The assessment of emotion reactivity: The Italian validation of the Perth Emotional Reactivity Scale-Short Form (PERS-S).

Emotion reactivity refers to the activation, intensity and duration of emotional responses to internal or external stimuli. It can be differentiated from emotion regulation since the former is the very first response to an emotional trigger, and the latter can be defined as a tool for maintaining one's arousal in a window of tolerance. Since, to date, there are no Italian self-report measures able to evaluate individuals' emotional reactivity, this study aimed to contribute to the Italian validation of the Perth Emotional Reactivity Scale-Short Form (PERS-S). The PERS-S is an 18-item self-report measure answered on a 5-point Likert scale that generates six subscale scores and two composite scores, with higher scores indicating higher levels of reactivity. Data from 768 individuals showed that the PERS-S had good to excellent goodness of fit. The internal consistency was high, with an overall reliability coefficient (Cronbach's α) of .87 and .86 for the negative and positive general scales, respectively. The PERS-S also demonstrated appropriate convergent validity, showing significant correlations with conceptually related measures, and acceptable divergent validity, showing minimal correlations with unrelated constructs. Finally, we evaluated the Test-Retest Reliability by administering the PERS-S to the same sample twice, with a 2-week interval. The significant correlations between the two PERS-S administrations suggest temporal stability. The Italian version of the PERS-S will enrich the repertoire of self-report measures for investigating the development and risk factors of mental health disorders and may have practical applications in clinical settings.

Early Life Trauma, Emotion Dysregulation and Hormonal Sensitivity Across Female Reproductive Life Events.

PURPOSE OF REVIEW: To explore the relationship between early life trauma, hormonal sensitivity, and psychiatric disorders across female-reproductive life events, with a focus on the neurobiological mechanisms. RECENT FINDINGS: Childhood trauma significantly increases the risk of subsequent mood disorders during periods of intense hormonal fluctuation such as premenstrual, pregnancy, postpartum, and perimenopause. Neurobiological changes resulting from early trauma influence emotion regulation, which emerges as a key predisposing, exacerbating, and perpetuating factor to hormonal sensitivity and subsequent psychiatric symptoms. We identified altered stress response and allopregnanolone imbalance, bias in cognitive processing of emotions, neuroimage correlates and sleep disturbances as potential underlying neurobiological mechanisms. This review integrates cumulative findings supporting a theoretical framework linking early life trauma to hormonal sensitivity and mood disorders. We propose that some women might be more susceptible to such hormonal fluctuations because of emotion dysregulation following significant early life trauma.

Emotion dysregulation, impulsivity and anger rumination in borderline personality disorder: the role of amygdala and insula.

Borderline Personality Disorder (BPD) is a severe mental disorder, characterized by deficits in emotion regulation, interpersonal dysfunctions, dissociation and impulsivity. Brain abnormalities have been generally explored; however, the specific contribution of different limbic structures to BPD symptomatology is not described. The aim of this study is to cover this gap, exploring functional and structural alterations of amygdala and insula and to highlight their contribution to neuropsychiatric symptoms. Twenty-eight BPD patients (23.7 ± 3.42 years; 6 M/22F) and twenty-eight matched healthy controls underwent a brain MR protocol (1.5 T, including a 3D T1-weighted sequence and resting-state fMRI) and a complete neuropsychiatric assessment. Volumetry, cortical thickness and functional connectivity of amygdala and insula were evaluated, along with correlations with the neuropsychiatric scales. BPD patients showed a lower cortical thickness of the left insula (p = 0.027) that negatively correlated with the Anger Rumination Scale (p = 0.019; r = - 0.450). A focused analysis on female patients showed a significant reduction of right amygdala volumes in BPD (p = 0.037), that correlate with Difficulties in Emotion Regulation Scale (p = 0.031; r = - 0.415), Beck Depression Inventory (p = 0.009; r = - 0.50) and Ruminative Response Scale (p = 0.045; r = - 0.389). Reduced functional connectivity was found in BPD between amygdala and frontal pole, precuneus and temporal pole. This functional connectivity alterations correlated with Anger Rumination Scale (p = .009; r = - 0.491) and Barratt Impulsiveness Scale (p = 0.020; r = - 0.447). Amygdala and insula are altered in BPD patients, and these two limbic structures are implicated in specific neuropsychiatric symptoms, such as difficulty in emotion regulation, depression, anger and depressive rumination.

Emotional dysregulation moderates the relation between perceived stress and emotional eating in adolescent military dependents.

