The longitudinal relationship between emotion awareness and internalising symptoms during late childhood

Parental criticism affects adolescents' mood and ruminative state: Self-perception appears to influence their mood response

Feeling and/or being criticized is a known risk factor for various psychiatric disorders in adolescents. However, the link between the experience of social stressors and the development of psychopathological symptoms is not yet fully understood. Identifying which adolescent subgroups are more vulnerable to parental criticism could be of great clinical relevance. In this study, 90 nondepressed 14- to 17-year-old adolescents were exposed to a sequence of auditory segments with a positive, neutral, and finally negative valence, mirroring parental criticism. Their mood and ruminative states were assessed before and after exposure to criticism. We observed an overall increase in mood disturbance and ruminative thoughts. Self-perception appeared to influence these mood changes, whereas no significant influence by perceived criticism, self-worth, or the general tendency to ruminate was found. Emotional awareness seemed to account for some of the variance in positive mood state changes. These findings point to the importance of adolescent self-perception (and emotional awareness) in dealing with parental criticism.

Emotion regulation as a mediator on the relationship between emotional awareness and depression in elementary school students

As a cognitive skill, emotional awareness plays a fundamental role in emotional intelligence and significant effect on the development of individuals’ social adaptation. However, the role of emotional awareness in children’s social adaptation, especially emotional development, remains unclear, the current study sought to determine the significant influence of emotional awareness in children’s emotional development. By using cross-sectional and longitudinal study designs, the current study explored the relationship between emotional awareness and children’s depression, as well as the mediation effect of emotion regulation on this relationship. The sample comprised 166 Chinese elementary school students (89 girls and 77 boys) ranging from 8 to 12 years old. After adjusting for demographic variables (gender, grade, etc.), the results showed that children with high emotional awareness were less likely to adopt expressive suppression as an emotion regulation strategy and had lower depression levels currently and in the future. In contrast, children with low emotional awareness were more likely to use suppression strategies and showed higher depression levels. Thus, the results indicated that emotional awareness could predict children’s current and future depression status. Meanwhile, emotional regulation strategies are an important mediating variable explaining the relationship between emotional awareness and children’s depression. Implications and limitations were also discussed.

The interplay between expressive suppression, emotional self-efficacy and internalizing behavior in middle adolescence

Background

Maladaptive emotion regulation strategies are predictive of negative outcomes in adolescence which, in turn, may impact on later well-being.

Objective

The current study aimed at testing the moderating role of emotional self-efficacy on the relation between expressive suppression and the engagement in internalizing behavior, controlling for gender effect.

Method

A total of 526 adolescents (Mage = 14.7 years, age range = 14–17 years) filled out self-report questionnaires evaluating expressive suppression, emotional regulatory self-efficacy, and internalizing behavior, respectively.

Results

Suppressors with lower positive emotion self-efficacy were more likely to engage in internalizing behavior than suppressors with higher positive emotion self-efficacy.

Conclusions

Despite several limitations, the study provided preliminary insights on the role played by emotional self-efficacy in the relation between expressive suppression and internalizing behavior in middle adolescence.

The Bifactor Structure of the Emotion Expression Scale for Children in a Sample of School-Aged Portuguese Children

The Emotion Expression Scale for Children (EESC) is a 16-item self-report questionnaire assessing children's difficulties in emotion expression (i.e., poor emotion awareness and reluctance to express emotions). Considering the inconsistent findings regarding its factorial structure and dimensionality, this study aims to explore the factor structure and psychometric properties of the EESC in a sample of 286 Portuguese children (8-12 years). Three competing models were analyzed through confirmatory factor analysis (correlated two-factor model, one-factor model, and bifactor model). The bifactor model provided a better fit than the competing models, and the results suggested a strong general factor of "difficulties in emotion expression." The validity of the EESC was also indicated by its positive correlations with variables assessing child anxiety, depression, and behavioral avoidance and its negative correlation with mindfulness skills. The EESC is a valid measure of children's difficulties in emotion expression and the use of its total score is recommended.

Longitudinal effects of emotion awareness and regulation on mental health symptoms in adolescents with and without hearing loss

Emotion awareness (EA) and regulation (ER) are each known to associate with mental health symptoms, yet there is a paucity of longitudinal studies examining them jointly during adolescence. Furthermore, little is known about these skills and their relations in deaf and hard-of-hearing (DHH) adolescents, who are at risk for reduced emotion socialization and for more mental health symptoms. This longitudinal study examined the development and unique contributions of EA (emotion differentiation, emotion communication and bodily unawareness) and ER (approach, avoidance and worry/rumination) to internalizing and externalizing symptoms in adolescents with and without hearing loss. Using self- and parent's reports, we assessed 307 adolescents (age 9-15) three times over 18-month period. We found stability over time in development of EA and avoidance ER, increase in approach ER and decrease in worry/rumination. High levels and increases over time in two aspects of EA, emotion differentiation and communication, and in approach and avoidance ER were related to decreases in depressive symptoms. An increase in approach ER was also related to a decrease in anxiety symptoms. Yet, low levels or decreases in worry/rumination were related to decreased levels of depressive, anxiety and externalizing symptoms. Hearing loss did not moderate any of the variables or relations tested. Preliminary tests suggested heterogeneity within the DHH group according to educational placement, language abilities and parental education level. Overall, findings pointed at unique contributions of EA and ER to mental health development, suggesting that DHH adolescents, especially in mainstream schools, do not differ from their hearing peers in their emotion awareness and regulation.

