The Difficulties in Emotion Regulation Scale (DERS)<\/strong>, developed by Kim L. Gratz and Lizabeth Roemer<\/a> in 2004, is one of the most widely utilized and rigorously validated self-report instruments designed to assess comprehensive, multidimensional difficulties in emotion regulation<\/a>. Comprising 36 self-report items scored on a 5-point Likert-type frequency scale ranging from 1 (“Almost never [0\u201310%]”) to 5 (“Almost always [91\u2013100%]”), the DERS assesses clinically relevant patterns of affective dysregulation across six distinct, theoretically grounded dimensions: (1) Nonacceptance of emotional responses<\/em> (Nonacceptance), (2) Difficulty engaging in goal-directed behavior<\/em> (Goals), (3) Impulse control difficulties<\/em> (Impulse), (4) Lack of emotional awareness<\/em> (Awareness), (5) Limited access to emotion regulation strategies<\/em> (Strategies), and (6) Lack of emotional clarity<\/em> (Clarity). Psychometric evaluations consistently demonstrate that the DERS possesses exceptional internal consistency (full-scale Cronbach\u2019s α ≥ .93; subscale α values typically ranging from .80 to .91), robust test-retest reliability across clinical and non-clinical intervals, and strong convergent validity with measures of experiential avoidance, generalized anxiety, depressive symptom severity, and borderline personality pathology. Furthermore, the instrument demonstrates discriminant validity against general distress and negative affectivity, confirming that it measures operational emotion regulation capabilities rather than affective intensity alone. By distinguishing between different mechanisms of emotional dysfunction, the DERS provides clinicians and researchers with an essential psychometric tool for identifying transdiagnostic vulnerability factors, monitoring therapeutic outcomes in cognitive-behavioral and acceptance-based frameworks, and personalizing psychiatric interventions<\/span>.<\/p>\n Difficulties in Emotion Regulation Scale, DERS, emotion dysregulation, emotional awareness, distress tolerance, psychological assessment, psychometrics, transdiagnostic mechanisms, experiential avoidance, borderline personality disorder<\/p>\n The Difficulties in Emotion Regulation Scale was formulated and validated by:<\/p>\n The landmark validation paper was published in the Journal of Psychopathology and Behavioral Assessment<\/em> under the title “Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale”<\/em> (Gratz & Roemer, 2004).<\/p>\n The primary purpose of the Difficulties in Emotion Regulation Scale is to provide a comprehensive, multifaceted operationalization of emotion regulation difficulties in clinical and research settings. Historically, emotion regulation research frequently conflated emotional regulation with the mere down-regulation or control of negative affect. In contrast, Gratz and Roemer (2004) developed the DERS to operationalize a functionalist, integrative conceptualization of emotional competence. Under this framework, adaptive emotion regulation involves not the avoidance or suppression of uncomfortable emotional states, but rather the ability to:<\/p>\n Clinically, the DERS serves as a diagnostic screening instrument, treatment planning framework, and longitudinal outcome measure. Its multidimensional architecture allows clinicians to detect whether an individual’s primary deficit lies in cognitive appraisals (e.g., poor clarity or nonacceptance), attentional dysregulation (e.g., lack of awareness), executive deficits during emotional arousal (e.g., goal disruption and impulse control difficulties), or perceived hopelessness regarding coping flexibility (limited strategy access). This granular profiling is instrumental in guiding targeted psychiatric interventions, such as Dialectical Behavior Therapy (DBT)<\/a>, Acceptance and Commitment Therapy (ACT)<\/a>, and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders<\/a>.<\/p>\n In empirical research, the DERS is one of the most prominent measures used to evaluate transdiagnostic vulnerability. Dysregulation identified by the DERS serves as a core maintenance factor across an expansive continuum of psychiatric disorders, including Borderline Personality Disorder (BPD)<\/a>, Post-Traumatic Stress Disorder (PTSD)<\/a>, Major Depressive Disorder, Generalized Anxiety Disorder, Anorexia and Bulimia Nervosa, Substance Use Disorders, and non-suicidal self-injury (NSSI).