[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-ders":3,"all-assessments-nav":252,"related-assessments-query":899},{"id":4,"title":5,"body":6,"category":211,"categoryTitle":212,"clinicalCitations":213,"copyright":211,"description":223,"disclaimer":211,"downloadLink":211,"extension":224,"faqs":225,"featured":241,"i18nReady":241,"icon":211,"interpreter":211,"lastReviewed":242,"meta":243,"navigation":244,"path":245,"permissionsNote":211,"published":241,"recommendedFrequency":211,"relatedCodes":211,"relatedConditions":211,"reviewedBy":211,"seo":246,"slug":247,"stem":248,"summary":249,"takeaways":211,"timeline":211,"type":250,"usedToDiagnose":211,"__hash__":251},"assessments\u002Fassessments\u002Fders.md","DERS: Difficulties in Emotion Regulation Scale (36-Item, 6 Subscales, Scoring)",{"type":7,"value":8,"toc":196},"minimark",[9,22,25,28,31,34,39,42,46,49,53,56,60,63,67,70,74,77,82,85,90,93,97,183,186,190,193],[10,11,12,13,17,18,21],"p",{},"The ",[14,15,16],"strong",{},"DERS (Difficulties in Emotion Regulation Scale)"," is a validated 36-item self-report measure of how much trouble a person has identifying, understanding, accepting, and modulating their emotions, especially during distress. Developed by ",[14,19,20],{},"Gratz and Roemer (2004)",", it scores six clinically distinct subscales — Nonacceptance of emotional responses, Difficulty engaging in goal-directed behaviour, Impulse control difficulties, Lack of emotional awareness, Limited access to emotion regulation strategies, and Lack of emotional clarity — plus a total. Items are rated 1 (almost never) to 5 (almost always); after reverse-scoring the relevant items (mainly those in the lack-of-emotional-awareness subscale), the total ranges from 36 to 180, where higher scores mean greater emotion regulation difficulty. The DERS is the de-facto outcome measure for dialectical behaviour therapy (DBT) programs and a sensitive marker in trauma, mood, anxiety, substance use, and borderline personality presentations.",[10,23,24],{},"This DERS online test lets you complete all 36 questions and receive an automated total score plus all six subscale scores. Use the interactive DERS scoring tool below. For related tools, see the assessment library and learn about measurement-based care.",[10,26,27],{},"HiBoop automates DERS delivery, subscale scoring, and longitudinal tracking, alongside depression, anxiety, and PTSD measures.",[10,29,30],{},"Rate how often each statement applies to you using the scale below. Some items ask about emotions in general; most items begin \"When I'm upset...\" and refer to how you respond during emotional distress.",[10,32,33],{},"Response scale: 1 = almost never, 2 = sometimes, 3 = about half the time, 4 = most of the time, 5 = almost always.",[35,36,38],"h3",{"id":37},"nonacceptance-of-emotional-responses","Nonacceptance of Emotional Responses",[10,40,41],{},"This subscale captures secondary negative reactions to one's own distress — feeling ashamed, guilty, angry, or embarrassed about being upset. People who score high tend to judge their emotions as unacceptable or as a sign of weakness, which can amplify the original distress. It reflects the tendency to react to emotions with further emotion rather than to tolerate them. (6 items.)",[35,43,45],{"id":44},"difficulty-engaging-in-goal-directed-behavior","Difficulty Engaging in Goal-Directed Behavior",[10,47,48],{},"This subscale measures how much distress disrupts concentration, task completion, and goal-directed action. People who score high find it hard to focus or get things done once they become upset. It indexes the functional cost of emotion to everyday work and follow-through rather than the emotion itself. (5 items.)",[35,50,52],{"id":51},"impulse-control-difficulties","Impulse Control Difficulties",[10,54,55],{},"This subscale assesses trouble controlling behaviour while experiencing negative emotions. High scorers report feeling out of control, acting rashly, or being unable to restrain impulsive responses when distressed. It is closely tied to acting-out behaviours and is often elevated in presentations marked by impulsivity. (6 