulation. Participants in the emotion modulation and impulsivity reduction conditions reported a significant reduction in risky behaviors from pre- to post-manipulation relative to the healthy living condition. Changes in emotion dysregulation from pre- to post-manipulation fully accounted for reductions in risky behaviors over time. Results provide preliminary experimental support for the role of emotion dysregulation in risky behaviors.

A Preliminary Examination of Negative Affect, Emotion Dysregulation, and Risky Behaviors Among Military Veterans in Residential Substance Abuse Treatment

“…Emotion dysregulation has been shown to be a significant and unique predictor of risky sexual behavior (Tull et al, 2012), deliberate self-harm (Gratz & Tull, 2010b), and overall risky behaviors (Weiss et al, 2012) among civilian SUD inpatients, above and beyond other well-established risk factors (see Weiss, Sullivan, & Tull, in press for a review). Further, extending these findings, prospective investigations have found that emotion dysregulation predicts substance use following residential substance abuse treatment (Axelrod, Perepletchikova, Holtzman, & Sinha, 2011; Berking et al, 2011), and changes in emotion dysregulation account for reductions in risky behaviors across time (Weiss, Tull, & Gratz, in press). Finally, and of particular relevance to the current study, extant research provides support for an indirect relation between negative affect and risky behaviors through emotion dysregulation in civilian samples, such that maladaptive responses to negative affect confer the greatest risk for risky behaviors (Bonn-Miller, Vujanovic, Boden, & Gross, 2011; Gratz, 2006; Veilleux, Skinner, Reese, & Shaver, 2014).…”

Predicting Sexual Assault Revictimization in a Longitudinal Sample of Women Survivors: Variation by Type of Assault

“…For instance, emotion dysregulation both mediates the path from betrayal traumas (such as interpersonal violence) to PTSD and the path from PTSD to substance use and sexual behaviors (Bonn-Miller, Vujanovic, Boden, & Gross, 2011; Goldsmith, Chesney, Heath, & Barlow, 2013; Weiss, Tull, & Gratz, 2014). Also, emotion dysregulation may increase compliance with sexual activity, impulsive behaviors, and maladaptive coping strategies, as well as decrease sexual refusal assertiveness, relationship stability, and the ability to use emotions as information to detect risk (Bonn-Miller et al, 2011; Cloitre & Rosenberg, 2006; Goldsmith et al, 2013; Marx, Heidt, & Gold, 2005; Messman-Moore, Walsh, & DiLillo, 2010; Orcutt et al, 2005; Walsh, DiLillo, & Messman-Moore, 2012;Walsh, Galea, & Koenen, 2012; Weiss et al, 2014; Zerubavel & Messman-Moore, 2013). Revictimized women report higher rates of emotion regulation difficulties (Walsh, DiLillo, & Scalora, 2011), and emotional dysregulation predicts revictimization (Messman-Moore et al, 2010; Messman-Moore, Ward, & Zerubavel, 2013; Messman-Moore, Ward, Zerubavel, Chandley, & Barton, 2015).…”

Explicating the role of emotion dysregulation in risky behaviors: a review and synthesis of the literature with directions for future research and clinical practice

“…While much of the extant research in this area is cross-sectional, initial prospective investigations also underscore the role of emotion dysregulation in risky behaviors. For example, NH Weiss, et al [26**] found that improvements in emotion regulation fully accounted for reductions in risky behaviors one month post-manipulation among African American women with sexual assault-related posttraumatic stress disorder. This preliminary research has provided a foundation for more complex investigations of the emotion dysregulation-risky behavior relation.…”