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Rosharudin NA, Muhammad NA, Mohd Daud TI, Hoesni SM, Yusoff SR, Razman MOI, Mohd Ali M, Khairuddin KF, Mohd Kari DNP. Psychometric properties of the Malay version of the difficulties in Emotion Regulation Scale-18 in Malaysian adolescents. PLoS One 2023; 18:e0289551. [PMID: 37639447 PMCID: PMC10461853 DOI: 10.1371/journal.pone.0289551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/20/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE The Difficulties in Emotion Regulation Scale-18 (DERS-18) is an instrument used to measure deficits in emotion regulation. However, the instrument has not been adapted to Malaysians and has never been validated in the Malay language. This study aimed to examine the psychometric properties of the Malay version of DERS-18. METHOD The DERS-18 underwent forward-backward translation and assessment of face and content validity. Both Malay version of the DERS-18 and DASS-21 were completed by 701 adolescents (44.4% boys) aged 13 and 14 years old. To assess its dependability, a floor and ceiling effect evaluation and Cronbach's analysis were both performed. A series of confirmatory factor analyses (CFA), bivariate correlation, and regression were performed to evaluate the construct and criterion validity, respectively. RESULTS The Malay version of DERS-18, after excluding "Awareness", indicated excellent reliability (Cronbach's α = 0.93), and acceptable internal consistency for each subscale (range of α from 0.63 to 0.82). Floor or ceiling effects were observed at item level and subscale level, but not at total level. CFA results revealed that the Malay version of the DERS-18 bifactor model (excluding "Awareness") portrayed the best construct validity (χ2/df = 2.673, RMSEA = 0.049, CFI = 0.977, TLI = 0.968) compared to a single factor, a correlated factor, and a higher-order factor model. The DERS-18 subscales (except "Awareness") and DERS-18 total scores were significantly correlated with stress, anxiety, and depression in a positive direction (r ranged from 0.62 to 0.64, p < 0.01). The general factor of the DERS-18 and its specific factors ("Clarity", "Goals", and "Non-Acceptance") significantly predicted the symptoms of stress, anxiety, and depression (R2 ranged from 0.44 to 0.46, p < 0.001). CONCLUSION The Malay version of the DERS-18, excluding "Awareness", possessed good reliability, construct validity, and criterion validity to assess emotion dysregulation among Malaysian adolescents.
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Affiliation(s)
- Nur Afrina Rosharudin
- Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Noor Azimah Muhammad
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Suzana Mohd Hoesni
- Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Siti Rashidah Yusoff
- Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Mohamad Omar Ihsan Razman
- Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Manisah Mohd Ali
- Centre for Research in Education and Community Wellbeing, Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Khairul Farhah Khairuddin
- Centre for Research in Education and Community Wellbeing, Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Dharatun Nissa Puad Mohd Kari
- Department of Counselor Education and Counseling Psychology, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Zhao Y, Wu K, Wang Y, Zhao G, Zhang E. Construct validity of brief difficulties in emotion regulation scale and its revised version: evidence for a general factor. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Thiruchselvam T, Patel A, Daros AR, Jain E, Asadi S, Laposa JM, Kloiber S, Quilty LC. A multidimensional investigation of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy. Psychiatry Res 2020; 293:113446. [PMID: 32980716 DOI: 10.1016/j.psychres.2020.113446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022]
Abstract
We examined how anxiety sensitivity - the fear of symptoms of anxiety due to their perceived harmful effects - and gender are associated with treatment trajectory and outcomes in a large outpatient sample (N = 278) who received 14-weeks of cognitive-behavioral group therapy (CBGT) for depression. Three dimensions of anxiety sensitivity (cognitive, physical, and social concerns) and depression were assessed at pre-treatment, and the latter was assessed weekly during treatment. Latent growth curve models supported a link between cognitive concerns (fears of losing control over thoughts) and greater improvement in depression near the end of treatment (i.e., weeks 10-14); gender did not moderate trajectory. Gender (i.e., identifying as a woman) and greater physical concerns (fears of physical consequences of arousal symptoms) were associated with completion of < 8 sessions. Results suggest that those with more cognitive concerns might require greater time in treatment and/or benefit most from the focus on maladaptive assumptions and core beliefs in later CBGT sessions. Future research, including investigation of intervening variables, may elucidate the mechanisms through which greater physical concerns and gender are associated with treatment non-completion. Results supported differential associations of anxiety sensitivity dimensions with depression treatment outcomes, though further research attention is needed.
