MEASURE NAME:
Acronym:
Difficulties in Emotion Regulation Scale
DERS
Basic Description
Author(s):
Author Contact:
Gratz, K.L., & Roemer, L.
Kim L. Gratz
Department of Psychology
University of Maryland
College Park, MD 20742
[email protected]
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.
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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.
Theoretical Orientation The measure is based on conceptual and empirical work that
Summary:
conceptualizes emotion regulation as involving “a) awareness
Difficulties in Emotion Regulation Scale
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and understanding of emotions, b) acceptance of emotions, c)
ability to control impulsive behaviors and behave in accordance
with desired goals when experiencing negative emotions, d)
ability to use situationally appropriate emotion regulation
strategies flexibly to modulate emotional responses as desired in
order to meet individual goals and situational demands.”
Problems in any of these areas would be indicative of emotion
regulation difficulties.
Domains Assessed:
1. Emotional/affective regulation (cgiver)
2. Emotional/affective regulation (child)
3.
4.
5.
6.
English, German, Turkish
Languages Available:
Age Range:
# of Items:
Time to Complete (min):
Time to Score (min):
Periodicity:
Response Format:
18.0 - 60.0 Measure Type:
General assessment
36
Measure Format:
Questionnaire
8
Reporter:
Self
1
Education Level:
99.00
unknown
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%)
Materials Needed:
Yes
(check all that apply)
Paper and pencil
Computer
Video equipment
Testing stimuli
Physiological equipment
Other
Material Notes:
Sample Items:
Domains
Scale
Nonacceptance of
emotional
responses
(NONACCEPTANCE
)
Difficulties engaging
in goal-directed
behavior (GOALS)
Impulse control
difficulties
(IMPULSE)
Lack of emotional
awareness
(AWARENESS)
Limited access to
Sample Items
When I'm upset, I feel guilty for feeling that way.
When I'm upset, I have difficulty concentrating.
When I'm upset, I lose control over my behaviors.
I am attentive to my feelings. (reverse)
When I'm upset, I believe that I'll end up feeling very
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emotion regulation
strategies
(STRATEGIES)
Lack of emotional
clarity (CLARITY)
depressed.
I have difficulty making sense out of my feelings.
Notes (additional scales and domains):
Information Provided: (check all that apply)
Diagnostic information DSM-III
Diagnostic information DSM-IV
Yes
Strengths
Yes
Areas of concerns/risks
Program evaluation information
Yes
Continuous assessment
Yes
Raw Scores
Standard Scores
Percentile
Graph (e.g., of elevated scale)
Dichotomous assessment
Clinical friendly output
Written feedback
Other
Training
Training to Administer: Yes
None
Must be a psychologist
(check all that apply)
Via manual/video
Prior experience psych
testing & interpretation
Training by experienced
clinician (<4 hours)
Training by experienced
clinician (≥4 hours)
Training to Interpret:
None
Must be a psychologist
(check all that apply)
Via manual/video
Training by experienced
clinician (<4 hours)
Training by experienced
clinician (≥4 hours)
Yes
Prior experience psych
testing & interpretation
Training Notes:
Parallel or Alternate Forms
Parallel Forms?
Alternate Forms:
Forms for Different Ages:
If so, are forms comparable:
Any Altered Versions of Measure:
Describe:
No
No
No
No
Population Used to Develop Measure
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 or
Difficulties in Emotion Regulation Scale
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unspecified 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.
Psychometrics
Global Rating (scale based on Hudall Stamm, 1996):
Basic properties established by author(s)
Norms:
No
For separate age groups:
For clinical populations:
Separate for men and women:
For other demographic groups:
Notes:
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.
Clinical Cutoffs:
Specify Cutoffs:
Used in Major Studies:
Specify Studies:
No
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Reliability:
Type:
Rating
Statistics
Min
Max
Avg
Test-Retest-# days: 42
Acceptable
Intraclass correlation 0.57
0.89
0.74
Internal Consistency:
Acceptable
Cronbach's alpha
0.84
0.93
0.86
Inter-Rater:
Parallel/Alternate Forms:
Notes:
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).
