Brief Report: Emotion Regulation Influences on Internalizing and Externalizing Symptoms Across the Normative-Clinical Continuum

Amygdala connectivity is associated with withdrawn/depressed behavior in a large sample of children from the Adolescent Brain Cognitive Development (ABCD) Study®

Many psychopathologies tied to internalizing symptomatology emerge during adolescence, therefore identifying neural markers of internalizing behavior in childhood may allow for early intervention. We utilized data from the Adolescent Brain and Cognitive Development (ABCD) Study® to evaluate associations between cortico-amygdalar functional connectivity, polygenic risk for depression (PRSD), traumatic events experienced, internalizing behavior, and internalizing subscales: withdrawn/depressed behavior, somatic complaints, and anxious/depressed behaviors. Data from 6371 children (ages 9-11) were used to analyze amygdala resting-state fMRI connectivity to Gordon parcellation based whole-brain regions of interest (ROIs). Internalizing behaviors were measured using the parent-reported Child Behavior Checklist. Linear mixed-effects models were used to identify patterns of cortico-amygdalar connectivity associated with internalizing behaviors. Results indicated left amygdala connections to auditory, frontoparietal network (FPN), and dorsal attention network (DAN) ROIs were significantly associated with withdrawn/depressed symptomatology. Connections relevant for withdrawn/depressed behavior were linked to social behaviors. Specifically, amygdala connections to DAN were associated with social anxiety, social impairment, and social problems. Additionally, an amygdala connection to the FPN ROI and the auditory network ROI was associated with social anxiety and social problems, respectively. Therefore, it may be important to account for social behaviors when looking for brain correlates of depression.

Internal Consistency of the Serbian Translation of the Stanford Social Dimensions Scale and Association to Strengths and Difficulties Questionnaire Scores in Male and Female Individuals on the Autism Spectrum and Non-autistic Individuals

We aimed to evaluate the internal consistency of Stanford Social Dimensions Scale (SSDS) translated to Serbian and to test it against the Strengths and Difficulties Questionnaire (SDQ). The sample consisted of 200 patients (32% ASD) of the Institute of Mental Health in Belgrade, Serbia (68 females, 132 males, Mage=9.61, SDage=4.06). Internal consistency coefficients were within good/acceptable range for Social Motivation, Affiliation, Recognition and Unusual Approach subscales and below acceptable for Expressive Social Communication subscale. The non-autistic group scored higher on all subscales compared to the ASD group. All SSDS subscales positively correlated with SDQ Prosocial Behaviors scale. The SSDS is a valuable instrument for accessing sociobehavioral phenotype in both individuals on the autism spectrum and non-autistic individuals.

Threat, Emotion Dysregulation, and Parenting in a Clinical Sample of Children with Disruptive Behaviour

Early-life adversity is associated with the development of internalizing and externalizing problems in children. Despite this, there is a need to understand the mechanisms linking these experiences to psychopathology, especially in clinical samples. This cross-sectional study tested emotion dysregulation as a mechanism linking early-life threat to psychopathology in a clinical sample of children with disruptive behavior problems. We also explored parental positive reinforcement as a protective factor in these pathways. A clinical sample of 606 children aged 6-12 years, referred to a mental healthcare hospital, were included. Parent-reported child threat, and parent- and teacher-reported child emotion dysregulation and psychopathology, were collected. Path analysis was used to explore the mediating effect of emotion dysregulation in the relation between threat and psychopathology. The moderating effects of parental positive reinforcement were explored through moderated-mediation analyses. Emotion dysregulation partially mediated the association between threat and both internalizing (β = .18, P = .006) and externalizing (β = .19, P = .002) problems. Positive reinforcement did not buffer the association between threat and emotion dysregulation (β = .09, P = .62) or the association between emotion dysregulation and internalizing (β = - .003, P = .20) or externalizing (β = - .002, P = .35). Poor emotion regulation may be a transdiagnostic mechanism linking early-threat with internalizing and externalizing problems in clinic-referred children with disruptive behaviors. Factors aside from parental positive reinforcement should be explored as protective factors in these pathways, including those directly implicated in the purported mechanisms linking these factors over time.

