OBJECTIVE Difficulties with emotion regulation (ER) are a risk factor for the development and maintenance of posttraumatic stress disorder (PTSD). Less is known about temporal relations between ER and PTSD symptom change during treatment, including whether ER may represent a more potent change ingredient for some patients relative to others. This study examined the association between within-patient changes in ER and next-session PTSD symptom change and whether this association was more pronounced for patients with poorer baseline ER, more severe depression, or higher borderline personality disorder symptoms. METHOD Data derived from a randomized controlled trial (NCT01600456) in which 149 adults with PTSD received up to 10 sessions of prolonged exposure (PE) or PE + sertraline. Patients rated difficulties with ER and PTSD symptoms repeatedly during treatment. Moderators were assessed at baseline. RESULTS Cross-lagged, dynamic structural equation models revealed that ER improvements were associated with next-session reductions in PTSD (standardized effect = 0.13). PTSD symptom reduction was also associated with next-session ER improvement (standardized effect = 0.34). Moderator analyses revealed that the within-person ER-PTSD symptoms association was stronger for patients with higher baseline depression (standardized effect = 0.39). CONCLUSIONS Reductions in PTSD symptoms may facilitate ER improvements during PE and PE augmented with sertraline rather than improvements in ER producing changes in PTSD symptoms. For patients with higher severity co-occurring depression, ER may represent a more active change ingredient. PE therapists could therefore consider placing particular emphasis on improving ER capabilities when working with this subgroup of patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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情绪调节与创伤后应激障碍长期暴露结果之间的患者内部关联。


目的 情绪调节困难 （ER） 是创伤后应激障碍 （PTSD） 发展和维持的危险因素。关于 ER 和 PTSD 治疗期间症状变化之间的时间关系知之甚少，包括 ER 是否可能代表某些患者相对于其他患者更有效的变化成分。本研究检查了 ER 患者内部变化与下一次 PTSD 症状变化之间的关联，以及这种关联是否对于基线 ER 较差、抑郁更严重或边缘型人格障碍症状较高的患者更明显。方法 数据来自一项随机对照试验 （NCT01600456），其中 149 名患有 PTSD 的成年人接受了多达 10 次长时间暴露 （PE） 或 PE + 舍曲林。患者在治疗期间反复对 ER 和 PTSD 症状的困难进行评分。在基线时评估调节剂。结果 交叉滞后、动态结构方程模型显示，ER 改善与 PTSD 的下一次治疗减少相关 （标准化效应 = 0.13）。PTSD 症状减轻也与下一次 ER 改善相关 （标准化效应 = 0.34）。调节器分析显示，基线抑郁程度较高的患者，体内 ER-PTSD 症状关联更强 （标准化效应 = 0.39）。结论 PTSD 症状的减轻可能促进 PE 期间的 ER 改善和舍曲林增强的 PE，而不是 ER 的改善导致 PTSD 症状的变化。对于患有更严重并发抑郁症的患者，ER 可能代表更活跃的变化成分。因此，PE 治疗师可以考虑在与这组患者合作时特别强调提高 ER 能力。 （PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。