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Affiliation(s)
- Thulasi Thiruchselvam
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Alina Patel
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Alexander R Daros
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Esha Jain
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Shayan Asadi
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Judith M Laposa
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Stefan Kloiber
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
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Struijs SY, Lamers F, Verdam MGE, van Ballegooijen W, Spinhoven P, van der Does W, Penninx BWJH. Temporal stability of symptoms of affective disorders, cognitive vulnerability and personality over time. J Affect Disord 2020; 260:77-83. [PMID: 31493643 DOI: 10.1016/j.jad.2019.08.090] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Signs and symptoms of psychopathology can be chronic but are generally regarded as less stable over time than markers of cognitive vulnerability and personality. Some findings suggest that these differences in temporal stability are modest in size but a rigorous examination across concepts is lacking. The current study investigated the temporal stability of affective symptoms, cognitive vulnerability markers and personality traits at various assessments over nine years. METHODS Participants of the Netherlands Study of Depression and Anxiety were assessed at baseline and reassessed after 2, 4, 6 and 9 years. They were grouped on the basis of waves of depression and anxiety CIDI-diagnoses into stable healthy (n = 768), stable patients (n = 352) and unstable patients (n = 821). We determined temporal stability by calculating intraclass correlation coefficients (ICC) and consistency indices of latent state-trait analyses (LST). RESULTS Temporal stability was moderate to high for symptoms (range ICC's 0.54-0.73; range consistency 0.64-0.74), cognitive vulnerability (range ICC's 0.53-0.76; range consistency 0.60-0.74) and personality (range ICC's 0.57-0.80; range consistency.60 -0.75). Consistency indices for all measures were on average a bit lower in the unstable group (ICC = 0.54) compared to the stable groups (ICC = 0.61). Overall stability was similarly high after 2, 4, 6 and 9 years. CONCLUSION The 9-year stability over time of symptoms of affective disorders and that of indices of cognitive vulnerability and personality are remarkably similar and relatively high.
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Affiliation(s)
- Sascha Y Struijs
- Institute of Psychology, Leiden University, AK Leiden 2333, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam 1081 HV, the Netherlands.
| | - Femke Lamers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam 1081 HV, the Netherlands
| | | | - Wouter van Ballegooijen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam 1081 HV, the Netherlands; Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, the Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, AK Leiden 2333, the Netherlands; Department of Psychiatry, Leiden University Medical Centre, 2333 ZA, the Netherlands
| | - Willem van der Does
- Institute of Psychology, Leiden University, AK Leiden 2333, the Netherlands; Department of Psychiatry, Leiden University Medical Centre, 2333 ZA, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam 1081 HV, the Netherlands
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Struijs SY, Lamers F, Spinhoven P, van der Does W, Penninx BWJH. The predictive specificity of psychological vulnerability markers for the course of affective disorders. J Psychiatr Res 2018; 103:10-17. [PMID: 29758471 DOI: 10.1016/j.jpsychires.2018.04.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/05/2018] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
High scores on markers of psychological vulnerability have been associated with a worse course of affective disorders. However, little is known about the specificity of those associations in predicting the course of different depressive and anxiety disorders. We examined the impact of psychological vulnerability on the short- and long-term course of depressive and anxiety disorders. Participants from the Netherlands Study of Depression and Anxiety with a current diagnosis of depression or anxiety (n = 1256) were reassessed after 2 and 6 years. Diagnostic status and chronic duration (>85% of the time) of symptoms were the outcomes. Predictors were neuroticism, extraversion, locus of control, cognitive reactivity (rumination and hopelessness reactivity), worry and anxiety sensitivity. High neuroticism, low extraversion and external locus of control predicted chronicity of various affective disorders. Rumination, however, predicted chronicity of depressive but not anxiety disorders. Worry specifically predicted chronicity of GAD and anxiety sensitivity predicted chronicity of panic disorder and social anxiety disorder. These patterns were present both at short-term and at long-term, without losing predictive accuracy. Psychological vulnerabilities that are theoretically specific to certain disorders indeed selectively predict the course of these disorders. General markers of vulnerability predicted the course of multiple affective disorders. This pattern of results supports the notion of specific as well as transdiagnostic predictors of the course of affective disorders and is consistent with hierarchical models of psychopathology.
