Psychometric properties of the Brazilian version of the Difficulties in Emotion Regulation Scale (DERS) / Propriedades psicométricas da versão Brasileira da Difficulties in Emotion Regulation Scale (DERS)

Abstract Introduction: Emotion regulation can be defined as the process by which individuals manage their emotional experience. It has been demonstrated that deficits in this ability are associated with various psychiatric disorders. In this direction, the Difficulties in Emotion Regulation Scale (DERS) was developed to measure difficulties in emotion regulation. Objective: To examine the psychometric properties of the Brazilian Portuguese version of the DERS. Method: A total of 377 individuals from the general population, selected by convenience, completed a sociodemographic form, the adapted Brazilian Portuguese DERS and the Depression Anxiety Stress Scale (DASS-21). Factor structure, reliability, and concurrent validity of the adapted version of the instrument were investigated. Results: The confirmatory factor analysis replicated the six-factor structure originally proposed for the instrument and confirmed the acceptability of a hierarchical model where all DERS subscales loaded on a general emotion dysregulation factor. Internal consistency indicators had adequate values for the general factor and subscales. The positive association between DERS and DASS-21 scores supports the instrument's concurrent validity. Conclusion: These results suggest that the Brazilian version of the DERS is reliable both as a general measure of difficulties in emotion regulation and as a measure of the constituents of this construct. Future research should investigate the psychometric properties of the scale in clinical and nonclinical populations, with equal gender proportions and diverse backgrounds, and preferably employing longitudinal designs.

Resumo Introdução: Regulação emocional pode ser definida como o processo pelo qual os indivíduos regulam sua experiência emocional. Tem sido demonstrado que déficits na regulação emocional podem estar associados a vários transtornos psiquiátricos. Nesta linha, a Difficulties in Emotion Regulation Scale (DERS) é um instrumento que foi desenvolvido para acessar dificuldades na regulação emocional. Objetivo: Examinar as propriedades psicométricas de uma versão da DERS adaptada ao português brasileiro. Método: Um total de 377 indivíduos da população geral foram selecionados por conveniência para completar um questionário sociodemográfico, a versão adaptada ao português brasileiro da DERS e a Depression Anxiety Stress Scale (DASS-21). Foram investigadas a estrutura fatorial, confiabilidade e validade concorrente da versão adaptada da DERS. Resultados: A análise fatorial confirmatória replicou a estrutura de seis fatores originalmente proposta para o instrumento e confirmou a aceitabilidade de um modelo hierárquico em que todas as subescalas são carregadas em um fator de desregulação emocional geral. Os indicadores de consistência interna apresentaram valores adequados para o fator geral e subescalas. A associação positiva entre os escores obtidos na DERS e na DASS-21 dá suporte à validade concorrente do instrumento. Conclusão: Esses resultados sugerem que a versão brasileira da DERS é confiável como medida geral de dificuldades na regulação emocional e como medida dos constituintes desta construção. Pesquisas futuras devem investigar as propriedades psicométricas da escala em populações clínicas e não clínicas, com igual proporção de gênero e diversas origens e, de preferência, empregando desenhos longitudinais.

Problematic and adaptive eating in people with obesity after a DBT-based skills training intervention: 3- and 8-month follow-up and mediation analysis

Abstract Background: Dialectical behavior therapy conceptualizes problematic behaviors as attempts to regulate emotions that occur when the individual lacks effective skills with which to manage his or her emotions and cope with distress. Problematic eating behaviors, e.g., binge and emotional eating, may serve to alleviate aversive emotional states, being highly associated with overweight and obesity. Dialectical behavior therapy skills training has been proven effective in reducing binge eating in several clinical studies. However, few studies reveal the effects of DBT on adaptive eating behaviors or the stability of outcomes. Objectives: This study aimed to test the effect of a brief DBT-based skills training intervention, and the stability of outcomes at 3- and 8-month follow-ups. Methods: Self-report measures of binge eating, emotional eating, intuitive eating, and mindful eating were taken on 5 timepoints before and after a 10-session DBT skills training intervention (2 baseline measures, 1 post-test, and 2 follow-ups). Data were analyzed using a mixed-model intention-to-treat approach and mediation analysis was conducted with path analysis. Results: After the intervention, intuitive eating and mindful eating scores were significantly higher than before the intervention, while emotional eating and binge eating scores were lower. The results remained stable during the follow-up period, with minor fluctuations and small trends towards returning to baseline values for binge eating and emotional eating. Mindful eating partially mediated the improvements in all outcomes. Limitations: Given that results are entirely based on self-report measures and that some instruments showed poor reliability, in addition to the high attrition rates, the results should be interpreted as preliminary. Conclusions: The results provide evidence that a brief DBT intervention is effective not only in reducing problematic eating but also in increasing adaptive eating, achieving reasonably stable results. Also, the mediation analysis results support the hypothesis that mindful eating partially explains the effects of the intervention on binge and emotional eating. Future research should address the limitations of this study by investigating a more diverse sample, triangulating different measurement strategies, and including other putative mediators.

Transtorno de déficit de atenção e hiperatividade e cocaína-crack: o que indica a comparação entre grupo de usuários e não usuários? / Attention deficit hyperactivity disorder and crack cocaine: what does the comparison between a group of users and non-users indicate? / Trastorno por Déficit de Atención y Hiperactividad y Cocaína de crack: que indica la comparación de los usuarios y no usuarios?

O objetivo, neste estudo, foi analisar a relação entre o uso de cocaína-crack e o diagnóstico de transtorno de déficit de atenção com hiperatividade. Foram analisadas associações entre o grupo clínico de usuários de cocaína-crack e o não clínico, proveniente da população geral, de amostra de 971 participantes, que responderam ao Adult Self-Report. Foram encontradas diferenças significativas relacionadas à presença do diagnóstico de transtorno de déficit de atenção e hiperatividade (p=0,001), como problemas de atenção (p=0,001) que podem estar relacionados a alterações associadas à busca por situações recompensadoras, como o uso de substâncias. Isso, aliado à impulsividade, nos dois transtornos, tornaria tal associação digna de formulação de diretrizes específicas a fim de maximizar a eficácia do tratamento.

The objective in this study was to analyze the relation between the use of crack-cocaine and the diagnosis attention deficit hyperactivity disorder. Associations were analyzed between the clinical group of crack-cocaine users and the non-clinical group, taken from the general population, through a sample of 971 participants who answered the Adult Self-Report. Significant differences were found in the presence of the attention deficit hyperactivity disorder diagnosis (p=0.001), such as attention problems (p=0.001), which can be related to changes associated with the search for rewarding situations, such as substance use. This, allied with the impulsiveness in both disorders, would make this association worthy of formulating specific guidelines to maximize the treatment efficacy.

El objetivo de este estudio es analizar la relación entre el consumo de cocaína crack y el diagnóstico de Trastorno por Déficit de Atención y Hiperactividad. Se analizaron asociaciones entre el grupo clínico de los consumidores de cocaína crack y no clínico de la población general de una muestra de 971 participantes que completaron el Adult Self-Report (ASR). Diferencias significativas fueron encontradas en relación al diagnóstico de Trastorno por Déficit de Atención y Hiperactividad (p = 0,001), como más problemas de atención (p = 0,001), que pueden estar vinculados a una mayor búsqueda de situaciones gratificantes, como el uso de sustancias. Esto, junto a la impulsividad en ambos trastornos, es digno de directrices específicas para maximizar la eficacia del tratamiento.