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Difficulties in Emotion Regulation Scale
The Difficulties in Emotion Regulation Scale (DERS) is a widely used, validated psychometric instrument designed to assess clinically significant deficits…
- Questions
- 36
- Duration
- 10 min
- Original title
- DERS-F — Difficulties in Emotion Regulation Scale
- Adaptation
- Difficulties in Emotion Regulation Scale
- Authors
- Gratz, K. L. & Roemer, L.
- Created
- 2004
The Difficulties in Emotion Regulation Scale (DERS) is a widely used, validated psychometric instrument designed to assess clinically significant deficits in how individuals process and respond to emotional distress. Rather than simply measuring the frequency or intensity of negative affect, the DERS evaluates the specific processes required to navigate strong emotions constructively, making it foundational for teaching emotion regulation skills. It provides clinicians with a robust, multidimensional profile of a patient's emotional capacities.
Routine use of this measure allows clinicians to anchor interventions effectively. By pinpointing whether a patient struggles more with acknowledging their feelings or with refraining from impulsive actions when distressed, therapy can be tailored to the exact point of breakdown. As a repeatable measure, it is highly sensitive to clinical change, making it an excellent tool for tracking progress across cognitive and acceptance-based therapeutic modalities, particularly when addressing experiential avoidance.
Example result
Fictitious result, computed from a sample set of answers.
Overall score
106/ 180
A 36-item self-report questionnaire assessing emotion regulation difficulties in adults across six dimensions: non-acceptance of emotional responses (NONACCEPT), difficulties engaging in goal-directed behavior (GOALS), impulse control difficulties (IMPULSE), lack of emotional awareness (AWARENESS), limited access to emotion regulation strategies (STRATEGIES), and lack of emotional clarity (CLARITY). A widely used transdiagnostic tool to characterize emotion dysregulation in anxiety, depressive, eating, borderline personality, addictive, and post-traumatic stress disorders. The DERS, developed by Gratz and Roemer, is a widely used and comprehensive self-report instrument designed to assess six dimensions of emotion regulation difficulties, comprising 36 items (6 to 8 per dimension).
généralefemale · students · female · 18–55 years · United States · n = 260 · 2004 · Gratz et al. (2004)
36180
106
M = 77.99 ± 20.72
généralemale · students · male · 18–55 years · United States · n = 97 · 2004 · Gratz et al. (2004)
36180
106
M = 80.66 ± 18.79
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
36180
106
M = 89.33 ± 22.64
cliniquemixed · pathology: Depression · mild level · Australia · n = 145 · 2022 · Burton et al. (2022)
36180
106
M = 89.9 ± 19.03
cliniquemixed · pathology: Depression · moderate level · Australia · n = 197 · 2022 · Burton et al. (2022)
36180
106
M = 101.12 ± 17.89
cliniquemixed · pathology: Depression · severe level and above · Australia · n = 132 · 2022 · Burton et al. (2022)
36180
106
M = 116.13 ± 17.52
For information
Cut-off≥ 84Clinically significant emotion dysregulation
Optimal cut-off score (Youden's index) distinguishing depressed from non-depressed participants.
Burton et al. (2022)View the study ↗
Scoring
Total sum and subscale sums (reverse-coded items recoded), total score ranging from 36 to 180, each item scored on a 5-point scale (from 1 to 5).
Difficulties engaging in goal-directed behavior
15/ 25
Difficulty concentrating and accomplishing goal-directed behavior when upset.
items 13, 18, 20, 26, 33
généralefemale · students · female · United States · n = 260 · 2004 · Gratz et al. (2004)
525
15
M = 14.41 ± 4.95
généralemale · students · male · United States · n = 97 · 2004 · Gratz et al. (2004)
525
15
M = 14.34 ± 5.16
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
525
15
M = 15.42 ± 4.215
Lack of emotional clarity
16/ 25
Ability to identify and differentiate what one is feeling.
items 1, 4, 5, 7, 9
généralefemale · students · female · United States · n = 260 · 2004 · Gratz et al. (2004)
525
16
M = 10.61 ± 3.8
généralemale · students · male · United States · n = 97 · 2004 · Gratz et al. (2004)
525
16
M = 10.74 ± 3.67
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
525
16
M = 12.01 ± 4.04
Impulse control difficulties
19/ 30
Difficulty maintaining behavioral control when experiencing distress.
