Understanding and measuring emotional dysregulation

Emotional dysregulation is a construct of transdiagnostic importance, playing a significant role in a range of psychopathologies. Despite its importance, questions remain regarding its aetiology, its treatment, the role that emotional invalidation plays in the disorder, and even how the construct should be defined and measured. This thesis addresses all these issues, with the ultimate aim being to provide a more nuanced model of emotional dysregulation that informs an improved measure. 

The initial chapters discuss challenges in relation to defining emotional dysregulation. In addition, Linehan’s (1993) well-established biosocial model, which attempts to explain the aetiology of emotional dysregulation and borderline traits, and which underpins the widely-used Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), is examined in detail. 

The first published paper describes the treatment of emotional dysregulation in a population of adolescents experiencing clinically elevated emotional dysregulation. The study aim was to better understand the emotional dysregulation construct, and the role that emotional invalidation may play in the development of emotion regulation difficulties. 

In the second published paper some outstanding concerns regarding the aetiology of emotional dysregulation, principally the role of emotional invalidation, are explored. Whilst this study found that an invalidating childhood environment was related to subsequent emotion regulation difficulties, the role of this factor seemed to be complicated, and appeared to change depending upon whether a clinical or non-clinical sample was examined. 

In the third published paper a clinical observation of emotionally dysregulated clients was explored: when such clients’ pre-existing emotional state was not clearly accounted for by their current context, they would often take steps to alter the context to better account for their emotional state. It was hypothesised that this process could be a response to such individuals having been raised in an emotionally invalidating environment, as such environments include the dismissal of individuals’ explanations for their emotions. While for some emotions there was evidence that individuals with emotion regulation difficulties might seek to alter their context to better account for their emotional state, methodological issues limited the utility of the findings for the development of a new model of emotional dysregulation. 

In the final published paper, previous findings are drawn together to develop and test an enhanced model and new measure of emotional dysregulation. Based on the findings of the three previous studies, a new scale, the Emotional Dysregulation Questionnaire (EDQ) was developed. The capacity of this scale to assess emotional dysregulation was compared to the DERS. It was found that the EDQ was generally superior in its capacity to predict the emotion regulation deficits present across a range of disorders. The findings for the EDQ were found to be consistent with the enhanced model of emotional dysregulation. 

In the final chapter of this thesis, the enhanced model of emotional dysregulation and the clinical utility of the EDQ are discussed. Other areas for further research are also identified, including further examining the dynamic where individuals with emotional regulation difficulties may seek to alter their social context to validate their current emotional state.