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Affiliation(s)
- Sascha Y Struijs
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Center, 1081 HJ Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Center, 1081 HJ Amsterdam, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, 2333 AK Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Centre, 2333 ZA, The Netherlands
| | - Willem van der Does
- Institute of Psychology, Leiden University, 2333 AK Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Centre, 2333 ZA, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Center, 1081 HJ Amsterdam, The Netherlands
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The Long Term Role of Anxiety Sensitivity and Experiential Avoidance on Pain Intensity, Mood, and Disability among Individuals in a Specialist Pain Clinic. Pain Res Manag 2016; 2016:6954896. [PMID: 27445621 PMCID: PMC4904606 DOI: 10.1155/2016/6954896] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/26/2015] [Indexed: 11/30/2022]
Abstract
Background. Anxiety sensitivity (AS) and experiential avoidance (EA) have been shown to have an interactive effect on the response an individual has to chronic pain (CP) potentially resulting in long term negative outcomes. Objective. The current study attempted to (1) identify distinct CP subgroups based on their level of EA and AS and (2) compare the subgroups in terms of mood and disability. Methods. Individuals with CP were recruited from an academic pain clinic. Individuals were assessed for demographic, psychosocial, and personality measures at baseline and 1-year follow-up. A cluster analysis was conducted to identify distinct subgroups of patients based on their level of EA and AS. Differences in clinical outcomes were compared using the Repeated Measures MANOVA. Results. From a total of 229 participants, five clusters were formed. Subgroups with lower levels of AS but similar high levels of EA did not differ in outcomes. Mood impairment was significantly greater among those with high levels of EA compared to lower levels (p < 0.05). Significant improvement in disability (p < 0.05) was only seen among those with lower levels of EA and AS. Conclusions. This cluster analysis demonstrated that EA had a greater influence on mood impairment, while both EA and AS levels affected disability outcomes among individuals with CP.
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Rosellini AJ, Boettcher H, Brown TA, Barlow DH. A Transdiagnostic Temperament-Phenotype Profile Approach to Emotional Disorder Classification: An Update. J Exp Psychopathol 2015; a2:110-128. [PMID: 30245804 PMCID: PMC6150461 DOI: 10.5127/pr.036014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Although the emotional disorders (EDs) have achieved favorable reliability in the Diagnostic and Statistical Manual of Mental Disorders (DSM), accumulating evidence continues to underscore limitations in ED diagnostic validity. In particular, taxometric, comorbidity, and other descriptive psychopathology studies of transdiagnostic phenotypes studies suggest that the EDs may be best conceptualized as dimensional entities that are more similar than different. Despite optimism that the fifth edition of the DSM (DSM-5) would constitute a meaningful shift toward dimensional ED assessment and diagnosis, most changes contribute little movement in that direction. In the present report, we summarize past and anticipate persisting (i.e., in DSM-5) limitations of a purely categorical approach to ED diagnosis. We then review our alternative dimensional-categorical profile approach to ED assessment and classification, including preliminary evidence in support of its validity and presentation of two ED profile case examples using our newly developed Multidimensional Emotional Disorder Inventory. We end by discussing the transdiagnostic treatment implications of our profile approach to ED classification and directions for future research.
