Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people.

This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK).

Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms.

SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions.

These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.

Since the onset of COVID-19 pandemic, additional risk factors affecting family caregivers’ mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers’ mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated.

This study analyzed data collected in April 2021 from 154 family caregivers (Mage = 38.79, SDage = 9.36, range = 22–64) recruited through Amazon’s Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated.

Both COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors.

The current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic.

Self-harming behaviours are reported to be increasing amongst young people and are associated with increased risk of suicide. The recently published UK clinical guidelines highlight that cross-sector awareness and early psychosocial assessment of self-harming is necessary, alongside careful triaging as to the level of support required. Dialectical behaviour therapy for adolescents (DBT-A) is a recommended intervention for young people with more severe difficulties. The current study aims to contribute to the data available to inform ongoing clinical decisions about the feasibility and implementation of DBT-A by reporting the intervention method, participant characteristics, and clinical outcomes of a national (UK) DBT service for young people with high levels of need and risk. Young people who commenced treatment between 2015 and 2021 were included. Completion rates, reasons for non-completion, and discharge pathways are reported. Measurement and changes in outcomes, including self-harm, in-patient bed days, accident and emergency department attendances and education/work status, are reported, as well as for routine outcome measures assessing emotion dysregulation and symptoms of emerging borderline personality disorder, depression and anxiety. The clinical significance of these outcomes are considered. Ideas for service evaluation, which are feasible and replicable in busy clinical settings are proposed, as well as a discussion of potential adaptations to standardised protocols needed in this context to fit with National Health Service (NHS) resources and the needs of the target population.

1. (1) To learn about the implementation of dialectical behaviour therapy (DBT) and concurrent outcome monitoring in a UK National Health Service CAMHS out-patient setting.

2. (2) To understand the clinical profile and response to treatment of young people with high levels of suicidal and non-suicidal self-harming behaviours.

3. (3) To present a potential method for outcome monitoring and collection for CAMHS DBT services.

Dialectical behaviour therapy (DBT) skills groups have shown promise as an effective treatment for clients with emotional dysregulation, especially when combined with individual DBT. However, their efficacy is not well established as an online therapy, or in the Latinx population.

This study aimed to explore satisfaction, retention and effects of an internet-based DBT group added to individual online sessions.

An ABAB withdrawal experimental single-case design was conducted to evaluate the effect of a brief online DBT skills group on emotional dysregulation, anxiety and depression for five Latinx participants. DBT skills group (phase B) were compared with placebo group sessions (phase A) and fortnightly individual DBT sessions were offered throughout to manage risk.

Visual inspection showed a decrease in level of emotional dysregulation and a large effect size according to the Nonoverlap of All Pairs when comparing group DBT and placebo phases. Although depression symptoms decreased after introducing group DBT, anxiety indicators decreased most during the second round of group placebo sessions.

Whilst only a pilot, this study suggests that online group DBT in Latinx populations is feasible and effective for changing emotional regulation processes but may not effectively target anxiety. Future research might increase the number of DBT sessions in order to enhance learning opportunities and generalization. Replication with larger sample sizes and diverse modalities is needed.

Findings from previous studies have implicated various forms of emotion dysregulation (EDys), including difficulties in emotion regulation, as important for the development and maintenance of borderline personality disorder (BPD). In addition, comorbid anxiety and depressive psychopathology has been found to contribute to the severity of BPD symptoms in this disorder.

This study aimed at extending extant research on the above issues by testing the mediational role of comorbid psychopathology (i.e., trait anxiety and depressive symptoms) in the relationship between EDys (specifically, difficulties in emotion regulation) and BPD symptoms in BPD patients.

64 BPD female inpatients completed the Emotion Dysregulation Scale, STAI, CESD–R, and BPD Checklist.

BPD symptoms were statistically significantly and strongly positively associated to EDys (rs = .55, p < .001) and to trait anxiety (rs = .52, p < .001). EDys and trait anxiety predicted the severity of BPD symptoms, R2 = 0.41, F(2, 61) = 20.90, p < .001. The examination of the indirect effect revealed a significant mediation, in which the association between EDys and BPD symptoms was mediated by trait-anxiety, B = 0.37, SE = 0.18, 95% CI = [0.10, 0.78]. However, the direct effect of EDys on BPD symptoms remained significant, B = 0.81, SE = 0.24, 95% CI = [0.32, 1.30].

The severity of BPD symptoms is associated with EDys and with trait anxiety. Moreover, our findings show that the latter partially mediates the link between EDys and BPD symptoms, which suggests that trait anxiety may contribute to the severity of BPD symptoms.

No significant relationships.

The current study tests the relationship between eating disorder (ED) symptoms and trauma exposure. The mechanisms via which trauma is related to ED symptoms have not been sufficiently examined. This study examines the complex role of dissociation and emotional dysregulation in the context of trauma, BMI, ED symptoms and body dissatisfaction (BD).

