Caroline Lawlor

Objectives: Individuals with psychosis report that emotion regulation (ER) difficulties are treatment priorities, yet little is known about how targeted ER interventions may help. We evaluated a new eight‐session Dialectical Behavioural Therapy (DBT)–informed skills group specifically adapted for individuals with psychosis: the Managing Emotions Group (MEG) in diverse, inner‐city community services. Method: A mixed‐method design was utilised to assess the feasibility (acceptability and potential clinical impact) of local delivery of MEG. Uptake, completion (≥50% of sessions), post‐session satisfaction ratings, and thematic analysis of qualitative feedback from 12 completers assessed acceptability. Pre–post‐intervention changes in psychological distress, self‐reported ER difficulties, and adaptive ER skill use assessed potential clinical impact. Results: Forty‐eight individuals (81% of attenders) completed the intervention ( M _age = 43, 54% female) of whom 39 completed pre‐ and post‐group measures. Participants reported high satisfaction and meaningful improvements in understanding and managing emotions, with positive impact on daily life. Self‐reported psychological distress, ER difficulties, and adaptive ER skill use significantly improved, with medium‐to‐large pre‐post effects ( d = 0.5–0.7) except lack of emotional clarity ( d = 0.3). Conclusions: MEG was feasible and acceptable, and a future feasibility randomised controlled trial is warranted. Practitioner points: Individuals with psychosis report that support with their emotions is a priority. Brief interventions for emotion regulation difficulties are acceptable to individuals with psychosis and can be feasibly delivered in a local outpatient service. Distress and emotion regulation difficulties and skills improved significantly from pre–post treatment for clients completing the managing emotions group. Further implementation and evaluation are needed to support continued refinement to meet the needs and priorities of individuals with psychosis.

Objective: Individuals with psychosis self‐report difficulties in understanding, relating, and responding to emotions as treatment priorities, yet we lack comprehensive, reliable, and valid assessments for routine clinical use.Methods: The psychometric properties of a brief version of the Difficulties in Emotion Regulation Scale‐16 (DERS‐16) were examined using anonymized data from a sample of 150 outpatients with psychosis.Results: Confirmatory factor analysis supported the five‐factor structure of the DERS‐16. The model fit was further improved by omitting two items. Measurement invariance was shown with respect to age and gender. The DERS‐16 demonstrated good internal consistency, well comparable to the original DERS. Evidence toward convergent validity is also presented.Conclusion: Findings suggest that the DERS‐16 is a reliable and valid measure of self‐reported emotion regulation difficulties in individuals with psychosis. Further research on the clinical utility of the DERS‐16 is needed, including examination of its test–retest reliability and predictive validity in response to targeted interventions.

Emotions play a key role in the development and experience of psychosis, yet there are important gaps in our understanding of how individuals with psychosis understand and respond to their emotions. This systematic review investigated self‐reported emotion regulation difficulties in individuals with psychosis compared with non‐clinical controls. An electronic database search was conducted in Medline, PsychINFO, and Embase and supplemented by searches of reference lists and citations. Seventeen studies were included. A narrative synthesis was conducted because contextual diversity was present across the studies and outcomes. Individuals with psychosis reported greater difficulties in (i) emotional clarity (specifically with identifying, describing, and understanding their emotions), (ii) emotional acceptance, (iii) engaging in goal‐directed behaviours when experiencing negative emotions, and (iv) willingness to experience emotional distress in the pursuit of meaningful activities in life. Evidence pertaining to other self‐reported emotion regulation difficulties was less clear. Effect sizes were generally large in magnitude but there were few studies on some self‐reported emotion regulation difficulties, and all studies were at moderate to high risk of bias. Further research is needed to clarify the nature of emotion regulation difficulties in individuals with psychosis to inform the provision of targeted clinical interventions.