Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review

Substance use patterns and mental health comorbidities in youth with a history of depression or suicidality: Findings from TX-YDSRN

BACKGROUND

There is a robust relationship between depression and substance use in youth, with higher levels of substance use associated with greater depressive symptomatology. However, previous research has examined individual substances, without consideration of psychiatric comorbidities. Here, we investigate patterns of substance use among depressed and/or suicidal youth within the context of psychiatric comorbidities.

METHODS

945 youth with depression and/or suicidality from the Texas Youth Depression and Suicide Research Network (TX-YDSRN) were assessed for current use of alcohol, nicotine, cannabis, and other drugs and comorbid psychiatric diagnoses. We used latent class analysis to identify patterns of past-year substance use, then examined if demographics or psychiatric disorders predicted class membership.

RESULTS

We identified three patterns of substance use: non-use (63.4 %), moderate likelihood of using alcohol, nicotine and cannabis (23.8 %), and high likelihood of using all substances (12.7 %). Compared to non-users, individuals in the moderate and high likelihood classes were more likely to be older. Individuals in the high likelihood class were more likely to have a substance use disorder, ADHD, and higher suicidality scores.

LIMITATIONS

We cannot ascertain the causal or temporal ordering of substance use and psychiatric diagnoses due to the cross-sectional nature of the study.

CONCLUSIONS

Using a brief, self-report measure of substance use, we identified three classes of substance users differing in probability of past-year use, which were predicted by older age and some psychiatric comorbidities. While research on universal screening of substance use in youth remains limited, we discuss who may benefit from such screening among depressed youth.

Emotion regulation mediates the relation between intolerance of uncertainty and emotion difficulties: A longitudinal investigation

Intolerance of uncertainty has been proposed as a transdiagnostic factor in emotional disorders. Despite comprehensive empirical evidence demonstrating the association between intolerance of uncertainty and emotional disorders, the underlying mechanism remains elusive. Drawing on theoretical frameworks and empirical studies, the current study proposed that emotion regulation emerges as a potential mechanism. We explored the connections among intolerance of uncertainty, eight emotion regulation strategies (both adaptive and maladaptive), and emotional difficulties (specifically anxiety and depression) using a three-wave longitudinal approach (N = 341). Our findings revealed that heightened intolerance of uncertainty predicted increased anxiety but not depression over time. Greater intolerance of uncertainty significantly predicted elevated levels of maladaptive emotion regulation strategies including experiential avoidance, thought suppression, rumination, and reassurance-seeking. Adaptive strategies (i.e., mindfulness, cognitive reappraisal, problem-solving) predicted lower anxiety and/or depression whereas maladaptive emotion regulation strategy rumination predicted greater levels of anxiety and depression. Surprisingly, thought suppression predicted lower levels of anxiety and depression. More importantly, our analysis showed that both rumination and thought suppression served as significant mediators in the relationship between intolerance of uncertainty and both anxiety and depression. These results hold implications for future interventions, emphasising rumination and thought suppression as potential targets for interventions aimed at alleviating emotional difficulties in individuals with intolerance of uncertainty.

The role of caregiver emotion regulation in youth mental health during the COVID-19 pandemic: A longitudinal study

The COVID-19 pandemic has presented youth and families with a broad spectrum of unique stressors. Given that adolescents are at increased risk for mental health and emotional difficulties, it is critical to explore family processes that confer resilience for youth in the face of stress. The current study investigated caregiver emotion regulation (ER) as a familial factor contributing to youth ER and risk for psychopathology following stressful life events. In a longitudinal sample of 224 youth (M age = 12.65 years) and their caregivers, we examined whether caregiver and youth engagement in ER strategies early in the pandemic mediated the associations of pandemic-related stress with youth internalizing and externalizing symptoms six months later. Leveraging serial mediation analysis, we demonstrated that caregiver and youth rumination, but not expressive suppression or cognitive reappraisal, mediated the prospective associations of pandemic-related stress with youth internalizing and externalizing symptoms. Greater exposure to pandemic-related stressors was associated with greater caregiver rumination, which, in turn, related to greater rumination in youth, and higher levels of youth internalizing and externalizing symptoms thereafter. Family interventions that target caregiver ER, specifically rumination, may buffer against the consequences of stress on youth engagement in maladaptive ER strategies and risk for psychopathology.

Fears of positive and negative evaluation and their within-person associations with emotion regulation in adolescence: A longitudinal analysis

Fear of positive evaluation (FPE) has recently emerged as an important aspect of social anxiety, alongside fear of negative evaluation. These evaluation fears peak during adolescence, a developmental stage that is also often accompanied by difficulties in emotion regulation, thereby increasing young individuals' vulnerability to mental disorders, such as social anxiety. We aimed to examine the longitudinal within-person associations between fears of evaluation, social anxiety, and three emotion regulation strategies (i.e., acceptance, suppression, rumination) in adolescents. Data were collected from a sample of 684 adolescents through an online survey three times over the course of 6 months and were analyzed using random intercept cross-lagged panel models. At the between-person level, FPE was linked to all three emotion regulation strategies, whereas fear of negative evaluation and social anxiety were associated with acceptance and rumination. At the within-person level, difficulties in accepting emotions predicted FPE, suppression predicted social anxiety, and social anxiety predicted rumination over time. These findings reveal complex interdependencies between emotion regulation, social anxiety, and evaluation fears, both reflecting individual differences and predicting changes within individuals, and further elucidate the developmental trajectory of social anxiety in adolescence.

The reflective function questionnaire for youth: Hungarian adaptation and evaluation of associations with quality of life and psychopathology

An important correlate of mental health problems is mentalizing capacity, which appears to be particularly influential during adolescence. However, quality of life has not been studied in relation to mentalizing capacity among adolescents. This study aimed to translate the Reflective Function Questionnaire for Youth (RFQY) into Hungarian, present its psychometric properties, and assess its relationship with demographic characteristics, psychopathology and quality of life. A community sample of 384 youths aged 12-18 years completed the RFQY, the Measure of Quality of Life for Children and Adolescents, and the Strengths and Difficulties Questionnaire. First, we conducted an exploratory factor analysis with direct oblimin rotation on the RFQY items. Next, we assessed the associations between the RFQY and demographics, quality of life, and psychopathology. The EFA resulted in four factors: Internal-self, Internal-other, Self-other, and Strong emotions. The Cronbach's alpha coefficients of the scales were .81, .82, .67, and .80, respectively. The subscales were uniquely associated with psychopathology and quality of life. Our study provides the first psychometric support for the Hungarian version of the RFQY and indicates that adolescents suffering from internalizing, externalizing symptoms or lower levels of quality of life could benefit from interventions aimed at enhancing mentalizing capacity.

Similarities and Differences in the Architecture of Cognitive Vulnerability to Depressive Symptoms in Black and White American Adolescents: A Network Analysis Study

The hopelessness theory, Beck's cognitive theory, and the response styles theory dominate our understanding and the treatment of depression in adolescents. However, research supporting them is largely based on White individuals. Further, the associations between stressors, cognitive vulnerabilities, and depressive symptoms in Black adolescents are not as one would expect based on the predictions from those theories. Both raise the question of if and to what degree these theories and previous findings can be generalized to Black adolescents. Additionally, without a theoretical basis, clinicians regularly use interventions developed based on one theory to influence vulnerabilities described in another theory. Thus, the purpose of our study was to examine the structure of an integrated cognitive stress-vulnerability model as well as the strengths of associations between stressors, cognitive vulnerabilities, and depressive symptoms in Black and White adolescents. In our study, 295 Black (37% female) and 213 White (49% female) ninth-grade students from a public high school participated. Network analyses demonstrated that the three original cognitive theories of depression can and should be integrated and that each variable we examined is comparably relevant for Black and White adolescents. At the same time, the structure of the two integrated networks differed significantly among Black and White adolescents, exhibiting specific distinctions at four edge levels. Furthermore, the predictability of the network is notably lower for Black adolescents than for White adolescents. Important theoretical and clinical implications can be derived.

