The DERS is a brief, 36-item, self-report questionnaire designed to assess multiple aspects of emotion dysregulation. The measure yields a total score as well as scores on six scales derived through factor analysis:
1. Nonacceptance of emotional responses (NONACCEPTANCE)
2. Difficulties engaging in goal directed behavior (GOALS)
3. Impulse control difficulties (IMPULSE)
4. Lack of emotional awareness (AWARENESS)
5. Limited access to emotion regulation strategies
(STRATEGIES)
6. Lack of emotional clarity (CLARITY)
Although the measure is psychometrically young, it is promising and taps an important domain for the field of child trauma. Nearly all empirically validated treatments for child trauma seek to make changes in the domain of emotion regulation, but there are few measures that assess this domain.
The DERS has been examined in a sample of college students aged 18 and older and a clinical sample of women with Borderline Personality Disorder; however, the items are simply and clearly written and warrant examination in an adolescent population.
Overview
DERS
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology & Behavioral Assessment, 26(1), 41-54.
Administration
5-point scale: 1=almost never (0-10%), 2=sometimes (11-35%), 3=about half the time (36-65%), 4=most of the time (66-90%), 5=almost always (91-100%)
| Domains | Scale | Sample Items |
|---|---|---|
| Nonacceptance of emotional responses (NONACCEPTANCE) | When I'm upset, I feel guilty for feeling that way. | |
| Difficulties engaging in goal-directed behavior (GOALS) | When I'm upset, I have difficulty concentrating. | |
| Impulse control difficulties (IMPULSE) | When I'm upset, I lose control over my behaviors. | |
| Lack of emotional awareness (AWARENESS) | I am attentive to my feelings. (reverse) | |
| Limited access to emotion regulation | ||
| strategies (STRATEGIES) | When I'm upset, I believe that I'll end up feeling very depressed. | |
| Lack of emotional clarity (CLARITY) | I have difficulty making sense out of my feelings. |
Training
Parallel or Alternate Forms
Psychometrics
A mean score of approximately 120 has been found in three samples of patients. One study is in press (Gratz & Gunderson, in press). The author says that the other two are currently in preparation.
| Type: | Rating | Statistics | Min | Max | Avg |
|---|---|---|---|---|---|
| Test-Retest | Acceptable | Intraclass correlation coefficient | 0.57 | 0.89 | 0.74 |
| Internal Consistency | Acceptable | Cronbach's Alpha | 0.84 | 0.93 | 0.86 |
| Inter-rater | |||||
| Parallel/Alternate Forms |
TEST-RETEST RELIABILITY (Gratz & Roemer, 2004): n=21, time period=4-8 weeks, measured using an intraclass correlation coefficient Total DERS (.88), NONACCEPTANCE (.69), GOALS (.69), IMPULSE (.57), AWARENESS (.68), STRATEGIES (.89), and CLARITY (.80). INTERNAL CONSISTENCY: (Cronbach’s alpha) Gratz & Roemer, 2004, DERS total (.93), NONACCEPTANCE (.85), GOALS (.89), IMPULSE (.86), AWARENESS (.80), STRATEGIES (.88), CLARITY (.84) In a sample of 325 participants aged 18-62 (50.8% White, 21.5% Black, 8.6% Asian/Pacific Islander, 6.5% Hispanic/Latino, 5.2% multiracial, and 3.1% other) recruited from a large urban university, Salters, Roemer, Tull, Rucker, & Mennin (in press) reported good internal consistency for the total score (alpha=.89) and subscale scores (alpha>.77).
Gratz & Roemer (2004) The initial 41 items were developed and selected based on “conversations with colleagues well versed in the emotion regulation literature.” The Generalized Expectancy for Negative Mood Regulation Scale was used as a template for the structure of some of the items (although not the content of the items). Items were selected to “reflect difficulties within the following dimensions of emotion regulation: a) awareness and understanding of emotions; b) acceptance of emotions; c) the ability to engage in goal-directed behavior, and refrain from impulsive behavior, when experiencing negative emotions; and d) access to emotion regulation strategies perceived as effective. Scales and items were further refined using factor analysis. One item was eliminated due to low correlations for other items and the total score, and 4 items eliminated because they loaded on two factors or failed to load above .50 on any factor.