The Long-Term Effects of Bullying, Victimization, and Bystander Behavior on Emotion Regulation and Its Physiological Correlates

Bullying at school is a serious social problem that influences the wellbeing of everyone involved, that is, victims, perpetrators, and bystanders. Among the many health and psychological problems that these individuals may develop, emotion dysregulation appears to be a common marker. To date, however, it remains unclear whether bullying experienced during the school years is associated with emotion dysregulation also in adulthood. In this study, by adopting a retrospective approach, we investigated whether involvement in bullying at school-either as a bully, victim, or bystander-could put these individuals at risk of presenting deficits in emotion regulation in adulthood, as assessed with behavioral (explicit) and physiological (implicit) indexes (i.e., skin conductance), and whether the association between the involvement in bullying and emotion regulation was direct or mediated by other factors, such as somatic complaints and sensation seeking. A total of 58 young adults were asked to control their emotional reactions in front of images with strong emotional content, and to explicitly evaluate them with ratings, while their arousal was measured through skin conductance. They also responded to questionnaires about retrospective involvement in bullying, somatic complaints, and sensation seeking. Results revealed that victimization and bystander behavior were directly and negatively associated with emotion regulation as assessed with skin conductance, whereas bullying was positively associated with implicit emotion regulation through the mediation of sensation seeking. Interestingly, emotion regulation as assessed with explicit ratings was not associated with any of the characteristics of the participants. Our study suggests that being directly (as victim) but also indirectly (as bystander) involved in bullying at school time is associated with difficulties in emotional wellbeing in adulthood. Furthermore, it reveals that behavioral and physiological indexes associated with emotion regulation dissociate, suggesting that subtle physiological changes may remain hidden from explicit behavior.

Positive Youth Development and Depression: An Examination of Gender Differences in Croatia and Spain

Depression is a major public health issue and the literature has consistently showed that the rates of depression increase dramatically during youth transition to adulthood, and gender differences merge in this period. Positive youth development (PYD) framework is focused on strengths that make young people more resistant to negative outcomes, like depression, and more capable to choose a positive life direction. The aim of the study was to examine the relationship between the 5Cs of PYD and depression in Croatia and Spain, as well as to analyze gender differences. This research was conducted within the PYD Cross-National Project. High school and university students from Eastern Croatia and Southern Spain participated in the study (M age = 19.37, SD = 2.11; 62.3% female). There were 584 students from Croatia and 768 students from Spain, who filled in self-reports of PYD and depression (i.e., PYD-SF and PHQ-9, respectively). Results showed that male participants presented more Competence and Confidence, while female participants reported more Connection, Caring, Character, overall PYD, but also more depressive symptoms. Furthermore, Confidence and Connection were negative correlates of depressive symptoms, with neither Spain nor Croatia showing remarkable gender differences. These results may have some implications concerning the promotion of the 5Cs of PYD as a recommendable approach to promote youth mental health in Croatia and Spain from a gender perspective. Youth mental health services and initiatives that engage the partnership of youth contexts, such as the family, schools and neighborhoods, should not only address risk factors for mental health problems, but also protecting factors as the 5Cs, thus providing a more inclusive and sustainable support for youth well-being.

Process-Oriented Measurement of Emotion Regulation: General and Specific Associations With Psychosocial Adjustment and Well-Being in (Pre-)Adolescence

The development of emotion regulation (ER) is associated with children's and adolescents' psychosocial adjustment and well-being. In this regard, previous studies have examined the role of different ER strategies, which can be characterized as being functional (e.g., reappraisal, problem solving) or dysfunctional (e.g., suppression, rumination). Based on the process model of emotion regulation, the strategies can also be classified according to their temporal position within the emotion generative process, with five families of ER strategies being proposed: situation selection, situation modification, attentional deployment, cognitive change, and response modulation. This study aimed to examine the role of ER for adolescents' psychosocial adjustment (internalizing and externalizing problems, prosocial behavior) and well-being. First, associations were investigated on a more general level by distinguishing between functional and dysfunctional ER. Second, relations were examined on a more specific level by additionally distinguishing between the five families of ER strategies as suggested in the process model of ER. Questionnaire self-reports of N = 1,727 German children and adolescents (55% girls) aged 9-18 years (M = 13.03, SD = 1.75) collected in schools were analyzed. Path analyses showed that more functional and less dysfunctional ER in general is associated with fewer internalizing and externalizing symptoms, and higher well-being. Prosocial behavior was only positively related to functional but not dysfunctional ER. Analyses of associations on the level of specific categories of ER strategies generally showed a similar pattern, but in part indicated differential associations with the dependent variables: Internalizing problems were particularly associated with functional situation selection, dysfunctional cognitive change, and dysfunctional response modulation. Externalizing problems were associated with functional situation selection and response modulation, as well as numerous dysfunctional strategies, none of which were particularly salient. Similarly, numerous rather than single specific associations emerged between prosocial behavior and the five categories of functional ER strategies. Well-being was particularly associated with functional situation selection and dysfunctional cognitive change. Overall, a more precise assessment of ER, as implemented in this study, could not only advance research in this field, but can also be helpful in planning and evaluating prevention and intervention programs.