Associations Between Parents' Cognitions About Child Anxiety and Emotion Dysregulation in Clinically Anxious Children: The Unique Contribution of Fathers

This study examined the influence of parental cognition, including attitudes, beliefs, and understanding of anxiety, on emotion dysregulation in children with anxiety disorder. A total of 47 clinically anxious children (6-17 years old) and their parents were involved in the current study. The mothers and fathers separately completed a self-reported questionnaire assessing their attitudes, beliefs, and understanding of their children's anxiety, while the children completed a self-report questionnaire assessing emotion dysregulation. Pearson correlation and hierarchical regression analyses were used for data analysis. The results indicated that only fathers' higher levels of unhelpful attitudes, beliefs, and understanding of anxiety were positively and significantly associated with greater emotion regulation (ER) difficulties in anxious children. Furthermore, fathers' unhelpful cognitions regarding anxiety uniquely predicted their children's emotion regulation difficulties. These findings highlight the importance of including fathers in preventive and therapeutic interventions in promoting ER abilities in children with anxiety disorder.

Should Adolescents Listen to Their Hearts? A Closer Look at the Associations Between Interoception, Emotional Awareness and Emotion Regulation in Adolescents

The aim of the current study was to replicate findings from prior work among adults showing that individuals with better interoceptive skills have more emotional awareness, and show better emotion regulation abilities, in a sample of adolescents and by relying on instructions that reduce the contamination of known confound variables. A total of 102 Belgian adolescents (Mage = 14.10 years, SDage = .63; 50 males) completed self-report questionnaires of emotional processes (FEEL-KJ and DERS) and the modified heartbeat counting task. From this task, interoceptive accuracy, interoceptive sensibility (confidence ratings), and interoceptive awareness scores (within-person correlations) were derived per participant. Results revealed no associations between the three dimensions of interoception and adolescents' levels of emotional awareness, adaptive, and maladaptive emotion regulation. The lack of associations which contrast some prior work with adults may be due to developmental differences. However, these might also support the low validity of the heartbeat counting task, or could be attributed to the measurement of the emotion measures (i.e., self-report). Future studies should, nevertheless, also test whether these non-significant results can be explained by the developmental differences in adolescents. Longitudinal research is needed to capture interoceptive changes during adolescence, as well as to replicate the current findings using rigorous multimethod approaches that increase the validity of interoception measurement.

The development of depression and social anxiety symptoms in adolescents and the negative impact of the COVID-19 pandemic and desire for peer contact

Introduction

Adolescence is a dynamic developmental phase in which contact with peers is crucial for socio-emotional development and wellbeing. Depression and social anxiety show patterns of high onset during this period, and more for girls than boys. Here we examine this development among Dutch adolescents, as well as how desire for more peer contact as a result of social distancing measures during the COVID-19 pandemic contributed to this increase.

Methods

We used a longitudinal three-wave design to examine 406 typically developing Dutch adolescents across two consecutive cohorts; Cohort 1: 2016-2019 (N = 138, 53.6% girls, age at T0 M = 13.00, SD = 0.42), Cohort 2: 2017-2020 (N = 268, 63.1% girls, age at T0 M = 13.05, SD = 0.39), final wave during spring 2020 during the first COVID-19 lockdown. Self-report questionnaires were used to measure depression and social anxiety symptoms, desire for change in the amount of peer contact during lockdowns, and emotion regulation. Parallel process dual latent growth models and autoregressive cross-lagged models were used to test the hypotheses.

Results

Results showed that symptoms of both depression and social anxiety increase during adolescence. Gender analysis reveal a higher initial level and increase in depression symptoms for girls, while levels for boys decreased. Adolescents exposed to the pandemic showed a steeper increase in depression but not in social anxiety. Desire for more peer contact was related to an increase in depression and social anxiety, though only in girls. No evidence was found for moderation of emotion regulation skills concerning COVID evoked emotions on the association between desire for peer contact and anxiety and depression symptom development.

Discussion

Symptoms of social anxiety increased during adolescence in boys and girls. Symptoms of depression increased for girls, but decreased for boys. The increase in depression was greater in a cohort who experienced the COVID-19 pandemic. For girls, a desire for more peer contact was associated with an increase of depression and social anxiety symptoms in times of social restrictions.

Daily Associations Between Sleep Parameters and Depressive Symptoms in Individuals with Insomnia: Investigating Emotional Reactivity and Regulation as Mediators

OBJECTIVES

Previous research suggests that insomnia and depressive symptoms might be causally related. Emotional reactivity and regulation have been proposed to explain the potential causal relationship between insomnia and depression. However, longitudinal evaluations of their mediating effects are limited. Hence, the current study aimed to examine the mediating effects of emotional reactivity and regulation on the longitudinal associations between daily sleep parameters and depressive symptoms over 14 days in individuals with insomnia.

METHODS

Participants were sixty adults aged 18-65 who had clinically significant insomnia. They filled out a survey each morning and evening and wore actigraphy watches for 14 consecutive days. The five sleep parameters were measured by sleep diary in the morning survey (subjective total sleep time, subjective sleep efficiency, and sleep quality) and actigraphy watches (objective total sleep time and objective sleep efficiency). Emotional reactivity and emotion regulation strategy use during the day were assessed in the evening survey using the International Positive and Negative Affect Schedule Short Form, Emotion Regulation Questionnaire, and Cognitive Emotion Regulation Questionnaire. Depressive symptoms of the day were evaluated in the evening survey with the Center for Epidemiologic Studies Depression Scale.

RESULTS

Results showed that sleep quality and depressive symptoms, as well as actigraphy-measured sleep efficiency and depressive symptoms, predicted each other in individuals with insomnia, mediated by negative reactivity but not emotion regulation.

CONCLUSIONS

The present findings support the mediating role of negative emotional reactivity in the bidirectional, daily relationship between sleep parameters and depression in individuals with insomnia.

The role of affective control, strategy repertoire and subjective emotion regulation success in developmental internalising psychopathology

Adolescence poses significant challenges for emotion regulation (ER) and is thus a critical phase in the emergence of various mental disorders, specifically internalising disorders such as anxiety and depression. Affective control, defined as the application of cognitive control in affective contexts, is crucial for effective ER. However, the relationship between ER and affective control is unclear. This study examined the predictive role of ER strategies and difficulties in affective control, measured as the congruency effect and error rate on an Emotional Stroop task (EST), in a sample of adolescents and young adults (aged 14-21, M = 17.28, 22% male). It was hypothesised that participants with internalising disorders would show higher congruency effects and error rates on the EST than healthy controls after a psychosocial stress induction, indicating lower affective control. Surprisingly, our findings revealed no significant differences in these measures between the groups. However, higher depression scores were associated with increased EST errors. While ER strategies and difficulties did not predict affective control, exploratory analyses unveiled associations between depression scores and ER strategy repertoire, perceived ER success and the ER strategy Acceptance. These findings underscore the importance of implicit ER facets, particularly perceived ER success and flexibility to change between applied strategies for adolescents and young adults with elevated depressive symptoms.

Reappraisal Mitigates, While COVID-19 Burnout Exacerbates the Impact of Depressive Symptoms on Suicidal Ideation Among Chinese College Students

Background

Suicide is a global public health issue. This study examined the role of COVID-19 burnout and reappraisal in suicidal ideation caused by depressive symptoms among Chinese college students.

Methods

587 students (261 boys, M age = 19.53, SD = 1.42) were assessed using the Short Depression-Happiness Scale (SDHS), Positive and Negative Suicide Ideation (PANSI) inventory, and Emotion Regulation Scale (ERS).

