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Objective: Existing literature suggests strong positive associations between posttraumatic stress disorder (PTSD) symptoms and emotion regulation difficulties; however, many of these findings are the result of monomethodological approaches (e.g., self-report questionnaires) versus multimethodological approaches. The current study utilized both self-report questionnaires and an emotion regulation choice paradigm (see Sheppes, Scheibe, Suri, & Gross, 2011) to assess various facets of emotion dysregulation in a sample of trauma-exposed undergraduate students with varying levels of self-reported PTSD symptoms (measured by the PTSD Checklist, fifth edition). Method: Data were collected from 83 students who underwent a laboratory paradigm, followed by completion of numerous self-report measures of emotion regulation (e.g., the Difficulties in Emotion Regulation Scale, the Acceptance and Action Questionnaire-II, and the Emotion Regulation Questionnaire). Results: Students with probable PTSD (n = 25) exhibited greater emotion dysregulation on self-report measures compared with students with nonprobable PTSD (n = 58; ηp2 ranged from .06 to .42). Additionally, results from the emotion regulation choice paradigm suggested that students with probable PTSD were more likely to exhibit regulatory inflexibility compared with students with nonprobable PTSD (ηp2 = .05). In other words, students with probable PTSD were less likely to use reappraisal (vs. distraction) to help regulate their emotions in response to low-intensity negative stimuli compared with students with nonprobable PTSD. Conclusions: Students with probable PTSD report greater perceived emotion regulation difficulties on self-report questionnaires as well as greater behavioral regulatory inflexibility during a laboratory paradigm.
Clinical Impact Statement
Teaching clients how to flexibly use emotion regulation strategies (e.g., reappraisal, distraction) in various contexts may be beneficial for clients with elevated PTSD symptoms. It may also be helpful to provide psychoeducation on the costs and benefits associated with the use of different emotion regulation strategies. Clinicians may also consider utilizing behavioral paradigms, such as the emotion regulation choice task, as an outcome tool for measuring relative preference for distraction/reappraisal following trauma-focused treatment. If a client demonstrates flexible use of both strategies on the choice paradigm following a trauma-focused treatment that may be one objective indicator of successful treatment.