Emotion Differentiation in Current and Remitted Major Depressive Disorder

People with current major depressive disorder (MDD) experience diminished emotion differentiation. We tested the hypothesis that this emotional disturbance is chronic and also characterizes those whose MDD has remitted. As our main aim, we examined emotion differentiation in conjunction with elevated negative and diminished positive emotional intensity, which are both cardinal symptoms of MDD. As an exploratory aim, we examined the predominant theoretical conceptualization that people low in emotion differentiation use more general state terms (e.g., bad) and fewer emotion terms (e.g., anger) to describe their emotional experience. Participants (assessed via diagnostic interview) included individuals who had current MDD (current depressed; n = 48), individuals whose MDD was in full remission (remitted depressed; n = 80), and healthy controls (n = 87). Participants also completed two self-report measures of depressive symptoms and reported momentary emotion repeatedly for 14 days via experience sampling, from which we computed emotion differentiation (i.e., intraclass correlation coefficient) and emotional intensity (i.e., average of the mean emotion ratings across surveys). Finally, participants described a momentary emotional experience via an open-response format, which was coded for the use of general state and emotion terms. Compared to the healthy control group, the current and remitted depressed groups showed similarly low levels of negative and positive emotion differentiation. These findings suggest that diminished emotion differentiation may be a stable characteristic of depressive disorders and a possible target for future prevention efforts. Diminished negative emotion differentiation was significantly associated with higher depressive symptoms as assessed by only one of the depression measures, though this finding did not hold after adjusting for negative emotional intensity. Finally, participants’ emotion differentiation was not associated with use of general state and emotion terms, and groups did not use general state and emotion terms in ways that were consistent with the predominant theoretical conceptualization of emotion differentiation, suggesting the need for clarification in this research domain.

Prevention and early intervention of depression in young people: an integrated narrative review of affective awareness and Ecological Momentary Assessment

Depression has a devastating impact on young people around the world. This impact is pervasive and long-long lasting, still causing havoc as young people transition into adulthood. Prevention and timely early intervention efforts are necessary to lessen the disease burden of depression in young people. There is some evidence for the effectiveness of existing prevention and early intervention programs when delivered early. However, there is no consensus on what the active ingredients of these programs are. Identifying these ingredients is important because focusing on those that have maximal benefit will help to minimise the costs and resourcing of (already intensive) therapeutic approaches. We explored whether, and in what circumstances, affective awareness (i.e., knowing how one feels) is a candidate for protecting against and decreasing vulnerability to depression in young people. We specifically looked at how Ecological Momentary Assessment methods (EMA) were used to measure and/or increase affective awareness. We integrated three streams of data, including narrative review findings, perspectives from young people and psychologists, and publicly available information online (e.g., discussion forums). Across data sources, we found converging evidence that affective awareness is important in the prevention and early intervention of depression although there were considerable gaps in knowledge. More work needs to be done with young people and their health care teams to build affective awareness in the right way, at the right time, with individual differences in mind. The identification of how EMA can be best incorporated into young people's lives to facilitate these outcomes is also needed.

Adolescent depressed mood and difficulties with emotion regulation: Concurrent trajectories of change

INTRODUCTION

Adolescent depression is a significant mental health concern. Emotion regulation difficulties have been associated with subsequent depressive symptoms, though different facets of emotion regulation are rarely compared. This study examined the degree to which trajectories of change in different facets of emotion regulation (goal-directed behavior, impulse control, and regulation strategies) and depressive symptoms were associated across twelve months in a clinical adolescent sample.

METHODS

Participants included 110 adolescents from the US who were enrolled in a randomized trial that tested a cognitive-behavioral treatment for youth with co-occurring mental health and substance use concerns (M_age = 15.71 years; 57.3% male). Assessments were conducted at baseline, 3-, 6-, and 12-month follow-ups. Three separate bivariate latent basis growth curve analyses were conducted. Correlations between latent intercepts and latent slopes, as well as overall model fit, were examined.

RESULTS

Impulse control and goal-directed behavior were each associated with depressive symptoms at baseline. Additionally, change in impulse control over time was significantly associated with change in depressive symptoms. However, the same was not true for goal-directed behavior. Overall fit indices for models of emotion regulation strategies were below acceptable levels and thus could not be interpreted.

CONCLUSIONS

Findings from the present study indicate that adolescents' depressive symptoms appear to improve as their perceived ability to control impulses improves. These results suggest that addressing impulse control difficulties may be an important step in treating adolescent depression and co-occurring disorders.

Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience

The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.

Moderating Role of Health Literacy on the Association between Alexithymia and Depressive Symptoms in Middle School Students

Depression is a common psychological problem in adolescents. At present, few studies have described the moderating role of health literacy on the association between alexithymia and depressive symptoms among adolescents. The purpose of this study was to explore the relation among health literacy, alexithymia, and depressive symptoms and the moderating role of health literacy in middle school students. In December 2017, data were collected from a school in Shenyang by the convenient sampling method using a questionnaire including demographic information, health literacy, alexithymia, and depressive symptoms. A total of 1068 junior and senior high school students were selected as subjects, and 1062 valid questionnaires were retained for analysis. Logistic regression models were used to examine the association between health literacy and alexithymia with depressive symptoms. The prevalence of depressive symptoms was 48.2%, and the prevalence of alexithymia was 17.9%. Low health literacy was significantly associated with depressive symptoms (odds ratio (OR) (95% confidence interval (CI)) = 3.648 (2.493–5.338)). Alexithymia was significantly correlated with depressive symptoms (OR (95% CI) = 3.091 (2.156–4.429)). Low health literacy was related to a greater increase in the risk of depressive symptoms for students with alexithymia (OR (95% CI) = 10.566 (5.175–21.570)). The findings suggest that alexithymia and health literacy are important factors influencing depressive symptoms and health literacy has a moderating role on the association between alexithymia and depressive symptoms. Enhancing health literacy of middle school students with alexithymia may improve their mental health.