Results

Correlation analysis indicated depressive symptoms were negatively correlated with reappraisal and positively correlated with suicidal ideation and COVID-19 burnout. Reappraisal was negatively correlated with suicidal ideation and COVID-19 burnout. The moderated mediation model showed COVID-19 burnout enhanced the direct effect of depressive symptoms on suicidal ideation and indirectly enhanced this effect by weakening the protective role of reappraisal.

Conclusion

These finding show that reappraisal acts as a protective factor against suicidal ideation in individuals with depressive symptoms, while COVID-19 burnout exacerbates this effect by weakening reappraisal's protective role.

It's a balancing act: The ratio of maladaptive (vs. All) emotion regulation strategies is associated with depression

Research on emotion regulation (ER) has increasingly recognized that people use multiple strategies simultaneously, often referred to as ER repertoire. Prior research found that ER repertoire is associated with psychopathology, but results have been mixed. Indeed, research from recent years suggests that it is the quality of ERs, more than their quantity, that needs to be considered. Based on the combination of the literatures on ER repertoire, polyregulation, and ER flexibility, we propose a novel metric: the ratio of using putatively maladaptive (vs. all) ER strategies. Using this metric, we examine (1) maladaptive ER ratio changes during the transition to adolescence, a developmental period in which the prevalence of depression sharply increases, and (2) whether changes in maladaptive ER ratio are associated with depressive symptoms. One-hundred and thirty-nine youths (baseline age: 8-15) reported ER strategies and depression daily for 21 days. One year later, 115 completed another 28-day daily-diary (Nassessments = 5631). Our results show that almost all youth use at least some maladaptive ERs. Importantly, maladaptive ER ratio decreases over a year of adolescence for most youths. Conversely, an increased maladaptive ER ratio predicted depression increases on the daily and on the yearly level. These results shed light on typical and atypical development of ER flexibility and emphasize the need to consider the balance between ERs in relation to psychopathology.

Approaching Temporal Dynamics in the Dimension-Level Associations Between Career Adaptability/Ambivalence and Internalizing Symptoms Among Chinese Adolescents Throughout Their High Middle School Years

Despite the well-established associations between adolescents' internalizing symptoms and career development, it still remains unclear whether adolescents' internalizing symptoms are precursors or consequences of their career adaptability/ambivalence. Subtler nuance inherent within such association also await to be revealed, because internalizing symptoms and career development have been primarily treated as broad constructs, despite the multifaceted nature of both. To narrow such gaps, this study examined the potentially dynamic associations among career adaptability, career ambivalence, and internalizing symptoms using three-wave longitudinal data. The study collected data from 3196 Chinese adolescents (52.72% girls, mean age = 15.56 years, SD = 0.58) at Wave 1, with 2820 (attrition rate = 11.76%) participating in Wave 2 and 2568 (attrition rate = 8.93%) in Wave 3. The measurement invariance suggested that there were no significant differences across both waves and genders. This study approached associations at both broader construct levels and subtler dimension levels. Results of cross-lagged path models at broader construct levels demonstrated a unidirectional association between internalizing symptoms and career adaptability. Results of models at subtler dimension levels indicated a series of transactional links over time between career adaptability dimensions/ambivalence and depressive symptoms in particular. Career adaptability dimensions and career ambivalence predicted later anxiety symptoms rather than the reverse. Group model comparisons showed no difference across waves and genders. These findings shed light on the dynamic nature of the associations during adolescence between career adaptability/ambivalence and internalizing symptoms, particularly at subtler dimensional levels, which should be considered in relevant clinical and educational practices.

What Emotion Regulation Strategies are Associated with a General Psychopathology Factor (p) in Adolescence? Identifying Possible Transdiagnostic Targets for Intervention

Mental health problems in adolescence are increasing and there is an urgent call for transdiagnostic interventions, as most adolescents experience problems across multiple domains. Research has identified a general psychopathology factor (p) capturing the shared variance across mental health problems. In parallel, there is empirical support for the transdiagnostic nature of emotion regulation. In the current study, we explore the associations between p and emotion regulation strategies to identify which strategies may be promising targets for intervention. Data from the population-based Youth and Mental Health Study (YAMHS) (N = 2,464, mean age 13.7 years, SD 0.6) was used. The fit of different structural models of emotion regulation and psychopathology were compared, and latent factors from the final models were included in multiple regression analyses to explore the associations between p and emotion regulation strategies. A bifactor exploratory structural equation model (B-ESEM) showed best fit for modelling p. For emotion regulation strategies, an ESEM model showed best fit, including Rumination, Reactive Impulsivity, Distraction, Non-Acceptance, Problem Solving, Social Support, and Proactive Behavior. Results showed that a higher score on p was predicted by higher scores on the emotion regulation strategies Rumination (β = .38, p < .001) and Reactive Impulsivity (β = .35, p < .001), and lower scores on Problem Solving (β = -.15, p < .001). The results indicate that Rumination and Reactive Impulsivity have the strongest associations with p and may be promising targets for mental health interventions for adolescents.

The impact of cognitive emotion regulation strategies on math and science anxieties with or without controlling general anxiety

It is well-established that general anxiety associates with the lower use of adaptive emotion regulation and the higher use of maladaptive emotion regulation. However, no study has previously investigated the impact of cognitive emotion regulation on academic anxieties. Using a sample of secondary school students (N = 391), this study examined the impact of cognitive emotion regulation on math and science anxieties. Math anxiety showed stronger correlations with adaptive than maladaptive emotion regulation, whereas general anxiety showed stronger correlations with maladaptive than adaptive emotion regulation. Hierarchical regression analyses showed that math anxiety was associated with the high uses of acceptance, rumination and other-blame and the low uses of positive reappraisal and putting into perspective. However, with controlling science and general anxieties, math anxiety was associated with the high use of rumination and the low use of positive reappraisal. In contrast, science anxiety was associated with the high uses of acceptance and other-blame and the low use of positive reappraisal. Importantly, however, with controlling math and general anxieties, those science anxiety associations did not remain. Accordingly, these results might provide important insights for the specificity, etiology, and intervention of math anxiety.

Momentary autonomic engagement during parent-adolescent conflict: Coping as a moderator of associations with emotions

Regulatory efforts are hypothesized to affect associations between emotions and physiology (i.e., concordance) to facilitate adaptive functioning. Assessing the role of coping on physiological-emotional concordance during ecologically relevant scenarios can elucidate whether concordance can serve as a biomarker of risk or resilience. The present study assessed self-reported coping as a moderator of minute-to-minute associations between autonomic nervous system activity and emotions (i.e., physiological-emotional concordance) in caregivers (N = 97) and adolescents (N = 97; ages 10-15) during a dyadic conflict task. Models included physiological variables (sympathetic, skin conductance level [SCL]; and parasympathetic, respiratory sinus arrhythmia [RSA]) and their interaction (SCL × RSA) as predictors of emotions, with coping variables as moderators. Caregivers' use of primary control coping (e.g., problem solving and emotional expression) and secondary control coping (e.g., cognitive reappraisal and acceptance) use in response to family stress predicted more positive emotional experiences during the laboratory conflict task. Adolescents' use of secondary control coping moderated the SCL-emotion association, such that increases in momentary SCL were associated with more positive emotion ratings for youth reporting higher secondary control coping. For youth who report more adaptive trait-level coping skills, momentary changes in SCL may reflect active engagement and attentiveness to facilitate more positive emotional experiences. Findings advance our understanding of the interrelationships between physiological responses and psychological experiences during relevant, interactive scenarios. Autonomic responses are differentially related to affective states depending on the coping strategies that adolescents employ, suggesting that concordance may be associated with intervention targets (i.e., coping skills).

Transgenerational transmission of psychopathology: when are adaptive emotion regulation strategies protective in children?

BACKGROUND

Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER.

METHODS

Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4-16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires.

RESULTS

Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low.

CONCLUSIONS

The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms.

