Interactive Effects of Anxiety Sensitivity and Difficulties in Emotion Regulation: An Examination Among Individuals in Residential Substance Use Treatment with Comorbid Posttraumatic Stress Disorder

Abstract

Individuals with posttraumatic stress disorder (PTSD) exhibit deficits in cognitive and emotional processes. PTSD severity is positively associated with anxiety sensitivity (AS) and difficulties in emotion regulation, and difficulties in emotion regulation mediate the relation between AS and PTSD. However, previous research has not examined the interactive nature of these variables. Associations between PTSD, AS, and difficulties in emotion regulation were examined in patients with PTSD in a residential substance treatment program (N = 120). Conditional process analyses indicated an interactive effect of difficulties in emotion regulation and AS for predicting PTSD symptom severity. For individuals high in emotion regulation difficulties, PTSD symptom severity was high regardless of level of AS; conversely, for individuals high in AS, increased PTSD severity was observed regardless of level of emotion regulation difficulties. Results suggest directions for future research, including targeting patient specific cognitive-affective processes to enhance PTSD treatment response among substance dependent individuals.

A pilot test of Written Exposure Therapy for PTSD in residential substance use treatment

“…Improvements in trauma‐coping self‐efficacy and emotion regulation are consistent with prior findings indicating that these outcomes improve following exposure therapy among individuals with PTSD‐SUD 20,33,34 . Improvements in recovery capital scores suggest that participants felt more positively about SUD recovery post‐WET 35 .…”

“…These findings are consistent with published reports indicating that PTSD can be treated concurrently with SUD and that exposure-based interventions are most effective 6,7,11 Improvements in trauma-coping self-efficacy and emotion regulation are consistent with prior findings indicating that these outcomes improve following exposure therapy among individuals with PTSD-SUD. 20,33,34 Improvements in recovery capital scores suggest that participants felt more positively about SUD recovery post-WET. 35 Overall, results suggest that WET is associated with improvements in mental health indicators important to PTSD-SUD recovery, in addition to PTSD symptom reduction.…”

Acculturative stress, emotion regulation, and affective symptomology among Latino/a college students.

“…A common method of operationalizing the construct of emotion regulation difficulties distinguishes six subfactors: emotional nonacceptance, difficulties in goal directed behavior, low emotional awareness, low emotional clarity, impulse control difficulties, and limited access to emotion regulation strategies (Gratz & Roemer, 2004). Moreover, across various demographic samples, difficulties in emotion regulation are implicated in the development of mental health problems, including depression (Joormann & Stanton, 2016; Tully et al, 2016; Van Beveren et al, 2016), suicidality (Gratz & Roemer, 2004), and anxiety (Sippel et al, 2015). In line with this work, difficulties in emotion regulation relate to greater levels of negative affect among both non-Latino (Kashdan et al, 2008) and Latino/a adults (Archuleta & Lakhwani, 2016; Paulus et al, 2016).…”

Assessment of the revised Difficulties in Emotion Regulation Scales among adolescents and adults with severe mental illness

“…The DERS has been used extensively in many different populations, spanning adult and adolescent age groups. It has been used with veterans (Sippel et al, 2015), community adults (Lilly et al, 2014), college students (O'Bryan, McLeish, Kraemer, & Fleming, 2015), outpatients (Khosravani et al, 2017), and inpatients (Fowler et al, 2014;Perez et al, 2012;Sippel et al, 2015). However, with 36 items and some over-lapping item content, it may be overly lengthy or redundant for some research questions or samples, and some studies have identified problems with its purported latent factor structure (Bardeen, Fergus, & Orcutt, 2012;Miguel, Giromini, Colombarolli, Zuanazzi, & Zennaro, 2017).…”