Development and validation of the Mentalizing Emotions Questionnaire: A self-report measure for mentalizing emotions of the self and other.

Mentalizing describes the ability to imagine mental states underlying behavior. Furthermore, mentalizing allows one to identify, reflect on, and make sense of one's emotional state as well as to communicate one's emotions to oneself and others. In existing self-report measures, the process of mentalizing emotions in oneself and others was not captured. Therefore, the Mentalizing Emotions Questionnaire (MEQ; current version in German) was developed. In Study 1 (N = 510), we explored the factor structure of the MEQ with an Exploratory Factor Analysis. The factor analysis identified one principal (R2 = .65) and three subfactors: the overall factor was mentalizing emotions, the three subdimensions were self, communicating and other. In Study 2 (N = 509), we tested and confirmed the factor structure of the 16-items MEQ in a Confirmatory Factor Analysis (CFI = .959, RMSEA = .078, SRMR = .04) and evaluated its psychometric properties, which showed excellent internal consistency (α = .92 - .95) and good validity. The MEQ is a valid and reliable instrument which assesses the ability to mentalize emotions provides incremental validity to related constructs such as empathy that goes beyond other mentalization questionnaires.

[Domestic violence and its psychological consequences during the COVID-19 pandemic-key findings from German-speaking countries]. / Häusliche Gewalt und ihre psychischen Folgen während der COVID-19-Pandemie ­ Zentrale Befunde aus dem deutschsprachigen Raum.

The impact of traumatic experiences on mental health during the COVID-19 pandemic has been insufficiently discussed in the German-speaking countries. Against this background, a working group of scientifically and clinically active colleagues was formed on behalf of the German-Speaking Society for Psychotraumatology (DeGPT). The aim of the working group was to summarize central research findings on the incidence of domestic violence and associated psychological distress during the COVID-19 pandemic in German-speaking countries and to discuss their implications. In addition, associations between pre-existing childhood trauma and psychological distress during the pandemic should be illuminated. The present narrative review was prepared for this purpose.The results of the studies conducted indicate high prevalences of domestic violence during the COVID-19 pandemic, which, however, predominantly correspond to pre-pandemic prevalences. Adults with current or pre-existing interpersonal traumatic experiences during childhood or adolescence reported increased psychological distress during the pandemic compared with adults without such experiences. A number of risk factors (e.g., female gender, lower frequency of social contacts) increased the risk of psychological distress and posttraumatic stress disorder symptoms during the pandemic. According to these findings, people with current or past interpersonal trauma exposure represent a vulnerable group with special support needs during pandemic contexts.

Transdiagnostic Mechanisms of Mental Health During the COVID-19 Pandemic on Adults and Families in Germany: Study Protocol of a Cross-Sectional and 1-Year Longitudinal Study.

Background: Since the outbreak of COVID-19 pandemic, psychological distress is increased. Transdiagnostic mechanisms, including trauma, personality functioning, mentalizing and emotion regulation are considered relevant to the development and maintenance of mental health problems and therefore may play a role in individuals' reactions to the pandemic. Aim: To identify moderating and mediating factors associated with pandemic-related distress and mental health problems in adults and families, we aim to investigate the interactions of interpersonal trauma (childhood trauma and domestic violence), psychological capacities (personality functioning, mentalizing and emotion regulation) and pandemic-related adversity on psychological distress during the COVID-19 pandemic. Furthermore, we aim to investigate behavioral and cognitive consequences of the pandemic (e.g., media consumption, vaccination status, conspiracy beliefs). Methods: Using an online-based cross-sectional and longitudinal design, we will investigate a sample of adult participants recruited via online platforms in German-speaking countries over the course of 1 year with four measurements points via self-report instruments (personality functioning: PID5BF +; mentalizing: MentS, PRFQ; emotion regulation: DERS-SF; mental health problems: PHQ-9, GAD-7; a composite pandemic-related stress score). Structural equation and multi-level modeling will be performed for data analyses. Implications: This study will provide data on the moderating and mediating effects of trauma, personality functioning and mentalizing during the pandemic in a large community sample, particularly on vulnerable groups like families. Identifying transdiagnostic mechanisms of psychopathology in the course of a pandemic crisis may provide valuable insight for the development of pre- and intervention measures for potential psychological distress during and post the pandemic.

Emotion Regulation as a Mediator between Childhood Abuse and Neglect and Posttraumatic Stress Disorder in Women with Substance Use Disorders.

OBJECTIVE: A history of childhood abuse and neglect (CAN) is significantly associated with psychopathologies in adulthood, including comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Difficulties in emotion regulation (ER) might influence the association between CAN and PTSD. The aim of this study was to examine the relationship between CAN and PTSD symptom severity in women with SUD and to investigate the mediating role of general difficulties in ER and its specific dimensions. Method: We examined 320 women, with a current diagnosis of at least subsyndromal PTSD and SUD, using self-report measures of CAN, PTSD symptom severity, and ER difficulties. We conducted both simple and multiple bootstrapping-enhanced mediation analysis to investigate whether general difficulties in ER and its specific dimensions mediate the relationship between CAN and PTSD symptom severity. Results: General difficulties in ER mediated the association between CAN and PTSD symptom severity. CAN significantly predicted adult PTSD symptom severity, directly and indirectly, through ER difficulties. Difficulties engaging in goal directed behavior when distressed was the only ER dimension, which mediated the effect of CAN on PTSD symptoms. Conclusions: Our results suggest that difficulties in ER and specifically difficulties engaging in goal directed behavior when distressed might constitute an influential factor in the relationship between CAN and PTSD symptom severity in a sample of SUD patients, and highlight the importance of targeting ER as a potential treatment focus for patients with comorbid PTSD and SUD.