items 3, 14, 19, 24, 27, 32
généralefemale · students · female · United States · n = 260 · 2004 · Gratz et al. (2004)
630
19
M = 10.82 ± 4.41
généralemale · students · male · United States · n = 97 · 2004 · Gratz et al. (2004)
630
19
M = 11.55 ± 4.59
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
630
19
M = 12.58 ± 4.97
Lack of emotional awareness
17/ 30
Degree of attention paid to and recognition of one's own emotions.
items 2, 6, 8, 10, 17, 34
généralefemale · students · female · United States · n = 260 · 2004 · Gratz et al. (2004)
630
17
M = 14.34 ± 4.6
généralemale · students · male · United States · n = 97 · 2004 · Gratz et al. (2004)
630
17
M = 16.26 ± 4.61
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
630
17
M = 15.55 ± 4.92
Non-acceptance of emotional responses
16/ 30
Tendency to react to one's own negative emotions with shame, guilt, or irritation.
items 11, 12, 21, 23, 25, 29
généralefemale · students · female · United States · n = 260 · 2004 · Gratz et al. (2004)
630
16
M = 11.65 ± 4.72
généralemale · students · male · United States · n = 97 · 2004 · Gratz et al. (2004)
630
16
M = 11.55 ± 4.2
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
630
16
M = 14.67 ± 5.92
Limited access to emotion regulation strategies
23/ 40
Belief that there are few effective strategies to soothe negative emotions.
items 15, 16, 22, 28, 30, 31, 35, 36
généralefemale · students · female · United States · n = 260 · 2004 · Gratz et al. (2004)
840
23
M = 16.16 ± 6.19
généralemale · students · male · United States · n = 97 · 2004 · Gratz et al. (2004)
840
23
M = 16.23 ± 6.26
cliniquemixed · pathology: Emotional disorders · United States · n = 427 · 2018 · Hallion et al. (2018)
840
23
M = 19.67 ± 7.31
Have your patient take this test
Assign it in one click: your patient answers on their phone, you receive the score and its interpretation.
What the test measures
The DERS measures emotion dysregulation as a multifaceted construct. It assesses six core clinical dimensions:
- Nonacceptance: The tendency to experience secondary negative emotions (like guilt or shame) in response to primary distress, often requiring structured judgment psychoeducation.
- Goals: Difficulties in maintaining focus and accomplishing tasks while experiencing strong emotions.
- Impulses: The inability to control behavior or resist urges when overwhelmed by negative affect.
- Awareness: A lack of attention to, or acknowledgement of, emotional experiences in daily life.
- Strategies: The belief that little or nothing can be done to alleviate emotional pain once it arises, indicating a need for a flexible coping strategies map.
- Clarity: Confusion regarding the specific nature or type of emotion being experienced.
This instrument is designed for adolescents and adults presenting with a range of clinical issues, including mood, anxiety, trauma, and personality-related distress.
When and why to use it
Clinicians use the DERS to systematically evaluate emotion regulation deficits and inform targeted skill-building.
- Intake baseline: To map out a patient's structural vulnerabilities in processing emotions before selecting a specific therapeutic approach.
- Treatment planning: To differentiate between a deficit in mindfulness practice (low awareness) and a need for immediate body-based distress tolerance (poor impulse control).
- Monitoring change: To track incremental improvements in emotional flexibility throughout the course of therapy.
- Targeting secondary emotion: To identify patients who chronically invalidate their own distress and need to build frustration tolerance.
Using a validated score adds precision over clinical impression alone, separating distinct regulatory failures that often present as a generalized overwhelmed state in session.