OBJECTIVE: Adolescent children of US service members (i.e., military-dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating. Difficulties with adaptively responding to stress and aversive emotions may play an important role in emotional eating. This study examined emotion dysregulation as a potential moderator of the association between perceived stress and emotional eating in adolescent military dependents. METHOD: Participants were military-dependent youth (N = 163, 57.7% female, Mage = 14.5 ± 1.6, MBMI-z = 1.9 ± 0.4) at risk for adult binge-eating disorder and high weight enrolled in a randomized controlled prevention trial. Prior to intervention, participants completed questionnaires assessing perceived stress and emotional eating. Parents completed a questionnaire assessing their adolescent's emotion dysregulation. Moderation analyses were conducted using the PROCESS macro in SPSS and adjusted for theoretically relevant sociodemographic covariates. RESULTS: The interaction between adolescent perceived stress and emotion dysregulation (parent-reported about the adolescent) in relation to adolescent emotional eating was found to be significant, such that higher emotion dysregulation magnified the association between perceived stress and emotional eating (p = .010). Examination of simple slopes indicated that associations between perceived stress and emotional eating were strongest for youth with above-average emotion dysregulation, and non-significant for youth with average or below-average emotion dysregulation. DISCUSSION: Findings suggest that greater emotion dysregulation may increase risk for emotional eating in response to stress among military-dependent youth at risk for binge-eating disorder or high weight. Improving emotion regulation skills may be a useful target for eating disorder prevention among youth who are at risk for emotional eating. PUBLIC SIGNIFICANCE: Prior research has shown that adolescent military dependents are at increased risk for eating disorders and high weight. The current study found that emotion dysregulation moderated the relationship between perceived stress and emotional eating among military-dependent youth. There may be clinical utility in intervening on emotion regulation for adolescent dependents at particular risk for emotional eating and subsequent eating disorders.

Study Protocol: Pegasus: psychotherapy incorporating horses for 'therapy-resistant' adolescents with autism spectrum disorders, a study with series of randomised, baseline controlled n-of-1 trials.

BACKGROUND: For people with autism spectrum disorder (ASD), daily life can be highly stressful with many unpredictable events that can evoke emotion dysregulation (ED): a strong difficulty with appropriately negative affect regulation. For some of the patients with ASD, treatment as usual does not prove to be effective for ED. They may be at risk of life-long impairment, development of other disorders and loss of motivation for most regular forms of therapy. A highly promising method that may prove effective for therapy-resistant individuals with ASD is Psychotherapy incorporating horses (PIH). PIH uses the interactions of the horse and the patients on the ground and does not include horseriding. While often met with prejudgment and scepticism, reports from parents and therapists as well as a recent systematic review suggest that PIH may have beneficial effects on youths with ASD. Therefore, we examine clinical outcomes both in the short and in the long terms of PIH offered to adolescents with ASD and severe ED despite regular therapy. METHODS: A total of 35 adolescents aged 11-18 years with ASD will receive PIH during 15 sessions once a week with randomization to five different groups differentiating in baseline phase from 2 to 6 weeks. PIH uses horses to promote social awareness and self-awareness as well as relationship management and self-management. The primary outcome is the response to treatment on the Emotion Dysregulation Index (EDI). The secondary outcome measures include ASD symptom severity, quality of life, self-esteem, global and family functioning, and goal attainment. Assessments take place at the baseline (T0), at the end of baseline phase A (T1), after completion of intervention phase B (T2), after the end of post-measurement phase C (T3) and after one year (T4). Qualitative interviews of participants, parents and therapists will be held to reveal facilitators and barriers of PIH and a cost-effectiveness study will be performed. DISCUSSION: This study aims at contributing to clinical practice for adolescents with ASD and persistent emotion regulation problems despite 1.5 year of treatment by offering Psychotherapy incorporating horses in a study with series of randomised, baseline controlled n-of-1 trials. TRIAL REGISTRATION: www. CLINICALTRIALS: gov NCT05200351, December 10th 2021.

Understanding emotion dysregulation from infancy to toddlerhood with a multilevel perspective: The buffering effect of maternal sensitivity.