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Affiliation(s)
- Anthony J. Rosellini
- Center for Anxiety and Related Disorders, Boston University, Boston, MA
- Department of Health Care Policy, Harvard Medical School, Boston, MA
| | - Hannah Boettcher
- Center for Anxiety and Related Disorders, Boston University, Boston, MA
| | - Timothy A. Brown
- Center for Anxiety and Related Disorders, Boston University, Boston, MA
| | - David H. Barlow
- Center for Anxiety and Related Disorders, Boston University, Boston, MA
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Development of an Anxiety Sensitivity (AS) Intervention for High-AS Individuals in Substance Use Disorders Treatment. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-014-9666-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rosellini AJ, Brown TA. Initial interpretation and evaluation of a profile-based classification system for the anxiety and mood disorders: Incremental validity compared to DSM-IV categories. Psychol Assess 2014; 26:1212-24. [PMID: 25265416 DOI: 10.1037/pas0000023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Limitations in anxiety and mood disorder diagnostic reliability and validity due to the categorical approach to classification used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) have been long recognized. Although these limitations have led researchers to forward alternative classification schemes, few have been empirically evaluated. In a sample of 1,218 outpatients with anxiety and mood disorders, the present study examined the validity of Brown and Barlow's (2009) proposal to classify the anxiety and mood disorders using an integrated dimensional-categorical approach based on transdiagnostic emotional disorder vulnerabilities and phenotypes. Latent class analyses of 7 transdiagnostic dimensional indicators suggested that a 6-class (i.e., profile) solution provided the best model fit and was the most conceptually interpretable. Interpretation of the classes was further supported when compared with DSM diagnoses (i.e., within-class prevalence of diagnoses, using diagnoses to predict class membership). In addition, hierarchical multiple regression models were used to demonstrate the incremental validity of the profiles; class probabilities consistently accounted for unique variance in anxiety and mood disorder outcomes above and beyond DSM diagnoses. These results provide support for the potential development and utility of a hybrid dimensional-categorical profile approach to anxiety and mood disorder classification. In particular, the availability of dimensional indicators and corresponding profiles may serve as a useful complement to DSM diagnoses for both researchers and clinicians.
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Affiliation(s)
- Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychology, Boston University
| | - Timothy A Brown
- Center for Anxiety and Related Disorders, Department of Psychology, Boston University
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PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation. J Anxiety Disord 2013; 27:645-51. [PMID: 24064333 DOI: 10.1016/j.janxdis.2013.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/17/2013] [Accepted: 07/26/2013] [Indexed: 11/23/2022]
Abstract
Reinforcement sensitivity theory (RST) stipulates that individuals have a behavioral activation system (BAS) guiding approach (rewarding) behaviors (Gray, 1971, 1981), and behavioral inhibition system (BIS) guiding conflict resolution between approach and avoidance (punishment) behaviors (Gray & McNaughton, 2000). Posttraumatic stress disorder (PTSD) severity overall relates to both BIS (e.g., Myers, VanMeenen, & Servatius, 2012; Pickett, Bardeen, & Orcutt, 2011) and BAS (Pickett et al., 2011). Using a more refined approach, we assessed specific relations between PTSD's latent factors (Simms, Watson, & Doebbeling, 2002) and observed variables measuring BIS and BAS using 308 adult, trauma-exposed primary care patients. Confirmatory factor analysis and Wald chi-square tests demonstrated a significantly greater association with BIS severity compared to BAS severity for PTSD's dysphoria, avoidance, and re-experiencing factors. Further, PTSD's avoidance factor significantly mediated relations between BIS/BAS severity and PTSD's dysphoria factor.
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Fairholme CP, Carl JR, Farchione TJ, Schonwetter SW. Transdiagnostic processes in emotional disorders and insomnia: results from a sample of adult outpatients with anxiety and mood disorders. Behav Res Ther 2012; 50:522-8. [PMID: 22560005 DOI: 10.1016/j.brat.2012.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 03/28/2012] [Accepted: 03/29/2012] [Indexed: 11/17/2022]
Abstract
Conceptual similarities between recent models of insomnia and emotional disorders suggest there may be common factors that underlie or maintain these difficulties. Maladaptive cognitive and behavioral processes similar to those described in connection with emotional disorders have been cited as key mechanisms in the maintenance of primary insomnia. Unfortunately, research on this potential overlap is lacking. The present study examined the relationship among anxiety sensitivity (AS), dysfunctional beliefs, fatigue, safety behaviors, and insomnia severity in 59 outpatients with anxiety and mood disorders. Key insomnia processes (dysfunctional beliefs, fatigue, safety behaviors) were all related to insomnia severity in the comorbid sample, although AS was not. However, as hypothesized, AS did moderate the relationship of both dysfunctional beliefs and fatigue with insomnia severity. The relationships between key insomnia processes and insomnia severity was strongest among individuals high in AS. Results support the hypothesis that common mechanisms are involved for insomnia and emotional disorders. AS might function as a mechanism for the maintenance of sleep disturbance in the context of anxiety and mood disorders, suggesting a promising avenue for future research.
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