Difficulties in Emotion Regulation Scale (DERS)

Abstract

The Difficulties in Emotion Regulation Scale (DERS) is a 36-item self-report instrument designed to comprehensively measure difficulties in emotion regulation (ER). It utilizes an integrative conceptual framework that extends beyond simple emotional arousal modulation to include the awareness, understanding, and acceptance of emotional states, and the capacity to act effectively despite intense feelings.

The DERS is highly valuable in clinical settings as a transdiagnostic tool, helping patients and clinicians identify specific areas of dysregulation that contribute to psychopathology. It is frequently employed in the assessment of individuals diagnosed with conditions such as Borderline Personality Disorder, Generalised Anxiety Disorder, and Substance Use Disorder, where ER deficits are central to symptom presentation.

Keywords

Emotion dysregulation, emotion regulation, self-report scale, Borderline Personality Disorder, transdiagnostic, assessment, psychometric properties, clinical psychology.

Authors

Kim L. Gratz, Lizabeth Roemer

Purpose

The primary purpose of the DERS is to provide a comprehensive, multidimensional assessment of clinically relevant difficulties in regulating emotions. It captures the complex array of deficiencies individuals experience when attempting to recognize, understand, and manage their affective responses effectively.

Clinically, the DERS is used to pinpoint specific domains of dysregulation (e.g., lack of clarity or impulse control difficulties). This detailed insight is crucial for tailoring psychological interventions, particularly for patients presenting with severe emotional disorders, and for tracking treatment progress over time.

Construct

The DERS measures emotion dysregulation as a complex, multifaceted psychological construct, conceptualized as a deficit in key abilities necessary for successful emotional functioning. Difficulties in emotion regulation are theorized to be a **transdiagnostic risk** factor for the onset and maintenance of various psychopathological disorders.

The scale encompasses six core dimensions of emotional dysregulation:

• Nonacceptance of emotional responses
• Difficulty engaging in Goal-directed behavior
• Impulse control difficulties
• Lack of emotional awareness
• Limited access to emotion regulation strategies
• Lack of emotional clarity

Validity

Initial validation studies conducted by Gratz and Roemer (2003/2004) established that the DERS possesses **adequate construct validity** and **predictive validity** in non-clinical samples, demonstrating expected relationships with measures of related constructs like impulsivity and psychological distress.

Subsequent research, including a study by Hallion et al. (2018) involving 427 adults diagnosed with one or more DSM-5 disorders in an outpatient clinic, confirmed the scale’s utility in clinical populations. These findings support the DERS as a valid measure for assessing the severity of emotion dysregulation across various emotional disorders.

Reliability

The DERS has demonstrated strong reliability across diverse populations. The initial validation documented **high internal consistency** (Cronbach’s alpha) across all subscales, along with **good test–retest reliability**, confirming the stability of the measure over time.

In clinical research (Hallion et al., 2018), the DERS maintained good internal consistency. However, some studies suggest that the overall reliability may slightly improve when the **Lack of Emotional Awareness** subscale is excluded, prompting ongoing discussion in the literature regarding whether awareness is a distinct or integrated component of the core dysregulation construct.

Factor Analysis

The DERS is based on a robust **six-factor structure**, which corresponds directly to the six subscales of emotion regulation difficulties. This structure was developed through exploratory and confirmatory factor analysis to represent the multidimensional nature of emotion dysregulation.

The six factors, along with the corresponding item numbers used for scoring, are:

1. Nonacceptance of emotional responses: Items 11, 12, 21, 23, 25, 29
2. Difficulty engaging in goal-directed behaviour: Items 13, 18, 20R, 26, 33
3. Impulse control difficulties: Items 3, 14, 19, 24R, 27, 32
4. Lack of emotional awareness: Items 2R, 6R, 8R, 10R, 17R, 34R
5. Limited access to emotion regulation strategies: Items 15, 16, 22R, 28, 30, 31, 35, 36
6. Lack of emotional clarity: Items 1R, 4, 5, 7R, 9

Note: Items marked with ‘R’ are reverse-scored.

Instrument

Test Type: Self-report psychological scale/inventory.

Format: 36 items utilizing a 5-point Likert scale (1 = Almost Never, 5 = Almost Always).

Language Available: English (Original), with numerous validated translations available globally.

Population Group: Clinical and Non-clinical populations; particularly effective for transdiagnostic assessment of emotional disorders.

Age Group: Typically utilized with adolescents (through adapted versions) and adults.

Population Details: Used extensively in research concerning Borderline Personality Disorder, Generalised Anxiety Disorder, trauma-related disorders, and Substance Use Disorder.

Test Methodology: Respondents rate the frequency with which each statement is true for them. Scores are summed to produce a total dysregulation score and six subscale scores. Higher scores indicate greater difficulties in emotion regulation.

Interpretation

Interpretation is based on both the overall **Total Score** and the scores for the six individual subscales. Critically, higher scores on the DERS reflect more severe problems with emotion regulation.

Scores can be compared against normative data, such as percentile ranks established for adults seeking outpatient psychological therapy (Hallion et al., 2018). A score at the 50th percentile indicates typical levels of difficulty relative to other treatment-seeking individuals. Furthermore, research has demonstrated that high (severe) baseline DERS scores are predictive of greater positive treatment outcomes following interventions like Cognitive Behavioral Therapy (CBT).

The descriptive statistics from the clinical sample analyzed by Hallion et al. (2018) are:

• Total M: 89.33, SD: 22.64
• Non-acceptance M: 14.67, SD: 5.92
• Goals M: 15.42, SD: 4.215
• Impulse M: 12.58, SD: 4.97
• Awareness M: 15.55, SD: 4.92
• Strategies M: 19.67, SD: 7.31
• Clarity M: 12.01, SD: 4.04

Permissions & Fee and Test Year

The DERS was initially validated and published in 2004.

Test Year: 2004

Permissions: The scale is generally available for non-commercial research and clinical use, though researchers should contact the primary author (Kim L. Gratz) for formal permission and specific usage guidelines.

Fee: Generally free for non-commercial use.

Reference’s

• 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 and behavioral assessment, 26(1), 41-54.
• Hallion, L. S., Steinman, S. A., Tolin, D. F., & Diefenbach, G. J. (2018). Psychometric properties of the Difficulties in Emotion Regulation Scale (DERS) and its short forms in adults with emotional disorders. Frontiers in psychology, 9, 539.

Items of the Difficulties in Emotion Regulation Scale (DERS)

INSTRUCTIONS: Please press the response that is most true for you.