Trauma-related reactivity and regulation of emotion: Associations with posttraumatic stress symptoms

Abstract

Background and Objectives Both emotional reactivity to traumatic event cues and difficulties regulating emotion have been linked to posttraumatic stress symptom severity. The current study uniquely extended these two lines of research by examining the degree to which these two factors alone, and in combination, account for variability in posttraumatic stress symptom severity. Method Self-reported emotion regulation difficulties, and both subjective and physiological reactivity in response to a script-driven imagery procedure, were assessed among a community sample of 21 adult women with a history of interpersonal assault. Relationships with an interview-based measure of posttraumatic stress symptom severity were examined. Results Results were consistent with hypotheses. Both traumatic event-related emotional reactivity and emotion regulation difficulties independently predicted posttraumatic stress symptom severity. A significant interaction also emerged such that traumatic event-related emotional reactivity and posttraumatic stress symptom severity were only significantly associated at relatively elevated levels of emotion regulation difficulties. Limitations Limitations included the use of a self-report questionnaire to assess emotion regulation difficulties, relatively small sample size, and lack of evidence regarding generalizability across gender or other traumatic event types. Conclusions These results highlight that the interaction of heightened emotional reactivity and difficulties regulating emotion may be particularly influential in posttraumatic stress symptom severity.

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

“…Notably, PTSD has demonstrated significant associations with heightened emotional intensity and reactivity (Orsillo, Batten, Plumb, Luterek, & Roessner, 2004; Tull, Jakupcak, McFadden, & Roemer, 2007), thus requiring increased regulation efforts. For example, in a laboratory study, Badour and Feldner (2013) found a significant, positive association between increased emotional reactivity to trauma narratives and posttraumatic stress symptom severity in individuals with high, but not low, emotion regulation difficulties. Moreover, in an effort to regulate emotions, individuals with PTSD often engage in maladaptive behavioral strategies, such as substance use (Khantzian, 1997; Simpson, Stappenbeck, Varra, Moore, & Kaysen, 2012).…”

Emotional Competence and Combat-Related PTSD Symptoms in Croatian Homeland War Veterans

“…All of these symptoms may disrupt the ability to assert some degree of control over emotions, including the ability to cope with 9 TABLE 3 Set correlation strong emotions, both positive and negative, without feeling overwhelmed, as well as the ability to easily transition between emotional states (Boden et al, 2013;Price et al, 2006;Shepherd & Wild, 2014). Individuals with PTSD dedicate significant resources in order to identify, label, evaluate, manage and modify the experience and expression of their emotions (Badour & Feldner, 2013;Tull et al, 2007) in which they are usually unsuccessful. Denial of emotions, e.g.…”

“…Habituation should be followed by the reduction of erroneous evaluation of the probability of risk and negative valence. However, individuals with low emotional competence engage in less adaptive strategies for handling emotional reaction elicited by traumatic event cues, thus interfering with the natural extinction process needed to reduce traumatic event--related reactions (Badour & Feldner, 2013;Tull et al, 2007). Improvement in emotional competence skills, especially emotional expression and regulation, have been shown to predict greater symptom reduction during treatments that target engagement in traumatic event cues in order to extinguish associated harmful emotional reactivity (Peterson et al, 2011;Price et al, 2006 petence may serve as a maintaining factor for PTSD reactions (Bensimon et al, 2013;Boden et al, 2013).…”

“…For example, avoidance symptoms include avoidance of people, places, thoughts and feeling closely associated with the traumatic event, so coping with emotions related to these events would be incomprehensible for them since they make additional effort to restrict the emotions they feel (Boden et al, 2013;Kashdan et al, 2010). PTSD models show a strong correlation between active or effortful avoidance and emotional difficulties (Badour & Feldner, 2013;Brackett et al, 2004;Palmieri & Fitzgerald, 2005;Rademaker et …”

Affective lability predicts decreased habituation in posttraumatic stress symptom responding during a single laboratory session of imaginal exposure

“…Exposure to a Diagnostic and Statistical Manual – Fourth Edition (DSM-IV)-defined traumatic event (American Psychological Association [APA], 1994) has been associated with an increase in emotional and physiological responding in the presence of trauma cues, even for those who do not meet full criteria for posttraumatic stress disorder (PTSD; Badour et al, 2011; Badour & Feldner, 2013; McDonagh-Coyle et al, 2001; Orr et al, 1998). Indeed, posttraumatic stress symptom (PTSS) level has been associated with emotion regulation difficulties in response to increased emotional or physiological responding (Badour & Feldner, 2013; Tull, Barett, McMillan, & Roemer, 2007).…”