Challenges with childhood emotion regulation may have origins in infancy and forecast later social and cognitive developmental delays, academic difficulties, and psychopathology. This study tested whether markers of emotion dysregulation in infancy predict emotion dysregulation in toddlerhood, and whether those associations depended on maternal sensitivity. When children (N = 111) were 7 months, baseline respiratory sinus arrhythmia (RSA), RSA withdrawal, and distress were collected during the Still Face Paradigm (SFP). Mothers' reports of infant regulation and orientation and maternal sensitivity were also collected at that time. Mothers' reports of toddlers' dysregulation were collected at 18 months. A set of hierarchical regressions indicated that low baseline RSA and less change in RSA from baseline to stressor predicted greater dysregulation at 18 months, but only for infants who experienced low maternal sensitivity. Baseline RSA and RSA withdrawal were not significantly associated with later dysregulation for infants with highly sensitive mothers. Infants who exhibited low distress during the SFP and who had lower regulatory and orienting abilities at 7 months had higher dysregulation at 18 months regardless of maternal sensitivity. Altogether, these results suggest that risk for dysregulation in toddlerhood has biobehavioral origins in infancy but may be buffered by sensitive caregiving.

Training to Reconnect with Emotional Awareness Therapy (TREAT): A Randomized Controlled Trial in Participants with Traumatic Brain Injury.

OBJECTIVE: To examine the efficacy of an intervention, training to reconnect with emotional awareness therapy (TREAT) at improving alexithymia, emotion dysregulation, anxiety, depression, anger and global positive and negative affect in participants with traumatic brain injury (TBI). SETTING: Outpatient brain injury rehabilitation center PARTICIPANTS: : Adult participants, who were on average 11.37 years post-complicated mild to severe TBI and also had elevated alexithymia (n=44), who were randomized to immediate treatment (TREAT; n=20) or waitlist control (WLC=24). DESIGN: Randomized, waitlist control trial with 3-month follow-up. INTERVENTION: Eight session, structured training program that teaches emotional awareness and discrete labeling of emotions. OUTCOME MEASURES: Toronto Alexithymia Scale-20 (TAS-20), Levels of Emotional Awareness Scale (LEAS), Difficulty with Emotion Regulation Scale (DERS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9); State-Trait Anger Expression Inventory (STAXI), Positive and Negative Affect Schedule (PANAS); and Patient Global Impression of Change (PGIC). RESULTS: Thirty-four participants completed the study per protocol. Compared to WLC participants (n=16) who had not yet received the intervention, TREAT participants (n=18) had significantly less alexithymia, emotion dysregulation, anxiety, and depression (all p's<.05) within approximately one week of completing the intervention. Before/after results from the pooled sample (n=34) showed significant improvements, immediately and 3 months after the intervention, on all outcomes except the STAXI and the Positive Affect subscale of the PANAS. On the PGIC, a noticeable change in global emotional function and quality of life was reported by 80%. Intent-to-Treat (ITT) analyses (n=38) revealed similar results to the per protocol sample. CONCLUSIONS: Findings support the efficacy of TREAT for reducing alexithymia and emotion dysregulation in individuals with chronic TBI. While outcomes were also promising for anxiety and depression, more research using attention-control designs are warranted to control for the attention received during treatment.

The role of emotion dysregulation in self-management behaviors among adults with type 2 diabetes.

Suboptimal disease self-management among adults with type 2 diabetes is associated with greater risk of diabetes related health complications and mortality. Emotional distress has been linked with poor diabetes self-management; however, few studies have examined the role of emotion dysregulation in diabetes management. The purpose of this study was to examine the relations between different facets of emotion dysregulation and diabetes self-management behaviors among a sample of 373 adults with type 2 diabetes. Separate median regression and binary logistic regression models were used to examine the association of emotion dysregulation facets and each diabetes self-care behavior (i.e., medication nonadherence, diet, exercise, self-monitoring of blood glucose (SMBG), foot care, and smoking). Generally, greater difficulties in emotion regulation were associated with poorer self-management behaviors. However, several facets of emotion dysregulation were linked with better self-management behaviors. Addressing emotion dysregulation among adults with type 2 diabetes has the potential to improve diabetes related self-management.

Association between Pathological Narcissism and Emotion Dysregulation: A Systematic Review.

