OBJECTIVE Difficulties with emotion regulation (ER) are a risk factor for the development and maintenance of posttraumatic stress disorder (PTSD). Less is known about temporal relations between ER and PTSD symptom change during treatment, including whether ER may represent a more potent change ingredient for some patients relative to others. This study examined the association between within-patient changes in ER and next-session PTSD symptom change and whether this association was more pronounced for patients with poorer baseline ER, more severe depression, or higher borderline personality disorder symptoms. METHOD Data derived from a randomized controlled trial (NCT01600456) in which 149 adults with PTSD received up to 10 sessions of prolonged exposure (PE) or PE + sertraline. Patients rated difficulties with ER and PTSD symptoms repeatedly during treatment. Moderators were assessed at baseline. RESULTS Cross-lagged, dynamic structural equation models revealed that ER improvements were associated with next-session reductions in PTSD (standardized effect = 0.13). PTSD symptom reduction was also associated with next-session ER improvement (standardized effect = 0.34). Moderator analyses revealed that the within-person ER-PTSD symptoms association was stronger for patients with higher baseline depression (standardized effect = 0.39). CONCLUSIONS Reductions in PTSD symptoms may facilitate ER improvements during PE and PE augmented with sertraline rather than improvements in ER producing changes in PTSD symptoms. For patients with higher severity co-occurring depression, ER may represent a more active change ingredient. PE therapists could therefore consider placing particular emphasis on improving ER capabilities when working with this subgroup of patients. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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情绪调节与长期暴露于创伤后应激障碍的结果之间的患者内部关联。

目的 情绪调节（ER）困难是创伤后应激障碍（PTSD）发生和维持的危险因素。关于治疗期间 ER 和 PTSD 症状变化之间的时间关系知之甚少，包括 ER 是否可能代表某些患者相对于其他患者更有效的变化因素。这项研究检验了患者内部 ER 变化与下次治疗 PTSD 症状变化之间的关联，以及这种关联对于基线 ER 较差、抑郁较严重或边缘性人格障碍症状较高的患者是否更为明显。方法 数据源自一项随机对照试验 (NCT01600456)，其中 149 名患有 PTSD 的成年人接受了最多 10 次长期暴露 (PE) 或 PE + 舍曲林治疗。患者在治疗期间反复评价 ER 和 PTSD 症状的困难。主持人在基线时进行评估。结果交叉滞后的动态结构方程模型显示，ER 的改善与下一次治疗后 PTSD 的减少相关（标准化效应 = 0.13）。PTSD 症状减轻也与下一次 ER 改善相关（标准化效应 = 0.34）。调节分析显示，对于基线抑郁程度较高的患者，人内 ER-PTSD 症状关联性更强（标准化效应 = 0.39）。结论 PTSD 症状的减轻可能有助于 PE 期间和 PE 增强舍曲林期间 ER 的改善，而不是 ER 的改善导致 PTSD 症状的改变。对于同时发生抑郁症的严重程度较高的患者，ER 可能代表更积极的改变成分。因此，体育治疗师在治疗这一亚组患者时可以考虑特别重视提高急诊室的能力。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。