The Role of Emotions and Motivations in Sport Organizations

In sport organizations, a stance aimed at creating a positive emotional and social climate may be necessary. This study examines athletes’ individual psychosocial factors that are linked to sports practice and sports performance. These factors include individual motivation, emotions, and beliefs. The main objective is to create a hierarchy of emotional and motivational factors that sport organizations can use to increase athletes’ commitment. The Analytic Hierarchy Process (AHP) is used to do so. This method enables analysis of priorities and criteria to support decision-making. The results show that motivation, defined here as the drive that leads individuals to develop plans to achieve their goals by balancing short- and long-term goals, and emotion regulation, defined as the capacity to be aware of and manage one’s emotions to reach a balanced emotional state, are the most important criteria to generate this commitment within sport organizations.

Positive Aspects of Emotional Competence in Preventing Internalizing Symptoms in Children with and without Developmental Language Disorder: A Longitudinal Approach

In order to better understand protective factors for internalizing problems, this longitudinal study examined positive emotions, emotion awareness and (non-)emotional communication skills in relation to somatic complaints and social anxiety in children with (N = 104) and without (N = 183) Developmental Language Disorder (DLD) using self-reported measures twice with a 9-month interval. Additionally, parents reported on their child’s communication problems and emotion communication at Time 1. Most importantly, since we found that increasing levels of emotion awareness related to decreases in social anxiety and somatic complaints in children with and without DLD, we conclude that children with DLD are likely to benefit from interventions aimed at improving their emotion awareness in addition to language interventions.

Emotional Awareness Predicts Specific Cognitive-Behavioral Therapy Outcomes for Anxious Youth

The current study examined emotional awareness as a predictor of differential outcomes for youth treated for an anxiety disorder. 37 youth ages 7-15 received either individual cognitive-behavioral therapy or family cognitive-behavioral therapy to treat generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Diagnoses were determined by independent evaluators, following semi-structured interviews (ADIS-IV-C/P) with youth and their parents. Self-report questionnaires, including the multidimensional anxiety scale for children and the emotion expressivity scale for children, were completed at pre- and posttreatment. Youth with higher levels of pretreatment emotional awareness had better treatment outcomes than youth with lower levels of emotional awareness, with specific regard to improved ability to cope with worry. Findings suggest that higher levels of emotional awareness facilitate better specific outcomes for anxious youth. Findings highlight the importance of understanding the emotions associated with worry during the treatment process.

Difficulties in Emotion Regulation Predict Depressive Symptom Trajectory from Early to Middle Adolescence

Major depressive disorder begins to increase in early adolescence and is associated with significant impairment (e.g., suicidality). Difficulties in emotion regulation (ER) have been associated with depressive symptoms; however, little research has examined this relation over time beginning in early adolescence. Starting when they were 11-14 years old, 246 adolescents (n_boys = 126; n_white = 158) completed self-report questionnaires on their ER at Time 1 and depressive symptoms every year for 2 years. Results revealed that overall difficulties in ER (and limited access to ER strategies) at Time 1 predicted depressive symptoms both cross-sectionally and longitudinally. Gender moderated this relation cross-sectionally, such that higher overall ER difficulties at Time 1 was more strongly associated with higher depressive symptoms for girls than for boys. These findings suggest that depression prevention efforts should promote adaptive ER in early adolescence, particularly for girls, in order to prevent the increases in depressive symptoms seen into middle adolescence.

The Relationship Between Trait Emotional Intelligence, Cognition, and Emotional Awareness: An Interpretative Model

Emotional awareness (EA) has been defined as the cognitive skill devoted to the identification and description of one’s own and others’ emotional experiences, an ability that has usually been conceptualized along with the development of cognitive intelligence. Despite this, EA has also been deemed a central constituent of Emotional Intelligence (EI), a construct that captures individual differences in how we perceive, communicate, regulate, and understand our own emotions, as well as the emotions of others. The overlap between the cognitive and the emotional domain in the definition of the EA construct has created several difficulties in both its understanding and its usage, so much so that several questions regarding its nature and structure remain unanswered. The aim of the present work was to test in a unique model the explanatory role of both trait EI and fluid nonverbal intelligence on EA variability in children, controlling for the effect of age, a variable strictly related to cognitive development, as well as gender, which is highly associated with trait EI during childhood. Four hundred and eighty-eight pupils (258 females and 230 males) ranging from 8 to 12 years old completed the Levels of Emotional Awareness Scale for Children, the Trait Emotional Intelligence Questionnaire – Child Form, and a measure of pure non-verbal reasoning ability, the Raven’s Progressive Matrices. The results of a structural equation model showed a positive explanatory power of both Raven and TEIQue scores on EA, revealing that both cognitive intelligence and trait EI significantly explained EA. The same model also showed an indirect effect of age, via intelligence scores, on EA, suggesting that the increase of EA with age could be partially imputed to the development of intelligence. Finally, a relation between gender and TEIQue scores confirmed higher trait EI scores in girls than in boys. The implications emerging from this model are discussed.

Emotion Control Predicts Internalizing and Externalizing Behavior Problems in Boys With and Without an Autism Spectrum Disorder

Children and adolescents with Autism Spectrum Disorder (ASD) often show comorbid emotional and behavior problems. The aim of this longitudinal study is to examine the relation between emotion control (i.e., negative emotionality, emotion awareness, and worry/rumination) and the development of internalizing and externalizing problems. Boys with and without ASD (N = 157; age 9–15) were followed over a period of 1.5 years (3 waves). We found that baseline levels of worry/rumination was a specific predictor of later externalizing problems for boys with ASD. Furthermore, the developmental trajectory of worry/rumination predicted the development of internalizing and externalizing problems in both groups. Our findings suggest that worry/rumination may constitute a transdiagnostic factor underlying both internalizing and externalizing problems in boys with and without ASD.