<\/p>\n The construct measured by the DERS is multidimensional emotion dysregulation<\/strong>. Rather than viewing emotion dysregulation as a single global deficit, Gratz and Roemer delineated six primary, inter-correlated dimensions. Each subscale addresses a specific component of emotional processing and response modulation under conditions of emotional distress:<\/p>\n This subscale evaluates the tendency to experience negative secondary reactions to one\u2019s own emotional distress or a fundamental inability to accept emotional vulnerability. Individuals scoring high on this dimension exhibit secondary distress, self-directed hostility, shame, and guilt triggered by their initial emotional reactions. Examples include believing that one is weak for feeling upset (Item 23) or becoming angry and embarrassed with oneself for exhibiting emotional sensitivity (Items 11 and 12). In psychological models of experiential avoidance<\/a>, nonacceptance magnifies primary emotional distress by compounding it with self-punitive cognitions.<\/p>\n The Goals subscale measures deficits in executive functioning and behavioral persistence during periods of heightened affective arousal. Individuals with elevated scores experience severe cognitive interference, task disruption, and an inability to concentrate or complete routine activities when distressed (Items 13, 18, 26, and 33). This dimension captures how negative affect disrupts attentional networks and task persistence, differentiating individuals who can function productively despite feeling upset from those whose goal pursuit collapses under affective load.<\/p>\n This dimension assesses the self-perceived inability to control behavioral responses, urges, and expressions when experiencing intense negative emotions. High scores reflect feelings of being completely overwhelmed, behavioral dyscontrol, and acting out impulsively (Items 3, 14, 19, 27, and 32). Clinically, this subscale is strongly linked with externalizing behaviors, non-suicidal self-injury, substance misuse, and reactive aggression, representing an affective modulation failure wherein emotions rapidly translate into behavioral instability.<\/p>\n The Awareness subscale assesses the degree to which an individual pays attention to, acknowledges, and values their emotional experiences. Uniquely, all six items of this subscale (Items 2, 6, 8, 10, 17, and 34) are positively worded and reverse-scored. Elevated scores indicate that an individual tends to overlook, ignore, or invalidate emotional cues, exhibiting emotional avoidance or lack of somatic\/affective attunement. This subscale reflects the attentional baseline necessary for initiating conscious regulation.<\/p>\n This subscale evaluates the belief that one has virtually no effective cognitive or behavioral tools to alleviate or modulate negative affect once activated. Elevated scores reflect a sense of affective helplessness, fatalism, and prolonged emotional recovery periods (Items 15, 16, 28, 30, 31, 35, and 36). Individuals scoring high on Strategies perceive negative moods as intractable states from which they cannot independently recover, which frequently drives desperate, maladaptive coping behaviors to forcibly terminate affective distress.<\/p>\n The Clarity subscale gauges the extent to which an individual understands, identifies, and differentiates their specific emotional states. High scores denote difficulty in emotional differentiation or high levels of alexithymia<\/a>, where individuals know they are upset but cannot pinpoint whether they are experiencing anger, sadness, fear, or frustration (Items 4, 5, and 9; Items 1 and 7 are reverse-scored). Without emotional clarity, selecting context-appropriate regulation strategies is significantly impaired.<\/p>\n The Difficulties in Emotion Regulation Scale is anchored within functionalist theories of emotion (functionalist emotion theory<\/a>; e.g., Campos et al., 1994; Frijda, 1986) and contemporary third-wave cognitive-behavioral traditions, particularly Marsha Linehan’s Biosocial Theory of Borderline Personality Disorder<\/a> and Acceptance and Commitment Therapy (Hayes et al., 1999).<\/p>\n Traditional psychiatric conceptualizations frequently framed negative affect as inherently maladaptive phenomena requiring suppression, distraction, or elimination. Conversely, functionalist emotion perspectives assert that emotions are evolutionarily adaptive action tendencies designed to convey rapid environmental information, guide decision-making, and facilitate social communication. Under Gratz and Roemer\u2019s model, distress is not pathogenic in isolation. Emotion dysregulation arises instead when individuals disrupt the functional signal of an emotion through invalidation, experiential avoidance, or behavioral inflexibility.