Violence against parents perpetrated by adolescent siblings of individuals with intellectual disability in South Korea

BACKGROUND

Few studies have focused on the daily hassles among adolescent siblings living with individuals with intellectual disability (IwID) and the resulting conflicts between family members. The pathway from stress (hassles) to adolescents' violent acts has been largely ignored.

OBJECTIVE

This study examined the link between hassles (independent variable) and violence against parents (dependent variable), with aggression as a mediator and social support as a moderator.

PARTICIPANTS

Data were collected from November 2018 to February 2019 in Seoul, Gyeonggi Province, and Incheon City. Participants were 303 adolescent siblings of IwID (male: 47.2 %; female: 52.1 %).

METHODS

Descriptive analysis was conducted using SPSS 24.0 and mediating pathways were determined using SPSS Macro 25.0. To verify the moderating role of social support, the entire sample was divided into two groups based on the mean value of social support and the mediating model was analyzed.

RESULTS

In the low social support group (n = 140), the direct effect was not significant (β = 0.0111, 95 % CI = -0.0044 to 0.0266), but the indirect effect was maintained (β = 0.0096, 95 % CI = 0.0005 to 0.0234). However, in the high support group (n = 118), neither the direct effect (β = 0.0106, 95 % CI = -0.0162 to 0.0373) nor the indirect effect (β = 0.0126, 95 % CI = -0.0013 to 0.0301) was significant. Social support as a moderator was statistically significant compared with different paths in the two-group analysis.

CONCLUSIONS

Counselling interventions are needed to alleviate the link between hassles and adolescent violence against parents through aggression.

Associations between physical activity, affect regulation difficulties, and mental health among Canadian adolescents at two different points of the COVID-19 pandemic

Objective. Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two independent adolescent samples (T1: Summer 2020; T2: Winter 2020/21).

Methods and Measures. Six hundred sixty-two Canadian adolescents (T1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (T2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation difficulties, and measures of anxious and depressive symptoms.

Results. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms through affect dysregulation, but only at T1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both T1 and T2 and had an indirect effect through affect dysregulation and suppression.

Conclusion. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities.

The effects of mindfulness-based techniques on self-rumination, cognitive reappraisal and expressive suppression among patients with major depression: a nursing perspective

Background

Patients with major depressive disorder (MDD) often struggle with adaptive strategies like self-reflection and cognitive reappraisal, relying instead on maladaptive ones like self-rumination and emotional suppression. Mindfulness-based techniques (MBTs) have been identified as a promising complementary psychological intervention for this population.

Aims

To evaluate the effects of MBTs on mindful attention awareness, self-rumination, self-reflection, cognitive reappraisal and expressive suppression in patients with MDD between patients who receive MBTs and those who do not.

Methods

This quasi-experimental research was carried out at the Psychiatric Outpatient Clinics. A representative sample of 120 patients with MDD were randomly recruited to either a study group (n = 60) or a control group (n = 60). The Mindful Attention Awareness Scale (MAAS), The Rumination-Reflection Questionnaire (RRQ) and The Emotion Regulation Questionnaire (ERQ) were utilised to collect data.

Results

After participation in MBTs, the study group had significantly greater improvements in the mean scores of MAAS, RRQ, Cognitive Reappraisal and Expressive Suppression compared to the control group (p < 0.001 each).

Recommendations

The study recommends developing and implementing training programmes for nurses to equip them with the skills and knowledge to effectively deliver MBTs as part of patient care. Conducting longitudinal studies is necessary to assess the sustainability of these improvements.

Connections between Parental Emotion Socialization and Internalizing Problems in Adolescents: Examining the Mediating Role of Emotion Regulation Strategies and Moderating Effect of Gender

To explore the mediating effect of emotion regulation strategies on the correlation between parental emotion socialization and internalizing problems in adolescents, as well as the moderating effect of gender, a questionnaire survey was administered to 1078 junior high school students (Mage = 13.96 ± 1.00). The results revealed that supportive parental emotion socialization was negatively correlated with adolescents internalizing problems, whereas non-supportive parental emotion socialization was positively correlated with such problems. Cognitive reappraisal and expressive suppression strategies functioned as parallel mediators in the relationship between supportive parental emotion socialization and adolescent internalizing problems, while only expressive suppression mediated the correlation between non-supportive emotion socialization and adolescent internalizing problems. Gender did not exhibit a moderating effect on the mediation model. These findings suggest that supportive parental responses to adolescents' negative emotions can reduce the incidence of depression and anxiety by cultivating increased utilization of cognitive reappraisal strategies and decreased reliance on expressive suppression strategies among adolescents, whereas non-supportive responses exacerbate the occurrence of depression and anxiety by promoting greater utilization of expressive suppression strategies. In addition, no significant gender differences were observed in the mediation effects. These findings emphasize the importance of prevention programs focusing on parental emotion socialization in adolescence.

Longitudinal Associations Between Depression, Suicidal Ideation, and Lack of Certainty in Control among Adolescents: Disaggregation of Within-Person and Between-Person Effects

PURPOSE

Depression and suicidal ideation (SI) are common in adolescents. However, the relation between the two is unclear. According to the cognitive model of suicidal behavior and learned helplessness theory, lack of certainty in control (LCC), referring to individuals' deficiency in predictability, certainty, and control of life, may be an important factor linking the two. Thus, the current study aimed to investigate the temporal relation between depression and SI in adolescents and to assess the mediating role of LCC in this relation.

METHODS

A three-wave survey was carried out at intervals of 1 and 1.5 years among 516 adolescents at several middle schools in Sichuan Province, China. The random-intercept cross-lagged panel model was used to examine the temporal relations between depression, SI, and LCC among adolescents, which can effectively distinguish between-person and within-person differences.

RESULTS

The results revealed that depression, SI, and LCC had positive intercorrelations at the between-person level. At the within-person level, early depression predicted subsequent depression and SI via LCC among adolescents. Additionally, early LCC promoted later SI through depression.

DISCUSSION

These findings highlight the mediating role of LCC, clarify the temporal relation between depression and SI, and provide theoretical support for interventions to address depression and suicide.

Coping strategies in young people during the COVID-19 pandemic: rapid review

AIMS AND METHOD

To better understand factors supporting young people's (age <18 years) mental health during pandemic-type conditions, we aimed to identify whether coping strategies adopted during the COVID-19 pandemic could be dichotomised according to manifesting positive or negative psychological outcomes. Medline, EMBASE, CINAHL, PsycINFO, Scopus and ASSIA databases were used to identify empirical studies that examined coping strategies used by young people experiencing psychological challenges during COVID-19.

RESULTS

Twenty-five international studies were included, identifying that coping strategies adopted could be significantly dichotomised according to reducing or exacerbating psychological challenges. Positive coping strategies were proactive and solutions-oriented, whereas negative coping strategies were more avoidant and emotion-oriented.

CLINICAL IMPLICATIONS

An internal locus of control may account for why adolescents exercised more proactive coping compared with their younger counterparts, although parents of younger children may offset the impact of stressors by drawing on a proposed coping framework emphasising proactivity and engagement. This would be an invaluable addition to future pandemic preparedness planning cycles.

Cognitive emotion regulation and learning effectiveness in college students with ADHD symptoms

BACKGROUND

College students with ADHD have difficulties with emotion regulation and have poorer academic skills than peers without ADHD; however, less is known regarding the relation between ADHD symptoms, maladaptive cognitive emotion regulation strategies (CERS), and learning effectiveness.

OBJECTIVES

We examined whether maladaptive CERS predicted learning effectiveness, and whether this relation was moderated by ADHD symptoms.

DESIGN

A cross-sectional online survey.

METHODS

College students (N = 4,183; Mage = 19.24; 70.1% female) at eight universities completed a battery as part of a larger study.