INTRODUCTION: Pathological narcissism (PN) can be defined as the compromised and fluctuating ability to regulate self-esteem, the latter depending on external validation, admiration, or enhancement, all resulting in grandiose (e.g., self-enhancement, aggressiveness, manipulation) or vulnerable (e.g., depression, anxiety, self-criticism, avoidance) dysfunctional reactions when confronting with self-esteem threats. A link has been suggested between PN and emotion dysregulation (ED), but to date, no systematic review has been conducted. METHODS: We conducted a systematic review of the literature published until February 2024 studying the association between PN (with or without a diagnosis of narcissistic personality disorder) and ED, divided in two domains: emotion regulation difficulties and strategies. RESULTS: Twenty-two studies were included in our analysis. Altogether, the available data are insufficient to conclude on the link between grandiose narcissism and emotion regulation difficulties in non-clinical population (notably due to different patterns of associations depending on the scale used to assess narcissism). However, the small number of studies conducted in clinical population seems to indicate a possible absence of association between the two constructs. On the other side, there is considerable evidence for the existence of a positive association between vulnerable narcissism and emotion regulation difficulties, regardless of the scale used to assess narcissism and the type of population considered. Finally, regarding emotion regulation strategies, data are too scarce to draw any conclusion, even though there seems to be a trend toward positive association between narcissistic vulnerability and expressive suppression. CONCLUSION: ED seems to be highly associated with narcissistic vulnerability. Given that every patient suffering from PN may experience vulnerable states, we believe that ED should be considered as an important part of psychoeducation programs and psychotherapeutic treatments designed for this population.

Children's emotional reactivity and negative affect predict future ADHD symptom severity beyond initial ADHD symptom severity.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience significant emotion dysregulation. However, there is limited longitudinal data on associations between multiple aspects of emotion dysregulation and ADHD symptoms. Additionally, given substantial evidence that increased levels and variability of negative affect (NA) are identified in children with ADHD, it is important to examine the role of NA in this relationship. The present study used momentary and longitudinal data to examine the relation between two aspects of emotion dysregulation (emotional lability and emotional reactivity), the two ADHD symptom clusters separately (inattentive and hyperactive/impulsive), total ADHD symptom severity, and NA variability over a period of six months. Participants (N = 68) were parents of children aged 7-12 years old (M = 9.80, SD = 1.34) who completed baseline and 6-month follow-up reports of children's ADHD symptoms and emotion dysregulation as well as ecological momentary assessments (EMA) of their children's NA for one week. Results were threefold: (1) children's emotional reactivity predicted inattentive, hyperactive/impulsive, and total ADHD symptom severity above and beyond initial ADHD symptom severity, but emotional lability did not significantly predict severity of any ADHD symptom cluster; (2) NA variability predicted hyperactive/impulsive and total ADHD symptom severity, but not inattentive severity; and (3) initial ADHD symptom severity did not predict emotion dysregulation at follow-up. The current study provides novel insight regarding the longitudinal influence of specific aspects of emotion dysregulation and NA on ADHD symptom severity in children and suggests that targeting emotional reactivity could minimize ADHD symptom severity.

Vocal emotion recognition in attention-deficit hyperactivity disorder: a meta-analysis.

There is debate within the literature as to whether emotion dysregulation (ED) in Attention-Deficit Hyperactivity Disorder (ADHD) reflects deviant attentional mechanisms or atypical perceptual emotion processing. Previous reviews have reliably examined the nature of facial, but not vocal, emotion recognition accuracy in ADHD. The present meta-analysis quantified vocal emotion recognition (VER) accuracy scores in ADHD and controls using robust variance estimation, gathered from 21 published and unpublished papers. Additional moderator analyses were carried out to determine whether the nature of VER accuracy in ADHD varied depending on emotion type. Findings revealed a medium effect size for the presence of VER deficits in ADHD, and moderator analyses showed VER accuracy in ADHD did not differ due to emotion type. These results support the theories which implicate the role of attentional mechanisms in driving VER deficits in ADHD. However, there is insufficient data within the behavioural VER literature to support the presence of emotion processing atypicalities in ADHD. Future neuro-imaging research could explore the interaction between attention and emotion processing in ADHD, taking into consideration ADHD subtypes and comorbidities.

Prospective Associations of Maternal Depressive Symptoms and Emotion Dysregulation with Children's Internalizing Problems: The Moderating Role of Fathers.

Parents, including fathers, contribute to the early development of internalizing symptoms, which is observable and prevalent among young children. This longitudinal study examined the moderating role of paternal depressive symptoms/emotion dysregulation in the prospective associations between maternal depressive symptoms/emotion dysregulation and children's internalizing problems (depressive and anxiety symptoms). Ninety-four preschoolers and their mothers and fathers participated. Parents completed online questionnaires when their children were four years old and one year later. Results indicated that higher paternal depressive symptoms were associated with an increase, while lower paternal symptoms were associated with a decrease, in the negative impact of maternal emotion dysregulation on children's later depressive, but not anxiety, symptoms. We also tested the moderating role of paternal emotion dysregulation, these pathways were not significant. The findings enhance our understanding of the interaction between maternal and paternal psychological characteristics in contributing to children's anxiety and depressive symptoms.

