Broad strokes or fine points: Are dialectical behavior therapy modules associated with general or domain-specific changes?

Dialectical behavior therapy (DBT) has demonstrated effectiveness for a range of emotional difficulties, and DBT skills training groups may be necessary to produce symptom change. However, it is unclear how skills training groups influence outcomes. Specifically, is participation in DBT skills modules associated with general effects (i.e., changes in multiple domains) or domain-specific effects (i.e., changes in the conceptually relevant domain)? Participants recruited from a university training clinic (n = 87; 75.9% diagnosed with borderline personality disorder) participated in standard DBT for 6 months. We conducted hierarchical linear mixed models to test whether self-reported changes in emotion regulation, interpersonal problems, and distress tolerance were associated with the specific DBT module intended to target that outcome. In 3 models, we regressed end-of-module ratings of each of our measures of interest on (a) premodule ratings of each measure of interest, (b) time, and (c) dummy-coded module completed. Although all modules were associated with similar reductions in emotion dysregulation, the Emotion Regulation module was associated with the greatest improvements in both interpersonal problems and distress tolerance. In contrast, the first skills module completed was unrelated to changes in any of these domains. These results suggest that Emotion Regulation skills are associated with improvements in patient symptoms across relevant domains and offer potential directions for optimizing the delivery of DBT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotions as context: Do the naturalistic effects of emotion regulation strategies depend on the regulated emotion?

Researchers have examined how several contexts impact the effectiveness of emotion regulation strategies. However, few have considered the emotion-to-be-regulated as a context of interest. Specific emotions are important contexts because they may require particular responses to internal and external stimuli for optimal regulation. Ninety-two undergraduates completed 10 days of ecological momentary assessment, reporting their current mood, recent emotions, and emotion regulation strategies three times per day. The frequency with which certain emotion regulation strategies were used (i.e., acceptance, positive refocusing, reappraisal, problem-solving, and other-blame) differed by the specific emotion experienced. Acceptance and positive refocusing were associated with better mood regardless of emotion, while substance use was associated with worse mood regardless of emotion. Reappraisal was associated with better mood in response to anger than anxiety or sadness, while emotional suppression and other-blame were associated with worse mood in response to anger. These results suggest some emotion regulation strategies exhibit emotion-invariant effects while others depend on the emotion-to-be-regulated.

Back to basics: a naturalistic assessment of the experience and regulation of emotion.

Emotion regulation research links regulatory responding to important outcomes in psychological well-being, physical health, and interpersonal relations, but several fundamental questions remain. As much of the previous research has addressed generalized regulatory habits, far less is known about the ways in which individuals respond to emotions in daily life. The literature is particularly sparse in explorations of positive emotion regulation. In the current study, we provide an assessment of naturalistic experiences and regulation of emotion, both positive and negative in valence. Using an electronic experience sampling methodology, participants reported on their use of 40 regulatory strategies in response to 14 emotions for 10 consecutive days. On average, participants used 15 different regulatory strategies in response to negative emotions over this time, most frequently relying on acceptance, behavioral activation, and rumination. Participants used a similarly large repertoire of strategies, approximately 16 total, in response to positive emotions, particularly savoring, future focus, and behavioral activation. Participants' mood ratings following strategy use, however, indicated that the most frequently used strategies were often not the most effective strategies. The results of this study provide estimates of the frequency and effectiveness of a large number of emotion regulation strategies in response to both negative and positive emotions. Such findings characterize naturalistic emotion regulation, and estimates of normative emotion regulation processes are imperative to determining the ways in which deviations (e.g., small emotion regulation repertoires, insufficient attention to regulation of positive emotions) impact emotional functioning.

A reexamination of the factor structure of the Center for Epidemiologic Studies Depression Scale: is a one-factor model plausible?

The Center for Epidemiologic Studies Depression Scale (CES-D) is one of the most widely used measures of depressive symptoms in research today. The original psychometric work in support of the CES-D (Radloff, 1977) described a 4-factor model underlying the 20 items on the scale. Despite a long history of evidence supporting this structure, researchers routinely report single-number summaries from the CES-D. The research described in this article examines the plausibility of 1-factor model using an initial sample of 595 subjects and a cross-validation sample of 661. After comparing a series of models found in the literature or suggested by analyses, we determined that the good fit of the 4-factor model is mostly due to its ability to model excess covariance associated with the 4 reverse-scored items. A 2-factor model that included a general depression factor and a positive wording method factor loading only on those 4 items had fit that was nearly as good as the original 4-factor model. We conclude that although a 1-factor model may not be the best model for the full 20-item CES-D, it is at least plausible. If a unidimensional set of items is required (e.g., for a unidimensional item response theory analysis), by dropping 5 items, we were able to find a 1-factor model that had very similar fit to the 4-factor model with the original 20 items.