Emotion regulation (ER) has been identified as a critical factor in the development and maintenance of posttraumatic stress symptoms (PTS; Bardeen, Kumpula, & Orcutt, 2013 [Journal of Anxiety Disorders, 27, 188-196]; Marx & Sloan, 2005 [Behaviour Research and Therapy, 43, 569-583]; Nightingale & Williams, 2000 [British Journal of Clinical Psychology, 39, 243-254]). The current meta-analysis aimed to provide a thorough, quantitative examination of the associations between PTS and several aspects of ER. A search of the PsychINFO database resulted in 2557 titles, of which 57 met full inclusion criteria (the cross-sectional association between PTS symptoms and ER was reported, participants were 18 years or older, the article was written in English, and sufficient information was reported to calculate effect sizes). From the 57 studies that were included, 74 effect sizes were obtained. All studies were independently coded by two of the study authors for the following: citation, sample type, total N size (and group n's if applicable), mean age of participants, type of traumatic event, study design, PTS measure(s), ER measure(s), and effect size information. Eight random effects models were conducted: seven for individual ER strategies (e.g., rumination) and one for general emotion dysregulation. The largest effects were observed for general emotion dysregulation (r = 0.53; k = 13), rumination (r = 0.51; k = 5), thought suppression (r = 0.47; k = 13), and experiential avoidance (r = 0.40; k = 20). Medium effects were observed for expressive suppression (r = 0.29; k = 3) and worry (r = 0.28; k = 6). Significant effects were not observed for acceptance or reappraisal. Moderator analyses (sample and trauma type) were conducted for general emotion dysregulation, experiential avoidance, and thought suppression; no significant differences were observed. Findings from the current analysis suggest that several aspects of ER are associated with PTS symptoms across a variety of samples. Additionally, the current study highlights a number of limitations in the existing ER and PTS symptom literature.

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A strong positive association between emotion regulation difficulties (ERD) and posttraumatic stress symptoms (PTSS) has been consistently evidenced in cross-sectional research. However, a lack of prospective research has limited hypotheses regarding the temporal relationship between trauma exposure, ERD, and PTSS. The present prospective study investigated the role of pre-trauma difficulties with emotion regulation in the development of PTSS following exposure to a potentially traumatic event. Between Time 1 (T1) and Time 2 (T2), a mass shooting occurred at the participants'(n = 691) university campus. ERD and PTSS were assessed prior to the shooting (T1), in the acute aftermath of the shooting (T2), and approximately eight months later (T3). Using a cross-lagged panel design, ERD was found to prospectively predict PTSS from T1 to T2 and T2 to T3. Additionally, PTSS prospectively predicted ERD from T1 to T2. However, T2 PTSS failed to predict T3 PTSS. Results indicate that ERD and PTSS are reciprocally influential from pre- to post-shooting. Further, results suggest that emotion dysregulation in the aftermath of a potentially traumatic event influences one's ability to recover from PTSS over time, even after accounting for the effects of existing symptomatology. To examine the specificity of temporal relations between ERD and PTSS a second cross-lagged panel design, in which a general distress construct was substituted for PTSS, was conducted. Results of this analysis, as well as conceptual and clinical implications, will be discussed.

Peritraumatic dissociation (PD) and experiential avoidance (EA) have been implicated in the etiology of posttraumatic stress symptomatology (PTSS); however, the function of these two factors in the onset and maintenance of PTSS following a potentially traumatic event is unclear. The temporal relationships between EA, PD, and the four clusters of PTSS proposed by the Simms/Watson dysphoria model (Simms, Watson, & Doebbeling, 2002) were examined in a three-wave prospective investigation of 532 undergraduate women participating in an ongoing longitudinal study at the time of a campus shooting. Path analyses indicated that pre-shooting EA predicted greater PD, intrusions, and dysphoria symptoms approximately one month post-shooting. PD was associated with increased symptomatology across all four clusters one-month post-shooting, while one-month post-shooting EA was associated with higher dysphoria and hyperarousal symptoms eight months post-shooting. PD had a significant indirect effect on all four PTSS clusters eight months post-shooting via one-month post-shooting symptom reports. The results suggest that both EA and PD show unique influences as risk factors for PTSS following a potentially traumatic event.

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