items.)",[35,57,59],{"id":58},"lack-of-emotional-awareness","Lack of Emotional Awareness",[10,61,62],{},"This subscale reflects the tendency not to attend to or acknowledge one's emotional states — being inattentive to feelings or dismissive of them. All of its items are reverse-scored, since they are phrased in terms of attending to and valuing emotions. High difficulty here means a person largely does not notice or take their emotions into account. (6 items.)",[35,64,66],{"id":65},"limited-access-to-emotion-regulation-strategies","Limited Access to Emotion Regulation Strategies",[10,68,69],{},"This subscale captures the belief that little can be done to feel better once distressed — a sense that negative emotions will persist and that no effective strategy is available. High scorers feel stuck in distress and helpless to change it, which overlaps closely with hopelessness and depressive thinking. It is the longest subscale and often carries substantial weight in the total score. (8 items.)",[35,71,73],{"id":72},"lack-of-emotional-clarity","Lack of Emotional Clarity",[10,75,76],{},"This subscale measures uncertainty about what one is feeling — difficulty identifying, labelling, and distinguishing between emotional states. People who score high are often confused about their emotions or unsure what an emotion means. It is conceptually distinct from awareness: a person may notice that they feel something yet remain unclear about what it is. (5 items.)",[78,79,81],"h4",{"id":80},"subscale-breakdown","Subscale Breakdown",[10,83,84],{},"Higher subscale scores indicate more difficulty in that area. Subscale scores are interpreted as a profile — comparing relative elevations across the six domains, and tracking change within a person over time, is more informative than any single threshold. There are no universally agreed clinical severity bands for the subscales.",[86,87,89],"h2",{"id":88},"ders-score-interpretation-guide","DERS Score Interpretation Guide",[10,91,92],{},"The DERS was built as a multidimensional, continuous measure, not a pass\u002Ffail screener. It does not have widely agreed clinical cutoff bands. In practice the total and subscale scores are most useful when interpreted relative to a person's own baseline across repeated administrations, or against published means for comparable samples. A 2025 study (Erez & Gordon) proposed a total-score cutoff of 95 to flag significant emotion regulation difficulties, but the authors explicitly called for further validation in diverse and clinical samples before routine use, so it should not be treated as an established clinical threshold.",[35,94,96],{"id":95},"ders-subscale-reference","DERS Subscale Reference",[98,99,100,116],"table",{},[101,102,103],"thead",{},[104,105,106,110,113],"tr",{},[107,108,109],"th",{},"Subscale",[107,111,112],{},"What it measures",[107,114,115],{},"Items",[117,118,119,131,142,152,162,173],"tbody",{},[104,120,121,125,128],{},[122,123,124],"td",{},"Nonacceptance of emotional responses",[122,126,127],{},"Secondary negative reactions to distress (shame, guilt, anger about feeling upset)",[122,129,130],{},"6",[104,132,133,136,139],{},[122,134,135],{},"Difficulty engaging in goal-directed behaviour",[122,137,138],{},"Impaired concentration and task completion when distressed",[122,140,141],{},"5",[104,143,144,147,150],{},[122,145,146],{},"Impulse control difficulties",[122,148,149],{},"Difficulty controlling behaviour while experiencing negative emotions",[122,151,130],{},[104,153,154,157,160],{},[122,155,156],{},"Lack of emotional awareness",[122,158,159],{},"Tendency not to attend to or acknowledge emotional states (items reverse-scored)",[122,161,130],{},[104,163,164,167,170],{},[122,165,166],{},"Limited access to emotion regulation strategies",[122,168,169],{},"Belief that nothing can be done to manage distress effectively",[122,171,172],{},"8",[104,174,175,178,181],{},[122,176,177],{},"Lack of emotional clarity",[122,179,180],{},"Uncertainty about, and difficulty identifying and distinguishing, what one is feeling",[122,182,141],{},[10,184,185],{},"The DERS-16 (Bjureberg et al., 2016) is a 16-item brief version that retains strong internal consistency