Emotion regulation and posttraumatic stress symptoms: a meta-analysis
Abstract
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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Extensive research links difficulties in emotion regulation with greater occurrence of negative emotions and symptoms of PTSD, depression, anxiety, and substance use disorders.
“Extensive research links difficulties in emotion regulation with greater occurrence of negative emotions (53) and symptoms of PTSD, depression, anxiety, and substance use disorders (54–56).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [55]
PTSD is driven by maladaptive coping processes, such as impaired emotion regulation and increased rumination, thought suppression and experiential avoidance.
“An alternative model is motivated by findings that PTSD is driven by maladaptive coping processes, such as impaired emotion regulation and increased rumination, thought suppression and experiential avoidance [20].”
From A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery (2021) · cites this paper as [20]
Meta-analyses of surveys have generally confirmed that adaptive and maladaptive emotion regulation strategies are on average related to different types of psychopathology in predicted directions.
“Within such systems, strategies are often classified as being either adaptive or maladaptive, and meta-analyses of surveys have generally confirmed that adaptive and maladaptive strategies are on average related to different types of psychopathology in predicted directions (e.g., Aldao et al., 2010; Seligowski et al., 2015).”
From Emotion Regulatory Strategies in Complicated Grief: A Systematic Review (2021) · cites this paper as Seligowski et al., 2015
Broader measures of emotion regulation difficulties and abilities show consistent associations with internalizing and externalizing symptoms.
“Broader measures of emotion regulation, such as difficulties (Prefit et al., 2019; Seligowski et al., 2015) and abilities (Compas et al., 2017), have also shown consistent associations with internalizing and externalizing symptoms.”
From Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis (2022) · cites this paper as Seligowski et al., 2015
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- Authors
- Seligowski, A. V., Lee, D. J., Bardeen, J. R., & Orcutt, H. K.
- Affiliations
- Northern Illinois University (US)
- Auburn University (US)
- Corresponding author
- Seligowski, Antonia V.
- Venue
- Cognitive Behaviour Therapy
- Publisher
- Informa UK Limited
- Published
- 2014-11-24
- Volume
- 44
- Issue
- 2
- Pages
- 87-102
- ISSN
- 1650-6073 (ISSN-L)
- 1651-2316
- OpenAlex
- W2088692967
- Cited by
- 408
- References
- 106
- Citations by year
- 2026: 36 · 2025: 44 · 2024: 49 · 2023: 36 · 2022: 59 · 2021: 38 · 2020: 49 · 2019: 28 · 2018: 29 · 2017: 17 · 2016: 14 · 2015: 7
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cognitive Behaviour Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- emotion regulation, posttraumatic stress symptoms, rumination, thought suppression, experiential avoidance, expressive suppression, worry, emotional dysregulation, acceptance, cognitive reappraisal, traumatic events
- MeSH terms
- Behavioral Symptoms, Emotions, Female, Humans, Male, Middle Aged, Models, Psychological, Stress Disorders, Post-Traumatic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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