| Validity Type | Not known | Not found | Nonclincal Samples | Clinical Samples | Diverse Samples |
|---|---|---|---|---|---|
| Convergent/Concurrent | Yes | ||||
| Discriminant | Yes | ||||
| Sensitive to Change | Yes | ||||
| Intervention Effects | Yes | ||||
| Longitudinal/Maturation Effects | Yes | ||||
| Sensitive to Theoretically Distinct Groups | Yes | Yes | |||
| Factorial Validity | Yes |
Gratz & Roemer (2004) DERS total and subscale scores were significantly correlated with the Generalized Expectancy for Negative Mood Regulation Scale (NMR), with the STRATEGIES scale showing the highest correlation with the NMR and with the Acceptance and Action Questionnaire (AAQ). Scales also correlated with the Emotional Expressivity Scale (EES). Salters, Roemer, Tull, Rucker, & Mennin (in press) found that the DERS total was significantly correlated with the Penn State Worry Questionnaire (r=.51, p<.001) as were all DERS scales excepting the Lack of Awareness scale. Participants with probable GAD, assessed using the Generalize Anxiety Disorder Questionnaire-IV, reported significantly higher scores on the DERS total score as well as the Nonacceptance, Goals, Impulse, and Strategies scales. The relationship between DERS scales and GAD diagnosis remained significant even after controlling for negative affect, assessed using the Positive Affect Scale and Negative Affect Scale. The measure was developed using factor analysis (Gratz & Roemer, 2004). A common factor analysis using principal axis factoring and a promax oblique rotation resulted in a 6-factor solution, based on the scree test and interpretability, accounting for 55.68% of the variance: 1) Nonacceptance of emotional responses, 2) Difficulties engaging in goal-directed behavior, 3) Impulse control difficulties, 4) Lack of emotional awareness, 5) Limited access to emotion regulation strategies, and 6) Lack of emotional clarity. The DERS has been shown to be sensitive to change in a randomized trial of a 14-week group treatment for Borderline Personality Disorder that targeted emotion dysregulation. Women (n=12) assigned to the group plus treatment as usual showed significant improvement on DERS scores while the women (n=10) assigned to the wait list plus treatment did not (Gratz & Gunderson, in press). The author also reports that “a second article, currently in preparation, shows changes in the DERS following specialized BPD treatment at the partial hospitalization and intensive outpatient levels of care. A final study, also in preparation, indicates significantly higher DERS scores among a sample of BPD outpatients, compared to outpatients without a personality disorder.”
| Not Known | Not Found | Nonclinical Samples | Clinical Samples | Diverse Samples | |
|---|---|---|---|---|---|
| Predictive Validity: | Yes | ||||
| Postdictive Validity: | Yes |
1. Gratz & Roemer (2004) report analyses that suggest that the DERS accounts for unique variance in clinically relevant behaviors above that accounted for by the Generalized Expectancy for Negative Mood Regulation Scale (NMR), an existing measure of affect regulation. 2. Although the measure was tested with a sample of college students, a significant number (24% of women and 17% of men) had a history of intimate partner violence. In addition: 35% of the women and 44% of the men reported a history of at least one incident of self-harm, and emotion dysregulation scores were related to self-harm behaviors in this sample; 86 women reported a history of sexual or physical abuse; and Affect Regulation scores were related to self-harm behaviors in this sample.
Translations
| Language: | Translated | Back Translated | Reliable | Good Psychometrics | Similar Factor Structure | Norms Available | Measure Developed for this Group |
|---|---|---|---|---|---|---|---|
| 1.German | Yes | Yes | |||||
| 2. Turkish | Yes | Yes |
Population Information
The measure was first tested with two samples. Sample 1: 373 undergraduates aged 18 to 55 (M=23.10, SD=5.67; 73% female, 27% male), from the University of Massachusetts, Boston, who returned questionnaire packets distributed during undergraduate psychology courses (response rate=78%: 373 of 479). The ethnicity was 65% White, 17% Asian, 8% African American, 4% Hispanic, 6% other orunspecified background. The sample was predominantly heterosexual (90%). Sample 2: Recruited for the purpose of examining test-retest reliability. Of 194 participants, 21 agreed to complete measures a second time. Participants were aged 18-48 (M=25.95, SD=8.94); 62% female, 38% male; 67% White, 24% African American, 5% Asian/Pacific Islander, and 5% unspecified background.
| Population Type: | Measure Used with Members of this Group | Members of this Group Studied in Peer-Reviewed Journals | Reliable | Good Psychometrics | Norms Available | Measure Developed for this Group |
|---|---|---|---|---|---|---|
| 1. Lower Socio-economic status | Yes | Yes |
Pros & Cons/References
1. The measure focuses on emotion regulation, an extremely important domain for the field of child trauma, and its theoretical foundation is consistent with that of empirically validated trauma focused interventions. 2. The measure contributes additional variance in clinically relevant behaviors, beyond that explained by an existing emotion regulation measure. 3. The measure appears to be related to self-harm behaviors in women with a history of childhood sexual or physical abuse. 4. The measure is free.
1. The measure is new and psychometrically young, but it is promising. 2. The measure has yet to be normed, and there are no clinical cutoffs to help with interpretation of scores.
A PsychInfo literature search (6/05) of the words "Difficulties in Emotion Regulation Scale" or “DERS” revealed that the measure has been referenced in 1 peer-reviewed journal article. The author provided two additional articles that are currently in press. 1. Gratz, K.L., & Roemer, L. (in press). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy. 2. Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology & Behavioral Assessment, 26(1), 41-54. 3. Salters, K., Roemer, L., Tull, M.T., Rucker, L., & Mennin, D.S. (in press). Evidence of broad deficits in emotion regulation associated with chronic worry and generalized anxiety disorder. Cognitive Therapy and Research.
The author provided comments, which were integrated.