Content Validity:
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.
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Construct Validity: (check all that apply)
Validity Type
Not known Not found
Convergent/Concurrent
Nonclinical Clinical
Samples
Samples
Yes
Discriminant
Yes
Sensitive to Change
Yes
Intervention Effects
Yes
Longitudinal/Maturation Effects
Yes
Sensitive to Theoretically
Distinct Groups
Yes
Factorial Validity
Yes
Notes:
Diverse
Samples
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.”
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Criterion Validity: (check all that apply)
Measures used as criterion: Deliberate Self Harm Inventory (DSHI), Abuse-Perpetration Inventory (API);
Gratz & Roemer, 2004)
Not known Not found
Predictive Validity:
Postdictive Validity:
Nonclinical Clinical
Samples
Samples
Yes
Diverse
Samples
Yes
Sensitivity Rate(s):
Specificity Rate(s):
Positive Predictive Power:
Negative Predictive Power:
Notes:
No information available.
Limitations of Psychometrics and Other Comments Regarding Psychometrics:
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.
Consumer Satisfaction
No information available
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Languages Other than English
Language:
Translation Quality (check all that apply)
1= Has been translated
2= Has been translated and back translated - translation appears good and valid.
3= Measure has been found to be reliable with this language group.
4= Psychometric properties overall appear to be good for this language group.
5= Factor structure is similar for this language group as it is for the development group.
6 = Norms are available for this language group.
7= Measure was developed for this language group.
1. German
2. Turkish
3.
4.
5.
6.
7.
8.
9.
10.
1
Yes
Yes
2
Yes
Yes
3
4
5
6
7
Use with Trauma Populations
Populations for which measure has demonstrated evidence of reliability and validity:
Physical abuse
Natural disaster
Terrorism
Yes
Sexual abuse
Accidents
Immigration related trauma
Yes
Yes
Neglect
Imprisonment
Kidnapping/hostage
Domestic Violence
Witness death
Traumatic loss (death)
Community violence
Assault
Other
Medical trauma
War/combat
Use with Diverse Populations
USE WITH DIVERSE POPULATIONS RATING SCALE
1. Measure is known (personal communication, conference presentation) to have been used with members of this group.
2=Studies in peer-reviewed journals have included members of this group who have completed the measure.
3=Measures have been found to be reliable with this group.
4=Psychometric properties well established with this group.
5=Norms are available for this group (or norms include a significant proportion of individuals from this group)
6=Measure was developed specifically for this group.
Population Type:
Degree of Usage: (check all that apply)
1
1. Developmental disability
2. Disabilities
3. Lower socio-economic status
Yes
4. Rural populations
5.
6.
Notes (including other diverse populations):
2
3
4
5
6
Yes
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Pros and Cons/Qualitative Impression
Pros:
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.
Cons:
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.
Difficulties in Emotion Regulation Scale
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References
(Representative sampling of publications, presentations, psychometric references)
Published References:
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), 4154.
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.
Unpublished References:
A PsychInfo literature search (6/05) of the words "Difficulties in Emotion Regulation Scale"
and “DERS” revealed that the measure has been referenced in 1 conference and 0
dissertations.
1. Gratz, K.L, & Tull, M.T. (2004, November). Differential correlates of self-harm among
abused and non-abused women. Poster presented at the annual meeting of the
International Society for Traumatic Stress Studies, New Orleans, LA.
Number of Published References:
3
(based on author provided information and a PsychInfo search, not including dissertations)
Number of Unpublished References:
1
(based on a PsychInfo search of unpublished doctoral dissertations)
Author Comments:
The author provided comments, which were integrated.
Citation for Review:
Chandra Ghosh Ippen, Ph.D.
Editor of Review:
Chandra Ghosh Ippen, Ph.D.
Last Updated:
6/20/2005
PDF Available:
yes
This project was funded by the
Substance Abuse and Mental Health Services Administration (SAMHSA),
U.S. Department of Health and Human Services (HHS). The views, policies and opinions
expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.
Difficulties in Emotion Regulation Scale
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