The Mediating Role of Emotion Dysregulation in the Association Between Impulsivity and Severity of Substance Dependence

Substance use disorders (SUDs) are among the leading causes of morbidity and mortality globally. Identification of aetiological factors related to the severity of substance use can offer targets for therapeutic interventions. Role of impulsivity and emotion dysregulation in SUDs is well established. Based on the evidence that the adverse effects of impulsivity on behavioural and mental health outcomes can be mediated by emotion dysregulation, this study explored the possible mediating role of emotion dysregulation in the association between impulsivity and the severity of substance dependence. One hundred treatment-seeking substance users (monosubstance users and polysubstance users) were enrolled. Impulsivity, emotion dysregulation and severity of substance dependence were assessed using the Barratt Impulsiveness Scale-11, the Difficulties Emotion Regulation Scale and the Severity Dependence Scale, respectively. Correlation, mediation and 95% bias-corrected and accelerated (BCa CI) bootstrapped analyses were run. Emotion dysregulation was found to mediate the association between attention impulsivity (indirect effect [BCa CI]: 0.22 [0.11–0.36]), motor impulsivity (indirect effect [BCa CI]: 0.15 [0.08–0.24]), non-planning impulsivity (indirect effect [BCa CI]: 0.11 [0.04–0.18]) and severity of substance dependence. The direct effect of different facets of impulsivity on dependence severity was not significant after accounting for emotion dysregulation. Impulsivity was found to have a significant indirect effect on the severity of substance use through emotion dysregulation. Among substance users, emotion dysregulation may be involved in the association between impulsivity and severity of substance dependence. Emotion dysregulation could be considered a possible therapeutic target to reduce the severity of substance dependence among substance users with impulsive tendencies.