We hypothesized that dissociation and emotional dysregulation would mediate the relationship between trauma exposure and ED symptoms / BD. We further hypothesized that BMI would play a moderating role in this association.

A community sample of 229 (16.2% male) participants, with a mean age of 29.08±10.68 reported online on traumatic events (Life Events Checklist), dissociation (Dissociative Experiences Scale – II), emotional dysregulation (Difficulties in Emotional Regulation Scale), ED symptoms (Eating Disorders Examination – Questionnaire) and BD (Figure Rating Scale).

Participants reported experiencing a mean of 2.87±2.27 traumatic events, with a relatively high percentage (˜86%) reporting at least one. The most commonly reported traumatic events were transportation accidents and physical assault. Although frequency of traumatic events did not directly predict ED symptoms, BMI, dissociation, emotional dysregulation and BD did. An SEM model showed that traumatic events predicted ED symptoms indirectly through dissociation, emotional dysregulation and BMI. Dissociation and emotional dysregulation predicted ED symptoms directly. BMI also moderated the association between traumatic events and both ED symptoms and BD.

Therapists treating patients with high BMI or obesity should be aware of these relationships and investigate the possibility that trauma and/or PTSD may underlie the presenting disordered eating or eating disorder.

No significant relationships.

The COVID-19 pandemic represents an epidemiological and psychological crisis (APA, 2020). In this context, although emerging adults are less likely to get COVID-19, they might have suffered from the national lockdowns over the last year, as they are indeed involved in a crucial development period wherein interpersonal relationships undertake a fundamental function in their psychological well-being. To this end, mentalizing abilities and emotion dysregulation may play a crucial role as possible salutogenic or pathogenic factors on the onset of psychiatric symptoms during the three waves of the COVID-19 pandemic.

1) To examine the relationship between emotion dysregulation assessed at the end of the first wave of COVID-19, mentalizing assessed during the second wave, and psychiatric symptoms levels assessed during the third wave. 2) To examine the moderation role of mentalizing within the relation between emotion dysregulation and psychiatric symptoms.

Participants were 83 non-clinical emerging adults (Mage=22.18, SD=4.36; 57.8% females). Measures applied were Difficulties in Emotion Regulation Scale (DERS) to examine emotion dysregulation, Reflective Functioning Questionnaire to examine mentalizing (RFQ_uncertainty; RFQ_certainty) and Symptom Checklist-90-Revised (SCL-90) to examine psychiatric symptoms (Global Severity Index, GSI).

DERS_total score (r=.31, p=.03) and both RFQ_uncertainty (r=.41, p<.01) and RFQ_certainty (r=-.33, p=.02) are associated with GSI. Secondly, a significant moderation role by RFQ_u emerged within the relation between DERS_total score and GSI (∆R2=.067, β=.001, SE=.00, CI[.000, .002]).

These results suggest that mentalizing and emotion dysregulation may play a pivotal role in the onset of psychiatric symptoms during the COVID-19 pandemic. Clinical implications are discussed.

No significant relationships.

Few studies investigated the role of psychological variables underlying polylove.

To extend the knowledge regarding the psychological profile of polylovers.

We administered to a sample of individuals reporting to be polylovers and a sample of participants reporting to not be polylovers a battery of self-report questionnaires including the Attitude Towards Polylove scale (ATP), the Multidimensional Sexuality Questionnaire (MSQ), The Experiences in Close Relationships 12 items (ECR-12), the Couple Satisfaction Inventory (CSI), the Difficulties in Emotion Regulation Scale (DERS) and the Difficulties in Emotion Regulation Scale Positive (DERS-P).

We found that controlling for age and gender, polylovers, compared to not polylovers, scored higher on some dimensions of the DERS-P, on the ATP scores and on some dimensions of the MSQ. No others significant differences between groups emerged. Moreover, in the group of polylovers, ATP scores were positively related to sexual satisfaction, sexual self-esteem and sexual consciousness and negatively related to avoidant attachment style and difficulties in regulating positive emotions. Finally, we found that avoidant attachment style moderated the link between ATP scores and sexual self-esteem.

Emotion dysregulation and attachment appear to be central variables explaining the specificity of psychological profiles of polylovers.

No significant relationships.

Sexual dysfunction is common in eating disorders (EDs), but its relevance is often overlooked.

To describe different ED clinical subgroups in terms of psychopathology, putative biological correlates, and consequences of dysregulated sexuality, focusing on the role of childhood trauma.

Healthy controls (n=60), binge-purging (n=38), and restricting patients (n=24) were compared (age- and BMI-adjusted ANOVA; Bonferroni post-hoc tests), using total scores of Eating Disorder Examination Questionnaire (EDE-Q), Emotional Eating Scale (EES), SCL-90-R Global Severity Index (GSI), Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), Childhood Trauma Questionnaire (CTQ), Female Sexual Functioning Index (FSFI), Hypersexual Behaviour Inventory (HBI), and patients’ hormonal profiles (gonadal and pituitary hormones, ghrelin). Self-reported voluntary termination of pregnancy (VTP) and promiscuous sexual activity were recorded. For ED patients (N=62), regression analyses between significant variables and HBI were carried, applying moderation models for different CTQ scores.

