Emotion Regulation and Posttraumatic Stress Symptoms: A Meta-Analysis

Abstract

Emotion regulation (ER) has been identified as a critical factor in the development and maintenance of posttraumatic stress symptoms (PTS; Bardeen, Kumpula, & Orcutt, 2013 [Journal of Anxiety Disorders, 27, 188-196]; Marx & Sloan, 2005 [Behaviour Research and Therapy, 43, 569-583]; Nightingale & Williams, 2000 [British Journal of Clinical Psychology, 39, 243-254]). The current meta-analysis aimed to provide a thorough, quantitative examination of the associations between PTS and several aspects of ER. A search of the PsychINFO database resulted in 2557 titles, of which 57 met full inclusion criteria (the cross-sectional association between PTS symptoms and ER was reported, participants were 18 years or older, the article was written in English, and sufficient information was reported to calculate effect sizes). From the 57 studies that were included, 74 effect sizes were obtained. All studies were independently coded by two of the study authors for the following: citation, sample type, total N size (and group n's if applicable), mean age of participants, type of traumatic event, study design, PTS measure(s), ER measure(s), and effect size information. Eight random effects models were conducted: seven for individual ER strategies (e.g., rumination) and one for general emotion dysregulation. The largest effects were observed for general emotion dysregulation (r = 0.53; k = 13), rumination (r = 0.51; k = 5), thought suppression (r = 0.47; k = 13), and experiential avoidance (r = 0.40; k = 20). Medium effects were observed for expressive suppression (r = 0.29; k = 3) and worry (r = 0.28; k = 6). Significant effects were not observed for acceptance or reappraisal. Moderator analyses (sample and trauma type) were conducted for general emotion dysregulation, experiential avoidance, and thought suppression; no significant differences were observed. Findings from the current analysis suggest that several aspects of ER are associated with PTS symptoms across a variety of samples. Additionally, the current study highlights a number of limitations in the existing ER and PTS symptom literature.

Trait rumination predicts onset of Post-Traumatic Stress Disorder through trauma-related cognitive appraisals: A 4-year longitudinal study

“…These results concur with the outcome of a recent meta-analysis on the relationships of several aspects of emotion regulation with posttraumatic stress symptoms showing a large association with rumination (r ¼ .51) and a medium association with worry (r ¼ .28) (Seligowski, Lee, Bardeen, & Orcutt, 2015). This difference in predictive power of rumination and worry for onset of PTSD could partly be explained by differences in the temporal orientation of rumination and worry.…”

Examining the Structure of Negative Affect Regulation and Its Association With Hedonic and Psychological Wellbeing

“…Results support a congruent relationship between the use of functional and dysfunctional strategies in episodes of anger and sadness and indicators of hedonic and psychological well-being (Seligowski et al, 2015). Forms of affect regulation were also related to well-being (Koval et al, 2014; Visted et al, 2018).…”

Relations among emotion regulation and DSM-5 symptom clusters of PTSD

“…A recent meta-analysis of emotion regulation and PTSD reported that the largest average effect sizes (for specific strategies, rather than a general inability to regulate emotion) were Personality and Individual Differences 92 (2016) 104-108 for rumination (r = .51), thought suppression (r = .47), and experiential avoidance (r = .40), suggesting that these strategies are particularly salient for individuals with PTSD symptoms (Seligowski et al, 2015).…”

“…In addition to the significant relations between the aforementioned emotion regulation strategies and psychopathology, they have all demonstrated strong relations with symptoms of posttraumatic stress disorder (PTSD) as well (Seligowski et al, 2015). A recent meta-analysis of emotion regulation and PTSD reported that the largest average effect sizes (for specific strategies, rather than a general inability to regulate emotion) were Personality and Individual Differences 92 (2016) 104-108 for rumination (r = .51), thought suppression (r = .47), and experiential avoidance (r = .40), suggesting that these strategies are particularly salient for individuals with PTSD symptoms (Seligowski et al, 2015).…”

“…Emotion regulation has been defined as the attempt to change the frequency, intensity, and/or duration of an emotion (Gross & Levenson, 1993). This may be done in a variety of ways, but recent meta-analyses suggest that three emotion regulation strategies may demonstrate the strongest relations with psychopathology: experiential avoidance, rumination, and thought suppression (Aldao et al, 2010;Seligowski, Lee, Bardeen, & Orcutt, 2015).…”