An Examination of the Role of Difficulties Regulating Positive Emotions in Posttraumatic Stress Disorder

Abstract

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; Mage = 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.

Emotion dysregulation and posttraumatic stress disorder: a test of the incremental role of difficulties regulating positive emotions

“…Emotion dysregulation is a multi-faceted construct involving maladaptive ways of responding to emotions, including: (a) a lack of awareness, understanding, and acceptance of emotions; (b) the inability to control behaviors when experiencing emotional distress; (c) a lack of access to situationally appropriate strategies for modulating the duration and/or intensity of emotional responses in order to meet individual goals and situational demands; and (d) an unwillingness to experience emotional distress as part of pursuing meaningful activities in life (Gratz & Roemer, 2004;Gratz & Tull, 2010). Research suggests that higher levels of emotion dysregulation are associated with more severe PTSD symptoms among women victims of IPV (Lilly & Hong, 2013;Lilly, London, & Bridgett, 2014;Weiss, Darosh, Contractor, Forkus, Dixon-Gordon, & Sullivan, 2018;Weiss, Dixon-Gordon, Peasant, & Sullivan, 2018). For instance, among community women with a history of IPV, Lilly and Hong (2013) found that emotion dysregulation was significantly positively related to PTSD severity at zero-order and when accounting for other known risk factors such as avoidant attachment and maladaptive cognitions.…”

Exploratory examination of clinician perspectives on positive memories and post‐traumatic stress disorder interventions

“…Indeed, tracking emotional intensity/valence may be a validating indicator of the hypothesised affect change that should accompany retrieval of positive memories (Pennebaker, ). One clinician added that tracking emotional intensity/valence may prevent avoidance of (positive) emotions, which is relevant, given that trauma‐exposed individuals may think that they do not deserve positive thoughts/emotions (Norman, Wilkins, Myers, & Allard, ) and may experience dysregulation related to positive emotions (Weiss, Dixon‐Gordon, Peasant, & Sullivan, ; Weiss, Nelson, Contractor, & Sullivan, ).…”

Dampening of positive affect is associated with posttraumatic stress following stressful life events

“…In addition, elevated responsiveness to environmental stimuli may cause PA to be perceived as aversive and, consequently, to be blocked (cf. Contractor et al, 2018 ; Weiss et al, 2018 , 2019 ).…”

“…Although studies indicated that PTS is not associated with an inability to experience PA per se (Dornbach-Bender et al, 2020 ), there is gradually growing evidence that the dysregulation of PA does contribute to PTS. For instance, in a study among women exposed to domestic violence, Weiss, Dixon-Gordon, Peasant, and Sullivan ( 2018 ) found that higher levels of nonacceptance of positive emotions, difficulties engaging in goal-directed behaviours, and difficulties to control impulsive behaviours when experiencing positive emotions were related to more severe PTS. In a further study, PA dysregulation was found to predict PTS, when controlling NA dysregulation (Weiss, Nelson, Contractor, & Sullivan, 2019 ).…”

“…Secondly, whereas prior studies (cf. Contractor et al, 2018 ; Weiss et al, 2018 , 2019 ) focused on dimensions of emotion regulations distinguished by Gratz and Roemer ( 2004 ), this study focused people’s reactions to PA (i.e. ‘response styles to PA’) as tapped by the Responses to Positive Affect questionnaire (RPA; Feldman, Joormann, & Johnson, 2008 ).…”