Examining the feasibility and utility of heart rate variability on intervention outcomes targeting emotion regulation in autism: a brief report

Autistic youth experience several behavioral and emotional characteristics that can predispose them to emotion dysregulation (ED). Current literature examining ED in autism spectrum disorder (ASD) is limited to parent- and self-reported measures, indicating a need for biological or physiological methods to better assess emotion regulation in ASD. Utilizing the autonomic nervous system, specifically heart rate variability (HRV), may be a promising method to objectively measure ED in ASD, given it is one of the body's primary means of regulating physiological arousal. Our pilot study is one of the first to examine the feasibility, utility, and construct validity of HRV along with clinical measures within an intervention targeting ED-specific symptoms in ASD. Participants included 30 autistic youth ages 8-17 years who participated in the pilot study of Regulating Together, a group-based intervention targeting emotion regulation. We demonstrate HRV is feasible, demonstrates adequate test-retest reliability, and is complimentary to clinician- and parent-reported measures. Our preliminary findings also point to certain HRV profiles being indicative of long-term outcomes after receiving treatment. HRV may be a useful, objective tool in determining differential needs of long-term follow-up care for treatment maintenance at screening or baseline stages.

Does emotion regulation mediate the relationship between self-compassion and subjective well-being? A cross-sectional study of adults living in the United States

Subjective well-being influences mental and physical health. Fortunately, interventions exist to improve people's subjective well-being. Emotion regulation and self-compassion are two transdiagnostic factors that impact mental health and have been separately shown to be associated with subjective well-being. However, their combined relationship with subjective well-being has not yet been examined. To address this gap, the current novel study aimed to determine if there is a combined relationship between self-compassion, emotion regulation, and dimensions of subjective well-being cross-sectionally in adults living in the United States. Participants (n = 559; 50% female; Mage = 57.70 years) completed an online survey via Prime Panels from CloudResearch, capturing their responses on the interested constructs. Analyses showed that emotion regulation significantly mediated the relationships between self-compassion and various subjective well-being dimensions, specifically, positive affect (d = 0.32), negative affect (d = 1.17), and eudemonic well-being (d = 0.79). Our findings have both clinical and research implications.

Effects of chronic home radon exposure on cognitive, behavioral, and mental health in developing children and adolescents

Introduction

It is well-established that chronic exposure to environmental toxins can have adverse effects on neuropsychological health, particularly in developing youths. However, home radon, a ubiquitous radiotoxin, has been seldom studied in this context. In the present study, we investigated the degree to which chronic everyday home radon exposure was associated with alterations in transdiagnostic mental health outcomes.

Methods

A total of 59 children and adolescents ages 6- to 14-years-old (M = 10.47 years, SD = 2.58; 28 males) completed the study. Parents completed questionnaires detailing aspects of attention and executive function. We used a principal components analysis to derive three domains of neuropsychological functioning: 1) task-based executive function skills, 2) self-and emotion-regulation abilities, and 3) inhibitory control. Additionally, parents completed a home radon test kit and provided information on how long their child had lived in the tested home. We computed a radon exposure index per person based on the duration of time that the child had lived in the home and their measured home radon concentration. Youths were divided into terciles based on their radon exposure index score. Using a MANCOVA design, we determined whether there were differences in neuropsychological domain scores across the three groups, controlling for age, sex, and socioeconomic status.

Results

There was a significant multivariate effect of radon group on neuropsychological dysfunction (λ = 0.77, F = 2.32, p = 0.038, ηp2 = 0.12). Examination of univariate effects revealed specific increases in self-and emotion-regulation dysfunction among the youths with the greatest degree of chronic home radon exposure (F = 7.21, p = 0.002, ηp2 = 0.21). There were no significant differences by group in the other tested domains.

