Emotion regulation in children and adolescents

Emotion Regulation Flexibility in Adolescents: A Systematic Review from Conceptualization to Methodology

Considerable attention has been devoted to the concept of flexible emotion regulation, which de-emphasizes the importance of any specific regulatory strategy in favor of the flexible deployment of strategies in response to specific situational challenges. The bulk of research in this area has been conducted on adult samples. Research on emotion regulation flexibility (ERF) in youth has been documented in only a limited number of studies and using various definitions. This systematic review aims to gather and summarize different conceptualizations and methodological approaches of adolescent ERF. We incorporate these findings into a general framework to understand ERF and its role in adolescents' emotional, behavioral and social functioning. Adhering to the PRISMA guidelines, 11 studies were included in the review. While ERF has been defined in various and inconsistent ways, the included studies utilized conceptualizations from two overarching domains: the regulation of expressed emotion and the repertoire of emotion regulation strategies. Promising approaches and future directions will be highlighted.

Effects of Mindfulness and Life-Skills Training on Emotion Regulation and Anxiety Symptoms in Chinese Migrant Children: A Randomized Controlled Trial

PURPOSE

China's rapid urbanization has been associated with increased mental health challenges, especially in rural-to-urban migrant children. This study evaluates the effects of mindfulness and life-skills (LS) training on emotional regulation and anxiety symptoms from a randomized controlled trial aimed at improving the mental health of Chinese migrant children.

METHODS

Two intervention arms-mindfulness training (MT) and MT plus LS mentorship (MT + LS)-were compared to a waitlist control group of 368 migrant children aged 9-17 years. Volunteers were trained to deliver interventions to 285 migrant children in small groups of 15 for eight weeks weekly. Social integration varied: migrant children mixed with local children at public schools were considered highly integrated, those in migrant-only classrooms at public schools had intermediate levels of integration, and children in private migrant schools had low integration. Emotion regulation and anxiety symptoms were assessed preintervention, postintervention, and three months postintervention.

RESULTS

Postintervention and compared to the control group, children with high social integration in the MT arm showed increased cognitive reappraisal ability (p < .05) but higher physical anxiety (p < .01). Children with high social integration in the MT + LS arm had lower anxiety symptoms of harm avoidance (p < .01) and physical anxiety (p < .05). Children with low social integration in the MT + LS arm showed lower cognitive reappraisal (p < .01) and poorer overall emotion regulation abilities (p < .01). Three months later, children with intermediate integration in the MT + LS arm had lower separation anxiety (p < .05) and harm avoidance anxiety (p < .05). No other groups showed significant improvements in emotion regulation or reducing in anxiety symptoms three months postintervention.

DISCUSSION

Mindfulness and LS training may benefit Chinese migrant children who have higher levels of social integration but increase anxiety in those with lower social integration. Future research should consider the sociocultural context in which a treatment is implemented.

Experiences and Cognitive Characteristics of Non-Suicidal Self-Injury in Adolescents With Depression: A Qualitative Study

PURPOSE

To elucidate the underlying motivations, experiential dimensions, and cognitive perceptions in adolescents with depression and non-suicidal self-injury (NSSI).

METHOD

A descriptive qualitative design was used. Participants were 18 Chinese adolescents with depression and NSSI. Conventional content analysis was used for data analysis.

RESULTS

Three primary themes and 11 subthemes were identified: Triggers of NSSI (personal, family, school, and social factors); Experiencing Emotional Complexity in NSSI Implementation (mitigating psychological distress, awakening a sense of existential life, generating secondary negative emotions, stimulating reflections on life and death); and Perceptions and Understandings of NSSI are Diverse (NSSI as a form of seeking validation or approval, an addictive behavior, a means to attain a sense of control, and unacceptable behavior).

CONCLUSION

Although nursing staff should provide comprehensive treatment and psychological support, efforts should also be made to strengthen caregiving skills of family members, thereby promoting overall physical and mental health of adolescents. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Differences in the effect of adolescents' strategies for expressing academic emotions on academic emotions and peer acceptance in competitive and cooperative situations

Two studies were conducted to explore the differences in the effect of adolescents' strategies for expressing academic emotions. In Study 1 a total of 65 adolescents participated in the study of the relationship between academic emotions and strategies for expressing them in competitive and cooperative situations. In Study 2 a total of 113 adolescents participated in the study of the relationship between the strategies and peer acceptance in competitive and cooperative situations. The results showed that the relationship between academic emotions and strategies for expressing them in competitive and cooperative situations was situation stable while the relationship between the strategies and peer acceptance was situation specific. Furthermore, emotional expression may be more adaptive when experiencing positive academic emotions. When adolescents experience negative academic emotions, expressing them is more adaptive from the perspective of their own academic emotional experience; whereas suppressing them is more adaptive from the perspective of peer acceptance. These findings (a) clarify how to use more adaptive strategies for emotional expression in various situations and (b) serve as a guide for helping adolescents use strategies to express emotions flexibly according to the situation.

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.

Growing Up Together in Society (GUTS): A team science effort to predict societal trajectories in adolescence and young adulthood

Our society faces a great diversity of opportunities for youth. The 10-year Growing Up Together in Society (GUTS) program has the long-term goal to understand which combination of measures best predict societal trajectories, such as school success, mental health, well-being, and developing a sense of belonging in society. Our leading hypothesis is that self-regulation is key to how adolescents successfully navigate the demands of contemporary society. We aim to test these questions using socio-economic, questionnaire (including experience sampling methods), behavioral, brain (fMRI, sMRI, EEG), hormonal, and genetic measures in four large cohorts including adolescents and young adults. Two cohorts are designed as test and replication cohorts to test the developmental trajectory of self-regulation, including adolescents of different socioeconomic status thereby bridging individual, family, and societal perspectives. The third cohort consists of an entire social network to examine how neural and self-regulatory development influences and is influenced by whom adolescents and young adults choose to interact with. The fourth cohort includes youth with early signs of antisocial and delinquent behavior to understand patterns of societal development in individuals at the extreme ends of self-regulation and societal participation, and examines pathways into and out of delinquency. We will complement the newly collected cohorts with data from existing large-scale population-based and case-control cohorts. The study is embedded in a transdisciplinary approach that engages stakeholders throughout the design stage, with a strong focus on citizen science and youth participation in study design, data collection, and interpretation of results, to ensure optimal translation to youth in society.

Parental and Adolescents' Anxiety during the COVID-19 Outbreak in Rural China: The role of Parent-child Communication

Purpose

It has been suggested that the intergenerational transmission of anxiety may be an important contributor to the high prevalence of anxiety in adolescents. The objectives of this study are to examine whether and how parental anxiety is related to adolescent's anxiety and to explore the associations of parental anxiety and parent-child communication with adolescents' anxiety across different grades.

