Difficulties in Emotion Regulation Scale – 16 item version (DERS-16)

The Difficulties in Emotion Regulation Scale – 16 item version (DERS-16) is a self-report measure that assesses individuals’ typical levels of difficulties in emotion regulation. Based upon the original 36 item version DERS, the DERS-16 uses a clinically-useful conceptualization of emotion regulation that was developed to be applicable to a wide variety of psychological difficulties and relevant to clinical applications and treatment development (Gratz, 2007; Gratz & Tull, 2010). The DERS-16 assesses five aspects of difficulties in emotion regulation:

  1. Nonacceptance of emotional responses
  2. Difficulty engaging in goal-directed behaviour
  3. Impulse control difficulties
  4. Limited access to emotion regulation strategies
  5. Lack of emotional clarity

Emotion regulation broadly refers to the intrinsic and extrinsic processes involved in monitoring, evaluating, and modulating emotional reactions in order to accomplish one’s goals (Thompson, 1994). Inherent within this definition of emotion regulation is the idea that emotions are functional, providing information about our environment and motivating behaviours that may facilitate adaptation to situational demands (Izard & Ackerman, 2000). Conversely, difficulties in the awareness, understanding, or modulation of emotion may interfere with adaptation and contribute to a wide range of negative outcomes. Indeed, a rapidly growing body of research offers support for the role of emotion regulation difficulties in multiple forms of psychopathology and maladaptive behaviours (Cichetti, Ackerman, & Izard, 1995; Gratz & Tull, 2010; Gross & Jazaieri, 2014; Sheppes, Suri, & Gross, 2015).

The DERS-16 can be especially useful in helping patients identify areas for growth in how they respond to their emotions, especially those with Borderline Personality Disorder, Generalised Anxiety Disorder or Substance Use Disorder.

Psychometric Properties

Items for the DERS-16 were selected from the 36 items in the original DERS on the basis of both item-total correlations and considerations regarding content validity. Items that were very similar in wording or that correlated highly (r > .90) with another item were excluded to reduce scale length and redundancy (Bjureberg et al., 2016). Findings that none of the items from the original DERS ‘lack of emotional awareness’ subscale was retained on the basis of the item-total correlations are consistent with past research indicating that this subscale is less strongly associated with the overall DERS score than the other subscales (Neumann, van Lier, Gratz, & Koot, 2010; Tull et al., 2007; Tull et al., 2010).

This DERS-16 demonstrated good internal consistency (Cronbach’s alpha = .92; Bjureberg et al., 2016) and was strongly associated with the original 36-item version (r = .93) in the original validation sample (Gratz & Roemer, 2004).

A normative community sample of 482 young adult women was assessed using the DERS-16 (Bjureberg et al., 2016) which resulted in a mean total score of 33.57 (SD = 13.14).

Scoring and Interpretation 

The total score ranges from 16-80 with higher scores indicating more difficulties with emotion regulation.

The normative percentile contextualises the respondent’s score in comparison to a community sample of young adult women (Bjureberg et al., 2016). For example, a percentile of 50 would indicate that the client is having an average (and healthy) level of difficulties with emotion regulation. In contrast, a percentile of 90 means the client scored higher than 90 percent of the normative group and would be indicative of significant difficulties with emotion regulation.

The mean score for subscales are presented (from 1-5) to allow for a comparison of the subscale areas (given there are different numbers of questions within each subscale) where higher scores in the subscales is indicative of more difficulties in that area of emotion regulation.

Subscale scores:

  1. Nonacceptance of emotional responses (items 9, 10, 13) – a tendency to have a negative secondary or non accepting reaction to one’s own distress
  2. Difficulty engaging in goal-directed behaviour (items 3, 7, 15) – difficulties in concentrating and/or accomplishing tasks when experiencing negative emotions
  3. Impulse control difficulties (items 4, 8, 11) – difficulties remaining in control of one’s behaviour when experiencing negative emotions
  4. Limited access to emotion regulation strategies (items 5, 6, 12, 14, 16) – the belief that there is little one can do to regulate oneself once upset
  5. Lack of emotional clarity (items 1, 2) – reflecting the extent to which an individual knows and is clear about their emotions

A graph is displayed after the initial assessment which shows the average score for the subscales which allows a comparison of relative strengths and weaknesses in the subscale areas. The dotted line on the graph is the total score average which allows for a determination of priority subscale areas that might need to be worked on in therapy (bars above the dotted line) and which aspects might be relative strengths (bars below the dotted line).

After multiple administrations of the DES-16, a graph is displayed to show the change of the normative percentile (total score) over time and also the change in subscales as shown by the mean subscale scores over time.


Bjureberg, J., Ljótsson, B., Tull, M. T., Hedman, E., Sahlin, H., Lundh, L.-G., Bjärehed, J., DiLillo, D., Messman-Moore, T., Gumpert, C. H., & Gratz, K.L. (2016). Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. Journal of Psychopathology and Behavioral Assessment, 1–13. http://doi.org/10.1007/s10862-015-9514-x


Cicchetti, D., Ackerman, B. P., & Izard, C. E. (1995). Emotions and emotion regulation in developmental psychopathology. Development and Psychopathology, 7(1), 1–10. https://doi.org/10.1017/S0954579400006301

Gratz K. L. (2007). Targeting emotion dysregulation in the treatment of self-injury. Journal of clinical psychology, 63(11), 1091–1103. https://doi.org/10.1002/jclp.20417

Gratz, K.L., Roemer, L. Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment 26, 41–54 (2004). https://doi.org/10.1023/B:JOBA.0000007455.08539.94

Gratz, K. L., & Tull, M. T. (2010). Emotion regulation as a mechanism of change in acceptance-and mindfulness-based treatments. In R. A. Baer (Ed.), Assessing mindfulness and acceptance: Illuminating the processes of change. Oakland, CA: New Harbinger Publications

Gross, J. J., & Jazaieri, H. (2014). Emotion, Emotion Regulation, and Psychopathology: An Affective Science Perspective. Clinical Psychological Science, 2(4), 387–401. https://doi.org/10.1177/2167702614536164

Izard, CE.; Ackerman, BP. (2000). Motivational, organizational, and regulatory functions of discrete emotions. In Lewis, M.; Haviland-Jones, JM. (Ed). Handbook of emotions. 2nd. New York: Guilford Press. p. 253-264.

Sheppes, G., Suri, G., & Gross, J. J. (2015). Emotion regulation and psychopathology. Annual review of clinical psychology, 11, 379–405. https://doi.org/10.1146/annurev-clinpsy-032814-112739

Thompson R. A. (1994). Emotion regulation: a theme in search of definition. Monographs of the Society for Research in Child Development, 59(2-3), 25–52.