Discussion

The data suggest potential specificity in the neurotoxic effects of everyday home radon exposure in developing youths, with significant aberrations in self-and emotion-regulation faculties. These findings support the need for better public awareness and public health policy surrounding home radon safety and mitigation strategies.

A Comparative Analysis of Emotional Regulation and Maladaptive Symptoms in Adolescents: Insights from Iran and Belgium

(1) Background: Emotional regulation is a critical determinant of adaptive functioning during adolescence, exerting a profound influence on psychological well-being. This study seeks to deepen our understanding of the intricate interplay between emotional regulation and maladaptive psychological symptoms, examining these dynamics through a cross-country comparison. (2) Methods: A total of 224 adolescents, aged 13 to 21 years, from both Iran and Belgium, participated in a cross-sectional comparative study. The study aimed to elucidate the relationship between emotional regulation and mental health functioning, assessing internalizing symptoms, externalizing symptoms, and self-injury. A demographic questionnaire, the Emotion Regulation Inventory, the Strengths and Difficulties Questionnaire, and the Self-Harm Inventory, were administered. Data analysis incorporated correlation assessments, multivariate analysis of variance, and structured equation modeling. (3) Results: The findings revealed a positive association between emotional dysregulation and psychological symptoms across the entire sample. Conversely, emotional suppression, more prevalent in Iran, showed no significant link with maladaptive symptoms but was associated with self-harm in the Belgian sample. Cultural disparities were evident, with internalizing problems more prevalent in Iran and externalizing issues more common in Belgium. (4) Conclusions: Emotional dysregulation emerged as a common factor compromising mental health. It emphasizes the necessity of considering cultural nuances when developing interventional and preventative programs and calls for further research in this field.

A multidimensional investigation of the relationship between skin-mediated somatosensory signals, emotion regulation and behavior problems in autistic children

Introduction

Autistic children may have abnormal sensory perception, emotion dysregulation and behavior problems. The aim of this cross-sectional study was to explore the relationship between skin-mediated somatosensory signals and emotion/behavior difficulties in autistic children and adolescents, in comparison typically developing peers (TDP).

Methods

Thirty-eight autistic children and adolescents and 34 TDP completed a multidimensional assessment consisting of the measurement of somatosensory thresholds of touch, pain and temperature, a task on emotion knowledge and parent-reported questionnaires on sensory reactivity, emotion regulation and behavior.

Results

Autistic children had higher pain sensitivity, less sensory reactive behaviors and more behavior problems than their TDP. In contrast to TDP, several somatosensory thresholds of autistic children correlated with emotion regulation and behavior problems.

Discussion

Sensory dysfunction may affect the development of emotional processing and behavior in autistic children and adolescents. This knowledge can lay the foundation for future studies on co-occurring alterations in corresponding neural networks and for the implementation of early interventions, including sensory rehabilitation therapy, for promoting regulated behaviors in autistic children and adolescents.

Examining how and why polygenic dopamine composite levels moderate adolescents' vulnerability to peer victimization

Extensive literature documents that dopaminergic genes play an important role in the link between adverse environments and adolescents' problem behavior. However, little is known about the potential mechanism underlying adolescents' vulnerability to peer victimization. The current study examined the effect of the interplay between a polygenic dopamine composite (i.e., COMT Val158Met and DRD2-141C Ins/Del polymorphisms) and peer victimization on adolescents' externalizing problems as well as the mediating role of emotion dysregulation in the interactive effects in a sample of 393 Chinese adolescents (Mean age = 14.71 years; 50.1% girls). A significant moderation of dopaminergic genetic composite was observed in girls but not in boys. In addition, emotion dysregulation partially explained the moderating effect of dopaminergic genes. Specifically, girls with genic composite indexing low dopamine activity reported a higher level of emotion dysregulation when faced with more peer victimization. More difficulties with emotion regulation, in turn, predicted more pronounced externalizing problems in girls. This study underscores polygenic underpinnings of adolescent vulnerability to negative peer experiences and suggests the importance of considering sex differences when investigating genic influence on the relationship between adverse environments and externalizing problems.