Development and Validation of the Heidelberg Form for Emotion Regulation Strategies (HFERST): Factor Structure, Reliability, and Validity.

The Heidelberg Form for Emotion Regulation Strategies (HFERST) was developed to complement previous emotion regulation (ER) questionnaires and addresses some of their limitations by measuring eight ER strategies. An initial item pool was developed in German following expert discussions and adaptation of the items from existing ER scales. Following a stepwise selection based on the experts' judgments, 32 items with the best content validity were chosen. Results of an exploratory factor analysis in Study 1 (N = 399) and two confirmatory factor analyses in Studies 2 (N = 715) and 3 (N = 408) supported the eight-factor structure of the HFERST and provided evidence for its internal consistency, construct and criterion validity, and clinical utility. Study 4 supported a 2-week stability of the HFERST and Study 5 showed that, following an ER intervention, the HFERST captured a reduction in dysfunctional and an improvement in functional ER strategies, which again supports the clinical utility of the HFERST.

[Mentalization-based Encounter to Challenges in Early Childhood Education with Refugee Families]. / Herausforderungen in der frühpädagogischen Arbeit mit geflüchteten Familien mentalisierungsbasiert begegnen.

Mentalization-based Encounter to Challenges in Early Childhood Education with Refugee Families This article introduces the mentalization concept into the field of early childhood education suggesting that it can also provide a helpful framework for working with refugee families in these settings. Mentalization is identified as a crucial element in establishing and maintaining relationships that are developmentally conducive. It is argued that a mentalizing attitude is relevant for dealing with children with traumatic experiences as well as families with a different cultural background due to its emphasis on openness, curiosity, and (self)reflexivity. In stressful contexts, however, mentalizing can fail or become biased. After providing information on psychotraumatology and cultural influences on child development, the paper will therefore focus on specific ways in which the confrontation with traumatized children and families from diverse cultural backgrounds can interfere with professionals' mentalizing capacities.

[Trauma, Resilience, and Emotion Regulation]. / Trauma, Resilienz und Emotionsregulation.

Background: History of childhood abuse and neglect is considered to be a relevant risk factor for adult psychopathology. A functional emotion regulation (ER) can account for resilience despite of traumatic experiences in childhood. Materials & Methods: This study compares the habitual use of specific ER strategies among mentally healthy individuals with (n=61) and without (n=52) experience of childhood abuse and neglect by using the self-rating instrument Heidelberg Form for Emotion Regulation Strategies (H-FERST). SCID-I, ADP-IV, SCL-27, and BDI-II were used for assessment of psychopathological distress. Results: We found no group difference in the habitual use of ER strategies. Healthy individuals with childhood abuse and neglect showed significantly more subjective distress symptoms. Discussion & Conclusion: Considering the significantly higher psychopathological distress reported by the trauma group, the functional habitual use of ER strategies could serve as a path to explain the resilient development of adult individuals after childhood abuse and neglect.

Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect.

Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.

Emotion dysregulation mediates the relationship between child maltreatment and psychopathology: A structural equation model.

The present study investigated the mediating effects of emotion dysregulation on the relationship between child maltreatment and psychopathology. An adult sample (N=701) from diverse backgrounds of psychopathology completed the Childhood Trauma Questionnaire (CTQ), the Difficulties in Emotion Regulation Scale (DERS), the Brief Symptom Inventory (BSI), and the negative affect subscale of the Positive and Negative Affect Schedule (PANAS) in a cross-sectional online survey. Correlational analyses showed that all types of child maltreatment were uniformly associated with emotion dysregulation, and dimensions of emotion dysregulation were strongly related to psychopathology. Limited access to strategies for emotion regulation emerged as the most powerful predictor. Structural equation modeling analyses revealed that emotion dysregulation partially mediated the relationship between child maltreatment and psychopathology, even after controlling for shared variance with negative affect. These findings emphasize the importance of emotion dysregulation as a possible mediating mechanism in the association between child maltreatment and later psychopathology. Additionally, interventions targeting specific emotion regulation strategies may be effective to reduce psychopathology in victims of child maltreatment.

Does Emotion Dysregulation Mediate the Relationship between Early Maltreatment and Later Substance Dependence? Findings of the CANSAS Study.

BACKGROUND/AIMS: Maltreatment in childhood and adolescence is a risk factor for substance use disorders (SUDs) in adulthood. This association has rarely been investigated in the light of emotion dysregulation. To fill this gap, this study examines emotion dysregulation and SUDs among adults with a history of early maltreatment. METHODS: Comparison of emotion dysregulation in adults with a history of early abuse and neglect who developed either an SUD (n = 105) or no mental disorder (n = 54). Further, a mediation model for the association between the severity of early maltreatment and SUDs was tested. Participants completed research diagnostic interviews for psychopathology, the Difficulties in Emotion Regulation Scale, and the Childhood Trauma Questionnaire. RESULTS: By using hierarchical regression techniques and mediational analyses controlling for age and gender, it was possible to provide evidence for the mediating role of emotion dysregulation between early emotional and physical maltreatment and later SUDs. CONCLUSIONS: Emotion dysregulation is a potential mechanism underlying the relationship between early emotional and physical maltreatment and the development of SUDs. In light of these findings, focusing on the early training of adaptive emotion regulation strategies after childhood maltreatment might be of considerable relevance to prevent the development of SUDs.