Methods

The current survey was conducted online from February 8th to February 27th, 2020.The questionnaires were distributed and retrieved through a web-based platform. A total of 6196 Chinese rural adolescents from grade seven to twelve (age ranging from 11 to 18 years old) were included.

Results

In this study, parental anxiety was significantly associated with higher adolescent anxiety (β = 0.14, p < 0.001) and this association was statically strongest at grade twelve. Besides, children with problematic parent-child communication related to COVID-19 reported elevated anxiety (β = 0.05, p < 0.01). In contrast, effective parent-child communication about COVID-19 mitigated the level of anxiety transmitted from parent to child (β = -0.04, p < 0.05).

Conclusions

During the COVID-19 epidemic, parents' anxiety was related to adolescents' anxiety. In addition, parent-child communication plays a moderating role in the above relationship. These findings emphasize the importance of implementing more psycho-education programs that specifically target parents' emotion regulation and effective communication abilities to ameliorate the psychopathological symptoms of parents and their children.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-023-00609-y.

Exploring the Relationship between Turkish Mothers' Parenting and Psychological Well-Being in Early Childhood: The Role of Child Emotion Regulation and Dysregulation

Although the importance of psychological well-being in early childhood is emphasized, the number of studies conducted with children and adolescents in this field is less than those carried out with adults. The present study aimed to explore the role of child emotion regulation in the relationship between parenting and psychological well-being among a sample of Turkish preschoolers aged 5-6. It further examines the mediating role of emotion regulation. The sample consisted of 416 mothers with children aged 5-6 (Mage = 5.38, SD = 0.48; 50% girls-boys). We collected the data using the Multidimensional Assessment of Parenting Scale (MAPS), the Emotion Regulation Checklist (ERC), and the Psychological Well-Being Scale for Children (PWBS-C). The findings revealed significant relationships among parenting practices (positive/negative), the child's emotion regulation/dysregulation, and the child's psychological well-being. Moreover, the findings revealed that positive parenting, directly and indirectly, affects children's psychological well-being through children's emotion regulation. On the other hand, findings disclosed that negative parenting has both a direct and indirect impact on children's psychological well-being through children's emotion regulation. Overall, the study may shed light on a possible process in which positive parenting boosts a child's emotional regulation and psychological well-being among preschoolers.

Etch the Emotional Life: Mother-Child Emotion Socialization from Age 3 to 6 Years

Emotion socialization is conceptualized as a relational process, yet children's role in socializing parents' emotions is rarely considered. This study explored longitudinal patterns of mother-child emotion socialization from early to middle childhood. Participants were 349 children (51% boys, 49% girls) and their mothers from the southeastern United States. Children were 79.4% White, 12% Black or African American, and 8.3% multi-racial or other; 6.3% were Hispanic/Latino. Mother-child dyads completed an etch-a-sketch task when children were 3, 4, and 6 years old. At each time, mothers' and children's expression, coaching, and dismissing of positive and negative emotions were observed. Hierarchical Linear Modeling analyses identified developmental trajectories and within-dyad associations of emotion coaching and dismissing with emotion expression. Over time, expression of positive emotions decreased and expression of negative emotions showed no change for both mothers and children. Mothers decreased in coaching children's positive emotions and showed no change in coaching children's negative emotions. Children increased in coaching mothers' positive emotions and showed no change in coaching mothers' negative emotions over time. Both mothers and children decreased in dismissing emotions over time. Within dyads, mothers' increases in coaching and in dismissing related to children's increased expression. Children's increases in coaching related to mothers' increased expression. Findings highlight complexity and dynamics of emotion socialization processes over time.

Development and adaptation of the Emotion Regulation Skills Questionnaire for adolescents

INTRODUCTION

The ability to effectively regulate one's emotions is important for adolescent mental health. However, extant assessments of how adolescents regulate their emotions can be expanded upon in several ways, including incorporating more strategies (e.g., cultural and spiritual) and positive emotions, and being informed by adolescents and expert consultation during the development process. Thus, our study aimed to improve the construct validity of an emotion regulation measure by adapting and refining the Emotion Regulation Skills Questionnaire (ERSQ) into an adolescent self-report.

METHODS

We recruited 24 13-17-year-olds (12 males; 11 females; 1 gender fluid) via social media advertisement in the United States in 2020. We used an iterative qualitative approach in which we combined expert consultation, cognitive interviewing with adolescents, and top-down and bottom-up coding to review and provide feedback on the ERSQ.

RESULTS

Findings of thematic analysis showed that a need for clarity in wording and inclusion of strategy examples across all sections of the ERSQ was needed. Adolescents also identified the need to replace the Silly/Excited section with a more age-appropriate positive emotion section.

CONCLUSION

Findings indicate cognitive interviewing can be successfully completed in a virtual format when necessary, youth utilize a wider range of strategies to maintain or upregulate positive emotions than what is represented in current measures, and use of qualitative methods may have reduced construct underrepresentation and construct-irrelevant variance in the adapted ERSQ.

The stability and change of wellbeing across the lifespan: a longitudinal twin-sibling study

BACKGROUND

Wellbeing is relatively stable over the life span. However, individuals differ in this stability and change. One explanation for these differences could be the influence of different genetic or environmental factors on wellbeing over time.

METHODS

To investigate causes of stability and change of wellbeing across the lifespan, we used cohort-sequential data on wellbeing from twins and their siblings of the Netherlands Twin Register (NTR) (total N = 46.885, 56% females). We organized wellbeing data in multiple age groups, from childhood (age 5), to adolescence, up to old age (age 61+). Applying a longitudinal genetic simplex model, we investigated the phenotypic stability of wellbeing and continuity and change in genetic and environmental influences.

RESULTS

Wellbeing peaked in childhood, decreased during adolescence, and stabilized during adulthood. In childhood and adolescence, around 40% of the individual differences was explained by genetic effects. The heritability decreased toward old adulthood (35-24%) and the contribution of unique environmental effects increased to 76%. Environmental innovation was found at every age, whereas genetic innovation was only observed during adolescence (10-18 years). In childhood and adulthood, the absence of genetic innovation indicates a stable underlying set of genes influencing wellbeing during these life phases.

CONCLUSION

These findings provide insights into the stability and change of wellbeing and the genetic and environmental influences across the lifespan. Genetic effects were mostly stable, except in adolescence, whereas the environmental innovation at every age suggests that changing environmental factors are a source of changes in individual differences in wellbeing over time.

Maternal alcohol dependence symptoms, maternal insensitivity to children's distress, and young children's blunted emotional reactivity

Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.

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.

Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey

BACKGROUND

Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic.

METHODS

A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11-14 years) and youth (15-18 years), April-May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location.

RESULTS

We analyzed data from 483 (51.7%) children (11-14 years; 227, 47.0% girls) and 450 (48.3%) youth (15-18 years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20 years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51-6.88; youth: OR 6.65 95%CI 3.98-11.23), anxiety (child: OR 4.24, 95%CI2.69-6.75; youth: OR 5.28, 95%CI 3.17-8.86), and irritability (child: OR 2.83, 95%CI 1.76-4.56; youth: OR 6.46, 95%CI 3.88-10.90).

