A longitudinal examination of emotion regulation: pathways to anxiety and depressive symptoms in urban minority youth

The mediating role of social connectedness and negative cognitive emotion regulation in the association between problematic Internet use and depression among adolescents

Introduction

While the relationship between adolescent problematic Internet use (PIU) and depression has been extensively researched, few studies have investigated the role and mechanisms of social connectedness (SC) in this context. This study aimed to investigate the mediating effect of social connectedness (SC) and cognitive emotion regulation (CER) in the relationship between PIU and depression.

Methods

We conducted a cross-sectional study involving 9,407 adolescents aged 12-18 years in China from September 2022 to March 2023. We employed Young's 20-item Internet Addiction Test (IAT-20), the Social Connectedness Scale-Revised (SCS-R), the Cognitive Emotion Regulation Scale (CER), and the DSM-5 Level-2 Depression Scale to assess mental health outcomes. Logistic regression analysis was also performed to examine the independent association between the measured variables and depression. Mediation analysis was then conducted to evaluate the mediating roles of social connectedness and cognitive emotion regulation in the relationship between PIU and depression.

Results

We found that the prevalence of PIU was 21.8%. Offline SC (indirect effect: 0.112, 95% CI: 0.104-0.121) and negative CER (indirect effect: 00.140, 95% CI: 0.129-0.152) mainly played a parallel mediating role in the relationship between PIU and depression, along with online SC (on_SC) (indirect effect: 0.007, 95% CI: 0.005-0.010).

Discussion

These findings provide valuable insights into how PIU is associated with depression and highlight the importance of fostering real-life interpersonal interactions. However, the generalizability of this study's findings to other populations may be limited due to cultural factors.

Nighttime Texting on Social Media, Sleep Parameters, and Adolescent Sadness: A Mediation Analysis

OBJECTIVES

The use of social media during bedtime has increased in the past years among adolescents, contributing to disturbed sleep quality, which could potentially be related to emotional problems. This study aimed to analyze the mediation effects of sleep parameters on the relationship between NightTime Texting (NTT) on social media and adolescent sadness.

METHODS

We used a cross-sectional study and evaluated a total of 1464 Swedish students aged 15-17 (55.7% girls) to examine their frequency of NTT on social media, sleep parameters, and adolescent sadness. Bivariate and mediation analyses were performed.

RESULTS

Approximately 60% (n = 882) of adolescents engaged in nighttime instant messaging, with 37% (n = 330) reporting texting every night. Higher frequency of NTT was significantly associated with later bedtimes (η2 > 0.12), extended weekend wake-up times (η2 = 0.07), increased social jetlag (η2 = 0.07), and reduced sleep duration on schooldays (η2 = 0.10). Multicategorical parallel mediation analyses revealed that sleep duration on schooldays had an indirect effect on the relationship between both Occasional NTT (a11b1 = 0.05, p < .05) and Daily NTT (a21b1 = 0.12, p < .05) with sadness. Mediation effects were not moderated by gender (p > .05), however, the association between Occasional NTT and higher sadness was significantly linked to boys (t = 2.72; p = .007).

CONCLUSIONS

Findings showed a large percentage of adolescents engaging in nighttime social media use with worse quality of sleep, and underlined sleep duration on schooldays as a mediator associated with emotional problems in adolescents. These insights can aid in developing strategies for healthier habits to address the misuse of social media and prevent related health problems.

Longitudinal Associations Between Nonsuicidal Self-Injury, Depressive Symptoms, Hopelessness, and Emotional Dysregulation in Adolescents

Nonsuicidal self-injury (NSSI) in adolescents has been associated with increased depressive symptomatology, hopelessness, and emotional dysregulation; however, few studies have examined longitudinal associations between NSSI and these problems. This study examines the longitudinal relationships among these variables in community adolescents and whether the pattern of relationships varies between boys and girls. The participants were 785 adolescents (57.1% girls) aged 13 to 18 years (M = 15.64; SD = 1.08) who completed self-reported measures of NSSI, depression, hopelessness, and emotional dysregulation at least once at two moments separated by 1 year. The longitudinal model was tested through structural equation modeling and multiple group analysis. NSSI predicted increased depressive symptoms, hopelessness, and emotional dysregulation; depressive symptoms predicted NSSI; hopelessness predicted depressive symptoms; and emotional dysregulation predicted depressive symptoms and hopelessness. The pattern was similar for girls and boys, although girls scored higher on all variables. The results underscore the important bidirectional associations between NSSI and other risk factors throughout adolescence. These findings will support prevention and interventions for NSSI and internalizing symptoms in adolescents in school and clinical settings.

Sexual harassment and patterns of symptoms and functional abilities in a psychiatric sample of adolescents

PURPOSE

To investigate how commonly adolescent psychiatric outpatients with symptoms of depression and anxiety report having been subjected to sexual harassment, and to explore how symptoms and functional abilities differ between adolescent psychiatric outpatients with symptoms of depression and anxiety who do report and those who do not report having been subjected to sexual harassment.