Understanding the role of self-esteem and emotion dysregulation in victims of intimate partner violence.

Self-esteem and emotion dysregulation appear to be important factors in the psychological well-being of trauma survivors. On the one hand, self-esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post-traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self-esteem play in the well-being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (meanage = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson-Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post-trauma affectivity (i.e., fear, terror, shame and guilt) and survivors' well-being. Furthermore, self-esteem negatively predicted lack of well-being and acted as a moderator of the relationship between emotion dysregulation and lack of well-being. In this regard, through the Johnson-Neyman analysis for regions of significance, it was possible to identify a cut-off value above which the relationship between emotion dysregulation and lack of well-being became non-statistically significant. This study contributed to understanding the role that emotion dysregulation and self-esteem play in the well-being of IPV survivors. In this regard, clinical implications will be presented.

Dynamic characteristics of parent-adolescent closeness: Predicting adolescent emotion dysregulation.

Emotion dysregulation is linked to adolescent psychological problems. However, little is known about how lability in daily closeness of parent-adolescent dyads affects the development of emotion dysregulation. This study examined how closeness lability with parents was associated with emotion dysregulation 12 months later. The sample included 144 adolescents (M = 14.62, SD = 0.83) who participated in a baseline assessment, 21-day daily diaries, and a 12-month follow-up assessment. Parents and adolescents both reported adolescent emotion dysregulation at baseline and follow-up assessments, while adolescents reported daily parent-adolescent closeness. Results indicate that lability in father-adolescent closeness was associated with increased emotion dysregulation at 12 months reported by adolescents. However, lability in mother-adolescent closeness was not associated with adolescent emotion dysregulation. Moreover, when baseline father-adolescent closeness was high, greater lability in father-adolescent closeness was associated with decreased emotion dysregulation. Findings indicate that daily fluctuations in father-adolescent closeness are a key family characteristic that links to long-term adolescent emotion dysregulation.

Social cognition and bulimic symptoms in male undergraduate students: The conditional effect of emotion dysregulation.

OBJECTIVE: Research demonstrates associations between poor social cognition and eating disorder (ED) pathology. Moreover, research shows that individuals with EDs struggle with emotion regulation. The present study replicates and extends the literature on social cognition and ED pathology, which previously focused largely on symptoms of anorexia nervosa among women while the present study focuses on symptoms of bulimia nervosa among undergraduate men. Further, this study tests the hypothesis that better emotion regulation mitigates the association between social cognition and ED pathology. METHODS: At a single timepoint, undergraduate males (n = 520) completed a series of questionnaires, and a task assessing mentalising, a key element of social cognition. RESULTS: Consistent with hypotheses, bulimic symptoms were associated with worse mentalising and worse self-reported emotion regulation. Moreover, the association between mentalising and bulimic symptomatology was conditional on emotion regulation, such that it was strongest among those with more difficulties regulating their emotions. CONCLUSION: Results are consistent with existing theories that highlight an interplay between interpersonal (e.g., mentalisation) and intrapersonal (e.g., affective functioning) factors in relation to ED symptomatology. Among undergraduate males, bulimic symptoms were associated with worse mentalisation. However, a good ability to regulate emotions interrupted this association.

A preliminary investigation of the mediating roles of self-compassion and emotion dysregulation in the relationship between maladaptive perfectionism and obsessive-compulsive behaviors.

INTRODUCTION: Recent research has highlighted an association between maladaptive perfectionism and obsessive-compulsive disorder (OCD). However, the mechanisms underlying this relationship are not well understood. The primary aim of this preliminary study was to investigate whether self-compassion and emotion dysregulation independently mediated this relationship. The secondary aim was to determine whether serial mediation existed between these factors. Whether these relations held for overall obsessive-compulsive (OC) symptoms, versus distinct dimensions of OCD, was also of interest. METHOD: Three hundred and ninety-two university students (Mage = 21.81, SD = 8.01), predominantly female (79.18%), participated in an online questionnaire that included a dimensional measure of OCD. Scales assessing maladaptive perfectionism, self-compassion, emotion dysregulation, and negative emotion states were also included. RESULTS: Greater maladaptive perfectionism was related to more severe OCD. Emotion dysregulation, but not self-compassion, independently mediated this relationship. A serial mediation relationship was found, in that greater maladaptive perfectionism was associated with lower self-compassion, which was linked to greater emotion dysregulation, and in turn related to more severe OC behaviors. In addition, distinct patterns emerged for separate OC dimensions. CONCLUSIONS: These findings highlight emotion regulation and self-compassion as potential targets for OCD prevention, especially in individuals with symptoms in the symmetry and unacceptable thoughts dimensions.