CONCLUSIONS

Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health.

Dynamic characteristics of parent-adolescent closeness: Predicting adolescent emotion dysregulation

Emotion dysregulation is linked to adolescent psychological problems. However, little is known about how lability in daily closeness of parent-adolescent dyads affects the development of emotion dysregulation. This study examined how closeness lability with parents was associated with emotion dysregulation 12 months later. The sample included 144 adolescents (M = 14.62, SD = 0.83) who participated in a baseline assessment, 21-day daily diaries, and a 12-month follow-up assessment. Parents and adolescents both reported adolescent emotion dysregulation at baseline and follow-up assessments, while adolescents reported daily parent-adolescent closeness. Results indicate that lability in father-adolescent closeness was associated with increased emotion dysregulation at 12 months reported by adolescents. However, lability in mother-adolescent closeness was not associated with adolescent emotion dysregulation. Moreover, when baseline father-adolescent closeness was high, greater lability in father-adolescent closeness was associated with decreased emotion dysregulation. Findings indicate that daily fluctuations in father-adolescent closeness are a key family characteristic that links to long-term adolescent emotion dysregulation.

Emotion Dysregulation Mediates the Relationship Between Sensory Processing and Behavior Problems in Young Children with Autism Spectrum Disorder: A Preliminary Study

Emotion dysregulation is one of the challenges that children with autism spectrum disorder (ASD) and their families face. It is unclear whether emotion dysregulation plays a mediating role in the relationship between sensory processing patterns and problem behaviors among these children. This study examined the relations between emotion dysregulation, behavioral problems, and sensory processing patterns among fifty-seven young children with ASD. Behavioral problems and sensory processing patterns were moderately to strongly correlated with emotion dysregulation. The relationship between sensory processing patterns and behavioral problems was significant with emotion dysregulation as a mediator. These findings help identify the relationship between emotion dysregulation, sensory processing patterns, and behavioral problems to facilitate the planning of intervention strategies for young children with ASD.

Social cognition, emotion regulation and social competence in classical galactosemia patients without intellectual disability

OBJECTIVE

Classical galactosemia (CG) is an inborn error of galactose metabolism. Many CG patients suffer from long-term complications including poor cognitive functioning. There are indications of social dysfunction but limited evidence in the literature. Therefore, this study aims to improve our understanding of social competence in CG by investigating social cognition, neurocognition and emotion regulation.

METHODS

A comprehensive (neuro)psychological test battery, including self and proxy questionnaires, was administered to CG patients without intellectual disability. Social cognition was assessed by facial emotion recognition, Theory of Mind and self-reported empathy. Standardised results were compared to normative data of the general population.

RESULTS

Data from 23 patients (aged 8-52) were included in the study. On a group level, CG patients reported satisfaction with social roles and no social dysfunction despite the self-report of lower social skills. They showed deficits in all aspects of social cognition on both performance tests (emotion recognition and Theory of Mind) and self-report questionnaires (empathy). Adults had a lower social participation than the general population. Parents reported lower social functioning, less adaptive emotion regulation and communication difficulties in their children. Individual differences in scores were present.

CONCLUSION

This study shows that CG patients without intellectual disability are satisfied with their social competence, especially social functioning. Nevertheless, deficits in social cognition are present in a large proportion of CG patients. Due to the large variability in scores and discrepancies between self- and proxy-report, an individually tailored, comprehensive neuropsychological assessment including social cognition is advised in all CG patients. Treatment plans need to be customised to the individual patient.

Impact of Care Burden on the Quality of Life in Families of Children with Solid-Organ Transplants

OBJECTIVES

This study aimed to investigate the effects of care burden on the quality of life of parents who have children who have undergone solid-organ transplant.

MATERIALS AND METHODS

The research was conducted as a descriptive correlational study. Researchers collected data through face-to-face interviews with parents of patients registered in the Solid Organ Transplantation and Pediatric Nephrology outpatient clinic of Akdeniz University Hospital. The data collection tools included a Descriptive Information Form, the SF-36 Quality of Life Scale, and the Zarit Caregiver Burden Scale. Data were analyzed using descriptive statistics, percentages, Pearson correlation analysis, t tests, analysis of variance, and the Kruskal-Wallis test.

RESULTS

Parents in the study had a mean age of 32.12 ± 5.42 years; 100% of the parent participants were mothers. Among children who received transplants, 55.8% were boys. Solid-organ transplant types included 86% with liver transplants and 6.9% with kidney transplants. The mean burden of care score of parents was 38.72 ± 7.12, and the mean quality of life score was 28.14 ± 1.49. A significant negative correlation was found between the care burden of parents and their quality of life.

CONCLUSIONS

Families of children with solid-organ transplants face a significant care burden, which negatively affects their quality of life. The burden extends beyond parents to siblings and the overall family dynamics. Health care providers should recognize and address this burden by implementing comprehensive support services tailored to the specific needs of these families. A multidisciplinary approach involving various professionals is necessary to provide effective support. Interventions such as respite care, support groups, counseling services, and educational programs can help alleviate the burden and improve the overall well-being of these families. Future research should aim to develop targeted interventions and explore the experiences of these families in more depth.

Bullying Victimization and Adolescent Depression, Anxiety and Stress: The Mediation of Cognitive Emotion Regulation

BACKGROUND

Existing research has revealed a robust association between bullying victimization and psychological distress, but less is known about the underlying mechanism of this link. cognitive emotion regulation (CER) strategies could be a potential mediator. The current study examined the role of functional and dysfunctional CER strategies as potential mediators of the association between bullying victimization and depression, anxiety, and stress symptoms among 638 high school students (53.9% boys; Mean age = 15.65, SD = 1.32).

METHOD

Participants completed a series of questionnaires assessing bullying victimization (Olweus Bully/Victim Questionnaire), CER strategies (CERQ-18), and symptoms of depression, anxiety, and stress (DASS-21). The indirect relationships between bullying victimization and psychopathological symptoms via functional and dysfunctional CER strategies were tested through structural equation modeling.

RESULTS

Dysfunctional CER strategies mediated the impact of bullying victimization on depression, anxiety, and stress. In contrast, bullying victimization did not significantly influence functional CER strategies.

CONCLUSIONS

The findings provide additional support for the detrimental role of bullying victimization on mental distress, also suggesting that this effect is not only direct, but indirect is well. These results are particularly relevant in light of the absence of mediation by protective factors such as the use of positive emotion regulation strategies.