METHODS

Swedish adolescent psychiatric outpatients with symptoms of depression or anxiety (n = 324; 66 boys and 258 girls, aged 12-19 years, M = 15.6, SD = 1.7) answered the PROMIS paediatric measures. Logistic regression analyses were performed to assess differences between the respondents classified as 'Sexually harassed' and 'Not sexually harassed' based on these self-report questionnaires.

RESULTS

About 60% of the adolescents reported having been subjected to sexual harassment, and reported higher levels of suicidal ideation, disturbed sleep, fatigue, anxiety, depression, anger, and pain interference, as well as lower functional ability in terms of school problems, alcohol consumption, and poor family relationships. Logistic regression analyses showed that the strongest associations were with suicidal ideation, disturbed sleep, anger, and alcohol consumption.

CONCLUSIONS

About 60% of the adolescents in the studied psychiatric cohort reported having been subjected to sexual harassment. Reported experiences were high in all three subtypes, with the most reports on having been subjected to verbal harassment. Clinicians should ask about experiences of sexual harassment and give information about the consequences of sexual violence and treatment options. Alcohol consumption should be addressed and tested for. Structured assessment of suicidality should always be done.

Socioeconomic inequalities in child and adolescent mental health in Australia: the role of parenting style and parents' relationships

BACKGROUND

Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents.

METHODS

This study utilized data from the Longitudinal Study of Australian Children (Waves 1-7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents.

RESULTS

This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents.

CONCLUSION

Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population.

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.

Short-term effects of the "I Spy Feelings" program on emotion regulation in 5- to 6-year-old children

Introduction

Mental health difficulties in early childhood can have a debilitating and ongoing impact throughout an individual's life; emotion regulation can serve as a protective factor. Therefore, evidence-based prevention programs that teach children effective skills and strategies for emotion regulation are needed.

Methods

As part of the Aussie Optimism pilot study evaluating the "I Spy Feelings" program, this study aims to assess the short-term effects of the program on emotion regulation in pre-primary aged children after 2 months via a longitudinal cluster randomized controlled trial. Participants included parents (N = 73) of 5- to 6-year-old children attending four different Catholic primary schools. Children from two of the schools were allocated to the intervention group where they participated in the program (N = 33), while children from the other two schools were allocated to the control group where they did not (N = 40). At each time point, all parents completed abridged Children's Emotional Management Scales measuring how well parents believe their child is able to cope with anger, sadness and worry.

Results

A significant intervention effect 2 months after intervention was found for the outcome of anger coping such that parents whose children were in the intervention group reported significantly greater improvement in their children's ability to cope with anger compared to parents whose children were in the control group. No significant effect was found for the outcome of sadness, and results for the worry subscale were inconclusive due to unacceptable internal consistency.

Discussion

The present study provides insight into the benefit of programs designed to enhance the emotion regulation skills of very young children. Further follow-up is needed to assess whether the "I Spy Feelings" program has lasting effects.

Supportive parent-adolescent relationships as a foundation for adolescent emotion regulation and adjustment

Introduction

The purpose of this investigation was to examine the influence of supportive parent-adolescent relationships on adolescent adjustment (i.e., prosocial behavior, aggression, depressive symptoms) both directly and indirectly (via adolescent emotion regulation). Scholars have posited that adolescent emotion regulation (ER) may serve as an underlying mechanism in the link between parenting and adolescent adjustment. Supportive parent-adolescent relationships (i.e., openness, acceptance, emotional responsiveness) may be a key emotion socialization mechanism influencing adolescent ER.

Methods

The sample included 206 adolescents (Age Range= 10-18years; 51% female; 70.4% ethnic minorities) and one primary caregiver (83.3% biological mothers, 38.7% single parents). Structural equation modeling (SEM) was implemented to investigate the direct and indirect (via adolescent ER) effects of supportive parent-adolescent relationships on adolescent adjustment. We also explored whether these indirect and direct effects varied by adolescent sex and age.

Results

Results suggested direct and indirect (via adolescent ER) links between supportive parent-adolescent relationships and adolescent prosocial behavior, aggressive behavior, and depressive symptoms. Moreover, evidence indicated that many of these pathways were significant for boys but not girls. No evidence of youth age as a moderator was found.

Discussion

These findings highlight the important role supportive parent-adolescent relationships play in adolescent emotional and behavioral adjustment. Parenting programs could focus on facilitating a mutually responsive parent-adolescent relationship with a specific focus on the dynamic nature of emotion socialization during adolescence.

Predictors and outcomes associated with the growth curves of self-efficacy beliefs in regard to anger and sadness regulation during adolescence: a longitudinal cross-cultural study

Introduction

This longitudinal study examined unique and joint effects of parenting and negative emotionality in predicting the growth curves of adolescents' self-efficacy beliefs about regulating two discrete negative emotions (anger and sadness) and the association of these growth curves with later maladjustment (i.e., internalizing and externalizing problems).