Emotionsbewusstsein und depressive Symptome im frühen Jugendalter

Zusammenfassung. Theoretischer Hintergrund: Ergebnisse aus Querschnittstudien weisen darauf hin, dass Emotionsregulationsstrategien den Effekt zwischen dem Emotionsbewusstsein und depressiven Symptomen vermitteln. Es fehlen jedoch prospektive Studien, die diesen Effekt bestätigen. Fragestellung: Diese Studie überprüft, ob die Veränderung in der Nutzung adaptiver und maladaptiver Trauer-Regulationsstrategien über drei Monate die Beziehung zwischen dem Emotionsbewusstsein zu T1 und der depressiven Symptomatik zu T2 vermittelt. Methodik: Bei N = 136 Jugendlichen (55.9 % ♀, M = 11.53 Jahre; SD = 0.82) wurde zu T1 das Emotionsbewusstsein erfasst. Adaptive sowie maladaptive Strategien zur Trauerregulation und die Depressionssymptomatik wurden zu zwei Messzeitpunkten, zwischen denen ein Abstand von M = 15 Wochen ( SD = 4.22) lag, erhoben. Ergebnisse: Die Ergebnisse zeigen, dass ein hohes Emotionsbewusstsein zu T1 über eine Zunahme maladaptiver Regulationsstrategien mit einer stärkeren depressiven Symptomatik zu T2 verknüpft ist. Ein vermittelnder Effekt über die Veränderung adaptiver Regulationsstrategien fand sich nicht. Eine Zunahme adaptiver Strategien stand in Zusammenhang mit niedrigen Depressionswerten zu T2. Schlussfolgerung: In der Prävention sollte das Emotionsbewusstsein in Kombination mit Techniken zur Beendigung maladaptiver Trauer-Regulationsstrategien vermittelt werden. Adaptive Strategien zur Bewältigung von Trauer sollten systematisch aufgebaut und eingeübt werden.

A mediational model linking perceptions of security, alexithymia and behavior problems of sexually abused children

BACKGROUND

Perceptions of security toward parents are related with internalized and externalized problems among victims of child sexual abuse (CSA). Alexithymia, which is difficulty in identifying and expressing feelings, is associated with the quality of parent-child relationships (Oskis et al., 2013) and behavior problems in children (Di Trani et al., 2013).

OBJECTIVE

The current study tested the mediational role of alexithymia in the relationship between perceptions of security toward parents and behavior problems among CSA victims.

PARTICIPANTS AND METHOD

Using a short-term multi-informant prospective design, 263 victims of CSA aged 6-12 years completed the Kerns Security Scale (Kerns, Klepac, & Cole, 1996), which evaluates perceived attachment security to mothers and fathers. Parents completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at Time 1 to provide baseline scores of behavior problems and again four months later. At Time 2, parents also assessed the children's alexithymia using the Children's Alexithymia Measure (Way et al., 2010).

RESULTS

Perceptions of security were both associated with alexithymia, as well as with internalizing and externalizing problems (p < .05). A mediational model showed that perception of security toward fathers outweighed the mother-child relationship in predicting children's alexithymia. Path analysis revealed that the father-child relationship predicted decreased behavioral problems at Time 2 through a lower level of alexithymia. The model explained 46.9% of internalizing problems and 56.1% of externalizing problems (p < .05).

CONCLUSIONS

The findings support the relevance of alexithymia as an intervention target for CSA victims and underscore the importance of the father-child relationship.

Emotional Understanding in Children with A Cochlear Implant

Emotional understanding plays an important role in the physical and mental health of children. To determine whether the development of emotional understanding is delayed in children with a cochlear implant (CI), 30 children with a CI and 30 matched children with typical hearing aged between 3 and 9 years old completed three tasks (facial expression, tone expression and scene of emotion matching), in which they identified four basic emotions (happiness, sadness, anger, and fear). The participants included 40 preschool children and 20 school-aged children. Compared with the children with typical hearing, the children with a CI were significantly delayed in the ability to understand emotion; the tone expression matching task was the most difficult task for all participants; and the school-aged children performed better than the preschool children, but this trend was only observed in the typical hearing group; and happiness was the easiest emotion to identify.

Relationship between Self-Esteem and Self-Consciousness in Adolescents: An Eye-Tracking Study

OBJECTIVE

Self-esteem and self-consciousness are important determinants of behaviors. This study aimed to explore the relationship between self-esteem and self-consciousness in adolescents using the eye-tracking measurement.

METHODS

Fifty-five adolescents with high self-esteem and 58 adolescents with low self-esteem participated in self-consciousness-related eye-tracking experiments of selecting happy, disgusted, and angry facial emotions while recognizing one's own usual expressions and the others' usual expressions toward oneself.

RESULTS

When recognizing one's own, adolescents with high self-esteem showed significantly more selection counts and longer fixation time for 'happy' than adolescents with low self-esteem. When recognizing the others', adolescents with low self-esteem showed significantly more selection counts and longer fixation time for 'disgusted' and 'angry' than adolescents with high self-esteem.

CONCLUSION

These suggest higher self-esteem is connected to more positive identification of one's usual expressions and others' usual expressions toward oneself. There is a close relationship among low self-esteem, suppressing positive emotions, decreased psychological adjustment, and increased negative emotions.