Yucatec Maya Children's Responding to Emotional Challenge

While the field of affective science has seen increased interest in and representation of the role of culture in emotion, prior research has disproportionately centered on Western, English-speaking, industrialized, and/or economically developed nations. We investigated the extent to which emotional experiences and responding may be shaped by cultural display rule understanding among Yucatec Maya children, an indigenous population residing in small-scale communities in remote areas of Mexico's Yucatan peninsula. Data were collected from forty-two 6- and 10-year-old Yucatec children who completed a resting baseline and a structured disappointing gift task. Children were asked about whether specific emotions are better to show or to hide from others and self-reported the intensity of their discrete positive and negative emotional experiences. We observed and coded expressive positive and negative affective behavior during and after the disappointing gift task, and continuously acquired physiological measures of autonomic nervous system function. These multi-method indices of emotional responding enable us to provide a nuanced description of children's observable and unobservable affective experiences. Results generally indicated that children's understanding of and adherence to cultural display rules (i.e., to suppress negative emotions but openly show positive ones) was evidenced across indices of emotion, as predicted. The current study is a step toward the future of affective science, which lies in the pursuit of more diverse and equitable representation in study samples, increased use of concurrent multimethod approaches to studying emotion, and increased exploration of how emotional processes develop.

Stress-induced alterations in resting-state functional connectivity among adolescents with non-suicidal self-injury

BACKGROUND

Non-suicidal self-injury (NSSI) is a major mental health problem among youth worldwide. Dysfunction in emotion regulation contributes to NSSI, but research on the underlying neurobiological mechanisms of NSSI is limited. Adolescents with emotion regulation difficulties are vulnerable to stress, making them susceptible to maladaptive coping mechanisms such as NSSI.

METHODS

This study examined the functional neurocircuitry relevant to emotion regulation and stress coping in individuals with NSSI compared with healthy controls. This case-control study included 34 adolescents with NSSI (15.91 years) and 28 (16.0 years) unaffected controls. Participants underwent a functional magnetic resonance imaging scan before and after completing a laboratory stress-induction paradigm (the Montreal Imaging Stress Test). The effects of stress induction were quantified by both physiological measures and self-reports.

RESULTS

Participants with NSSI showed distinctive alterations in functional resting-state following stress induction, which differentiated them from unaffected controls. Results show a reduction in functional connectivity between frontoparietal regions and the angular gyrus within the patient group compared to controls, as well as an increase in functional connectivity between visual regions, the insular cortex, the planum polare, and the central opercular cortex. After conditions of acute stress, adolescents with NSSI show changes in functional connectivity of regions associated with sensorimotor alertness, attention, and effortful emotion regulation.

LIMITATIONS

The patient group showed both NSSI and suicidal behavior, therefore results might be partly due to suicidality.

CONCLUSION

The findings emphasize the importance of targeting emotion regulation within therapeutic approaches to enhance stress coping capacity, which in turn may contribute to counteracting self-injurious behavior.

Maternal postnatal depressive symptoms and children's internalizing problems: The moderating role of mother-infant RSA synchrony

Maternal depressive symptoms are a crucial risk factor for children's internalizing problems, though positive mother-child relationships may buffer this risk transmission. Mother-child physiological coregulation (e.g., synchrony) has emerged as a potentially important mechanism of developmental psychopathology and may play a role in the transmission of internalizing symptoms. In this two-wave longitudinal study, we examined whether and how mother-infant physiological synchrony (of respiratory sinus arrhythmia; RSA) moderated the association between maternal postnatal depressive symptoms and children's internalizing problems in a rural, low-SES community sample (N = 166 dyads). At 6 months, mother-infant RSA synchrony and infant negative affect were assessed during free play. Mother reported their depressive symptoms at 6 months and children's internalizing problems at 24 months. Multilevel structural equation models indicated that mother-infant dyads demonstrated significant and positive RSA synchrony on average and RSA synchrony significantly moderated the association between maternal depressive symptoms and children's internalizing problems even after controlling for infant negative affect. Greater maternal depressive symptoms were associated with higher child internalizing problems when RSA synchrony was lower but not when it was higher. This finding suggests that mother-infant RSA synchrony may operate as a resilience factor for the intergenerational transmission of internalizing symptoms in community samples.

Longitudinal Relations Between Childhood Maltreatment, Emotion Regulation Difficulties, and Suicidal Ideation and Non-Suicidal Self-Injury: An 18-Month Investigation of Psychiatrically Hospitalized Adolescents

Within the Dimensional Model of Adversity and Psychopathology, extant research shows that exposure to threat-including emotional, physical, and sexual abuse-is linked to psychopathology among adolescents; problems with emotion regulation may, at least in part, explain this association. Both theoretical and empirical work also suggests that emotion regulation difficulties-particularly access to emotion regulation strategies-may mediate the relation between threat and self-injurious thoughts and behavior, though no studies to date have explicitly tested this model. The current study tested relations between threat, limited access to emotion regulation strategies, and self-injurious thoughts and behaviors among high-risk youth across an 18-month follow-up. The sample consisted of 180 adolescents (Mage = 14.89; SD = 1.35; ages 12-17; 71.7% female; 78.9% White; 55.0% heterosexual) recruited from an inpatient psychiatric unit. Threat was assessed at baseline using the abuse subscales from Childhood Trauma Questionnaire. Access to emotion regulation strategies was assessed using the Difficulties in Emotion Regulation Scale at baseline, 6-, and 12-months. Presence (versus absence) of non-suicidal self-injury and suicidal ideation severity were assessed at baseline, 12-, and 18-months using the Self-Injurious Thoughts and Behaviors Interview and the Suicidal Ideation Questionnaire-JR, respectively. After accounting for baseline levels of the mediator, outcome, and depressive symptoms, structural equation models supported the role of 12-month access to emotion regulation strategies as a mediator between baseline threat and 18-month suicidal ideation and non-suicidal self-injury. Treatment aimed at bolstering access to emotion regulation strategies may help reduce suicide risk among youth who have experienced childhood abuse.

Nurturing child social-emotional development: evaluation of a pre-post and 2-month follow-up uncontrolled pilot training for caregivers and educators

BACKGROUND

Social-emotional capacities contribute to children's mental health by helping them navigate their own and others' emotional states and forge healthy relationships. Caregivers and educators are critical socialization agents in early and middle childhood, but gaps remain in the systematic integration of social-emotional research into caregiver and educator trainings. The aim of this pilot study was to test the feasibility and preliminary efficacy of a social-emotional training designed to promote caregivers' and educators' capacities to support social-emotional development in children ages 3-8 years.

METHODS

Fifty adults (n = 24 caregivers of children ages 3-8 years, n = 26 educators working with children ages 3-8 years) participated in a virtual training over 3 weeks. Participants completed pre-training, post-training, and 2-month follow-up questionnaires evaluating their knowledge of social-emotional concepts, use of training strategies, mental health, and satisfaction with the training. Caregivers also reported children's social-emotional capacities and mental health.

