Emotion Dysregulation in Adults with Acquired Brain Injury: Conceptualization of Emotion Dysregulation, Validation of the French DERS-16 Scale and its Utility in Clinical Practice

Background Emotional consequences are a major area of interest in the field of acquired brain injury (ABI), yet less studied than the other consequences of ABI, despite particularly deleterious consequences on quality of life. Objectives and methods This study assessed the relevance of the French version of Difficulties in Emotion Regulation Scale-16 and developed a model of emotional dysregulation in ABI through four studies. Results Study 1 confirmed the unidimensional structure and internal consistency (Cronbach's α = 0.95) of DERS-16 in non-clinical controls. Study 2 established a cutoff of 33.5 for pathological emotional dysregulation and found significantly higher DERS-16 scores in ABI participants compared to non-clinical controls but lower than in borderline personality disorder (BPD) participants ( p < 0.001). Study 3 demonstrated consistency between clinical assessments and DERS-16 results, characterizing emotional dysregulation in ABI. Study 4 showed DERS-16 sensitivity to changes (mean DERS-16 difference of 1.21 [0.42; 2.00] per month, p = 0.003). Conclusions DERS-16 is a valuable scale for screening and monitoring emotional dysregulation in ABI, highlighting the importance of addressing emotional difficulties in rehabilitation programs. The proposed model highlights organic, cognitive, psychological, environmental, vulnerability factors and general population factors contributing to emotional dysregulation in ABI.