Associations between executive functioning, challenging behavior, and quality of life in children and adolescents with and without neurodevelopmental conditions

The present study sought to clarify the impact of executive and social functioning on challenging behavior and the downstream influence of challenging behavior on quality of life and functioning in a large transdiagnostic sample. Understanding these relationships is crucial for developing and designing tailored intervention strategies. In a cross-sectional study, parent informants of 2,004 children completed measures of executive and social functioning, challenging behavior, child and family quality of life, and reported on functional impacts of challenging behavior. Using structural (path) modeling, analyses evaluated the associations between executive and social functioning, including emotion regulation and risk avoidance, with overall and specific types of challenging behavior. Structural models also examined the influence of challenging behavior on child and family quality of life, including measures of the immediate and extended environment, and functional impacts on the parent/child as well as interactions with the medical/legal systems. Finally, mediational models explored the direct and indirect effects of executive and social functioning on quality of life and impact measures via challenging behavior. Results indicated that executive functioning accounts for substantial variance (R² = 0.47) in challenging behavior. In turn, challenging behavior accounts for substantial variance in child and family quality of life (R² = 0.36) and parent/child impacts (R² = 0.31). Exploratory mediational models identified direct effects from executive and social functioning measures on quality of life and functional impacts and indirect effects for executive functioning via challenging behavior. These findings support the development of new intervention strategies and suggest the need to measure executive functioning when assessing and tailoring the treatment of challenging behavior in clinical practice.

Regulating Together: Emotion Dysregulation Group Treatment for ASD Youth and Their Caregivers

Individuals with autism spectrum disorder (ASD) experience behavioral and emotional symptoms hypothesized to arise from emotion dysregulation (ED), difficulty modulating emotional experience, expression, and intensity in an acceptable and contextually appropriate manner. We developed Regulating Together (RT)-an intensive-outpatient, caregiver-assisted group program to meet the ASD + ED intervention critical need. A within-subjects trial was conducted (5-week-control lead-in period, 5-week-treatment, and 5-and 10-weeks-post-treatment follow-ups). Forty-four youth with ASD + ED (25 8-12, 19 13-18 yr-olds, 88% male, mean FSIQ of 96) participated. Improvements were found in reactivity, emotion regulation knowledge, and flexibility post-treatment and 10-weeks post-treatment. A reduction in inpatient hospitalization rates by 16% from the 12 months pre-RT to 12 months post-RT was observed. RT shows promise to reduce ED in ASD.

Development and validation of the Executive Functioning Scale

Executive functioning (EF) processes are essential for adaptive and flexible responding to the demands and complexities of everyday life. Conversely, if impaired, these processes are a key transdiagnostic risk factor that cuts across autism and a range of other neurodevelopmental (NDD) and neuropsychiatric (NPD) conditions. However, there are currently no freely available informant-report measures that comprehensively characterize non-affective (e.g., working memory, response inhibition, and set shifting) and affective (e.g., emotion regulation) EF subdomains. This study describes the development, refinement, and initial psychometric evaluation of a new 52-item Executive Functioning Scale (EFS). Two independent data collections yielded exploratory (n = 2004, 169 with autism, ages 2-17) and confirmatory (n = 954, 74 with autism, ages 2-17) samples. Exploratory Structural Equation Modeling (ESEM) model with six specific factors that closely matched hypothesized executive functioning subdomains of working memory and sequencing, response inhibition, set-shifting, processing speed, emotion regulation, and risk avoidance, and one general factor, showed the best fit to the data and invariance across age, sex, race, and ethnicity groups. Model reliability and internal consistency were excellent for the general factor (ω = 0.98; α = 0.97) and specific factors (ω ≥ 0.89-0.96; α ≥ 0.84-0.94). Conditional reliability estimates indicated excellent reliability (≥0.90) for the total EF scale and adequate or better reliability (≥0.70) for subscale scores. With further replication, the EFS has excellent potential for wide adoption across research and clinical contexts.