(PS10-10) Emotion Regulation Difficulties, Distress Intolerance, and Anxiety Sensitivity: A Cross-Sectional Structural Equation Model of PTSD Risk Factors

Resilience is the most common outcome of trauma exposure, yet around 7% of individuals experience posttraumatic stress disorder (PTSD) in their lifetime. Greater difficulties in emotion regulation (ER; multimodal construct of difficulties with acceptance of emotions, emotional clarity, regulation of emotions, impulse control, and goal-directed behaviors when experiencing negative emotions), distress intolerance (DI; difficulty tolerating negative emotions), and anxiety sensitivity (AS; fear of anxious arousal) have all been indicated as transdiagnostic risk factors for symptoms of mental illness, including PTSD. While each risk factor has been examined individually, no studies to our knowledge have examined all three together with PTSD using a structural equation modeling framework. The current study examined the relationships between ER subscales, DI total score, and AS subscales and their unique associations with PTSD symptoms. Using structural equation modeling, we hypothesized based on prior research that difficulties with impulse control (ER) and cognitive concerns (AS) would be uniquely, cross-sectionally associated with PTSD symptoms in a trauma-exposed sample of diverse undergraduate students. Participants included 849 undergraduate students (Mage=20.18 ; 68.2% cisgender female; 44.4% White or Caucasian, 33.5% Hispanic or Latino, 21.8% Asian, 13.0% Black or African American) who completed an online survey battery, including the Difficulties in Emotion Regulation Scale (DERS), Distress Intolerance Index (DII), Anxiety Sensitivity Index-3 (ASI-3), and the PTSD Checklist for DSM-5 (PCL-5). For the current study, participants were required to report exposure to at least one type of potentially traumatic event. Initial CFAs were conducted for each measure to ensure adequate model fit using the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI), and the Root Mean Square Error of Approximation (RMSEA) as model fit indices. The final model included a 5-factor DERS, a 3-factor ASI-3, a unidimensional DII, and a hybrid 7-factor PCL-5, with good model fit (CFI=.93, TLI=.92, RMSEA=.05). Results indicated that greater scores on the DERS Lack of Emotional Clarity subscale (𝛽=.15, p=.025; contrary to our hypothesis) and the ASI Cognitive Concerns subscale (𝛽=.28, p=.002; in support of our hypothesis) were uniquely associated with greater levels of PTSD symptoms. No other DERS or ASI subscales were significantly associated with PTSD symptoms. DII total scores were not significantly associated with PTSD symptoms when all variables were included in the model. While limited by a cross-sectional design and use of self-report, these findings help to distill critical components of transdiagnostic risk factors such as ER and AS that may play a role in maintaining PTSD symptoms. Future research exploring the relationships between these factors in their conferment of risk among individuals with trauma exposure is needed.