How do I feel right now? Emotional awareness, emotion regulation, and depressive symptoms in youth

Decreased emotional awareness contributes to the risk of internalizing disorders, such as depression. Although emotional awareness may be especially important during adolescence, a developmental period in which emotional arousal is high and the risk of depression rises dramatically, little research has examined the mechanisms linking emotional awareness to depression. Starting from affect regulation models, the current study proposes emotion regulation (ER) as a key underlying mechanism in the emotional awareness-depression relationship. The current study investigated whether maladaptive and adaptive ER strategies mediate the relationship between emotional awareness and depressive symptoms among youth using a cross-sectional design. Participants were 220 youth (65% girls; [Formula: see text] = 11.87, SD = 1.94) who filled out a set of questionnaires assessing emotional awareness, ER strategies, and depressive symptoms. Results revealed no direct relationship between emotional awareness and depressive symptoms. However, emotional awareness yielded a significant mediation effect through total adaptive ER strategies on higher depressive symptoms. No evidence was found for the mediating role of maladaptive ER strategies in this relationship. The current study provides further support for affect regulation models positing that emotional awareness may be a basic skill that is required for learning adaptive ER skills, and thus call for greater attention to adaptive ER strategies.

The temporal association between emotional clarity and depression symptoms in adolescents

INTRODUCTION

Low emotional clarity, that is, problems in understanding and identifying one's own emotions, is generally seen as related to depression. Most empirical studies on this topic focused on the link between low levels of emotional clarity predicting depression problems, fewer studies on depression symptoms predicting low emotional clarity. All studies were restricted to unidirectional associations. The present study evaluated the reciprocal associations between emotional clarity and depression symptoms. Additionally, we tested the role of rumination as a mediator of the links between depression symptoms and emotional clarity.

METHODS

For the main analyses, data of 230 Dutch participants (M_age = 13.40, SD = 2.24; 48% girls) over three time points of a 5-year longitudinal study were used. Depression symptoms, emotional clarity, and rumination were self-reported. Cross-lagged panel analysis was used to test a model of reciprocal associations between depression symptoms and emotional clarity against models of unidirectional associations. The role of rumination as mediator and sex as moderator in the links between depression symptoms and emotional clarity were evaluated in separate analyses on a subsample (n = 151).

RESULTS & CONCLUSIONS

A model of reciprocal associations where depression symptoms and low emotional clarity predict relatively high scores of the other over time offered a good representation of the data. Rumination mediated the link between depression symptoms predicting prospective emotional clarity for both sexes. These findings suggest a vicious cycle between depression symptoms and low emotional clarity. We discuss possible implications of these results for the treatment of depression in youth.

Improving emotion regulation ability in autism: The Emotional Awareness and Skills Enhancement (EASE) program

Emotion regulation impairments are common among individuals with autism spectrum disorder and are believed to often underlie commonly seen problems with aggression, depression, and anxiety. The Emotional Awareness and Skills Enhancement program was developed to reduce emotion regulation impairment and thereby improve behavioral disturbance, via mindfulness. Emotional Awareness and Skills Enhancement consists of a 16-week individual therapy treatment targeting emotion regulation impairments among individuals with autism spectrum disorder. We describe the conceptual framework and development of the program and present data on feasibility and preliminary efficacy from a pilot trial. The Emotional Awareness and Skills Enhancement manual was developed using a participatory action framework, based on emotion regulation research specific to autism spectrum disorder and input from individuals with autism spectrum disorder, therapists, and parents of children with autism spectrum disorder. Emotional Awareness and Skills Enhancement was piloted in a two-site open trial with 20 participants with autism spectrum disorder (12-17 years old, confirmed autism spectrum disorder diagnosis, IQ > 80).Outcome data support program feasibility and acceptability to participants, as well as significant improvement in emotion regulation impairments and related concerns.Findings offer preliminary support for both the feasibility and clinical effectiveness of the Emotional Awareness and Skills Enhancement program.

The German Version of the Emotion Awareness Questionnaire for Children and Adolescents: Associations with Emotion Regulation and Psychosocial Adjustment

Emotional awareness is an important variable for children's and adolescents' social and emotional development. The aim of this study was to examine the psychometric properties (e.g., factor structure, internal consistencies) of scores on the German translation of the Emotion Awareness Questionnaire (EAQ; Rieffe, Oosterveld, Miers, Meerum Terwogt, & Ly, 2008 ). Furthermore, to examine the concurrent validity, associations of the six subscales (Differentiating Emotions, Verbal Sharing of Emotions, Not Hiding Emotions, Bodily Unawareness, Attending to Others' Emotions, Analyses of Emotions) with emotion regulation, internalizing and externalizing problems, and prosocial behavior were investigated. Questionnaire data of 1,018 adolescents aged between 11 and 18 were analyzed. The proposed six-factor structure was replicated and internal consistencies were satisfactory. Meaningful associations of the six EAQ subscales with emotion regulation and psychosocial adjustment were found, proving the concurrent validity of this questionnaire. In general, higher emotional awareness was associated with more functional emotion regulation and prosocial behavior, and less dysfunctional emotion regulation and internalizing and externalizing problems. Significant gender differences were detected and are discussed. Overall, the findings suggest that the German EAQ is a useful instrument to assess children's and adolescents' emotional awareness.

Emotion Regulation and Parental Bonding in Families of Adolescents With Internalizing and Externalizing Symptoms

Parental bonding and emotional regulation, while important to explain difficulties that may arise in child development, have mainly been studied at an individual level. The present study aims to examine alexithymia and parental bonding in families of adolescents with psychiatric disorders through different generations. The sample included a total of 102 adolescent patients with psychiatric disorders and their parents. In order to take a family level approach, a Latent Class Analysis was used to identify the latent relationships among alexithymia (Toronto Alexithymia Scale), perceived parental bonding (Parental Bonding Instrument) and the presence of adolescent internalizing or externalizing psychiatric symptoms (Youth Self-Report). Families of internalizing and externalizing adolescents present different and specific patterns of emotional regulation and parenting. High levels of adolescent alexithymia, along with a neglectful parenting style perceived by the adolescent and the father as well, characterized the families of patients with internalizing symptoms. On the other hand, in the families with externalizing adolescents, it was mainly the mother to remember an affectionless control parental style. These results suggest the existence of an intergenerational transmission of specific parental bonding, which may influence the emotional regulation and therefore the manifestation of psychiatric symptoms.