<\/p>\n Gratz and Roemer synthesized Linehan\u2019s biosocial framework—which posits that emotional dysregulation results from transactions between biological affective vulnerability and invalidating developmental environments—with acceptance-based theories. Under this theoretical integration, emotional health is operationalized as emotional acceptance paired with behavioral control. Consequently, the DERS reflects four central theoretical assumptions:<\/p>\n The psychometric validity of the DERS has been extensively investigated across diverse non-clinical, university, community, and severe psychiatric samples worldwide.<\/p>\n Gratz and Roemer (2004) established robust convergent validity by demonstrating significant positive correlations between the DERS total score and validated measures of emotional vulnerability, including the Negative Mood Regulation Scale<\/em> (NMR; r<\/em> = −.69, confirming that higher DERS scores reflect lower expected self-efficacy in mood repair) and the Acceptance and Action Questionnaire<\/em> (AAQ; r<\/em> = .70, demonstrating high convergence with generalized experiential avoidance). Furthermore, the DERS correlates positively with trait anxiety on the State-Trait Anxiety Inventory<\/em> (STAI; r<\/em> ≈ .50 to .65) and depressive symptomatology on the Beck Depression Inventory<\/em> (BDI; r<\/em> ≈ .55 to .70)<\/span>.<\/p>\n Subscale-specific convergent validity has been similarly documented. For example, the Clarity<\/em> and Awareness<\/em> subscales exhibit strong inverse associations with emotional intelligence measures (e.g., the Mayer-Salovey-Caruso Emotional Intelligence Test) and strong positive associations with the Toronto Alexithymia Scale (TAS-20). The Impulse<\/em> subscale correlates heavily with behavioral impulsivity domains on the UPPS-P Impulsive Behavior Scale, particularly negative urgency (r<\/em> > .60)<\/span>.<\/p>\n The DERS demonstrates exceptional criterion validity in differentiating clinical from non-clinical cohorts and predicting high-risk psychological behaviors:<\/p>\n The DERS demonstrates strong discriminant validity against constructs such as cognitive intelligence, social desirability response biases (using the Marlowe-Crowne Social Desirability Scale; r<\/em> values typically < −.20), and raw negative emotional intensity. While positive affectivity and negative affectivity (e.g., PANAS) share modest variance with DERS scores, hierarchical regression modeling reveals that the DERS predicts behavioral dysfunction, self-harm, and anxiety disorders above and beyond trait emotional reactivity<\/span>.<\/p>\n The DERS exhibits outstanding internal consistency, test-retest stability, and cross-cultural measurement reliability.<\/p>\n In the initial psychometric validation study by Gratz and Roemer (2004) involving 357 undergraduate participants, the full scale displayed high internal consistency (α = .93). Subscale internal consistencies were similarly robust<\/span>:<\/p>\n Subsequent investigations across clinical populations (e.g., Fowler et al., 2014; Hallion et al., 2018) have confirmed Cronbach\u2019s alpha (α) and McDonald\u2019s omega (ω) values for the total score ranging from .93 to .97, with individual subscales routinely maintaining reliability coefficients between .80 and .92 across both adult and adolescent clinical cohorts.<\/p>\n Gratz and Roemer (2004) assessed test-retest reliability across a subset of participants (n<\/em> = 21) over a period ranging from 4 to 8 weeks. The test-retest reliability coefficient for the full score was r<\/em> = .88 (p<\/em> < .01). Individual subscales yielded stable correlations over this interval<\/span>:<\/p>\n These findings substantiate that although the DERS assesses situational difficulties in emotion regulation, it reliably captures an enduring, trait-like psychological vulnerability structure while remaining sensitive to clinical change following interventions.<\/p>\n The factor structure of the DERS was originally derived via exploratory factor analysis (EFA) and has subsequently been examined using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) across numerous samples.