Randomized effectiveness-implementation trial of dialectical behavior therapy interventions for young people with borderline personality disorder symptoms.

OBJECTIVES: Dialectical behavior therapy (DBT) is an evidence-based treatment for people with emerging borderline personality disorder (BPD). In "real world" clinical settings, standard DBT is resource intensive. Emerging evidence suggests that group-based DBT skills training alone can lead to promising outcomes. This hybrid type 1 effectiveness-implementation trial directly compared the effectiveness of an 8-week group DBT-skills training program and a 16-week DBT-informed program including individual treatment and group-based skills training. METHODS: This pragmatic trial employed a staggered, parallel-groups design. We recruited 104 participants, aged 16-25 years, with emotion dysregulation or emerging BPD symptoms. Participants were randomized to receive either program at a youth mental health service located in the Gold Coast, Australia. Data was collected via online surveys at baseline, 8-week, 16-week, and 24-week follow-up. Mixed effect linear models compared groups on the primary outcomes of emotion dysregulation and BPD symptoms, and secondary outcomes of suicidal ideation, coping skills, depression, anxiety, and stress. RESULTS: Across groups there were significant and sustained improvements relating to emotion dysregulation, BPD symptoms, stress, depression, and emotion-focused coping; but not suicide risk, anxiety, or task-focused coping. There was no significant time by group differences between the 8-week and 16-week interventions on any primary or secondary outcome. CONCLUSION: The more intensive mode of delivering DBT was not more effective than the brief group-based skills training. Both interventions resulted in significant improvements across both primary and most secondary outcomes. These results have implications for clinical practice regarding length and intensity of DBT treatment in young people.

Clinical outcomes for sexual and gender minority adolescents in a dialectical behaviour therapy programme.

BACKGROUND: Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people. AIMS: This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK). METHOD: Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms. RESULTS: SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions. DISCUSSION: These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.

A Daily Diary Study of the Relation between Stress and Nonsuicidal Self-Injury and the Moderating Role of Emotion Dysregulation in Emerging Adulthood.

Research on exposure to stressors and nonsuicidal self-injury (NSSI) in daily life has been lacking, particularly among emerging adults (aged 18-25 years). The aim of this study was to determine whether daily stressors predicted same-day and next-day NSSI thoughts and engagement, and whether emotion dysregulation moderated this relation. Participants included 160 emerging adults (83% female, Mage = 19.75, SD = 1.8, 44% White, 22% East Asian, 11% South Asian, and 23% other) who completed a baseline assessment and 14 days of daily diary entries which resulted in 1982 daily assessments (median compliance = 86%; IQR = 12-14). It was found that daily stressors significantly predicted same-day, but not next-day, NSSI thoughts and engagement and this relation was more pronounced for individuals with greater emotion dysregulation. The present study provides new insight into when individuals may be most at risk for NSSI, as well as which individuals may be most vulnerable.

Identifying High-Risk Subgroups of College Students with Non-Suicidal Self-Injury: A Latent Profile Analysis and Two-Years Follow-up Study.

Non-Suicidal Self-Injury (NSSI) is associated with a heightened overall risk of future psychopathological problems. However, elucidating specific characteristics that determine an increased risk for certain individuals remains an area requiring further exploration. This study aimed to identify latent subgroups in a sample of college students with NSSI. Additionally, it sought to explore the differential associations of these subgroups with their psychopathological status (e.g., borderline symptoms and suicidal tendencies) both at baseline and after two years. The sample comprised 259 participants (89% females, Mage = 20.39, SD = 1.90) who reported engaging in NSSI in the last year. Three latent groups were found. The group exhibiting severe NSSI-features, high emotion dysregulation, and low perceived social support was the profile with high-risk of psychopathology both at baseline and follow-up. The findings enhance our understanding of the complex association between NSSI and future mental health issues, aiding in the early identification of at-risk individuals.