RESULTS

College students in our elevated ADHD group used significantly more maladaptive CERS and performed worse in three domains of learning effectiveness (i.e., Academic Self-Efficacy [ASE], Organization and Attention to Study [OAS], Stress and Time Press [STP]) than college students in our non-ADHD group. Further, ADHD symptoms moderated the relation between maladaptive CERS and OAS, such that individuals with the highest levels of ADHD symptoms were less impacted by maladaptive CERS.

CONCLUSION

Increased use of maladaptive CERS is unique to ADHD rather than lack of adaptive CERS. Also, maladaptive CERS and low ADHD symptoms interact to predict poor OAS. Interventions for college students, regardless of ADHD status, should incorporate emotion regulation components to improve learning effectiveness.

Emotion Regulation Can Effectively Improve Decision-Making Behaviors of Individuals Who Use Methamphetamine

PURPOSE

Negative emotions can cause people to make irrational decisions, and decision-making disorders may lead individuals who use methamphetamine (meth) to relapse. Therefore, the current study was performed to investigate whether emotion regulation (ER) can improve negative emotions and thus improve decision-making behavior of individuals who use meth.

METHOD

Based on the Iowa Gambling Task, a three-factor mixed experimental design was used to examine the effects of cognitive reappraisal and expressive suppression strategies on negative emotions and decision-making behaviors of 157 individuals who use meth.

RESULTS

Cognitive reappraisal and expressive suppression were effective in reducing participants' negative emotions and improving decision-making behaviors. Specifically, two types of ER strategies were effective in improving decision-making abilities of participants with negative emotional distress, and cognitive reappraisal was more effective than expressive suppression.

CONCLUSION

Regarding cognitive reappraisal, female participants showed better decision-making behavior than males, which predicts that females who use meth might be more adept at using cognitive reappraisal. This finding suggests that mental health providers should aid substance users in managing their negative emotions and also pay attention to gender differences during the nursing process. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

An investigation into symptoms of depression and anxiety and emotion regulation among older adolescents from low-income settings in South Africa

INTRODUCTION

Mental health conditions (MHC) among adolescents in low- and middle-income countries, including South Africa, are estimated to be high. Adaptive emotion regulation (ER) skills can protect against MHC among adolescents. In South Africa, there is limited adolescent mental health prevalence data as well as little understanding of the associations between MHC and ER among adolescents. This study aimed to address these gaps by describing the psychosocial characteristics of older South African adolescents from low-income settings as well as investigating associations between depression and anxiety symptoms and ER.

METHODS

We selected 12 schools in collaboration with two NGOs. Learners aged 15-18-years were recruited to complete a tablet-based survey. ER, depression, anxiety, and other psychosocial measures were included. Two multiple linear regression models were used to determine associations between depression symptoms, anxiety symptoms, other psychosocial factors, and ER.

RESULTS

Of the 733 participants from 12 Western Cape schools, 417 (56.90%) screened at risk for clinically significant anxiety symptoms, 423 (57.70%) participants for depression symptoms, 229 (31.40%) participants for PTSD symptoms and 263 (35.90%) for risky alcohol use. Depression and anxiety scores were found to be significantly positively correlated with ER difficulties and adolescents struggled most with identifying and utilizing adaptive ER strategies. The adjusted linear regression model reported that female gender, clinically significant depressive, anxiety, post-traumatic stress symptoms and risky-alcohol use were all significantly associated with poorer ER scores, while self-esteem was significantly associated with better ER scores.

CONCLUSION

These findings contribute to the South African adolescent mental health literature and to the research gap on the links between depression and anxiety and ER. Future research should consider further exploration of the relationships between psychosocial factors and ER to inform the urgent development and testing of appropriate adolescent interventions in this setting.

Internet-based emotion regulation training aimed at reducing violent revictimization and depressive symptoms in victimized depressed patients: Results of a randomized controlled trial

BACKGROUND

Depressed patients who have become victim of violence are prone to revictimization. However, no evidence-based interventions aimed at reducing revictimization in this group exist.

METHODS

This multicenter randomized controlled trial evaluated the effectiveness of an internet-based emotion regulation training (iERT) added to TAU in reducing revictimization, emotion dysregulation, and depressive symptoms in recently victimized, depressed patients compared to TAU alone. Adult outpatients (N = 153) with a depressive disorder who had experienced threat, physical assault, or sexual assault within the previous three years were randomly allocated to TAU+iERT (n = 74) or TAU (n = 79). TAU involved psychotherapy (mainly cognitive behavioral therapy [77.8 %]). iERT comprised six guided online sessions focused on the acquisition of adaptive emotion regulation skills. The primary outcome measure was the number of revictimization incidents at 12 months after baseline, measured with the Safety Monitor. Analyses were performed according to the intention-to-treat principle.

RESULTS

Both groups showed a large decrease in victimization incidents. Mixed-model negative binomial regression analyses showed that TAU+iERT was not effective in reducing revictimization compared to TAU (IRR = 0.97; 95%CI = 0.64,1.46; p = .886). Linear mixed-model analyses demonstrated that TAU+iERT yielded a larger reduction of emotion dysregulation (B = -7.217; p = .046; Cohens d = 0.33), but not depressive symptoms (B = -1.041; p = .607) than TAU.

LIMITATIONS

The study was underpowered to detect small treatment effects. Additionally, uptake of iERT was quite low.

CONCLUSIONS

Although TAU+iERT resulted in a larger decrease of emotion dysregulation than TAU alone, it was not effective in reducing revictimization and depressive symptoms. Patients' revictimization risk substantially decreased during psychotherapy.

Enhancing Emotion Regulation Skills in High-Risk Adolescents Due to the Existence of Psychopathology in the Family: Feasibility and Uncontrolled Pilot Study of a Group Intervention in a Naturalistic School Setting

BACKGROUND

Emotion regulation skills form part of many interventions for youth with internalizing and externalizing difficulties. This pilot study examines a prevention program delivered at school to improve adolescents' emotion regulation skills, focusing on those at risk for mental health problems.

METHODS

Adolescents 12-18 years old were referred to a six-session group program by their school counselors, based on inclusion criteria related to family sociodemographic and mental health characteristics. Group sessions took place during school hours to facilitate participation and reduce dropout. The intervention targeted emotion regulation skills, drawing from central components of different cognitive behavioral approaches. To assess clinical outcomes, participants answered questionnaires before and after the program, which covered emotion regulation strategies, addictive behaviors, and internalizing and externalizing symptoms. The acceptability of the program was also assessed.

RESULTS

Emotion regulation skills improved after the program, and there was a significant reduction in internalizing and externalizing problems. The program was evaluated as useful by participants. Counsellors reported satisfaction with the program.

CONCLUSIONS

Targeted emotion regulation skills training is a potentially useful transdiagnostic intervention to prevent mental health problems in youth. Bringing the intervention to the school setting and involving counsellors in referring at-risk students can facilitate uptake and reduce dropout.

Gamified Assessment of the Emotion Regulation Abilities in Youth: Validation of the REThink Online System

Objective: Emotional problems in the youth population are a major issue that can have a significant negative impact for their future development as adults. Their emotion regulation (ER) abilities represent a preventive measure for those emotional problems. REThink is an online therapeutic game that was proved to be effective in rigorous studies, and is based on the rational emotive behavioral therapy, with seven levels built to train various emotional regulation skills. Each level has a section that can be used for the assessment of the targeted skills within the level. The present study aimed at investigating the reliability and validity of the evaluation modules from the REThink game regarding the assessment of ER abilities in children/adolescents. Methods: In accordance with established guidelines, 110 children and adolescents aged 8-14 years old were recruited. Following parental informed consent, the participants filled out the standard questionnaires and, subsequently, they played the evaluation module of the REThink game. The reliability aspect was investigated by evaluating internal consistency, while validity was evaluated by using concurrent and predictive validity analyses. Results: The results revealed statistically significant positive associations between the game scores obtained by the participants and the emotion regulation scale. In terms of predictive validity, there were significant negative associations between game scores and the presence of emotional and behavioral problems. Moreover, in terms of the reliability of the REThink game, an acceptable value for the internal consistency was observed. Conclusion: In conclusion, the REThink therapeutic game was proved to be a valid measure for assessing emotion regulation abilities in children and adolescents. Clinical Trial Registration No. NCT04788901.