RESULTS

On average, caregivers and educators completed 83% of the virtual training sessions and reported high satisfaction with the training. Further, preliminary evidence indicated that caregivers' and educators' knowledge of social-emotional concepts increased pre- to post-training and was maintained at the 2-month follow-up. Increases in caregivers' and educators' knowledge and greater use of training strategies were associated with improvements in children's social-emotional capacities and caregivers' and educators' own mental health.

CONCLUSIONS

These pilot results support the feasibility of infusing evidence-based social-emotional content into caregiver and educator training initiatives aimed at nurturing child social-emotional development and mental health. The results inform future evaluation of the short- and long-term benefits of this training with a full-scale randomized controlled trial design.

Effectiveness and mechanisms of change of a mindfulness-based intervention on elementary school children: A cluster-randomized control trial

Mindfulness-based interventions (MBIs) in the school context are increasingly widespread worldwide. The present study evaluates the effectiveness of a school-MBI (GrowingUp Breathing program) on children's socio-emotional and academic development. Three hundred thirteen elementary students from 7 to 12 years old from two schools in Madrid (Spain) participated. A cluster-randomized control trial was designed, assigning eight classrooms to the MBI-group (N = 155) and eight classrooms to the waiting-list control group (N = 158). Measures were evaluated at pre- and post-intervention in both groups and a 3-month follow-up was collected in the MBI-group. Children self-reported their mindfulness skills (i.e., dispositional mindfulness and psychological inflexibility) and well-being (i.e., anxiety and life satisfaction) and teachers evaluated children's social-emotional competence (i.e., emotion regulation, peer-relationship problems, and prosociality), well-being (i.e., emotional symptoms), and academic competence (i.e., student engagement and academic achievement). Mindfulness skills and emotional regulation were examined as potential mediators. Results revealed that children who received the MBI, compared to children in the WLC-group, improved their mindfulness skills, emotion regulation, prosociality, and emotional and behavioral engagement and decreased anxiety and peer-relationship problems. Positive changes in dispositional mindfulness led to reductions in children's anxiety and psychological inflexibility. Positive changes in emotional regulation led to improvements in prosociality and student engagement and decreased peer-relationships problems and emotional symptoms. Therefore, the results showed that a brief-MBI integrated in the Spanish regular school curriculum enhanced children's socio-emotional and academic development. Dispositional mindfulness and emotion regulation work as processes of change that underlie the intervention's impact.

Associations between parental dispositional attributions, dismissing and coaching reactions to children's emotions, and children's problem behaviour moderated by child gender

This study examined whether parents' attribution of their child's emotions (internalizing, externalizing) to dispositional causes is associated with children's problem behaviour (internalizing, externalizing). The mediating roles of parents' emotion-dismissing and -coaching reactions and the moderating role of child's gender was also examined. Participants were 241 US parents with a child (43% girls) between the ages of 5 and 7. Parents were presented with vignettes in which a gender-neutral child displayed internalizing and externalizing emotions and were asked to imagine their own child in the vignettes. Subsequently, parents indicated whether they attributed the child's emotion to dispositional causes and the likelihood of reacting in an emotion-dismissing and -coaching way in each situation. Child problem behaviour was measured using the CBCL. Results show that parental dispositional attributions were associated with child internalizing and externalizing problems, and this association was consistently mediated by emotion-dismissing reactions. The association between parental dispositional attributions and emotion-dismissing, as well as its indirect effect on child internalizing problems, was stronger for boys than for girls, whereas the indirect effect via emotion-coaching was stronger for girls than for boys. Thus, the parental attribution process seems to be different for boys and girls.

Peer facilitation of emotion regulation in adolescence

Emotion regulation is particularly important for adolescents as they undergo normative developmental changes in affective systems and experience heightened risk for psychopathology. Despite a high need for emotion regulation during adolescence, commonly studied emotion regulation strategies like cognitive reappraisal are less beneficial for adolescents than adults because they rely on neural regions that are still developing during this period (i.e., lateral prefrontal cortex). However, adolescence is also marked by increased valuation of peer relationships and sensitivity to social information and cues. In the present review, we synthesize research examining emotion regulation and peer influence across development to suggest that sensitivity to peers during adolescence could be leveraged to improve emotion regulation for this population. We first discuss developmental trends related to emotion regulation at the level of behavior and brain in adolescents, using cognitive reappraisal as an exemplar emotion regulation strategy. Next, we discuss social influences on adolescent brain development, describing caregiver influence and increasing susceptibility to peer influence, to describe how adolescent sensitivity to social inputs represents both a window of vulnerability and opportunity. Finally, we conclude by describing the promise of social (i.e., peer-based) interventions for enhancing emotion regulation in adolescence.

Observed Engagement in Community Implemented Evidence-Based Practices for Children and Adolescents: Implications for Practice Delivery

OBJECTIVE

This observational study characterizes youth and caregiver behaviors that may pose challenges to engagement within a system-driven implementation of multiple evidence-based practices (EBPs). We examined links between Engagement Challenges and therapist EBP implementation outcomes.

METHOD

Community therapists (N = 102) provided audio recordings of EBP sessions (N = 666) for youth (N = 267; 71.54%, Latinx; 51.69%, female; Mage = 9.85, Range: 1-18). Observers rated the extent to which youth and/or caregivers engaged in the following behaviors: Caregiver and/or Youth Expressed Concerns about interventions, and Youth Disruptive Behaviors. Multilevel modeling was used to identify predictors of observable Engagement Challenges, and examine associations between Engagement Challenges, and therapist-reported ability to deliver planned activities, and observer-rated extensiveness of EBP strategy delivery.

RESULTS

At least one Engagement Challenge was observed in 43.99% of sessions. Youth Engagement Challenges were not associated with outcomes. Caregiver Expressed Concerns were negatively associated with therapist-reported ability to carry out planned session activities (B = -.21, 95% CI[-.39-(-.02)], p < .05). However, Caregiver Expressed Concerns were positively associated with extensiveness of EBP Content strategy delivery (B = .08, 95% CI[.01-.15], p < .05).

CONCLUSIONS

Results suggest that Youth Engagement Challenges have little observed impact on EBP delivery. In contrast, although therapists perceive that Caregiver Expressed Concerns derail their planned activities, Caregiver Expressed Concerns are associated with more extensive delivery of content about therapeutic interventions. Community therapists' implementation of EBPs appear unaffected by common youth in-session behavioral challenges, but future research is needed to clarify whether caregivers' concerns about interventions prompt, or are prompted by, more intensive therapist EBP content instruction.

Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods

Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.

The mediating role of self-regulation on the link between child maltreatment and later substance use among Latinx youth

BACKGROUND

Children who experience maltreatment are at heightened risk for substance use initiation and mental health disorders later in life. Few studies have assessed the relationship between child maltreatment and substance use among Latinx youth.

OBJECTIVE

The current study assessed the potential mediating effect of three aspects of self-regulation (emotional, behavioral, and cognitive) on the association between child maltreatment and substance use and examined whether effects varied depending on maltreatment type and severity.