<\/p>\n Gratz and Roemer (2004) subjected an initial pool of 41 items to principal components analysis followed by an oblique (Promax) rotation. Analysis of the scree plot and eigenvalues revealed a clean six-factor solution accounting for 55.68% of the total variance. Five items demonstrating cross-loadings greater than .35 or item-to-factor loadings beneath .40 were systematically eliminated, yielding the final, psychometrically refined 36-item instrument. The factor structure aligned with the hypothesized theoretical dimensions: Strategies (Factor 1, accounting for 19.34% of variance), Nonacceptance (Factor 2, 7.82%), Impulse (Factor 3, 6.78%), Goals (Factor 4, 5.72%), Awareness (Factor 5, 4.41%), and Clarity (Factor 6, 3.86%). Subscale correlations ranged from .11 to .62, supporting the use of oblique rotations reflecting correlated latent factors.<\/p>\n Subsequent confirmatory factor analyses (e.g., Bardeen et al., 2012; Fowler et al., 2014) have generally confirmed that the correlated six-factor model yields superior fit relative to single-factor or orthogonal models. Standard fit indices in clinical cohorts typically demonstrate acceptable to good structural fit (e.g., χ²\/df < 3.0, Comparative Fit Index [CFI] ≥ .90–.94, Tucker-Lewis Index [TLI] ≥ .90–.93, and Root Mean Square Error of Approximation [RMSEA] ≈ .05–.07)<\/span>.<\/p>\n A notable topic in psychometric literature concerns the Awareness<\/em> subscale (Bardeen et al., 2012; Hallion et al., 2018). In multiple CFA studies, the Awareness subscale demonstrates lower loadings onto a general second-order “Emotion Dysregulation” superordinate factor compared to the other five subscales (frequently displaying loadings < .30), and occasionally demonstrates weak or non-significant correlations with Nonacceptance and Strategies. Psychometricians note two primary reasons for this phenomenon<\/span>:<\/p>\n Consequently, many contemporary researchers utilize bifactor CFA models, which model a global emotion dysregulation factor alongside specific group factors, or examine the subscales as an interrelated profile rather than solely relying on the composite total score.<\/p>\n The Difficulties in Emotion Regulation Scale was formally published in 2004<\/strong> by Kim L. Gratz and Lizabeth Roemer. The copyright for the empirical article is held by Springer Science+Business Media within the Journal of Psychopathology and Behavioral Assessment<\/em>. However, consistent with academic open-science traditions in psychological assessment, the scale items and scoring guidelines were published directly within the seminal 2004 journal article for non-commercial research and clinical applications.<\/p>\n Researchers and clinical practitioners may administer the original 36-item DERS without payment of licensing or royalty fees, provided that appropriate bibliographic attribution is granted to the original authors (Gratz & Roemer, 2004). Commercial use, digital electronic integration into fee-for-service healthcare platforms, or publishing translations may require formal permissions from the authors and the original publisher.<\/p>\nKeywords<\/h2>\n
Authors<\/h2>\n
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Purpose<\/h2>\n
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Psychological Construct<\/h2>\n
1. Nonacceptance of Emotional Responses (Nonacceptance; 6 items)<\/h3>\n
2. Difficulty Engaging in Goal-Directed Behavior (Goals; 5 items)<\/h3>\n
3. Impulse Control Difficulties (Impulse; 6 items)<\/h3>\n
4. Lack of Emotional Awareness (Awareness; 6 items)<\/h3>\n
5. Limited Access to Emotion Regulation Strategies (Strategies; 8 items)<\/h3>\n
6. Lack of Emotional Clarity (Clarity; 5 items)<\/h3>\n
Theoretical Framework<\/h2>\n
The Functionalist Foundation<\/h3>\n
Integration of Acceptance and Behavioral Flexibility<\/h3>\n
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Validity<\/h2>\n
Construct and Convergent Validity<\/h3>\n
Predictive and Criterion-Related Validity<\/h3>\n
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Discriminant Validity<\/h3>\n
Reliability<\/h2>\n
Internal Consistency<\/h3>\n
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Test-Retest Stability<\/h3>\n
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Factor Analysis<\/h2>\n
Original Exploratory Factor Analysis<\/h3>\n
Confirmatory Factor Analysis and Model Fit<\/h3>\n
The Awareness Subscale Debate and Bifactor Modeling<\/h3>\n
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Instrument \/ Measurement Tool<\/h2>\n
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Permissions & Fee and Test Year<\/h2>\n
References<\/h2>\n
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13. Items of the Scale (Questionnaire)<\/h2>\n