Emotion Regulation and Posttraumatic Stress Disorder: A Prospective Investigation

Current conceptualizations suggest that individuals with Posttraumatic Stress Disorder (PTSD) over-utilize relatively ineffective emotion regulation strategies such as expressive suppression, and under-utilize relatively effective emotion regulation strategies such as cognitive reappraisal. In the first prospective investigation of the association between emotion regulation use and PTSD symptom severity among military veterans in residential treatment for PTSD, we found that: (1) at both treatment intake and discharge, use of expressive suppression was associated with more severe PTSD symptoms and use of cognitive reappraisal was associated with less severe PTSD symptoms; (2) from treatment intake to discharge, use of expressive suppression decreased and use of cognitive reappraisal increased; and (3) change in expressive suppression, but not cognitive reappraisal, from treatment intake to discharge was significantly and incrementally predictive of PTSD symptom severity at treatment discharge after accounting for intake PTSD symptom severity, length of treatment stay, and participant age. These results highlight the clinical importance of targeting and reducing the use of relatively ineffective regulation strategies within the context of PTSD treatment, in addition to providing alternative emotion regulation strategies.