PTSD and Self-Rated Health in Urban Traumatized African American Adults: The Mediating Role of Emotion Regulation

Objective: Although previous research has demonstrated a link between posttraumatic stress disorder (PTSD) and self-rated health, the role of regulatory processes within this relationship has yet to be fully understood for African American urban populations. The goal of the present study was to determine whether emotion dysregulation mediated the relationship between PTSD diagnosis and self-rated health problems. Method: Data were collected from 446 adult participants (92% female, 97% African American) between the ages of 18 and 65 years who were recruited as part of the Grady Trauma Project, a National Institutes of Health-funded study of risk and resilience factors related to PTSD. Participants were recruited from a public hospital, and interviews included demographic characteristics, self-rating of health, assessment of emotion dysregulation using the Difficulties in Emotion Regulation Scale, and PTSD diagnosis using the Modified PTSD Symptom Scale. Results: Results revealed that emotion dysregulation significantly mediated the relationship between PTSD and self-rated health. Exploratory analyses revealed that specific dimensions of emotion regulation were significant mediators in this relationship. Age, sex, education, marital status, income, and total number of lifetime traumas experienced were controlled for in all analyses. Conclusions: Our findings suggest that emotion dysregulation may play a significant role in the PTSD-health relationship for African Americans. Future research investigating culturally relevant emotion regulation strategies are warranted given likely consequences for both physical and mental health outcomes. Clinical Impact Statement The primary goal of this article is to investigate the role of emotion regulation in mediating the relationship between PTSD and self-rated health in a sample of primarily urban African American adults, with consideration that examination of regulatory processes within the PTSD- health relationship among this population may provide insights into disparities of health. Findings revealed that despite other risk factors among this population (i.e., low socioeconomic status and high levels of trauma exposure), emotion dysregulation continued to be an impactful risk factor in the relationship between PTSD and self-rated health.