Emotion Regulation Difficulties and Maladaptive Behaviors: Examination of Deliberate Self-harm, Disordered Eating, and Substance Misuse in Two Samples

Data from two studies were utilized to examine whether the co-occurrence of maladaptive behaviors thought to serve an emotion regulating function would be associated with greater emotion regulation difficulties compared to one or none of these behaviors. Study 1 included an undergraduate sample (N = 119; 76 % female) and Study 2 included a sample of patients receiving treatment at a residential substance abuse treatment facility (N = 82; 48 % female). Subgroups were created based on the presence or absence of the following maladaptive behaviors: (a) deliberate self-harm (DSH) and disordered eating (Study 1); and (b) DSH, disordered eating, and substance misuse (Study 2). Subgroup differences in mean levels of emotion regulation difficulties (overall and six dimensions) were evaluated for each study. In Study 1, individuals who reported clinically-relevant levels of both DSH and disordered eating had more difficulties with emotion regulation (overall and three dimensions) compared to those who reported neither behavior. In Study 2, individuals who reported clinically-relevant levels of both DSH and substance misuse had more difficulties with emotion regulation (Study 2; overall and five dimensions) compared to those with only substance misuse. Overall, the results of these studies support the hypothesis that the co-occurrence of clinically-relevant maladaptive behaviors is associated with greater difficulties regulating emotions than the presence of only one maladaptive behavior (or no maladaptive behaviors). These findings suggest that clinical interventions targeting emotion regulation skills may be particularly useful for individuals who display a pattern of co-occurring maladaptive behaviors.