DERS: Difficulties in Emotion Regulation Scale (36-Item, 6 Subscales, Scoring)

The DERS (Difficulties in Emotion Regulation Scale) is a 36-item self-report measure of how much trouble a person has identifying, understanding, accepting, and modulating their emotions, especially during distress. It was developed by Gratz and Roemer ^[1] and is a widely used, theoretically driven measure of emotion regulation difficulties ^[2].

It scores six subscales plus a total:

• Nonacceptance of emotional responses
• Difficulty engaging in goal-directed behaviour
• Impulse control difficulties
• Lack of emotional awareness
• Limited access to emotion regulation strategies
• Lack of emotional clarity

Totals run from 36 to 180, and higher scores mean greater emotion regulation difficulty. Emotion regulation is a core target of dialectical behaviour therapy (DBT); emotion dysregulation is also central to borderline personality disorder.

What does the DERS measure?

The DERS measures difficulties in emotion regulation across six subscales, each described below.

Nonacceptance of emotional responses

This subscale captures secondary negative reactions to one's own distress: feeling ashamed, guilty, angry, or embarrassed about being upset. It has 6 items.

People who score high tend to judge their emotions as unacceptable or as a sign of weakness, which can amplify the original distress. They react to emotions with further emotion rather than tolerating them.

Difficulty engaging in goal-directed behaviour

This subscale measures how much distress disrupts concentration, task completion, and goal-directed action. It has 5 items.

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.

Impulse control difficulties

This subscale assesses trouble controlling behaviour while experiencing negative emotions. It has 6 items.

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.

Lack of emotional awareness

This subscale reflects the tendency not to attend to or acknowledge one's emotional states: being inattentive to feelings or dismissive of them. It has 6 items.

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.

Limited access to emotion regulation strategies

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. With 8 items, it is the longest subscale.

High scorers feel stuck in distress and helpless to change it, which overlaps with hopelessness and depressive thinking.

Lack of emotional clarity

This subscale measures uncertainty about what one is feeling: difficulty identifying, labelling, and distinguishing between emotional states. It has 5 items.

People who score high are often confused about their emotions. Clarity is distinct from awareness: a person may notice that they feel something yet remain unclear about what it is.

How do you give the DERS?

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.

Response scale: 1 = almost never, 2 = sometimes, 3 = about half the time, 4 = most of the time, 5 = almost always.

How do you score and interpret the DERS?

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 was built as a multidimensional, continuous measure, not a pass/fail screener, and it does not have widely agreed clinical cutoff bands.

• Own baseline. The total and subscale scores are most useful read against a person's own baseline across repeated administrations, or against published means for comparable samples.
• Proposed cutoff. A 2025 study of 502 adults proposed a total-score cutoff of 95 to flag significant emotion regulation difficulties, linked to psychopathology; its authors called for further validation in diverse and clinical samples ^[3], so it is not yet an established clinical threshold.

Subscale breakdown

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.

DERS subscale reference

Psychometric properties

The DERS is a widely used, theoretically driven self-report measure of emotion regulation difficulties ^[2]. In a 2025 study of 502 adults, a bifactor model fit best; the total score was reliable and valid, explaining 53.3% of the variance, with emotional awareness forming a distinct subfactor ^[3].

The DERS-16 ^[2] 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.

Limitations

• Not a diagnostic test. The DERS describes emotion regulation difficulty; it does not diagnose any disorder.
• No established cutoff. The proposed total-score cutoff of 95 still needs validation in diverse and clinical samples ^[3].
• Awareness subscale behaves differently. Emotional awareness forms a distinct subfactor, so the total is not purely unidimensional ^[3].
• Self-report. Scores rely on the respondent's insight into their own emotional responses.
• Length. At 36 items it can be hard to administer in some settings, which motivated the DERS-16 ^[2].

Documenting DERS scores in clinical notes

DERS total and subscale scores belong in the Objective section of your clinical note. See the SOAP notes guide for templates and examples.

The DERS was developed by Kim L. Gratz and Lizabeth Roemer ^[1].