and good convergent and discriminant validity as an overall index of emotion regulation difficulty. Because it drops the awareness items, it is best suited to situations needing a single overall score rather than a full six-subscale profile.",[35,187,189],{"id":188},"documenting-ders-scores-in-clinical-notes","Documenting DERS scores in clinical notes",[10,191,192],{},"DERS total and subscale scores belong in the Objective section of your clinical note. See our SOAP notes guide for templates and examples.",[10,194,195],{},"The DERS was developed by Kim L. Gratz and Lizabeth Roemer (2004); the full citation appears in the References below.",{"title":197,"searchDepth":198,"depth":198,"links":199},"",2,[200,202,203,204,205,206,207],{"id":37,"depth":201,"text":38},3,{"id":44,"depth":201,"text":45},{"id":51,"depth":201,"text":52},{"id":58,"depth":201,"text":59},{"id":65,"depth":201,"text":66},{"id":72,"depth":201,"text":73},{"id":88,"depth":198,"text":89,"children":208},[209,210],{"id":95,"depth":201,"text":96},{"id":188,"depth":201,"text":189},null,"Emotion Regulation",[214,217,220],{"text":215,"link":216},"Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess. 2004;26(1):41-54.","https:\u002F\u002Fdoi.org\u002F10.1023\u002FB:JOBA.0000007455.08539.94",{"text":218,"link":219},"Bjureberg J, Ljótsson B, Tull MT, et al. Development and validation of a brief version of the Difficulties in Emotion Regulation Scale: the DERS-16. J Psychopathol Behav Assess. 2016;38(2):284-296.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F27239096\u002F",{"text":221,"link":222},"Erez C, Gordon I. The imperfect yet valuable Difficulties in Emotion Regulation Scale: factor structure, dimensionality, and possible cutoff score. Assessment. 2025;32(5):778-795.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F39054870\u002F","DERS scoring guide for clinicians. 36 items, 6 subscales, total 36–180 (higher = more dysregulation). Used in DBT outcome tracking and trauma populations.","md",[226,229,232,235,238],{"question":227,"answer":228},"What does the DERS measure?","The DERS measures difficulties in emotion regulation — how much trouble a person has identifying, understanding, accepting, and modulating their emotions when distressed. It captures six related dimensions rather than a single trait, so it can show where someone struggles (for example, with impulse control versus emotional awareness). Higher scores indicate greater emotion regulation difficulty.",{"question":230,"answer":231},"How many items is the DERS and how is it scored?","The original DERS has 36 items, each rated on a 5-point frequency scale from 1 (almost never) to 5 (almost always). Several items, mainly from the emotional-awareness subscale, are reverse-scored before summing. The total score ranges from 36 to 180, with higher totals reflecting more emotion regulation difficulty.",{"question":233,"answer":234},"What are the six DERS subscales?","The six subscales are Nonacceptance of emotional responses, Difficulty engaging in goal-directed behaviour, Impulse control difficulties, Lack of emotional awareness, Limited access to emotion regulation strategies, and Lack of emotional clarity. Each is scored separately so clinicians can see a profile of strengths and difficulties across emotion regulation domains.",{"question":236,"answer":237},"Is there a short version of the DERS?","Yes. The DERS-16 (Bjureberg et al., 2016) is a 16-item brief version that retains excellent internal consistency and good convergent and discriminant validity for assessing overall emotion regulation difficulty. It omits the lack-of-emotional-awareness items, so it is best used when a single overall index is needed rather than a full six-subscale profile.",{"question":239,"answer":240},"Does the DERS have clinical cutoff scores?","The DERS was designed as a multidimensional, continuous measure and does not have widely agreed clinical severity bands the way a screener does. Scores are most useful when interpreted relative to a person's own baseline over time, or against published sample means for similar populations. 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