Longitudinal prediction of primary school children's COVID-related future anxiety in the second year of the pandemic in Germany

Although research has confirmed that the first COVID-19-related lockdown has increased stress and mental health problems in children, less is known about the longer-term effects of the pandemic on children's COVID-related future anxiety (CRFA). Because of CRFA's potentially debilitating effects, risk and resilience factors against this anxiety were investigated. To this end, n = 140 children (49% female) in 3rd and 4th grade classrooms in Germany were asked to perform a working memory task and to self-report about their CRFA and emotion regulation in December 2020 and in May 2021. More maladaptive emotion regulation in December 2020 contributed to the explanation of a high CRFA score in May 2021, whereas a better performance on working memory updating contributed a lower CRFA score later when controls were in place. These results were confirmed when children's CRFA in December 2020 was included in the prediction of their later CRFA. They suggest that maladaptive strategies of emotion regulation, such as rumination, may explain higher or increasing levels of CRFA, whereas efficient working memory updating may be an indicator of processing information in a way which shields children from CRFA-related thoughts. The concepts underlying these variables should be included in prevention and intervention efforts.

To reappraise or not to reappraise? Emotion regulation strategies moderate the association of loneliness during COVID-19 with depression and anxiety

BACKGROUND

The COVID-19 pandemic resulted in heightened feelings of loneliness due to lockouts and social restrictions.

OBJECTIVE

In the present study, we examined the association of loneliness during the pandemic with anxiety and depression, while exploring the moderating role of the tendency to use two emotion-regulation strategies (expressive suppression, cognitive reappraisal).

DESIGN

We chose to examine these associations in a sample of older adults, because they faced higher risk for loneliness and health problems during the COVID-19 pandemic.

METHODS

Specifically, 174 Israeli veterans and ex-prisoners of wars from the 1973 Yom Kippur war (mean age = 69) completed self-report scales tapping loneliness, depression, anxiety, and emotion regulation strategies at the beginning of the COVID-19 outbreak (April-May 2020).

RESULTS

Findings revealed a stronger association between loneliness and depression among participants who had a greater tendency of using suppression. The tendency to use suppression did not significantly moderate the link between loneliness and anxiety. Additionally, a weaker association between loneliness and depression was found among participants who has a greater tendency of using reappraisal. However, these participants showed a stronger association between loneliness and anxiety.

CONCLUSIONS

These findings highlight the complexity of reappraisal and adds to the growing body of work on emotion regulation.

Longitudinal relationships across emotional distress, perceived emotion regulation, and social connections during early adolescence: A developmental cascades investigation

Early adolescence is a vulnerable period for emotional distress. Both emotion regulation and social connection to peers and family adults are understood to be associated with distress. However, existing longitudinal work has not explored these constructs jointly in a way that estimates their reciprocal relationships over adolescence. We present a three-wave random-intercepts cross-lagged panel model of reciprocal relationships between emotional distress, perceived emotion regulation, and social connections during early adolescence, among 15,864 participants from education settings in disadvantaged areas of England, over three annual waves (at ages 11/12, 12/13, and 13/14 years). Findings showed that emotional distress and perceived emotion regulation share a negative relationship over time, and that higher perceived emotion regulation predicts greater family connection in the initial stages of early adolescence (from age 11-12 to 12-13 years). Findings also indicated that connection to peers is positively associated with family connection, but also positively predicts slightly greater distress in the later stages of early adolescence (from age 12-13 to 13-14 years). Findings indicate a risk of negative spiral between emotional distress and perceived emotion regulation in early adolescence, and that social connection may not necessarily play the role we might expect in reducing distress.

Effect of emotional stimulus on response inhibition in people with mild cognitive impairment: an event-related potential study

Background

A few studies are emerging to explore the issue of how aging promotes emotional response inhibition. However, there is a lack of empirical study concerning the impact of pathological cognitive impairment on emotional response inhibition. The present study investigated the effect of emotion on response inhibition in people with mild cognitive impairment, the stage of cognitive impairment before dementia.

Methods

We used two emotional stop-signal tasks to explore whether the dual competition framework considering limited cognitive resources could explain the relationship between emotion and response inhibition in mild cognitive impairment.

Results

The results showed that negative emotions prolonged N2 latency. The Go trial accuracy was reduced in the high-arousal negative conditions and the stop-signal reaction time was prolonged under high-arousal conditions. This study also verified impaired response inhibition in mild cognitive impairment and found that negative emotions prolonged P3 latency in mild cognitive impairment.

Conclusion

Emotional information interferes with response inhibition in mild cognitive impairment populations, possibly because emotional information captures more attentional resources, thus interfering with response inhibition that relies on common-pool resources.

Empathy and psychopathology in children and adolescents: the role of parental mental illness and emotion regulation

Objective

Although empathy is known to be a strength, recent studies suggest that empathy can be a risk factor for psychopathology under certain conditions in children. This study examines parental mental illness as such a condition. Further, it aims to investigate whether maladaptive emotion regulation (ER) mediates the relationship between empathy and psychopathological symptoms of children.

Methods

Participants were 100 children of parents with a mental illness (55% female) and 87 children of parents without a mental illness (50% female) aged 6 - 16 years and their parents.

Results

Greater cognitive empathy was related to more psychopathological symptoms in COPMI, but not in COPWMI. In addition, in COPMI maladaptive ER mediated this relationship. In contrast, greater affective empathy was associated with more psychopathological symptoms regardless of whether parents had a mental illness.

Conclusion

Our findings highlight the importance of implementing preventive programs for COPMI that specifically target the reduction of maladaptive ER.

Parenting and Emotional and Behavioral Difficulties in a General Population Sample of Adolescents: The Mediating Role of Emotional Dysregulation

Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.

Emotional competencies and psychological distress: Is loneliness a mediating factor?

Emotional competencies, such as emotion regulation and empathy, are essential for social interaction. Impairment of these skills has been associated with increased rates of anxiety/depressive symptoms and loneliness, which has been defined as the discrepancy between the desired and actual quality and quantity of social relationships a person maintains. The aim of the present study was to shed light on the associations between these constructs and to examine the possible mediating role of loneliness in the relationship between emotional competencies and anxiety/depressive symptoms in a sample of non-clinical individuals. A total of 298 participants were recruited for this study and were asked to complete a series of measures assessing difficulties in emotion regulation, empathy, loneliness, and anxiety/depressive symptoms. Regression and mediation models were tested to analyze the associations between these variables. Results showed that reduced emotional competencies in emotion regulation and empathy were both directly and indirectly associated with increased anxiety/depressive symptoms and emotional loneliness, which in turn was related to higher levels of psychological distress (with a partial mediation of loneliness). Overall, the present findings seem to indicate that emotional competencies play a key role in the experience of loneliness and psychological distress. Therefore, individuals reporting high levels of loneliness in combination with anxious/depressive symptoms should receive appropriate assessment and treatment of emotion regulation and empathic skills.

Internalizing and Externalizing Symptoms Moderate the Relationship Between Emotion Dysregulation and Suicide Ideation in Adolescents

The relationship between emotion dysregulation and suicide ideation may depend on the level of internalizing and externalizing symptoms. It was expected that both internalizing and externalizing symptoms would moderate the relationship between emotion dysregulation and suicide ideation, such that greater symptoms would strengthen the relationship between emotion dysregulation and suicide ideation. Adolescent participants (n = 559, Mage = 15.40, 85.0% white, 57.2% female) completed self-report measures that assessed emotion dysregulation, internalizing and externalizing symptoms, and recent suicide ideation. Both internalizing and externalizing symptoms moderated the relationship between emotion dysregulation and suicide ideation; this relationship strengthened as internalizing and externalizing symptoms increased. The results of this study indicate that internalizing and externalizing symptoms may both affect the connection between emotion dysregulation and suicide ideation. Future research should focus on targeting both internalizing and externalizing symptoms in treatment to help reduce emotion dysregulation and suicide ideation in adolescents.