PARTICIPANTS AND SETTING

This study involved a random sample of 504 Latinx youth (52 % girls, 48 % boys) between the ages of 10-12 at the start of the study.

METHODS

Study hypotheses were tested through structural equation modeling and bootstrapped random errors using the R programming language.

RESULTS

Our results indicated that higher levels of child maltreatment predicted higher levels of later substance use, as mediated by emotional and behavioral dysregulation (β = 0.09, p < 0.01), but not cognitive regulation. When separating maltreatment by subtype, we found the mediating effect was present for abuse (β = 0.09, p < 0.01), but not neglect.

CONCLUSIONS

Findings contribute to our understanding of potential causal mechanisms for the association between child maltreatment and substance use for Latinx youth.

The Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y): Adaptation and Validation Across a Varied Sample of Children and Adolescents

Flexible self-regulation has been shown to be an adaptive ability. This study adapted and validated the adult Flexible Regulation of Emotional Expression (FREE) Scale for use with youth (FREE-Y) in community and maltreatment samples. The FREE-Y measures the ability to flexibly enhance and suppress emotion expression across an array of hypothetical social scenarios. Participants (N = 654, 8-19 years) were included from three studies. Confirmatory factor analysis (CFA) confirmed a theoretically appropriate higher order factor structure. Using multiple-group CFAs, measurement invariance was achieved across maltreatment status, age, and gender. Reliabilities were adequate and construct validity was demonstrated through associations with measures of emotion regulation, psychopathology, IQ, and executive functioning. Group comparisons indicated lower Suppression and Flexibility scores for maltreated versus comparison participants. Findings suggest that the FREE-Y is a valid measure of expressive regulation ability in youth that can be applied across a range of populations.

The Relationship Between Temperament Characteristics and Emotion Regulation Abilities in Institutionalized and Noninstitutionalized Children

This study examined the role of institutionalization and temperament dimensions on emotion regulation and negative lability in school-aged (6-10 years) children. Participants were 46 institutionalized (22 boys; 24 girls) and 48 noninstitutionalized children (23 boys; 25 girls), matched in age and sex. Emotion regulation and negative lability were assessed with the Emotion Regulation Checklist (ERC). The School-Age Temperament Inventory (SATI) was used to measure temperament dimensions. No significant between-group differences emerged in temperament dimensions, emotion regulation and negative lability. After controlling for institutionalization status, results indicated that (a) approach/withdrawal (sociability) and persistence positively predicted emotion regulation, (b) negative reactivity positively predicted negative lability, and (c) persistence negatively predicted negative lability. Institutionalization did not predict emotion regulation or negative lability. The protective role that specific temperament characteristics, such as persistence and approach/withdrawal (sociability), may have for at risk populations (e.g., institutionalized) and typically developing (e.g., noninstitutionalized) children is highlighted.

Sustained increase in depression and anxiety among psychiatrically healthy adolescents during late stage COVID-19 pandemic

Background

Adolescents have experienced increases in anxiety, depression, and stress during the COVID-19 pandemic and may be at particular risk for suffering from long-term mental health consequences because of their unique developmental stage. This study aimed to determine if initial increases in depression and anxiety in a small sample of healthy adolescents after the onset of the COVID-19 pandemic were sustained at follow-up during a later stage of the pandemic.

Methods

Fifteen healthy adolescents completed self-report measures at three timepoints (pre-pandemic [T1], early pandemic [T2], and later pandemic [T3]). The sustained effect of COVID-19 on depression and anxiety was examined using linear mixed-effect analyses. An exploratory analysis was conducted to investigate the relationship between difficulties in emotion regulation during COVID-19 at T2 and increases in depression and anxiety at T3.

Results

The severity of depression and anxiety was significantly increased at T2 and sustained at T3 (depression: Hedges' g [T1 to T2] = 1.04, g [T1 to T3] = 0.95; anxiety: g [T1 to T2] = 0.79, g [T1 to T3] = 0.80). This was accompanied by sustained reductions in positive affect, peer trust, and peer communication. Greater levels of difficulties in emotion regulation at T2 were related to greater symptoms of depression and anxiety at T3 (rho = 0.71 to 0.80).

Conclusion

Increased symptoms of depression and anxiety were sustained at the later stage of the pandemic in healthy adolescents. Replication of these findings with a larger sample size would be required to draw firm conclusions.

The Development of Appetite: Tracking and Age-Related Differences in Appetitive Traits in Childhood

Appetitive traits are associated with body weight. Increased understanding of how appetitive traits evolve from early life could advance research on obesity risk and inform intervention development. We report on tracking and age-related differences in appetitive traits in childhood within the RESONANCE cohort. Parents of RESONANCE children aged 6.02 ± 2.99 years completed the Child Eating Behavior Questionnaire (CEBQ). Pearson correlations of appetitive traits and age were tested for all participants contributing at least one observation, using each participant’s first observation (N = 335). Children’s first and second observations of the CEBQ (n = 127) were used to test tracking (paired correlations) and age-related differences (paired t-tests) within individuals. CEBQ correlations with age suggested that satiety responsiveness, slowness in eating, emotional undereating, and desire to drink decreased with age (r = −0.111 to r = −0.269, all p < 0.05), while emotional overeating increased with age (r = 0.207, p < 0.001). Food fussiness demonstrated a quadratic relationship with age. Paired t-tests further supported an increase in emotional overeating with age (M: 1.55 vs. 1.69, p = 0.005). All CEBQ subscales demonstrated moderate to high tracking (r = 0.533 to r = 0.760, p < 0.001). Our initial findings within the RESONANCE cohort suggest that food avoidant traits are negatively related with age, while emotional overeating increases with age, and that appetitive traits track through childhood.

Comparing the centrality symptoms of major depressive disorder samples across junior high school students, senior high school students, college students and elderly adults during city lockdown of COVID-19 pandemic-A network analysis

INTRODUCTION

Recently, in the view of network analysis, depression has been conceptualized as a complex and dynamic network model combining individual symptoms. To date, no studies have systematically examined and compared depressive symptom networks across different populations.

METHODS

A total of 36,105 participants were recruited and asked to complete the Patient Health Questionnaire-9 among junior high school students, senior high school students, college students, and elderly adults who were more susceptible to depression during the COVID-19 lockdown in China. In the analysis, we applied the optimal cutoff score ≥ 8 for students and a score ≥ 6 for elderly adults to identify 5830 participants who were likely to be depressed. The index of "strength" was used to identify central symptoms in the network structure.

RESULTS

The results showed that Sad Mood was the most central symptom among junior high school students, senior high school students, and college students, but the most central symptom in the elderly was Guilt. Among the top three central symptoms, Suicide Ideation was unique to senior high school students, while Anhedonia was most prevalent among college students. Guilt - Suicide Ideation, Anhedonia - Energy, Anhedonia - Sad Mood, and Sleep - Energy showed the strongest association among junior and senior high school students, college students, and elderly adults, respectively. NCT (i.e., Network Comparison Test) suggested that the network's global connectivity was ultimately inconsistent, but the network structure remained roughly intact.

