DERS-18: Difficulties in Emotion Regulation Scale-18

What this assessment is

The Difficulties in Emotion Regulation Scale-18, or DERS-18, is an 18-item self-report measure of emotion regulation difficulties.

It retains all six domains from the original 36-item DERS. The result can be reported as one total and six subscale scores.

Higher scores indicate more reported difficulty.

This page covers the form developed by Sarah Victor and E. David Klonsky. It does not cover the separate 18-item DERS-SF developed by Kaufman and colleagues.

The two forms contain different question sets. Their shared length does not make them interchangeable.

The version matters.

Who it was designed for

The original DERS-18 study evaluated five samples with 1,624 participants in total. They included high-school students, adolescent psychiatric inpatients, university participants, and community adults.

The study included people from age 13 through adulthood and groups with different levels of clinical difficulty. Some samples overrepresented people with a history of self-injury.

That breadth is useful, but it is not a universal norm.

Context still matters.

Later research in treatment-seeking adults with emotional disorders supported the brief form's reliability and close relationship with the full DERS. Results still need context for the population, language, and setting in which the form is used.

How it is administered

The DERS-18 is completed by the person being assessed. Each question asks how often an emotional experience or response generally applies.

Responses receive values from 1 to 5. Three questions in the Awareness subscale point in the opposite direction and must be reverse-scored.

The measure usually takes several minutes.

Use the Victor and Klonsky question set and scoring key together. A DERS-SF form cannot be scored as the DERS-18, even though both contain 18 questions.

Keep them separate.

What it measures

The DERS-18 reports six domains:

• Awareness: attending to and acknowledging emotions
• Clarity: understanding which emotions are present
• Goals: continuing purposeful activity while distressed
• Impulse: controlling behavior while distressed
• Nonacceptance: responding to distress without secondary judgment or shame
• Strategies: perceiving that effective ways to respond are available

Each domain contains three questions.

The measure describes perceived difficulty. It does not directly observe behavior, test emotion-recognition skill, or measure every adaptive strategy a person uses.

How scoring works

Reverse the three Awareness responses specified by the scoring key. Then add the relevant three responses for each subscale.

Every subscale ranges from 3 to 15. Add all six subscale totals to produce the overall score, which ranges from 18 to 90.

Higher values mean more reported difficulty for both the total and each subscale.

The authors' scoring form requires complete inputs. Its computer-scoring example returns a missing result when a required value is absent.

Do not replace a missing response with the person's average unless a separate validated protocol explicitly allows it.

How to interpret a DERS-18 score

Start with the total, then review the six domains if that detail serves the assessment purpose.

A higher total reflects broader or more frequent reported problems with emotion regulation. A higher subscale can identify the type of difficulty the person endorsed, but it does not explain its cause.

The DERS-18 development study did not establish universal severity bands or a diagnostic cutoff. Labels such as low, moderate, high, and very high should not be created by dividing the 18-to-90 range into equal sections.

Do not improvise.

For monitoring, record the exact form and scoring convention. A DERS-18 result should not be compared directly with a DERS-16 or DERS-SF result as though the scales were identical.

What the score cannot tell you

The DERS-18 cannot diagnose a disorder. Emotion regulation difficulty occurs across many diagnoses and also outside mental illness.

It cannot show whether a person's response was effective in a specific situation. It asks about reported tendencies rather than observing what happened in real time.

The total also hides different profiles. Two people can receive the same total from different combinations of awareness, clarity, acceptance, goal-directed behavior, impulse control, and perceived strategies.

Profiles can differ.

Use the domain pattern carefully. Three responses per domain provide limited detail.

Evidence and limitations

The original study found that the six-factor structure held across five samples. The DERS-18 totals and subscales were strongly related to their longer DERS-36 counterparts.

Independent clinical research found that the DERS-18, DERS-16, and DERS-SF all performed reasonably well. The full DERS still explained a small additional share of variation in some clinical outcomes.

Shorter is easier. It also means less information.

The Awareness domain deserves particular care because it has behaved less consistently than other DERS domains in several studies. Self-report can also be affected by insight, current mood, language, and willingness to disclose difficulty.

Treat the result as one structured view of emotion regulation, not a complete judgment about the person.