Children's emotion understanding in relation to attachment to mother and father

Although attachment plays a key role in children's socio-emotional development, little attention has been paid to the role of children's attachment to their father. This study examined whether insecure attachment to each parent was associated with reduced emotion understanding in children and whether children showed consistent attachments to their mother and father. We measured children's attachment to each parent using the Manchester Child Attachment Story Task and child emotion understanding using the Test of Emotion Comprehension (children's M_age  = 5.64 years, SD = 0.84). The results indicated that insecure father-child attachment and insecure mother-child attachment were each associated with lower emotion understanding in children after controlling for parent's depressive symptoms and children's age. There was significant concordance of child attachment to mother and father. The findings provide support for convergence of children's attachment across parents and suggest that father-child attachment is an important factor to consider when examining children's emotion understanding. Statement of contribution What is already known on this subject Secure mother-child attachment is positively associated with children's emotional competence. Children form similar representations of attachment to their mother and father. What the present study adds Both mother-child and father-child attachment are associated with children's emotion understanding. The study's findings highlight the importance of father-child attachment in their children's emotion understanding. The study provides support for concordance of children's attachment across parents.

Das Emotionstraining in der Schule

Zusammenfassung. In der Forschung wird zunehmend die Bedeutung emotionaler Kompetenzen in der Entstehung und Aufrechterhaltung von depressiven Symptomen bei Jugendlichen herausgestellt, woraus Implikationen für Präventionsmaßnahmen resultieren. Das Emotionstraining in der Schule stellt ein schulbasiertes Präventionsprogramm für die Altersgruppe der 10- bis 13-Jährigen dar, das emotionale Kompetenzen fördert, um der Entwicklung einer depressiven oder Angstsymptomatik vorzubeugen. Ziel der Studie ist es, die Effektivität des Trainings in einem Wartekontrollgruppen-Design zu bestimmen. Eine Stichprobe von insgesamt 543 Schülerinnen und Schüler (Altersmittelwert = 11.46 Jahre; SD .69) nahmen an der Studie teil. Der Mangel an emotionalem Bewusstsein, die Abneigung gegen den Emotionsausdruck und das subjektive Wohlbefinden, welches als Gegenpol zur depressiven Symptomatik zu verstehen ist, wurden im Selbsturteil unmittelbar vor und nach dem Training erhoben. Gegenüber dem ersten Erhebungszeitpunkt zeigten sich nach Abschluss der Maßnahme keine Änderungen in den Merkmalsausprägungen. Im Rahmen einer Moderatorenanalyse konnten jedoch puffernde Effekte in der Trainingsgruppe belegt werden. In zukünftigen Studien muss der Wirkmechanismus hinter diesen Effekten weiter exploriert werden.

Assessing Empathy across Childhood and Adolescence: Validation of the Empathy Questionnaire for Children and Adolescents (EmQue-CA)

Empathy plays a crucial role in healthy social functioning and in maintaining positive social relationships. In this study, 1250 children and adolescents (10-15 year olds) completed the newly developed Empathy Questionnaire for Children and Adolescents (EmQue-CA) that was tested on reliability, construct validity, convergent validity, and concurrent validity. The EmQue-CA aims to assess empathy using the following scales: affective empathy, cognitive empathy, and intention to comfort. A Principal Components Analysis, which was directly tested with a Confirmatory Factor Analysis, confirmed the proposed three-factor model resulting in 14 final items. Reliability analyses demonstrated high internal consistency of the scales. Furthermore, the scales showed high convergent validity, as they were positively correlated with related scales of the Interpersonal Reactivity Index (Davis, 1983). With regard to concurrent validity, higher empathy was related to more attention to others' emotions, higher friendship quality, less focus on own affective state, and lower levels of bullying behavior. Taken together, we show that the EmQue-CA is a reliable and valid instrument to measure empathy in typically developing children and adolescents aged 10 and older.

Emotion Understanding in Preschool Children with Mild-to-Severe Hearing Loss

Deaf and hard of hearing school-aged children are at risk for delayed development of emotion understanding; however, little is known about this during the preschool years. We compared the level of emotion understanding in a group of 35 4-5-year-old children who use hearing aids to that of 130 children with typical hearing. Moreover, we investigated the parents' perception of their child's level of emotion understanding. Children were assessed with the Test of Emotion Comprehension. Parents were presented with the same test and asked to guess what their child answered on each item. The results showed that children with hearing loss performed at the same level as typically hearing children, despite having lower vocabulary scores. Parents of children with hearing loss were more accurate in their estimations of their child's competence, and higher accuracy was associated with better emotion understanding. These findings may have implications for early intervention planning.