Methods

Participants were 285 children (T1: M age = 10.57, SD = 0.68; 53.3% girls) and their parents (mothers N = 286; fathers N = 276) from Colombia and Italy. Parental warmth, harsh parenting, and internalizing and externalizing problems were measured in late childhood at T1, whereas early adolescents' anger and sadness were measured at T2 (T2: M age = 12.10, SD = 1.09). Adolescent self-efficacy beliefs about anger and sadness regulation were measured at five time-points from T2 to T6 (T6: M age = 18.45, SD = 0.71), and internalizing and externalizing problems were measured again at T6.

Results

Multi-group latent growth curve models (with country as the grouping variable) demonstrated that in both countries there was on average a linear increase in self-efficacy about anger regulation and no change or variation in self-efficacy about sadness regulation. In both countries, for self-efficacy about anger regulation (a) T1 harsh parenting and T1 externalizing problems were negatively associated with the intercept, (b) T2 anger was negatively associated with the slope, and (c) the intercept and the slope were associated with lower T6 internalizing and externalizing problems, controlling for T1 problems. For self-efficacy about sadness regulation, (a) T1 internalizing problems were negatively associated with the intercept only in Italy, (b) T2 sadness was negatively associated with the intercept only in Colombia, and (c) the intercept negatively predicted T6 internalizing problems.

Discussion

This study advances knowledge of the normative development of self-efficacy beliefs about anger and sadness regulation during adolescence across two countries, highlighting the predictive value of pre-existing family and individual characteristics on this development and prediction by the development of self-efficacy beliefs on later adjustment.

Longitudinal Relations Between Emotion Regulation and Internalizing Symptoms in Emerging Adults During the Covid-19 Pandemic

Background

Maladaptive and adaptive emotion regulation are putative risk and protective factors for depression and anxiety, but most prior research does not differentiate within-person effects from between-person individual differences. The current study does so during the early part of the Covid-19 pandemic when internalizing symptoms were high.

Methods

A sample of emerging adult undergraduate students (N = 154) completed online questionnaires bi-weekly on depression, anxiety, and emotion regulation across eight weeks during the early days of the Covid-19 pandemic (April 2nd to June 27th, 2020).

Results

Depression demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, catastrophizing, and self-blame, and negative correlations with overall adaptive emotion regulation and reappraisal. Anxiety demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, rumination, and catastrophizing, and a negative correlation with reappraisal. After controlling for these between-person associations, however, there were generally no within-person associations between emotion regulation and internalizing symptoms.

Conclusions

Emotion regulation and internalizing symptoms might be temporally stable individual differences that cooccur with one another as opposed to having a more dynamic relation. Alternatively, these dynamic mechanisms might operate over much shorter or longer periods compared to the two-week time lag in the current study.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10366-9.

Child maltreatment exposure and adolescent nonsuicidal self-injury: the mediating roles of difficulty in emotion regulation and depressive symptoms

BACKGROUND

Although child maltreatment (CM) experiences are recognized risk factors for nonsuicidal self-injury (NSSI), the mechanisms underlying this relationship remain unclear. The purpose of this study was to examine whether difficulty in emotion regulation (DER) and depressive symptoms mediate the relationship between child maltreatment experiences and NSSI severity, adjusting for demographic variables.

METHODS

The participants were 224 adolescent inpatients recruited from a hospital in China (mean age 15.30 years, SD = 1.83; 78.6% females). Study measures included the Clinician-Rated Severity of Nonsuicidal Self-Injury (CRSNSSI), Childhood Trauma Questionnaire (CTQ-SF), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9). The hypothesized chain mediation model was tested using the structural equation model.

RESULTS

A total of 146 (65.18%) adolescents reported engaging in NSSI during the past 12 months, and 103 (45.98%) participants met the DSM-5 diagnostic criteria for NSSI. Emotional neglect (48.1%) and emotional abuse (46.1%) had the highest prevalence, followed by physical neglect (43.1%) and physical abuse (24.1%), whereas sexual abuse (12.5%) was the least prevalent form of CM. Separately, both DER and depressive symptoms significantly mediated the association between CM and NSSI, with DER being the strongest mediator, with an indirect effect of 49.40% (p = 0.014). At the same time, we also proved a potential chain-mediated pathway of DER and depression in the relationship between CM and NSSI.

CONCLUSION

Child maltreatment seems to play a role in the aetiology of NSSI. DER and depressive symptoms both have a mediating role in the relationship between CM and NSSI. Importantly, DER seems to be a mediator with a stronger indirect effect compared to depressive symptoms.

Childhood maltreatment and depressive disorders in Chinese children and adolescents: A population-based case-control study

OBJECTIVE

The association between childhood maltreatment (CM) and clinically diagnosed depressive disorders (DD) in children and adolescents remains inconclusive, in large part due to a lack of high-quality epidemiological evidence. This study aimed to investigate the association between CM and DD in a large sample of Chinese children and adolescents.

METHODS

The study subjects were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), and a population-based and individually-matched case-control study design was adopted.

