Examining Indirect Effects of Emotion Dysregulation Between PTSD Symptom Clusters and Reckless/Self-Destructive Behaviors

Objectives: Emotion dysregulation theoretically and empirically explains the link between posttraumatic stress disorder (PTSD) and posttrauma reckless and self-destructive behaviors (RSDBs). Method: The current study uniquely examined the role of emotion dysregulation in the association between the four heterogeneous PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]) and an overall measure of posttrauma RSDBs. Trauma-exposed participants (n = 411) completed self-report measures assessing PTSD symptoms (PTSD Checklist for DSM-5), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), and engagement in RSDBs (Posttrauma Risky Behaviors Questionnaire). Results: Direct and indirect effects were examined using PROCESS Model 4. The bias-corrected bootstrap revealed a significant indirect effect of emotion dysregulation in posttrauma RSDBs' relation with PTSD's intrusions (B = -.13, SE = .04, 95% CI [-.23, -.06]), avoidance (B =.15, SE =.07, 95% CI [.04, .33]), NACM (B =.17, SE =.05, 95% CI [.09, .27]), and AAR (B =.14, SE =.05, 95% CI [.05, .27]). Conclusions: Emotion dysregulation explained associations between the severity of each PTSD symptom cluster and overall posttrauma RSDBs. PTSD treatments targeting emotion dysregulation may help to reduce posttrauma RSDBs for trauma-exposed individuals. Clinical Impact Statement This research suggests that trauma-exposed individuals with greater posttraumatic stress disorder (PTSD) symptoms of avoidance, negative cognition and mood, and arousal, as well as fewer symptoms of intrusions are more likely to experience difficulties regulating emotions, which may increase engagement in reckless/self-destructive behaviors. Trauma treatments that improve emotion regulation skills may prevent or reduce reckless/self-destructive behaviors.