1. The role of Emotion Regulation Difficulties and Anxiety Sensitivity
EP060085
The role of Emotion Regulation Difficulties and Anxiety Sensitivity
in predicting Post-Traumatic Stress Disorder symptoms
among Alcohol/Substance dependent patients
Zeynep ERDOĞAN Serap TEKİNSAV SÜTCÜ Ender ALTINTOPRAK2
1 Ege University, Department of Psychology, İzmir, Turkey
2Ege University, Medical Sciences- Psychiatry MD, İzmir, Turkey
INTRODUCTION
Alcohol / substance dependence is one of the most serious and comprehensive problems.  Post Traumatic Stress Disorder (PTSD) is commonly co-occur or co-morbid with alcohol /substance dependence. In individuals with both PTSD and alcohol /substance dependence, the symptoms of PTSD tend to be more severe (Saladin et al, 1995). Furthermore, researches showed that these individuals are more prone to alcohol /substance use relapse than non-co-morbid individuals (Jacobsen et al., 2001).There is evidence that co-morbidity of PTSD and alcohol/ substance use is associated with a higher rate of psychosocial and medical problems (Jacobsen et al., 2001) Thus, it is important that understanding the related factors of PTSD symptoms in alcohol/substance dependence to plan an effective treatment. Literature showed that the factors such as anxiety sensitivity and difficulties in emotion regulation are important for understanding the onset, maintenance, and treatment of overall anxiety disorders and PTSD in particular. Hence, the aim of this study is to investigate the relationship between anxiety sensitivity and emotion regulation difficulties, and PTSD symptoms in Alcohol / Substance dependent individuals.
METHOD
The participants in this study consists of 219 males who had been diagnosed with alcohol and/or substance dependence in Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Turkey. Turkish version of Difficulties in Emotion Regulation Scale (DERS), Anxiety Sensitivity Index-3(ASI-3), PTSD Checklist – Civilian Version (PCL-C) and demographic information form used.
A regression and correlation analysis was used to examine the relationships between difficulties in emotion regulation, anxiety sensitivity and Post traumatic stress disorder symptoms among Alcohol/Substance dependent patients.

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RESULTS
Relationships between PTSD score, DERS and ASI-3 total and subscale scores investigated via Pearson correlation analyzes for Alcohol/ Substance dependent patients.
Table 1 showed that all ASI-3 and DERS dimensions and their total scores significantly correlate with PTSD score. And also, almost all of the dimensions positively correlate with each other. Nevertheless, It can be seen that awareness subscale of the DERS doesn’t seem any correlation with ASI-3 total and its subscales, and also Nonacceptence subscale of DERS.
Table 1: Pearson correlation coefficients between PTSD score, anxiety sensitivity dimensions and difficulties in emotion regulation dimensions.
* p< ** p<.01

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A multiple regression analysis was conducted to evaluate which anxiety sensitivity and difficulties in emotion regulation dimensions predicted to PTSD scores. In a stepwise regression, the predictors were 3 ASI-3 and 6 DERS dimensions while the criterion variable was the total PCL-C score (PTSD total score) Cognitive subscale which is one of ASI-3 dimensions entered into the Model 1 and this model is significant, R2=.45, F (1, 217) = , p< .01. Additionally, two of the DERS dimensions are Goals and Clarity, entered into the model 2 (R2=.55, F (2, 216) = , p< .01) and 3 (R2=.57, F (3,215) = 94.35, p< .01) , respectively. Then, Social, is an ASI-3 subscale, entered into the Model 4 and thereby Cognitive, Goals, Clarity and Social dimensions explained 58% of the variance of PTSD score. Referring to the β values, It is possible to say that AS may play a less fundamental role for PTSD score than emotion regulation difficulties.
Table 2: A stepwise regression for PTSD score
Variable B
SE B β
Anxiety Sensitivity/ Cognitive
.61
.16
.29**
Difficulties in Emotion Regulation/ Goals 1
.18
.32**
Difficulties in Emotion Regulation / Clarity
.56
.20
.15**
Anxiety Sensitivity / Social
.44
.17* R2
.58 F
73.74**
F için ∆R2
5.71*
p< ** p<.01
DISCUSSION
The underlying aim of this study is to understand the relationship between anxiety sensitivity, difficulties in emotion regulation and post traumatic stress disorder symptoms among alcohol/substance dependent patients. The finding that the variance associated with both emotion regulation difficulties and AS dimensions to PTSD symptoms among Alcohol/ Substance dependent patients.
A limitation of the study is the absence of data on co-occurring psychopathology among patients. In particular, given that PTSD has been found to co-occur with a number of psychiatric disorders, especially major depression. In addition, women were not included in this study, thus it was not examined gender differences between variables. Future studies should take into consideration these issues. Treatments may focus specifically on the development of adaptive emotion regulation strategies for dependent patients with PTSD symptoms may help reduce the risk for negative outcomes.