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SO497

Emotion regulation in forensic psychiatry: conceptualization, measurement, and dynamics

EMOTION REGULATION IN FORENSIC PSYCHIATRY: CONCEPTUALIZATION, MEASUREMENT, AND DYNAMICS

Emotion regulation is consistently associated with aggressive antisocial behavior in forensic psychiatry; however, overall difficulties in emotion regulation do not mediate the association between adverse childhood experiences and aggression, and the field’s measurement instruments should be reconsidered in favor of short forms.

The aim is to integrate existing knowledge on the conceptualization and measurement of emotion regulation (ER) in forensic psychiatry with research on its relationship with trauma and its temporal dynamics. The project comprises four complementary studies: a systematic review of ER conceptualization and measurement in forensic settings; an empirical study examining the relationships between adverse childhood experiences (ACEs), ER, and aggressive antisocial behavior (AAB) using mediation analyses; a psychometric evaluation of the Difficulties in Emotion Regulation Scale (DERS) in two forensic samples; and an ongoing study examining within-person ER dynamics using experience sampling methodology in a high-security forensic psychiatric clinic. In Study I (N = 97 Swedish high-security inpatients), the association between ACEs and AAB remained strong, and mediation through overall emotion dysregulation was not supported; difficulty maintaining goal-directed behavior under distress partially mediated the relationship between ACEs and aggression, while ACEs remained a more consistent predictor. The systematic review examined 59 studies: 93% used self-report scales, 7 distinct measurement models were identified, 64% of studies reported reliability, and 80% used either the DERS (abilities) or the ERQ (strategies). In the psychometric study (N = 88 + 389), the DERS-36 showed poor structural fit, the DERS-16 performed substantially better, and the DERS-8 showed promise despite mixed fit. In the ongoing fourth study, approximately 12 patients in a high-security clinic are completing 6 x 14 = 84 assessments per person over 14 days through semi-random sampling using customized offline smartphones, with affect, four ER strategies, social context, and events recorded at each prompt. In conclusion, despite heterogeneity in measurement and conceptualization, the field converges on two core frameworks; short forms may offer practical advantages in this population, and intensive sampling methods remain uncommon in forensic settings, representing an important area for research.

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