Emotion Regulation Difficulties and Coping Strategies in Substance Use Disorders: Effects of Severity, Impulsivity, and Social Support in a Clinical Sample

(1) Background. Substance use disorders are frequently associated with difficulties in emotion regulation and the use of ineffective coping strategies. (2) Methods. A total of 201 participants undergoing specialized treatment for substance use disorders in Romania completed the Difficulties in Emotion Regulation Scale (DERS) and the Strategic Approach to Coping Scale (SACS). Statistical analyses included independent samples t-tests, Pearson correlations, path analysis, and linear regression. (3) Results. Participants with more severe substance use (history of hospitalization, detoxification treatment, and polysubstance use) exhibited significantly higher levels of emotion regulation difficulties. The latent factor DIFFICULTY was predicted by two correlated SACS predictors: Assertive Action (AA) and Antisocial Action (AS). Substance type differentially influenced DERS dimensions. The strongest correlation with the total DERS score was observed for antisocial action. (4) Conclusions. Emotion regulation and coping optimization are key targets in the treatment of substance use disorders, reflecting persistent difficulties in effectively managing emotions despite cognitive awareness. Social support may function as both an adaptive and maladaptive mechanism in this clinical context.