RESULTS

CM was in general associated with an odds ratio (OR) of 5.38 (95% CI: 3.33, 8.71) for DD in children and adolescents, and a prominent dose-response association was detected. For the five specific types of CM, emotional abuse was independently related to the highest odds of DD (OR=3.90, 95% CI: 2.75, 5.54), followed by physical neglect (OR=2.04, 95% CI: 1.45, 2.87) and physical abuse (OR=1.51, 95% CI: 1.06, 2.13), while insignificant associations were found between DDs and sexual abuse and emotional neglect. Subsequently performed stratified analyses identified noticeable effect modification by important demographic factors.

CONCLUSION

CM was significantly associated with increased risk of DD in Chinese children and adolescents. The major findings of the current study suggest that victims of CM, especially those who had been emotionally abused, were susceptible to early-onset DD. Targeted interventions should be considered.

Indicators of suicidal outcomes among 6- to 12-year-old treatment seeking youth

Suicide among elementary school-age youth is vastly understudied despite being a major health concern. This study utilized mediation and moderation models to elucidate the nature of risk factors for suicide by examining the effect emotion dysregulation (of anger, sadness, and worry) has on the relation between ADHD symptoms (hyperactivity/impulsivity and inattention) and suicidal outcomes (suicidal behavior and risk for suicide) in children ages 6 to 12. When accounting for sex, age, depressive symptoms, and emotion dysregulation, hyperactivity/impulsivity was positively associated with suicidal behavior; however, inattention was negatively associated with suicidal behavior. After accounting for the variance associated with sex, age, and depressive symptoms, two interaction effects were evident. At low levels of sadness and worry dysregulation, hyperactivity was positively associated with suicide risk. However, at high levels of sadness and worry dysregulation, hyperactivity was not related to suicide risk. Findings support moderation over mediation.

A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

Objective

The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

Method

Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

Results

A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

Conclusion

This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.Reprinted from J Am Acad Child Adolesc Psychiatry, 60, Zeytinoglu et al., A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic, pp. 1300-1308, copyright 2021, with permission from Elsevier.

Association of Emotion Regulation Trajectories in Childhood With Anorexia Nervosa and Atypical Anorexia Nervosa in Early Adolescence

IMPORTANCE

People with anorexia nervosa often experience difficulties regulating their emotions. There is no longitudinal evidence as to whether these differences are already present in childhood or when they begin to emerge.

OBJECTIVE

To investigate the association between emotion regulation trajectories from 3 to 7 years of age and symptoms of anorexia nervosa and atypical anorexia nervosa in adolescence.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study included all children with complete exposure data in the Millennium Cohort Study, a UK general population birth cohort. Data were acquired from June 2001 to March 2016 and analyzed from June to November 2020.

EXPOSURES

Mothers reported on their children's emotion regulation skills at 3, 5, and 7 years of age using the Children's Social Behavior Questionnaire. Multilevel models were used to derive early childhood emotion regulation scores (ie, predicted intercept) and within-child changes in emotion regulation scores from 3 to 7 years of age (ie, predicted slope).

MAIN OUTCOME AND MEASURES

Symptoms consistent with a DSM-5 diagnosis of anorexia nervosa or atypical anorexia nervosa at 14 years of age, defined using a range of questions relative to body image, weight perception, and dieting behaviors (hereinafter referred to as broad anorexia nervosa). Univariable and multivariable logistic regression models tested the association between exposures and outcome. Regression models were adjusted for child and family sociodemographic and socioeconomic characteristics and mental health difficulties, prenatal and perinatal factors, child's cognitive development, and maternal attachment.

RESULTS

A total of 15 896 participants (85.7% of total sample; 51.0% boys; 84.5% White individuals) had complete data on the exposure and were included in the main analyses. Among those with complete exposure and outcome data (9912 of the analytical sample [62.4%]), 97 participants (1.0%; 86 [88.7%] girls and 85 [87.6%] White individuals) had symptoms consistent with a diagnosis of broad anorexia nervosa at 14 years of age. No evidence suggested that children with lower emotion regulation ability at 3 years of age had greater odds of later reporting symptoms of broad anorexia nervosa (odds ratio [OR], 1.21; 95% CI, 0.91-1.63). However, children whose emotion regulation skills did not improve over childhood and who had greater problems regulating emotions at 7 years of age had higher odds of having broad anorexia nervosa at 14 years of age (OR, 1.45; 95% CI, 1.16-1.83).

CONCLUSIONS AND RELEVANCE

These findings suggest that difficulties in developing age-appropriate emotion regulation skills in childhood are associated with experiencing broad anorexia nervosa in adolescence. Interventions to support the development of emotion regulation skills across childhood may help reduce the incidence of anorexia nervosa.

A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

OBJECTIVE

The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

METHOD

Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

RESULTS

A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

CONCLUSION

This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.