Triadic Interactions in Families of Adolescents with Anorexia Nervosa and Families of Adolescents with Internalizing Disorders

The latest studies and practice guidelines for the treatment of adolescent patients with anorexia nervosa agree in pointing out the key role played by parents in determining the young patients’ therapeutic possibilities and outcomes. Still family functioning has usually been studied using only self-reported instruments. The aim of the present study is therefore to investigate the triadic interactions within the families of adolescents with anorexia nervosa using a semi-standardized observational tool based on a recorded play session, the Lausanne Trilogue Play (LTP). Parents and adolescent daughters, consecutively referred to adolescent neuropsychiatric services, participated in the study and underwent the observational procedure (LTP). The 20 families of adolescent girls with anorexia nervosa (restricting type) were compared with 20 families of patients with internalizing disorders (anxiety and depression). The results showed different interactive patterns in the families of adolescents with anorexia nervosa: they had greater difficulties in respecting roles during the play, maintaining the joint attention and in sharing positive affect, especially in the three-together phase (third phase). The majority of these families (12) exhibited collusive alliances. The parental subsystem appeared frequently unable to maintain a structuring role, i.e., providing help, support and guidance to the daughters, while the girls in turn often found it hard to show independent ideas and develop personal projects. Parents experienced difficulty in carving out a couple-specific relational space, from which the ill daughter was at least temporarily excluded also when they were asked to continue to interact with each other, letting the daughter be simply present in a third-part position (fourth phase). The study of the triadic interactions in the families of adolescents with anorexia nervosa may help to shift the attention from the exclusive mother–daughter relation to the involvement of the father, and of the parental couple as a whole. The family functioning is in fact well established as a maintaining factor of anorexia nervosa or vice versa as a facilitating factor in the therapeutic process.

Bodily maps of emotions across child development

Different basic emotions (anger, fear, disgust, happiness, sadness, and surprise) are consistently associated with distinct bodily sensation maps, which may underlie subjectively felt emotions. Here we investigated the development of bodily sensations associated with basic emotions in 6- to 17-year-old children and adolescents (n = 331). Children as young as 6 years of age associated statistically discernible, discrete patterns of bodily sensations with happiness, fear, and surprise, as well as with emotional neutrality. The bodily sensation maps changed from less to more specific, adult-like patterns as a function of age. We conclude that emotion-related bodily sensations become increasingly discrete over child development. Developing awareness of their emotion-related bodily sensations may shape the way children perceive, label, and interpret emotions.

Disentangling proactive and reactive aggression in children using self-report

The distinction between proactive and reactive functions of aggression is one of the most common divisions when investigating aggression among children and adolescents. To date, self-report is the least used measurement, despite existing literature supporting the view that the best informant regarding internal processes and motives are children themselves. The main aim of this study was to examine the construct and concurrent validity of a new self-report questionnaire, which aims to disentangle acts of reactive vs. proactive aggression that are most common within the daily lives of children. We examined the self-report measure among 578 children (313 girls, 265 boys, mean age 11 years, range 9-13 years). Most children (90% boys; 85% girls) reported at least one act of aggression over the last four weeks. Furthermore, the outcomes support the two-factor structure (reactive and proactive aggression) and the questionnaire showed good concurrent and discriminant validity with measures for emotional and social functioning. This study validates the use of the self-report instrument for reactive and proactive aggression and demonstrates that children can successfully distinguish between their own motives for reactive and proactive forms of aggressive behaviours.

Empathy in adolescence: Relations with emotion awareness and social roles

In this study, we aimed at gaining a better understanding of the individual differences contributing to feelings of empathy in adolescents. Therefore, we examined the extent to which emotion awareness (e.g., recognizing and appreciating one's own and the emotions of others) and a tendency for certain social roles (e.g., helping or teasing peers when being bullied) are related to adolescents' levels of empathy. The sample was comprised of 182 adolescents aged between 11 and 16. Empathy and emotion awareness were assessed using self-report measures. Peer reports were used to indicate adolescents' different social roles: Bullying, defending the victim, and outsider behaviour. Outcomes demonstrated that evaluating one's own and the emotions of others, and more defending nominations were associated with both affective and cognitive empathy, whereas aspects of emotion awareness which are linked with internalizing symptoms were related to empathic distress, suggesting maladaptive emotion appraisal. Furthermore, outsider behaviour was associated with empathic distress, emphasizing a self-focused orientation. In contrast, more bullying was negatively associated with cognitive empathy. Overall, these outcomes demonstrate that, besides social roles, emotion awareness is an important factor for adaptive empathic reactions, whereas emotion dysregulation might cause distress when witnessing the negative feelings of others.

Children's emotion understanding: A meta-analysis of training studies

BACKGROUND

In the course of development, children show increased insight and understanding of emotions-both of their own emotions and those of others. However, little is known about the efficacy of training programs aimed at improving children's understanding of emotion.

OBJECTIVES

To conduct an effect size analysis of trainings aimed at three aspects of emotion understanding: external aspects (i.e., the recognition of emotional expressions, understanding external causes of emotion, understanding the influence of reminders on present emotions); mental aspects (i.e., understanding desire-based emotions, understanding belief-based emotions, understanding hidden emotions); and reflective aspects (i.e., understanding the regulation of an emotion, understanding mixed emotions, understanding moral emotions).

DATA SOURCES

A literature search was conducted using PubMed, PsycInfo, the Cochrane Library, and manual searches.

REVIEW METHODS

The search identified 19 studies or experiments including a total of 749 children with an average age of 86 months (S.D.=30.71) from seven different countries.

RESULTS

Emotion understanding training procedures are effective for improving external (Hedge's g = 0.62), mental (Hedge's g = 0.31), and reflective (Hedge's g = 0.64) aspects of emotion understanding. These effect sizes were robust and generally unrelated to the number and lengths of training sessions, length of the training period, year of publication, and sample type. However, training setting and social setting moderated the effect of emotion understanding training on the understanding of external aspects of emotion. For the length of training session and social setting, we observed significant moderator effects of training on reflective aspects of emotion.

CONCLUSION

Emotion understanding training may be a promising tool for both preventive intervention and the psychotherapeutic process. However, more well-controlled studies are needed.