CONCLUSION

In treatment, targeting central symptoms may be critical to alleviating depression.

Music as an alternative self-regulation strategy to snack foods following a negative mood induction in 5-7-year-old children: Interactions with parental use of food as a reward

This study aimed to extend studies that have looked at snack food consumption following a negative mood induction, and examine whether listening to a happy song would counteract food consumption in children. A second aim was to examine whether parental feeding practices (use of food as a reward and the use of food to regulate emotions) and child Body Mass Index (BMI) would moderate any differences. Eighty 5-7-year-old children took part in a negative mood induction and were then assigned to either a happy music condition or a silent control condition. The weight (g) consumed of four snack foods was measured (fruit hearts, crisps, chocolate biscuits, and breadsticks). Parents filled in baseline measures of feeding practices. There were no significant differences in food consumption between conditions. There was, however, a significant interaction between the high use of food as a reward and the condition on the amount of food eaten. In particular, following a negative -mood induction, those children whose parents reported using food as a reward and who were in the silent condition ate significantly more snack foods. There were no significant interactions with child BMI or with parental use of food to regulate emotions. This research suggests that the use of certain parental strategies may influence how children respond to novel emotion regulation techniques. Further research is needed to evaluate the best types of music to regulate emotions in children, and whether parents can be encouraged to replace maladaptive feeding practices with more adaptive non-food practices.

Daily affect intensity and variability of adolescents and their parents before and during a COVID-19 lockdown

INTRODUCTION

The corona virus (COVID-19) pandemic may have a prolonged impact on people's lives, with multiple waves of infections and lockdowns, but how a lockdown may alter emotional functioning is still hardly understood.

METHODS

In this 100-daily diaries study, we examined how to affect intensity and variability of adolescents (N = 159, M_age  = 13.3, 61.6% female) and parents (N = 159, M_age  = 45.3, 79.9% female) changed after the onset and during (>50 days) the second COVID-19 lockdown in the Netherlands, using preregistered piecewise growth models.

RESULTS

We found only an unexpected increase in parents' positive affect intensity after the lockdown onset, but no immediate changes in negative affect intensity or variability. However, both adolescents and parents reported gradual increases in negative affect intensity and variability as the lockdown prolonged. Lockdown effects did not differ between adolescents and parents. However, within groups, individuals differed. The individual differences in the effects were partly explained by life satisfaction, depressive symptoms, and self-reported lockdown impact.

CONCLUSIONS

Overall, these findings suggests that a lockdown triggers changes in daily affective well-being especially as the lockdown prolongs. Individual differences in the effects indicate heterogeneity in the impact of the lockdown on daily affect that was partly explained by baseline life satisfaction and depressive symptoms. However, more knowledge on the causes of this heterogeneity is needed to be able to increase resilience to lockdown effects in the population.

What do I want to feel? Emotion goals in childhood, adolescence, and adulthood

Beliefs about emotion utility can influence context-sensitive emotion goals (i.e., desired emotional responses). Although key for emotion regulation, emotion goals have been overlooked in children and adolescents. In 2018-2019 results of Studies 1 and 2 showed that children (N = 192, M_age  = 8.65, 47% girls, 96% White) were less motivated by and found anger less useful in confrontation than adolescents (N = 192, M_age  = 12.96, 50% girls, 93% White) and adults (N = 195, M_age  = 29.82, 51% women, 96% White). The link between emotion goals and beliefs about emotion utility was weaker in children. In 2021, Study 3 (N = 60, 8-year-olds, 47% girls, 90% White) ruled out expectations as a possible explanation for the previous findings. Context-sensitive utility of emotions may be acquired during development.

Linking ADHD and ASD Symptomatology with Social Impairment: The Role of Emotion Dysregulation

Children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often experience social impairments. These children also frequently struggle with emotion regulation, and extant literature suggests that emotion dysregulation predicts social impairment in both clinical and neurotypical populations. However, the evidence base linking ADHD/ASD with social impairment comes primarily from samples meeting full diagnostic criteria for ADHD and/or ASD despite evidence that both syndromes reflect extreme ends of natural continuums that are normally distributed across the general population. To our knowledge, the present study is the first to concurrently examine unique and overlapping relations among ADHD/ASD symptoms, emotion regulation, and social difficulties using multi-informant measures (parent, teacher) with a clinically-evaluated sample of 108 children ages 8-13 (40 girls; 66% White/Non-Hispanic) with and without clinically-elevated ASD and ADHD symptoms and other common clinical disorders. Bias-corrected, bootstrapped conditional effects modeling revealed that ADHD-inattentive (β=-0.23) and ASD-social communication (β=-0.20) symptoms predicted social impairment directly, whereas ADHD-hyperactive/impulsive (β=-0.06) and ASD-restricted/repetitive behavior/interests (β=-0.06) symptoms predicted social impairment only via their shared associations with emotion dysregulation. Sensitivity analyses revealed that most relations were robust to control for item overlap across measures. In contrast, only the ADHD-inattention/social impairment link was robust to control for mono-informant bias, highlighting the importance of multi-informant methods and the potential for different determinants of social functioning across settings. Overall, this study implicates emotion regulation skills and all four ADHD/ASD symptom clusters as potential influences on children's social functioning, albeit with a more nuanced and potentially setting-specific pattern than suggested by prior work.

Association of Emotion Regulation and Dispositional Mindfulness in an Adolescent Sample: The Mediational Role of Time Perspective

This study relates emotional regulation strategies with dispositional mindfulness and the mediating role of time perspective. It is based on the fact that one of the mechanisms of mindfulness consists in providing protective emotional regulation strategies. At the same time, a direct relationship between dispositional mindfulness and time perspective has been observed. To do this, a representative sample of 320 Chilean adolescents from the city of Talcahuano, whose age ranged between 14 and 17 years old, and who were attending high school, was evaluated. The Zimbardo Time Perspective Inventory, the Difficulties in Emotion Regulation Scale, and the Five Facet Mindfulness Questionnaire were applied. Regression analysis results verified the close relationship between emotional regulation and dispositional mindfulness (R² = 0.54), as well as with the factors of time perspective (R² = 0.41), explaining, between both of them, 60% of the variance of difficulties in emotional regulation. The possible mediational role of time perspective between dispositional mindfulness and emotional regulation is established.

Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness

BACKGROUND

Dysfunctional emotion regulation (ER) is associated with symptoms of depression and anxiety in adolescents. This pilot study aimed to examine the acceptability and feasibility of a guided internet-based emotion regulation training (ERT) added to cognitive behavioral therapy (CBT). Furthermore, we aimed to examine the feasibility of the randomized study design and to provide a first estimate of the effectiveness of CBT + ERT compared with CBT alone in adolescents with depressive or anxiety disorders.