Promoting healthy trajectories for urban middle school youth through county-funded, parks-based after-school programming

Ongoing pressure for public schools to prioritize academics has increased attention on after-school settings as a critical space for social-emotional learning (SEL). After-school programs are uniquely positioned to build protective and promotive factors that contribute to positive future orientation, especially within communities where systemic inequities create barriers to high school graduation, higher education, employment, and earnings. This study examines Fit2Lead Youth Enrichment and Sports (YES), a county-funded, parks-based after-school collaboration for middle schoolers that merges mental health and recreation to promote healthy trajectories. Eight Miami neighborhood parks were selected based on county data indicating high rates of violence. An open trial design (N = 9 parks, 198 youth; ages 9-15; 40.5% female; 66.5% Black/African American, 24.9% Hispanic/Latinx, and 76.3% low-income) tested hypotheses that participation for adolescents exposed to community violence would disrupt a commonly reported decline in self-regulation and self-efficacy, and mitigate risk for anxiety and depression. Youth completed questionnaires at the beginning and end of one school year. Paired t-tests revealed no changes from pre to post, and no differences by baseline levels of youth and parent mental health. Findings highlight the promise of prevention programs to disrupt downward trajectories for youth during the risky time of early adolescence.

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.

Measurement and correlates of irritability in clinically referred youth: Further examination of the Affective Reactivity Index

BACKGROUND

Research on youth irritability has proliferated in recent years, largely facilitated by items from existing measures and by key new instruments like the Affective Reactivity Index (ARI). The present study extends this literature by investigating the psychometric properties of the parent- and youth-report ARI and the correlates of irritability in an independent, clinically referred sample.

METHOD

Baseline assessment data were collected from 237 youths (ages 3-18; 36% female) and their parents, seen for outpatient therapy and/or assessment. We examined the ARI in terms of (1) its item, scale, and factor properties; (2) convergent/discriminant validity with internalizing, externalizing, and emotion regulation problems; (3) specificity of associations with reactive aggression, anger, dysregulation, and coping; and (4) robustness of associations after controlling for demographic variables (e.g., age, gender).

RESULTS

The ARI's internal consistency and unidimensional factor structure were acceptable or better, with some variation across items and informants. Irritability, as measured by parent- and youth-report, was associated with variables in the externalizing (inattention, hyperactivity, executive dysfunction, aggression), internalizing (anxiety, depression, suicidality), and emotion regulation domains. Associations with reactive aggression, anger, dysregulation, and coping problems were especially pronounced. Irritability's links with internalizing and externalizing problems remained robust after controlling for demographic covariates.

LIMITATIONS

The sample was limited in diversity and moderate in size.

CONCLUSIONS

Findings support the reliability and validity of the ARI for assessing parent- and youth-rated irritability among clinically referred youth. Future research is needed to understand variations in irritability's manifestations, measurement, and correlates across demographic groups.

The Interplay of Parental Response to Anger, Adolescent Anger Regulation, and Externalizing and Internalizing Problems: A Longitudinal Study

Numerous studies have reported substantive correlations between anger socialization, children’s anger regulation, and internalizing/externalizing problems. However, substantially less is known about the interplay among these constructs during the developmental stage of adolescence, and longitudinal studies on causal relations (i.e., parent-directed, adolescent-directed, or reciprocal effects) are rare. It is also unclear whether the development of internalizing and externalizing problems have similar causal relations. We collected three waves of longitudinal data (Grade 6, Grade 7, Grade 9) from multiple informants. A sample of N = 634 adolescents (mostly 11–12 years at Time 1; 50.6% male) and their parents (predominantly Caucasian with German nationality) completed questionnaires assessing parents’ responses to anger, adolescents’ anger regulation, and adolescents’ internalizing/externalizing problems at each wave. Comparisons of different cross-lagged models revealed reciprocal rather than unidirectional effects. However, we found more parent-directed effects with respect to the development of internalizing problems, whereas relations regarding externalizing problems were more adolescent-directed, i.e., adolescents’ externalizing problems and their anger regulation predicted changes in their parents’ responses to anger across time. Adolescent anger regulation was an important maintaining factor of parents’ responses to anger in later adolescence. Our findings suggest that assumptions regarding bidirectional relations should be emphasized much more in emotion socialization frameworks, particularly for the period of adolescence. Moreover, our study emphasizes the transdiagnostic importance of parents’ responses to anger for both externalizing and internalizing problems and also suggests different underlying mechanisms.

Behavioral and physiological stress responses: Within-person concordance during pregnancy

During pregnancy, a woman's emotions can have longstanding implications for both her own and her child's health. Within-person emotional concordance refers to the simultaneous measurement of emotional responses across multiple levels of analysis. This method may provide insight into how pregnant women experience emotions in response to stress. We enrolled 162 pregnant women and assessed concordance through autonomic physiology (electrodermal activity [EDA], respiratory sinus arrhythmia [RSA]), and coded behavior (Prosocial, Flight, Displacement) during the Trier Social Stress Test-Speech. We used multilevel models to examine behavioral-physiological concordance and whether self-reported emotion dysregulation moderated these effects. Participants exhibited EDA-Prosocial concordance, suggesting that prosocial behavior may be a marker of stress. Emotion dysregulation did not moderate concordance. These findings provide novel information about behavioral coping to stress in pregnancy. Given the importance of observed behavior in the maintenance and treatment of psychopathology, these findings may provide a launchpad for future perinatal intervention research.

Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.

Sleep restriction alters children's positive emotional responses, but effects are moderated by anxiety

BACKGROUND

An abundance of cross-sectional research links inadequate sleep with poor emotional health, but experimental studies in children are rare. Further, the impact of sleep loss is not uniform across individuals and pre-existing anxiety might potentiate the effects of poor sleep on children's emotional functioning.

METHODS

A sample of 53 children (7-11 years, M = 9.0; 56% female) completed multimodal, assessments in the laboratory when rested and after two nights of sleep restriction (7 and 6 hr in bed, respectively). Sleep was monitored with polysomnography and actigraphy. Subjective reports of affect and arousal, psychophysiological reactivity and regulation, and objective emotional expression were examined during two emotional processing tasks, including one where children were asked to suppress their emotional responses.

RESULTS

After sleep restriction, deleterious alterations were observed in children's affect, emotional arousal, facial expressions, and emotion regulation. These effects were primarily detected in response to positive emotional stimuli. The presence of anxiety symptoms moderated most alterations in emotional processing observed after sleep restriction.

CONCLUSIONS

Results suggest inadequate sleep preferentially impacts positive compared to negative emotion in prepubertal children and that pre-existing anxiety symptoms amplify these effects. Implications for children's everyday socioemotional lives and long-term affective risk are highlighted.

Co-Rumination Moderates the Relation between Emotional Competencies and Depressive Symptoms in Adolescents: a Longitudinal Examination

Research suggests co-rumination during adolescence has developmental tradeoffs that result in elevated self-disclosure and intimacy between friends but also can be associated with increases in depression (Rose et al. 2007; Rose 2002). The current study further examined this paradox by assessing the role of emotional competencies in co-rumination as they predict depressive symptoms over a 2-year period. We tested whether co-rumination moderated the relation between emotional awareness and emotion regulation and depressive symptoms in reciprocated best friend dyads. At Time 1, 202 adolescents (101 same-sex best friend dyads; M_age = 12.68, 52.5% girls, 76.6% White, middle-class) reported on their emotional competencies (i.e., emotional awareness and perceptions of their friend's anger and sadness regulation), and depressive symptoms as well as engaged in a discussion task where co-rumination was observed. Multilevel modeling (Actor-Partner Interdependence Modeling) was used to account for similarity within friend dyads. The results indicated that when girls engaged in high levels of co-rumination, poor emotional awareness was related to greater depressive symptoms in their friend. Regarding the analyses of emotion regulation, at high levels of co-rumination, Friend A's perceptions of stronger anger regulation by Friend B predicted fewer depressive symptoms in Friend A. Stronger sadness regulation in Friend B at high levels of co-rumination predicted fewer depressive symptoms in Friend B. Our findings highlight the potentially adaptive nature of emotional competencies that may ameliorate the negative sequelae of co-rumination as adolescents are afforded the opportunity to discuss problems, better understand their emotions, skills that are then associated with fewer depressive symptoms over time.

Emotion Regulation Attenuates the Prospective Links from Peer Victimization to Internalizing Symptoms during Middle Childhood

Objective: Peer victimization has been shown to be a robust predictor of depressive and anxiety symptoms over time. Relatively little is known, however, regarding what protective factors may attenuate these associations and render youth more resilient to this interpersonal stressor. Therefore, the current study examined sadness and worry regulation as moderators of the prospective links from peer victimization to internalizing symptoms over a 1-year period.Method: Participants included 464 predominantly Caucasian children (54.7% boys; ages 7-10), as well as their homeroom teachers, from an elementary school located in the Midwestern United States. Child and teacher reports of peer victimization and child reports of sadness and worry regulation were assessed at Time 1. Children also provided ratings of depressive and anxiety symptoms at Time 1, approximately 6 months later (Time 2), and again approximately 1 year later (Time 3). Moderating effects were evaluated using a series of multivariate latent growth curve models.Results: Consistent with expectations, sadness regulation attenuated the prospective links from both child- and teacher-reported peer victimization to internalizing symptoms. Worry regulation also attenuated the prospective links from teacher-reported peer victimization to internalizing symptoms. The moderating effects of emotion regulation did not differ according to gender.Conclusions: Findings suggest that the ability to effectively manage feelings of sadness and worry may serve as a buffer against the internalizing symptoms associated with peer victimization. Additional research is needed to determine whether interventions focused on enhancing victims' emotion regulation skills reduce their subsequent risk for depressive and anxiety symptoms.