Table 1 outlines significant between-group comparisons (°: different from controls; *: different from restricting patients; p<0.05). Binge-purging patients had higher FSH, LH, and ghrelin levels, more VTPs and promiscuity. HBI showed significant correlations with EES, SCL-90-R-GSI, DERS, CTQ, and ghrelin levels. CTQ moderated interactions for DERS and EES (Figure 1).

Dysregulated sexuality is linked to emotion dysregulation and childhood trauma. Binge-purging patients experience adverse behavioural consequences.

No significant relationships.

Suicide attempts and suicidal ideation are peculiar aspects of several cluster b disorders, including Narcissistic Personality Disorder. Similarly, difficulty in regulating negative affects can play a role in the relationship between narcissist features and suicidal ideation. To date, it is still unclear which facet of narcissism is more related to the desire to die and which other factors are involved in this relationship.

To offer preliminary empirical evidences concerning the relationship between narcissism, emotion regulation and suicide ideation.

We administered Pathological Narcissism Inventory (PNI), Difficulties in Emotion Regulation Scale (DERS) and Beck Scale for Suicidal Ideation (BSI) to a sample of individuals with Suicide ideation (n= 68) and a sample of community participants (n=140).

Controlling for age and gender, we found that BSI scores correlated significantly with the vulnerable dimension of narcissism, but not with the grandiose one, and with all DERS dimensions. Nevertheless, emotion dysregulation moderates the relationship between vulnerable narcissism and suicidal ideation.

Suicide ideation seems to be deeply connected with the vulnerable dimension of pathological narcissism and the relationship between the constructs is partially mediated by emotion dysregulation. Future directions and clinical implications are discussed.

Leading theories suggest that borderline personality disorder (BPD) is an emotion dysregulation disorder involving lower basal vagal tone, higher baseline emotion, heightened emotional reactivity, delayed emotional recovery, and emotion regulation deficits. However, the literature to date lacks a unifying paradigm that tests all of the main emotion dysregulation components and comprehensively examines whether BPD is an emotion dysregulation disorder and, if so, in what ways. This study addresses the empirical gaps with a unified paradigm that assessed whether BPD is characterized by five leading emotion dysregulation components compared to generalized anxiety disorder (GAD) and healthy control (HC) groups.

Emotion was assessed across self-report, sympathetic, and parasympathetic indices. Participants with BPD, GAD, and HCs (N = 120) first underwent baseline periods assessing basal vagal tone and baseline emotional intensity, followed by rejection-themed stressors assessing emotional reactivity. Participants then either reacted normally to assess emotional recovery or attempted to decrease emotion using mindfulness or distraction to assess emotion regulation implementation deficits.

Individuals with BPD and GAD exhibited higher self-reported and sympathetic baseline emotion compared to HCs. The BPD group also exhibited self-reported emotion regulation deficits using distraction only compared to the GAD group.

There is minimal support for several emotion dysregulation components in BPD, and some components that are present appear to be pervasive across high emotion dysregulation groups rather than specific to BPD. However, BPD may be characterized by problems disengaging from emotion using distraction.

Individual variability in tonic (resting) and phasic (reactivity) respiratory sinus arrhythmia (RSA) may underlie risk for dysregulated emotion and behavior, two transdiagnostic indicators that permeate most psychological disorders in youth. The interaction between tonic and phasic RSA may specify unique physiological profiles during the transition to adolescence. The current study utilized clinically referred youth (Mage = 12.03; s.d. = 0.92) to examine baseline RSA, RSA reactivity, and their interaction as predictors of dysregulated emotion and behavior in daily life.

Participants were 162 youth (47% female; 60% minority) in psychiatric treatment for any mood or behavior problem. RSA was assessed during three, 2-minute baselines and an 8-minute parent-child conflict discussion task. Dysregulated emotion and behavior were assessed during a 4-day ecological momentary assessment protocol that included 10 time-based prompts over a long weekend.

Greater RSA withdrawal to the conflict was associated with dysregulated basic emotion (sadness, anger, nervousness, stress) in daily life. Two distinct interactions also emerged, such that baseline RSA was related to dysregulated complex emotion (shame, guilt, loneliness, emptiness) and dysregulated behavior as a function of RSA reactivity to conflict. Lower baseline RSA and greater RSA withdrawal were associated with dysregulated complex emotion, while higher baseline RSA and greater RSA withdrawal were associated with dysregulated behavior.

Findings point to physiological profiles that increase the risk of dysregulated emotion and behavior during the transition to adolescence. Excessive RSA withdrawal uniquely, and in combination with baseline RSA, increased risk for dysregulation in daily life, underscoring the role of autonomic stress responding as a risk factor for psychopathology.