The Role of Emotion Regulation Strategies in the Relationship Between Temperament and Depression in Preadolescents

This study explored the relationship between temperament-i.e., negative affectivity (NA) and effortful control (EC)-and depression in preadolescents, considering emotion regulation (ER) strategies as mediating mechanisms in this relationship. We examined data from 535 children aged 8-12 years (M ± SD = 10.01 ± 1.42) who completed self-report measures related to NA, EC, ER strategies, depressive symptoms, and depressive mood. The results demonstrated that NA was significantly positively related to both depressive symptoms and depressive mood, while EC was significantly negatively related to both depressive symptoms and depressive mood. The structural equation model of latent variable analysis showed that cognitive reappraisal mediated the relationship between NA and depressive symptoms and depressive mood. Moreover, cognitive reappraisal was also identified as a mediator of the association between EC and depressive symptoms and depressive mood. However, expressive suppression only mediated the relationship between NA and depressive symptoms. Interventions aimed at ER strategies would be an effective program for preadolescents with depression and further improve preadolescents' social-emotional development.

Reductions in Anxiety are Associated with Decreased Expressive Suppression and Increased Cognitive Reappraisal After Cognitive-Behavioral Treatment: A Naturalistic Study in Youth

Broad deficits in emotion regulation skills have been observed in children with anxiety-related disorders. These deficits typically improve during cognitive-behavioral therapy (CBT), but few studies have examined changes in expressive suppression and cognitive reappraisal in youth with anxiety disorders and/or obsessive-compulsive disorder (OCD) during CBT, especially in real-world settings. In a naturalistic treatment-seeking sample, 123 youth completed measures of anxiety, depression, and emotion regulation strategy use before and after 15 sessions of CBT. For anxious youth, anxiety and expressive suppression decreased over treatment, while cognitive reappraisal increased. Reductions in expressive suppression and increases in cognitive reappraisal were significantly associated with improvements in anxiety and remained significantly associated with post-treatment anxiety after accounting for baseline anxiety and depression. Changes in expressive suppression and cognitive reappraisal over the course of treatment were not found for youth with primary OCD. Thus, CBT improves emotion regulation abilities in anxious youth, and these improvements are associated with anxiety reduction; improvements in emotion regulation do not appear to drive changes in OCD symptoms. Further research is needed to determine whether changes in emotion regulation strategies mediate changes in anxiety among youth receiving CBT.

Depressive symptoms in early adolescence: the dynamic interplay between emotion regulation and affective flexibility

Individual differences in affective flexibility may be an important factor in understanding how emotion regulation is associated with adolescents’ depressive symptoms. The current study explored the role of affective flexibility as a moderator in the relationship between the use of both adaptive and maladaptive emotion regulation strategies and depressive symptoms in 65 young adolescents (11–13 years). Affective flexibility was indicated by the reaction time and accuracy index on the Emotional Flexible Items Selection Task. Emotion regulation strategies and depressive symptoms were assessed by the use of self-report questionnaires. Contrary to the hypotheses, affective flexibility did not moderate the relationship between emotion regulation and adolescents’ depressive symptoms. Instead, only a direct effect of the use of adaptive emotion regulations strategies on adolescents’ depressive symptoms was found. Additionally, post-hoc analyses revealed that there may exist an indirect relationship between affective flexibility and adolescents’ depressive symptoms through the use of adaptive emotion regulation strategies. These findings help to formulate a better understanding of how emotion regulation and affective flexibility in early adolescents are related to depressive symptoms.

In the anticipation of threat: Neural regulatory activity indicated by delta-beta correlation and its relation to anxiety

The anticipation of oncoming threats is emotionally challenging and related to anxiety. The current study aimed to investigate the neural regulatory processes during the anticipatory preparations in stressful situations in relation to trait anxiety, especially in an uncertainty-related stressful situation. To this end, we measured within-subjects delta-beta amplitude-amplitude correlation (AAC) and phase-amplitude coupling (PAC) with electroencephalography using a well-defined stress-inducing paradigm in 28 high-trait-anxiety (HTA) and 29 low-trait-anxiety (LTA) college students. Specifically, a threat probability task was conducted, where participants anticipated the future stimuli under the uncertain (i.e., an average of 50% electric shocks), certain (i.e., 100% electric shocks) and no threat conditions, as well as a resting state task. Results showed a generally larger delta-beta AAC in the LTA group relative to the HTA group across conditions, supporting the hypothesis that delta-beta AAC reflects the efficiency of stress regulation and trait anxiety could compromise this adaptive regulatory activity. Furthermore, a larger delta-beta PAC was found under the uncertain threat condition relative to the no threat condition, indicating the sensitivity of delta-beta PAC in reflecting state anxiety. These findings indicate that while delta-beta AAC is more related to trait anxiety and could distinguish between high and low trait anxiety irrespective of conditions, delta-beta PAC is more related to state anxiety and is sensitive enough to detect the uncertainty-related anxious state.

Hypnosis with depressed children and teens: Building skills, creating connection

Depression in children and teens has been on the rise for several years. Recent increases in anxiety and loneliness, both contributors to the development of depression, are putting more young people at risk for chronic and comorbid mental health struggles. The use of hypnosis with depressed children offers the opportunity to target the identified skills depressed and anxious children need and is a modality clinicians should embrace. This article describes how to create hypnotic interventions focusing on improved emotional and cognitive management, better sleep, and the ability to make positive social connections. Such interventions serve to not only build the resources depressed children need for recovery, but also support a paradigm shift toward prevention in children and families.

Childhood Maltreatment and Non-Suicidal Self-Injury in Adolescents: Testing a Moderated Mediating Model

There is a wealth of evidence to suggest that childhood maltreatment is a major risk factor contributing to non-suicidal self-injury (NSSI) among adolescents. However, how and under what conditions childhood maltreatment is related to NSSI remains largely unclear. This study examined the indirect effect of depressive symptoms in the relation between childhood maltreatment and non-suicidal self-injury, as well as the moderating role of cognitive reappraisal and emotion reactivity in those associations. A sample of 1,984 Chinese adolescents (Mage = 12.84, SD = 1.27, 47.9% girls) completed self-report questionnaires. The results of path analysis showed that childhood maltreatment was significantly related to NSSI and that depressive symptoms play an indirect effect in the relation between them. Cognitive reappraisal mitigated the effect of childhood maltreatment on depressive symptoms, and emotion reactivity strengthened the effect of depressive symptoms on non-suicidal self-injury. The results further showed that the indirect effect of depressive symptoms was more prominent for youths with lower levels of cognitive reappraisal and greater emotion reactivity. Interventions that enhance cognitive reappraisal and reduce emotion reactivity may interrupt the pathway from childhood maltreatment to NSSI via depressive symptoms.

Research Review: Child emotion regulation mediates the association between family factors and internalizing symptoms in children and adolescents - a meta-analysis

BACKGROUND

Parental influence on children's internalizing symptoms has been well established; however, little is known about the underlying mechanisms. One possible mechanism is child emotion regulation given evidence (a) of its associations with internalizing symptoms and (b) that the development of emotion regulation during childhood and adolescence is influenced by aspects of the family environment. This meta-analysis aimed to systematically investigate the mediating role of child emotion regulation in the relationship between various family factors and internalizing symptoms in children and adolescents.

