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Trauma and Stressor Related Disorders and Disasters

Poor cognitive control confers risk for subsequent stress via specific emotion regulation difficulties: A Longitudinal multiple mediation study

(PS11-A5) Poor Cognitive Control Confers Risk for Subsequent Stress via Specific Emotion Regulation Difficulties: A Longitudinal Multiple Mediation Study

Saturday, November 18, 2023
2:30 PM – 3:30 PM PST
Location: Regency Ballroom, Level 7


Introduction: Cognitive control deficits are well-documented across stress-related disorders. For example, post-traumatic stress disorder is associated with medium-sized deficits in attention/working memory (d = -.50) and major depressive disorder is associated with broad executive function impairments ranging from small to large sized (ds = .32-.97; mean d = .4) (Moran 2016; Snyder, 2013; Scott et al., 2015). Less is known about the intermediary mechanisms that may link poor cognitive control to symptoms of stress-related disorders. Emotion regulation, which involves complex cognitive functions, may be one such mechanism. The present study aimed to (1) explore which difficulties in emotion regulation were most related to cognitive control (i.e., attentional control, executive functioning), and (2) examine which difficulties in emotion regulation mediated the link between cognitive control and subsequent symptoms of stress.

Methods: 637 adult participants aged 18-66 (M = 44.14, SD = 13.81) completed measures of attentional control (Attentional Control Scale; ACS; Derryberry & Reed, 2002), executive dysfunction (Webexec; WEX; Buchanan et al., 2010), emotion regulation difficulties (Difficulties in Emotion Regulation Scale-Brief; DERS; Bjureberg et al., 2016), and stress (Depression, Anxiety, and Stress Scales- Short Form Stress Subscale; DASS-S; Lovibond & Lovibond, 1995) every month for three months (time 1 – time 3).

Results: Attentional control and executive dysfunction were significantly associated with all DERS subscales at time 1, with the largest correlations between difficulties engaging in goal-directed behavior (ACS: r(632) = -.56, p < .001; WEX: r(633) = .59, p < .001) and limited access to effective emotion regulation strategies (ACS: r(630) = -.42, p < .001; WEX: r(630) = .47, p < .001). A multiple mediation model examining the five DERS subscales at time 2 as mediators of the relationship between ACS at time 1 and DASS-S at time 3 revealed significant mediation by difficulties with emotional clarity (indirect effect = -.02, SE = .01, p < .001) goal-directed behavior (indirect effect = -.03, SE = .01, p < .01), and nonacceptance of emotions (indirect effect = -.01, SE = .00, p < .05), after controlling for age, gender, and time 1 DASS-S. A second multiple mediation model examining the five DERS subscales at time 2 as mediators of the relationship between WEX at time 1 and DASS-S at time 3 also revealed partial mediation by difficulties with emotional clarity (indirect effect = .06, SE = .02, p < .001) goal-directed behavior (indirect effect = .06, SE = .03, p < .01), and nonacceptance of emotions (indirect effect = .02, SE = .01, p < .05), after controlling for age, gender, and time 1 DASS-S.

Conclusion: Findings point to specific aspects of emotion dysregulation (lack of emotional clarity, difficulties engaging in goal-directed behavior, and emotional nonacceptance) as mechanisms explaining the relationship between poor cognitive control and subsequent stress. Clinical implications for targeting cognitive control and emotion regulation deficits in stress-related disorders will be discussed.