The Differential Victimization Associated With Depression and Anxiety in Cross-Cultural Perspective: A Meta-Analysis

Traditional bullying and cyberbullying have become serious worldwide issues. The meta-analysis in this article took a cross-cultural perspective to explore whether there were any differences between the effects of cyber victimization and traditional victimization on the presence of depression and anxiety in children and adolescents and to examine the effects of moderators in explaining these differences/similarities. Fifty-six empirical studies (generating 148 independent samples) were included with a total sample size of 214,819 participants. The results indicated that the effects of cyber victimization and the subtypes of traditional victimization on anxiety were significantly different, and there was a marginally significant difference for depression. The moderating effects of country of origin were found to be significant for depression, with the mean effect size in North America being significantly higher than in China and Europe, which suggested that culture was an important factor. The moderating effects of age were also found to be significant for the relationships between traditional victimization and depression, traditional victimization and anxiety, cyber victimization and depression, and cyber victimization and anxiety. In addition, the effect size for cyber victimization and depression has increased in more recent publication years.

Project GOLD: A pilot randomized controlled trial of a novel psychoeducational HIV/STI prevention intervention for heterosexually-active black youth

Black youth account for the largest number of new HIV infections among heterosexual youth. Mental illness and difficulties in emotion regulation contribute to increased reports of HIV/sexually transmitted infection (STI) risk-related sexual behaviors in this group. Yet limited interventions exist to address this affective component of the sexual decision-making process. The purpose of this paper was to describe the trial design, research challenges, and baseline characteristics from a study designed to fill this gap. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually-active Black youth aged 14 to 17 (N = 108). Challenges encountered in the research process warrant further attention in future research (e.g., disagreement among the regulatory bodies on parental permission requirements). The most common mental health diagnoses were Recurrent Major Depressive Disorder (15.7%) and current substance abuse (7.4%). Participants reported higher levels of emotional suppression, and adaptive methods of emotion management, than culturally inappropriate expressions of anger or sadness. They also reported a mean age of 13.6 at first vaginal sex, used condoms 66% of the time for vaginal sex, and had an average of three sexual partners in the past 6 months. More than one-quarter (26.9%) had sex with more than one person in the same day. These findings indicate intervention is crucial for this population. The forthcoming trial evaluation will indicate the promise of such interventions in reducing HIV/STI infections in this key population.

Maternal Incarceration, Children's Psychological Adjustment, and the Mediating Role of Emotion Regulation

Children who live in the context of maternal incarceration (MI) are exposed to both general environmental risk and incarceration-specific risk increasing the probability of their developing externalizing and internalizing behaviors problems. Little research has examined the socio-emotional mechanisms that account for the psychological effects of MI. This research examined children's anger and sadness regulation as mediators between environmental and incarceration-specific risk and psychological functioning. Participants were 117 children (60% Black; 52% boys; M age = 9.85 years, SD = 1.65 years), their incarcerated mother, and current caregiver. All informants completed questionnaires assessing children's anger and sadness regulation as well as externalizing and internalizing behaviors. Mothers and caregivers provided information concerning children's exposure to environmental risk and all three reporters provided information on incarceration-specific risk experiences (ISRE). Structural equation modeling was used to test indirect effects of risk variables (ISRE, environmental) on psychological functioning (externalizing, internalizing behaviors) via emotion regulation (anger, sadness). Gender, age, and race were covariates. The analyses revealed significant indirect effects of incarceration-specific risk on both externalizing and internalizing behavior problems via anger regulation but not via sadness regulation. The findings highlight the centrality of emotion regulation as a mechanism that helps explain the negative psychological outcomes experienced by children exposed to ISRE with implications for preventive interventions.

Measurement Invariance and Convergent Validity of Anger and Sadness Self-Regulation Among Youth From Six Cultural Groups

The present study examined measurement invariance and convergent validity of a novel vignette-based measure of emotion-specific self-regulation that simultaneously assesses attributional bias, emotion-regulation, and self-efficacy beliefs about emotion regulation. Participants included 541 youth-mother dyads from three countries (Italy, the United States, and Colombia) and six ethnic/cultural groups. Participants were 12.62 years old ( SD = 0.69). In response to vignettes involving ambiguous peer interactions, children reported their hostile/depressive attribution bias, self-efficacy beliefs about anger and sadness regulation, and anger/sadness regulation strategies (i.e., dysregulated expression and rumination). Across the six cultural groups, anger and sadness self-regulation subscales had full metric and partial scalar invariance for a one-factor model, with some exceptions. We found support for both a four- and three-factor oblique model (dysregulated expression and rumination loaded on a second-order factor) for both anger and sadness. Anger subscales were related to externalizing problems, while sadness subscales were related to internalizing symptoms.

Angststörungen

Zusammenfassung. Angststörungen zählen zu den häufigsten psychischen Störungen des Kindes- und Jugendalters. Bei der Entwicklung von Ängsten kommt dem frühkindlichen Temperament, der elterlichen Psychopathologie und der genetischen Disposition eine zentrale Rolle zu. Aspekte der Emotionsregulation und Auffälligkeiten im Bindungsmuster werden zunehmend diskutiert. Gemeinsam mit den Angststörungen treten sowohl weitere internalisierende Störungen (z. B. die Depression) als auch externalisierende Auffälligkeiten (z. B. aggressives Verhalten) auf. In der Behandlung von Angststörungen scheint eine transdiagnostische Sichtweise besonders erfolgversprechend.