METHODS

In a pilot randomized controlled trial (RCT) with a parallel group design, 39 patients (13-18 years) with depressive or anxiety disorder were assigned to CBT + ERT (n = 21) or CBT (n = 18). Assessments at baseline, three-months and six-months follow-up included treatment adherence, satisfaction, depressive symptoms, anxiety symptoms, and ER strategies.

RESULTS

Adherence to ERT was 66.5 %, and treatment satisfaction was adequate. 76.5 % of eligible patients participated in the study. Linear mixed-model analyses showed significantly reduced anxiety symptoms (p = .003), depressive symptoms (p = .017), and maladaptive ER (p = .014), and enhanced adaptive ER (p = .008) at six months follow-up in the CBT + ERT group compared to controls.

LIMITATIONS

The sample size was small, and results regarding effectiveness remain preliminary. Data-collection took place during COVID-19, which may have influenced the results.

CONCLUSIONS

Both the intervention and the study design were found to be feasible. In a larger RCT, however, improvement of recruitment strategy is necessary. Preliminary results indicate potential effectiveness in decreasing anxiety, depression, and emotion dysregulation in adolescents. The next step should be the development of an improved internet-based ERT and its evaluation in a larger RCT.

TRIAL REGISTRATION

Registered on January 14th, 2020 in The Netherlands Trial Register (NL8304).

Longitudinal links between expressive flexibility and friendship quality in adolescence: The moderating effect of social anxiety

INTRODUCTION

Expressive flexibility, or the ability to both up- and down-regulate emotional expressions in social interactions, is thought as an indicator and a consequence of healthy interpersonal relationships. The present longitudinal study examined bidirectional associations between expressive flexibility and friendship quality in early adolescence. Since prior research found inconsistent results regarding the adaptiveness of expressive flexibility, which indicated the necessity to consider individual variability in the process, we further tested the potential moderating effect of social anxiety in the links from expressive flexibility to friendship quality.

METHODS

Participants from two junior high schools in eastern China (N = 274; 50.4% female; M_age  = 13.56) were surveyed at three time points with 6-month intervals. Expressive flexibility, friendship quality, and social anxiety were all assessed via self-reported scales.

RESULTS

According to the cross-lagged model results, friendship quality significantly predicted increased expressive flexibility over time. Conversely, the longitudinal association from expressive flexibility to friendship quality was not significant, but the interaction between expressive flexibility and social anxiety significantly predicted later friendship quality. Further analyses via the Johnson-Neyman technique revealed that expressive flexibility only positively predicted friendship quality for adolescents with lower levels of social anxiety.

CONCLUSION

Our results suggest that expressive flexibility is not always socially adaptive, so practical interventions that aim to improve youths' social adjustment via expressive flexibility training might need to consider the role of individual characteristics.

How parents assist children’s emotion regulation in Turkey: The Turkish adaptation of the parental assistance with child emotion regulation (PACER) questionnaire

Parents play a critical role in emotional socialization and the development of emotion regulation during childhood. The tools to measure how parents assist children’s emotion regulation are very limited. The Parental Assistance with Child Emotion Regulation (PACER) Questionnaire is a novel scale developed for this purpose with excellent psychometric properties. The aim of this study is to adapt the PACER to Turkish and investigate its psychometric properties in the Turkish cultural setting. The data were collected from 700 parents who have children aged birth to 17 years. In addition to the PACER, participants filled out some scales about their own beliefs and behaviors, also their children’s psychological symptoms. We confirmed the original ten-factor structures of the PACER in a Turkish sample and the measurement invariance supported the PACER’s structure across subgroups. The high internal consistencies of factors were achieved; however, the test-retest reliability was lower than expected. The factors of maladaptive emotion regulation strategies (e.g., rumination, expressive suppression, avoidance) were positively associated with parents’ own emotion regulation deficit, symptoms, and child’s symptoms, while others (e.g., reappraisal, problem-solving) were negatively associated with them. Overall, our results suggest that the Turkish version of the PACER is a psychometrically valid and reliable measurement to assess how parents support their children to regulate their emotions. We believe that this adaptation allows the scale to be used in developmental and clinical psychology studies and will pave the way for cross-cultural studies.

Emotion regulation, perfectionism, and eating disorder symptoms in adolescents: the mediating role of cognitive eating patterns

Poor emotion regulation, along with elevated perfectionism, is recognised as a risk factor for the development of eating disorder (ED) symptoms. Therefore, the aim of our study was to examine the relationship between emotion regulation difficulties and perfectionism with ED symptoms, while controlling for emotional eating, uncontrolled eating, and cognitive restraint as mediators. In total, 482 adolescents (246 girls and 236 boys; M = 15.00, SD = 0.31) participated in this study. Based on the participants' body height and weight measured by the medical team during their regular preventive health examinations, the body mass index (BMI) was calculated. Participants also answered the Difficulties in Emotion Regulation Scale, Multidimensional Perfectionism Scale, Three-Factor Eating Questionnaire, and Eating Disorder Examination Questionnaire. According to the results obtained, adolescent girls in our sample reported more difficulties in emotion regulation, more uncontrolled and emotional eating, and more ED symptoms. A significant direct effect was found for difficulties in emotion regulation and ED symptoms but not for perfectionism. In addition, only emotional eating and cognitive restraint (not uncontrolled eating) mediated the relationship between difficulties in emotion regulation and perfectionism and ED symptoms. The results suggest that difficulties in emotion regulation may be more important than perfectionism in explaining ED symptoms in a sample of healthy adolescents. When adolescents experience problems in emotion regulation in combination with emotional or uncontrolled eating, they might be at a higher risk of experiencing concerns about weight and a variety of other ED symptoms, and this should be considered when planning preventive interventions for adolescents.

Fact- and emotion-focused conversations elicit differential patterns of reporting and distress in children

We examined the role of emotion- versus fact-focused conversations in the details children reported about a stressful event and whether the details provided were prompted or spontaneously offered. We also tested how these conversational strategies, in conjunction with children's emotion regulation skills, influenced children's event-related distress. Children (N = 100 8- to 13-year-olds) experienced a stressor in the laboratory and were randomly assigned to participate in a fact-focused conversation (prompted about objective event elements) or an emotion-focused conversation (prompted about subjective reactions to the event) with an unfamiliar adult. Caregivers reported on children's emotion regulation skills. Children reported more overall prompted and spontaneous details in the fact-focused condition, but reported proportionally more spontaneous details than prompted detail in the emotion-focused condition compared to the fact-focused condition. Children with lower emotion regulation skills found the emotion-focused conversation (but not the fact-focused conversation) about the laboratory stressor significantly less distressing than children with high emotion regulation skills (when controlling for initial distress about the task). We propose that combining both fact- and emotion-focused conversational techniques may be most effective for encouraging detailed disclosures from children and for providing a respite from distress for children with emotion-regulation difficulties.