METHODS

We searched Medline, Embase, PsychInfo, and Web of Science for English articles up until November 2022. We included studies that examined child emotion regulation as a mediator between a family factor and child/adolescent internalizing symptoms. Random-effects models were used to calculate pooled indirect effects and total effects for nine family factors. Heterogeneity and mediation ratio were also calculated.

RESULTS

Of 49 studies with 24,524 participants in this meta-analysis, family factors for which emotion regulation mediated the association with child/adolescent internalizing symptoms included: unsupportive emotion socialization, psychological control, secure attachment, aversiveness, family conflict, parent emotion regulation and parent psychopathology, but not supportive emotion socialization and behavioral control.

CONCLUSIONS

Various family factors impact children's emotion regulation development, and in turn, contribute to the risk of internalizing symptoms in young people. Findings from this study highlight the need for interventions targeting modifiable parenting behaviors to promote healthy emotion regulation and better mental health in children and adolescents.

Adolescents' Emotion Regulation Strategies Questionnaire-Extended: Further Development and Associations With Mental Health Problems in Adolescence

Emotion regulation (ER) is implicated in a range of psychopathologies and behavioral problems that are prevalent or have their initial onset in adolescence. In this study, we aim to evaluate the psychometric properties (factor structure, internal consistency, and construct validity) of the Adolescents' Emotion Regulation Strategies Questionnaire-Extended (AERSQ-E), a modified and extended version of an ER instrument developed by Zhou et al. Across six sub-studies using data from different Swedish adolescent community samples (1,104 students in total), we generated and validated a 23-item version containing six subscales: rumination/negative thinking, positive reorientation, creative expression, aggressive outlet, social support, and distraction. Assessing test-retest reliability, internal consistency, measurement invariance as well as convergent and discriminant validity, we could establish, with some limitations, the general reliability and validity of the AERSQ-E as a valid measure of ER strategies for use in adolescence.

Longitudinal associations between response-style strategies and abnormal eating behaviors/attitudes in adolescents: a cross-lagged panel model

BACKGROUND

Previous studies have suggested that response-style strategies (rumination, problem-solving, and distraction) can be risk or protective factors for the development of abnormal eating behaviors/attitudes (AEB) during adolescence. However, due to limited empirical data regarding the prospective effects of these strategies on AEB, further research is needed to clarify their role in developing AEB in adolescence.

METHODS

This study investigated the one-year lagged effects of response-style strategies on AEB in 24,883 fourth- to eighth-grade students in Japan between 2015 and 2019 using a cross-lagged panel model. Depressive symptoms and body mass index (BMI), which are reported to relate to AEB, were also included in the analytic model. The students self-reported their levels of response-style strategies, AEB, and depressive symptoms. We also evaluated BMI based on teachers' reports.

RESULTS

We found that greater rumination significantly predicted more severe AEB in the following year among students from all grades, with small to moderate effect sizes. In addition, distraction significantly predicted more severe binge eating/purging behaviors, but with very weak small effect sizes. Problem-solving did not predict any level of AEB. Furthermore, we observed significant reciprocal relationships between response-style strategies, AEB, and depressive symptoms. Positive reciprocal associations between BMI and AEB were also found except for some intervals.

CONCLUSIONS

We concluded that a decrease in rumination is critical to alleviating mental health problems, such as AEB and depressive symptoms, during adolescence. This suggests that interventions to reduce the level of rumination should be conducted in the early stages of adolescence.

TRIAL REGISTRATION NUMBER

Not Applicable.

The association between family functioning and problem behaviors among Chinese preschool left-behind children: the chain mediating effect of emotion regulation and psychological resilience

Objective

The family environment has a significant impact on the psychological and behavioral development of children, especially those who are left behind in preschool and experience parent-child separation at a young age. These children face a greater risk of family dysfunction, which can lead to internalizing and externalizing problem behaviors. While numerous studies have established a connection between family functioning and problem behaviors, few have explored the underlying mechanisms driving this relationship. Our study seeks to address this gap by examining how emotion regulation and psychological resilience mediate the link between family functioning and problem behavior.

Methods

The sample consisted of 940 preschool children (51.5% male, 48.5% female) with a mean age of 5.07 ± 0.80. The main guardians of the children were given the Family Assessment Device, Preschool Children's Emotion Regulation Scale, the Devereux Early Childhood Assessment for Preschoolers (2nd edition), and the Social Skills Improvement System-Rating Scales to assess their family functioning, emotion regulation, psychological resilience, and problem behavior respectively.

Results

Lower family functioning was associated with more severe problem behaviors in preschool left-behind children, and emotion regulation and psychological resilience partially mediated the relationship between family functioning and problem behaviors, respectively. In addition, emotion regulation and psychological resilience were also chain mediators between family functioning and problem behaviors.

Conclusion

The study's findings highlighted the crucial role of emotional regulation and psychological resilience in the correlation between family functioning and problem behaviors. It is recommended that policymakers and educators place a high priority on the cultivation of internal psychological resources, such as emotional regulation and resilience, in preschool-aged children when designing interventions to address problem behaviors.

Glow up: does a professional photoshoot intervention affect self-esteem and emotions among adolescent psychiatric patients?-A longitudinal intervention study

Background

Today, online communication is shaped by a billion-dollar social media (SM) and social networking site (SNS) industry. Visual content consumed by children and adolescents has been shown to influence behavioral patterns, state emotions, and self-esteem (SE). In this study, we introduced a novel intervention creating visual content through a professional photoshoot and investigated its impact on state emotions and SE in child and adolescent psychiatric (CAP) patients.

Methods

Standardized and validated self-rating questionnaires were used to assess SE, state emotions, coping mechanisms, psychopathological symptoms, and internet use behavior at baseline. SE and state emotions were monitored at different time points around a professional photoshoot within 45 CAP patients (30 female patients; mean age, 15.1 years) using a longitudinal design.

Results

Within-subject repeated-measures ANOVA and bootstrapped paired-sample t-tests showed a significant fluctuation in state emotions and SE throughout the intervention. Spearman correlations and univariate logistic regressions revealed that internalizing symptomatology and maladaptive coping significantly worsened the outcome of the intervention on state emotions and SE in girls. Internet-related variables heightened the positive effect of the intervention in boys and lowered SE in girls during the intervention.

Conclusion

The photo intervention had various gender-specific effects. Boys did benefit from the intervention in terms of longitudinal outcome on positive state emotions (PE) and SE, even positively influenced by SNS and SM. Thus, it might be concluded that online social comparison was processed more beneficial in boys. In contrast, when working with visual content in girls, psychopathology and coping must be considered. Internet consumption in general, especially SM and SNS, was related to low SE in girls. Nevertheless, when therapeutically accompanied, the "glow up moment" during the shoot (high on PE and SE; low on negative state emotions) could be used as an index moment for therapeutic reflection.

Real-world flexibility in adolescent girls' emotion regulation strategy selection: An investigation of strategy switching

Adolescence is an important stage for the development of emotion regulation skills, especially for adolescent girls who are at elevated risk for the development of depression and anxiety. Although some emotion regulation strategies are more effective at helping adolescents regulate negative affect on average, research indicates strategy effectiveness varies with the context in which a strategy is deployed. Yet less work has been done examining which contextual factors are associated with adolescents switching emotion regulation strategies in their daily lives. This study examined individual and contextual factors related to negative interpersonal events that are associated with strategy effectiveness, including age, emotional intensity, perceived controllability, and co-regulatory support, and their association with adolescent emotion regulation strategy switching in daily life via ecological momentary assessment. Results indicated that adolescent girls differed in the degree to which they altered their emotion regulation strategies throughout their daily lives, and that switching strategies was associated with age as well as individual and within-person differences in perceived controllability, emotional intensity, and co-regulatory support. This study provides critical proof-of-concept of the utility of emotion regulation strategy switching as a measure of regulatory flexibility and highlights regulatory processes that may hold clues to the mechanisms of developmental psychopathology.