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The questions
- Please indicate how often the following statements apply to you by choosing the appropriate response: almost never, sometimes, about half the time, most of the time, or almost always.1. I understand my feelings well.Assesses the patient's general ability to accurately label and understand their affective states.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 2. I pay attention to how I'm feeling.Probes the baseline tendency to monitor and tune into internal emotional experiences.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 3. Emotional experiences are overwhelming and uncontrollable.Evaluates the subjective experience of being completely flooded and overpowered by feelings.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 4. I have no idea how I am feeling.Explores the degree of emotional numbness or profound confusion regarding internal states.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 5. I have difficulty making sense of my feelings.Examines difficulties in extracting meaning or coherence from emotional arousal.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 6. I pay attention to my feelings.Measures the ongoing, deliberate allocation of attention to one's feelings.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 7. I know exactly how I am feeling.Captures the level of certainty and precision a patient has in identifying their emotions.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 8. I pay close attention to what I am feeling.Assesses the perceived value and importance the patient places on their own emotional life.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 9. I am confused about my feelings.Probes the sense of bewilderment or disorientation when affective shifts occur.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 10. When I'm upset, I acknowledge this emotion.Evaluates the capacity to consciously recognize and accept distress without instantly suppressing it.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 11. When I'm upset, feeling this way makes me angry with myself.Highlights secondary anger directed at oneself as a reaction to feeling upset.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 12. When I'm upset, I'm embarrassed for feeling this way.Captures feelings of embarrassment or social anxiety specifically related to experiencing distress.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 13. When I'm upset, I have difficulty finishing my work.Assesses the interference of negative emotions with the capacity to complete tasks.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 14. When I'm upset, I get out of control.Explores the sense of losing behavioral restraint when emotional intensity rises.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 15. When I'm upset, I believe I will stay this way for a long time.Probes the cognitive belief that emotional pain is permanent and intractable.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 16. When I'm upset, I believe I will soon feel very depressed.Evaluates the fear that momentary distress will inevitably spiral into clinical depression.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 17. When I'm upset, I believe my feelings are valid and important.Assesses the patient's ability to self-validate and legitimize their own painful feelings.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 18. When I'm upset, I have difficulty concentrating on other things.Measures how thoroughly negative emotions hijack cognitive focus and attention.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 19. When I'm upset, I feel out of control.Captures the internal, subjective sensation of losing one's grip on emotional stability.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 20. When I'm upset, I can carry on with things.Highlights resilience in maintaining functional behaviors despite the presence of distress.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 21. When I'm upset, I am ashamed for feeling this way.Evaluates secondary shame arising as a direct reaction to being emotionally activated.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 22. When I'm upset, I know I can find a way to eventually feel better.Probes the presence of hope and self-efficacy regarding eventual emotional recovery.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 23. When I'm upset, I feel helpless.Assesses the feeling of vulnerability or inadequacy when confronted with strong emotions.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 24. When I'm upset, I feel I can stay in control of my behaviors.Explores the perceived capacity to inhibit problematic actions even when highly distressed.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 25. When I'm upset, I feel guilty for feeling this way.Captures secondary guilt generated by the mere presence of negative feelings.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 26. When I'm upset, I have difficulty concentrating.Measures the specific cognitive deficit in concentration caused by emotional arousal.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 27. When I'm upset, I have difficulty controlling my behavior.Assesses the failure of behavioral inhibition systems during moments of upset.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 28. When I'm upset, I believe there's nothing I can do to feel better.Evaluates a state of perceived helplessness and a lack of viable coping mechanisms.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 29. When I'm upset, I blame myself for feeling this way.Probes self-directed frustration and invalidation in response to experiencing negative affect.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 30. When I'm upset, I feel really bad.Explores the tendency for emotional distress to globally degrade self-esteem.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 31. When I'm upset, I think wallowing in my feelings is the only thing to do.Captures a sense of resignation, where the patient feels trapped in rumination and distress.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 32. When I'm upset, I lose control of my behaviors.Evaluates the outright failure to manage actions and urges under emotional pressure.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 33. When I'm upset, I have difficulty thinking about anything else.Measures the cognitive rigidity and narrow focus that often accompanies severe distress.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 34. When I'm upset, I take time to figure out what I'm really feeling.Assesses the proactive willingness to pause and investigate the true nature of one's upset.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 35. When I'm upset, it takes a long time for me to feel better.Explores the extended duration of the recovery phase after an emotional peak.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
- 36. When I'm upset, my emotions take over.Captures the sensation that emotions have become the dominant, overriding force in the patient's experience.
- Almost never
- Sometimes
- About half the time
- Most of the time
- Almost always
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