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Background:  Substance use disorders (SUDs) are frequent concerns among healthcare providers serving military personnel and Veterans, and SUDs are also associated with high healthcare utilization. Problematic substance use is consistently associated with deficits in emotion regulation, and changes in emotional regulatory processes may be important factors during treatment and recovery.  Methods:  The present study examined emotion regulation and substance use risk and protective factors among Veterans seeking residential treatment for SUD within the Veterans Health Administration (VHA). Data were collected from 138 Veterans at pre-treatment and post-treatment to examine if changes in emotion regulation were associated with post-treatment outcomes.  Results:  Results indicated difficulties with emotion dysregulation at discharge predicted substance use risk factors, but not substance use protective factors, after controlling for scores at intake. Emotion regulation significantly improved throughout the course of treatment. Facets of emotion dysregulation at post-treatment, specifically difficulties engaging in goal-directed behavior, lower emotional clarity, lower emotional awareness, and more impulse control difficulties, predicted future admission to withdrawal management services, but not future mental health engagement, mortality, or resumed use (positive urine drug screen).  Conclusions:  Emotion regulation skills may be valuable treatment components, as they are related to reduced substance use risk factors; however, the results of improved emotion regulation were mixed for other measures of treatment outcome.

Emotion Dysregulation and Substance Use Risk and Protective Factors among Veterans in Residential Treatment