The Interplay Between Negative Emotion Differentiation and Emotion Regulation Problems in Posttraumatic Stress Disorder

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Project Summary/Abstract Posttraumatic stress disorder (PTSD) is characterized by inflexible patterns of experiential, behavioral, and physiological emotional responding. Following trauma exposure, the indiscriminate avoidance of trauma- related cues contributes to the maintenance of PTSD, which tends to be chronic and associated with a myriad of deleterious personal and public health consequences. Although inflexible emotional responding has been identified as a critical maintenance factor for PTSD, less is understood about how trauma-exposed people fall into these problematic emotion regulation patterns. Recent theory posits that the ability to differentiate between discrete negative emotions allows individuals to extract emotion-related information to guide the effective use of emotion regulation strategies in service of personal goals. When negative emotions are experienced with less granularity, emotion information becomes less readily available and places people at risk for maladaptive emotion regulation. Negative emotion differentiation (NED) has yet to be examined in the context of avoidance in PTSD, however, or in relation to markers of physiological inflexibility that are believed to contribute to emotion regulation problems across a range of clinical disorders, including PTSD. Thus, there is a need for an integrated investigation spanning multiple units of analysis to understand how NED confers risk for emotion regulation problems known to maintain PTSD. The objective of the proposed research is to elucidate whether NED is impaired in PTSD and associated with avoidance and resting respiratory sinus arrythmia (RSA) – a marker of physiological flexibility – in the lab and in daily life. Aims of the proposal include determining whether NED is impaired among those with PTSD relative to those without PTSD (Aim 1), whether NED is associated with self-reported trait avoidance and daily trauma-related avoidance (Aim 2), and whether NED is associated with resting RSA in the lab and in daily life (Aim 3). Given that NED is believed to guide emotion regulation strategy use based on the demands imposed by the environment, this project will also examine whether NED moderates the links between avoidance and PTSD (Aim 4). These aims will be tested using data from an ongoing NIH-funded study (1R15MH114142) of 80 trauma-exposed community members with and without PTSD. PTSD diagnosis and severity, trait-level avoidance, and resting RSA are assessed in the lab and three days of ecological momentary assessment and ambulatory physiological assessment are used to monitor daily trauma-related avoidance, resting RSA, and PTSD symptoms. The proposed project will advance the field by delineating associations between NED and emotion regulation problems across multiple units of analysis in PTSD. Elucidating the interplay between NED and emotion regulation problems may also provide insight into the etiology and maintenance of PTSD. As an NRSA F31 proposal, this project includes a training plan consisting of formal coursework, workshops, experiential learning, and mentorship in PTSD, emotion dynamics and regulation, autonomic psychophysiology, ambulatory assessment, and multilevel modeling.