Emotion regulation in posttraumatic stress disorder (PTSD): Rumination accounts for the association between emotion regulation difficulties and PTSD severity

Objective The current study investigated whether rumination accounts for the relationship between multiple aspects of emotion regulation (ER) difficulties and posttraumatic stress disorder (PTSD) severity. Method Participants were 90 community members (43% diagnosed with PTSD; M-age =( )26.7, 86% female) who were interviewed using the Clinician-Administered PTSD Scale-5 and completed self-reported measures of ER and rumination. Results The indirect effect of rumination completely accounted for the relationship between overall ER difficulties and PTSD severity. This finding was replicated for three unique aspects of ER (i.e., nonacceptance of negative emotions, impulse control difficulties under emotional distress, and the ability to maintain goal-oriented behavior under emotional distress). Reverse models testing the indirect effect of ER on the link between rumination and PTSD were nonsignificant. Conclusions Rumination is an important cognitive process linking specific aspects of ER difficulties to PTSD. Clinical interventions focused on improving ER abilities among those with PTSD may benefit from targeting rumination.