The specificity of emotion dysregulation in adolescents with borderline personality disorder: comparison with psychiatric and healthy controls

BACKGROUND

Research has supported the notion that emotion dysregulation is a core feature of BPD. However, given that this feature is typical of healthy adolescents as well as adolescents with other psychiatric disorders, the specificity of emotion dysregulation to BPD in this age group has not yet been determined. The overall aim of this study was to examine emotion dysregulation in adolescent inpatients with BPD compared with non-BPD inpatient adolescents and healthy non-clinical adolescents, taking into account both global emotion dysregulation deficits and more specific impairments.

METHOD

The sample included 185 adolescent inpatients with BPD (M = 15.23, SD = 1.52), 367 non-BPD psychiatric inpatient adolescents (M = 15.37, SD = 1.40), and 146 healthy adolescents (M = 15.23, SD = 1.22), all of whom were between the ages of 12 and 17. Borderline personality features were assessed, along with emotion dysregulation and psychiatric severity.

RESULTS

After controlling for age, gender, and psychiatric severity, results revealed that adolescents with BPD had higher overall emotional dysregulation compared with non-BPD psychiatric controls and healthy controls. These differences were apparent in only two domains of emotion dysregulation including limited access to emotion regulation strategies perceived as effective and impulse control difficulties when experiencing negative emotions.

CONCLUSIONS

Findings suggest BPD-specific elevations on emotion dysregulation generally, and subscales related to behavioral regulation specifically.

Emotion dysregulation mediates the longitudinal relation between peer rejection and depression

The goal of the current investigation was to test emotion dysregulation as a mechanism explaining the longitudinal association between peer rejection and depressive symptoms across 1 school year in middle childhood and to determine whether this process differed based on gender and grade. Youth in Grades 3 through 6 ( N = 131; 71 girls) and their primary school teachers ( n = 8) were recruited from a Midwestern elementary school. Youth reported on their emotion dysregulation and depressive symptoms at two time points (T1 and T2), approximately 6 months apart. Teachers completed ratings of peer rejection at T1. Peer rejection at T1 predicted youth-report of depressive symptoms at T2, even after controlling for depression at T1. Moderated mediation suggested that change in emotion dysregulation mediated the relation of peer rejection to depressive symptoms over time, but only for older boys. Results underscore the importance of considering gender-specific processes within interpersonal risk models of depression, and provide support for peer rejection as a critical social process shaping emotion regulation in middle childhood.

Emotion regulation and psychopathological symptoms of Chinese school-age children: A person-centred and multi-informant approach

Emotion regulation (ER) is a critical component of children's development. Many previous studies have utilised a single-assessment method to reflect child ER, which might result in losing important information regarding the unique contribution of each informant. With a person-centred approach and multi-informant reports (mother, teacher and child), the current study examined 196 children's (age M = 9.21, SD = 1.10, range = 7-11 years; 51% girls) ER patterns and their associations with psychopathological symptoms in a Chinese sample. A model-based clustering procedure resulted in 3 ER groups: the poor family ER group (n = 36), poor school ER group (n = 120), and overall good ER group (n = 40). Significant differences were found among ER clusters on teacher-reported child psychopathological symptoms compared on the levels of withdrawn depression, somatic complain, thought problems and attention problems. No significant differences were found on the mother-reported psychopathological symptoms. Compared with children in the poor school or poor family ER clusters, children in the overall good ER group demonstrated fewer psychopathological symptoms at school. Our results confirmed the advantage of adopting multi-informant assessments to fully capture children's emotional profiles and linked these profiles with children's emotional and behavioural functioning at school.

Socialization in the Context of Risk and Psychopathology: Maternal Emotion Socialization in Children of Incarcerated Mothers

Children of incarcerated mothers are at increased risk for psychological, social, and emotional maladaptation. This research investigates whether perceived maternal socialization of sadness and anger may moderate these outcomes in a sample of 154 children (53.9% boys, 61.7% Black, M age = 9.38, range: 6 - 12), their 118 mothers (64.1% Black), and 118 caregivers (74.8% female, 61.9% grandparents, 63.2% Black). Using mother, caregiver, and child report, seven maternal socialization strategies were assessed in their interaction with incarceration-specific risk experiences predicting children's adjustment. For sadness socialization, the results indicated that among children reporting maternal emotion-focused responses, incarceration-specific risk predicted increases in psychological problems, depressive symptoms, increased emotional lability, and poorer emotion regulation. For children who perceived a problem-focused response, incarceration-specific risk did not predict outcomes. There were no significant interactions with incarceration-specific risk and perceived maternal anger socialization strategies. These results indicate a critical need to examine how socialization processes may operate differently for children raised in atypical socializing contexts.