Emotional dysregulation is a transdiagnostic formulation mechanism that can amplify impulsivity, interpersonal rupture, avoidance, and risk.
AffectBehaviourInterpersonal+1
Shame often links trauma, attachment threat, avoidance, concealment, anger, self-criticism, and disengagement from care.
AffectTraumaAttachment+1
Difficulty understanding, modulating, tolerating or recovering from affect in a particular context, with relevant functional or interpersonal consequences. Specify which part is difficult. “Dysregulation” is not an explanation of its own cause.
Painful negative evaluation of the self, often involving felt exposure or anticipated devaluation. Distinguish this from guilt about an action, while allowing overlap.
Candidate maintaining process, to be tested in the individual case: trigger → escalating affect → impulsive action or withdrawal → short-term change in distress → conflict, shame or restriction. Strategy–symptom associations vary and do not establish a single aetiology.
Candidate maintaining process, to be tested in the individual case: perceived exposure → shame → concealment, withdrawal or self-attack → reduced access to support or further negative self-evaluation. Do not infer this sequence solely from quietness, substance use or self-harm.
Rapid affect shifts · Impulsive coping
Downcast gaze · Concealment
“It goes from zero to one hundred”
“There is something wrong with me”
Trigger -> intense emotion -> urgent behaviour -> consequences -> shame or threat -> further dysregulation
Exposure -> shame -> hiding or attack -> isolation or rupture -> shame intensifies
Increase pause, labelling, and tolerable regulation options before action urges dominate.
Reduce concealment and self-attack while building tolerable interpersonal safety.
Mood shifts are better explained by episodic mania, delirium, intoxication, or seizure activity.
The primary affect is guilt about a specific harm with intact self-worth.