Emotion Regulation Strategies Predict PTSS During the COVID-19 Pandemic in an American Indian Population

Abstract

Background Poor emotion regulation is associated with post-traumatic stress symptoms (PTSS). However, limited prospective research prevents any directional conclusions. No known studies have assessed emotion regulation with PTSS in American Indians, a high-risk population for poor mental health outcomes. The present prospective study explored whether emotion regulation strategies (cognitive reappraisal, expressive suppression) predicted later PTSS related to the COVID-19 global pandemic in a solely American Indian sample. Methods American Indian participants (N = 210; Mean ( SD ) age = 54.85(13.08) years, 58.7% female) completed the Emotion Regulation Questionnaire (ERQ) during Phase 1 (a few weeks before pandemic declaration) and the Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic during Phase 2 (7–8 weeks after pandemic declaration). Bivariate correlations and hierarchical linear regression analyses were utilized. Results ERQ reappraisal was negatively associated with IES-R total scores, such that higher reappraisal predicted lower PTSS. In contrast, ERQ suppression was positively associated with IES-R total scores, such that higher suppression predicted higher PTSS. Conclusions Greater suppression and lower reappraisal predicts PTSS in response to the COVID-19 pandemic in an entirely American Indian sample, providing critical information for future interventions in a population at high-risk for mental health disparities.

"Post-traumatic Stress Disorder and Difficulties in Emotion Regulation Among University Students under the COVID-19 Condition"

“…The results showed that students who had COVID-19 symptoms, had a greater prevalence of PTSD symptoms and DERS. The current study adds to the body of knowledge suggesting a link between emotion regulation difficulties and PTSD (Weiss et al, 2012;Ehring & Quack, 2010;Tyra et al, 2021). Students who exposed to trauma reported significantly higher levels of overall difficulty with emotion regulation, as well as difficulties controlling impulsive behaviors when distressed, difficulties engaging in goal-directed behavior when upset, limited access to effective emotion regulation strategies, difficulties accepting emotions, difficulties having a clear understanding of their emotions, and difficulties with self-awareness.…”

Childhood adversity and emotion regulation strategies as predictors of psychological stress and mental health in American Indian adults during the COVID-19 pandemic.

“…Compared to the general United States population, AIs experience disproportionately high rates of childhood trauma and adversity (Beals et al, 2013; Manson et al, 2005). While emotion regulation strategy use is implicated in the relationship between adversity and mental health in other ethnic minority groups, research is limited in AI populations (Carter et al, 2020; Tyra et al, 2021). Additionally, evidence suggests that culture plays a role in how we experience and express emotions.…”

Associations Between Early-Life Stress Exposure and Internalizing Symptomatology During the COVID-19 Pandemic: Assessing the Role of Neurobehavioral Mediators

“…Additionally, difficulties with ER associated with alterations in frontoamygdala circuitry following ELS may have particularly important implications during times of heightened stress. The regulatory processes (e.g., reappraisal, suppression) by which individuals initiate, maintain, and modify their own reactions to the negative emotions that are often engendered during experiences of heightened stress may influence subsequent psychological states ( 35 , 36 ). Recent work has shown that disruptions in ER processes have been associated with increased risk for mental health issues during the COVID-19 pandemic ( 35 , 37 , 38 ).…”

“…The regulatory processes (e.g., reappraisal, suppression) by which individuals initiate, maintain, and modify their own reactions to the negative emotions that are often engendered during experiences of heightened stress may influence subsequent psychological states ( 35 , 36 ). Recent work has shown that disruptions in ER processes have been associated with increased risk for mental health issues during the COVID-19 pandemic ( 35 , 37 , 38 ). For example, Tyra and colleagues (2021) demonstrated that greater use of reappraisal and lesser use of suppression was associated with reduced risk for developing stress-related symptomatology during the COVID-19 pandemic ( 35 ).…”

“…Recent work has shown that disruptions in ER processes have been associated with increased risk for mental health issues during the COVID-19 pandemic ( 35 , 37 , 38 ). For example, Tyra and colleagues (2021) demonstrated that greater use of reappraisal and lesser use of suppression was associated with reduced risk for developing stress-related symptomatology during the COVID-19 pandemic ( 35 ). Importantly, these findings lend support to the notion that reliance on distinct types of ER strategies may be associated with distinct mental health outcomes ( 39 , 40 ).…”