The Difficulties in Emotion Regulation Scale (DERS) is commonly used to assess dimensions of emotion dysregulation, including emotion nonacceptance, limited strategies, and difficulty with goal-directed behavior, impulse control, and emotional clarity. Despite considerable work examining the DERS' factor structure, reliability, and validity, there is limited psychometric support for its use with Black women.(1) Examine the factor structure of the DERS; (2) Compare fit of short-form versions; and (3) Assess whether scores differ based on diagnoses.Sample consisted of Black women (n = 667) recruited in urban, community hospital setting.The DERS-18 correlated traits model without awareness demonstrated the best fit, χ  (80) = 261.09, root mean square error of approximation = 0.06 [0.05, 0.07], comparative fit index = 0.99, Tucker Lewis Index = 0.98, weighted root mean square residual = 0.89. Additionally, those with current diagnoses of posttraumatic stress disorder (PTSD) or major depressive disorder (MDD) reported higher dysregulation (vs. lifetime/no diagnoses). Further, women with comorbid PTSD/MDD reported greater dysregulation (vs. single disorder/no diagnoses).This study provides evidence supporting the model fit, reliability, and validity of the DERS-18 for Black women.