A Meta-Analytic Review of Emotion Regulation Focused Psychosocial Interventions for Adolescents

Eadeh, Hana-May; Breaux, Rosanna; Nikolas, Molly A.

doi:10.1007/s10567-021-00362-4

Cited by 33 publications

(20 citation statements)

References 79 publications

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“…Similarly, although Vidal-Ribas et al provided a conceptual and quantitative review on the status of irritability in psychiatry, they did not discuss the effectiveness of existing treatments ( 9 ). Beyond these irritability specific review articles, several recent reviews have discussed psychosocial interventions for the treatment of emotion dysregulation ( 10 , 11 ), a broader transdiagnostic factor that is related but not identical to irritability; however, these have encompassed a wide range of studies, most of which did not assess ADHD, and such reviews do not provide direct insight into which interventions are effective at reducing irritability specifically in ADHD. Given prior evidence that evidence-based treatments for ADHD are associated with smaller treatment effects for irritability than for ADHD symptoms ( 12 ), it is critical to offer a detailed synthesis of existing pharmacological and non-pharmacological interventions within this population.…”

Section: Introductionmentioning

confidence: 99%

A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD

et al. 2022

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Approximately a third of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) experience significant irritability; despite this, no study has reviewed whether interventions for youth with ADHD can improve irritability. This mini review sought to address this gap in the literature by discussing existing pharmacological and psychosocial interventions for irritability among children and adolescents with ADHD. A literature search was conducted in April 2021, with a total of 12 intervention articles identified (six pharmacological, one psychosocial, five combined). Studies were excluded if they did not involve an intervention, a measure of irritability, or the population was not youth with ADHD. Of these articles, two were with an ADHD only sample; seven included ADHD with comorbid disruptive behavior, disruptive mood dysregulation disorder (DMDD), or severe mood dysregulation (SMD); and three included ADHD with comorbid autism spectrum disorder (ASD). Findings suggest that central nervous system stimulants used alone or in combination with behavior therapy are effective at reducing irritability in youth with ADHD only or comorbid ADHD and DMDD/SMD. Less evidence was found for the efficacy of guanfacine and atomoxetine for youth with ADHD only or comorbid ADHD and ASD. Parent training alone or in combination with atomoxetine was found to be effective at reducing irritability in youth with comorbid ADHD and ASD. Future research assessing the efficacy of other psychosocial interventions, particularly cognitive behavioral therapy is necessary, as are randomized trials assessing intervention sequencing and intensity among youth with ADHD. Researchers are advised to utilize well-validated measures of irritability in future research.

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Section: Introductionmentioning

confidence: 99%

A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD

et al. 2022

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“…These findings exist against a backdrop of mixed findings on school-based emotion regulation interventions. In one recent meta-analysis of emotion regulation psychosocial interventions for adolescents in community-based and war-affected settings [ 49 ]), there were mixed results regarding immediate post-treatment efficacy, with the largest effect sizes observed among youth with clinical diagnoses, and the smallest sizes found in studies implementing prevention programs for community youth. A parallel systematic review on efficacy of DBT skills groups among school-going youth [ 50 ] also showed mixed immediate post-treatment results in primary and secondary school students in HIC (vs. replicated efficacy in college student populations).…”

Section: Discussionmentioning

confidence: 99%

“…The frequency and timing of measurement (i.e., only baseline and immediate post-treatment measurement) may also explain lack of detected main and secondary effects. Studies of adolescent emotion regulation interventions in HIC indicate mixed findings upon inclusion of follow-up periods [ 49 ], with some promising work showing increased gains over time as skills begin to solidify and generalize. Future research should consider more intensive follow-up measurement, in addition to employment of alternative measurement models (e.g., ecological momentary assessment of emotion regulation, observational ratings from program facilitators, observable behavioral outcomes).…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Acceptability of a School-Based Emotion Regulation Prevention Intervention (READY-Nepal) for Secondary School Students in Post-Earthquake Nepal

Ramaiya

McLean

Pokharel

et al. 2022

IJERPH

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Background: Child and adolescent mental health problems are major contributors to the global burden of disease in low- and middle-income country (LMIC) settings. To advance the evidence base for adolescent mental health interventions in LMICs, we evaluated the feasibility and acceptability of a school-based emotion regulation prevention intervention (READY-Nepal) for adolescents who had a recent exposure to a humanitarian disaster. Methods: A mixed-method, non-randomized controlled trial was conducted with Nepali secondary school students in one heavily affected post-earthquake district. Students (N = 102; aged 13 to 17 years) were enrolled in the intervention (n = 42) and waitlist control (n = 60) conditions. Feasibility and acceptability were examined via attendance, and by qualitative interviews with a subset of students (n = 15), teachers (n = 2), and caregivers (n = 3). Preliminary efficacy was examined on primary outcome (emotion regulation) and secondary outcomes (anxiety symptoms, posttraumatic stress symptoms, functional impairment, resilience, coping skills), which were measured at baseline and post-intervention (four weeks). Results: Delivering the intervention was feasible and acceptable, as demonstrated by low dropout (8%) and high program attendance (6.7 of 8 sessions). Qualitative data suggested high uptake of anger regulation skills, but lower uptake of mindfulness skills. Despite this, there were no significant differences by condition on primary or secondary outcomes at four-week follow-up. Students provided suggestions for improvement of the program. Conclusion: Further research on longitudinal outcome measurement, use of alternatives to retrospective self-report data, and rigorous development of culturally grounded models of emotion regulation is necessary to explore the utility of school-based emotion regulation interventions in Nepal and other LMICs.

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“…A recent meta-analysis showed that improvements in ER skills were associated with reduced depression and anxiety in adolescents aged 14–24 [ 32 ]. To date, however, even though interventions exist that may improve ER skills for these adolescents (e.g., traditional CBT, dialectical behavior therapy, mindfulness-based cognitive therapy), most of them do not exclusively focus on targeting ER [ 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

“…Holmqvist Larsson et al [ 41 ] showed that a group skills training in ER for adolescents and their parents led to a decrease in ER difficulties in an outpatient sample of adolescents with a mental disorder. Furthermore, in a recent review on emotion regulation focused interventions four studies that include adolescents with internalizing disorders are discussed [ 34 ]. In all four studies, adding an ER regulation component to the intervention led to improvement of ER skills in adolescents [ 42 – 45 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an add-on guided internet-based emotion regulation training (E-TRAIN) in adolescents with depressive and/or anxiety disorders: study protocol for a multicenter randomized controlled trial

et al. 2022

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Background During adolescence, depressive and anxiety disorders are among the most common mental health disorders. Both disorders tend to persist, are predictive for other mental disorders, and are associated with severe impairment in diverse areas. Although Cognitive Behavioral Therapy (CBT) has proven to be an effective treatment, a considerable number of adolescents do not respond to CBT and residual symptoms often remain. Therefore, it is of great importance to improve treatment outcomes for depressed and/or anxious adolescents. Dysfunctional emotion regulation appears to be a transdiagnostic factor in the development and maintenance of aforementioned disorders. Enhancing emotion regulation skills may therefore reduce symptom severity. In light of this, we developed a guided internet-based emotion regulation training (E-TRAIN) that will be added to CBT. This study aims to evaluate the effectiveness of E-TRAIN + CBT compared to CBT alone on depressive and anxiety outcomes among adolescents with depressive and/or anxiety disorder. Methods In this multicenter two-arm randomized controlled trial with parallel group design, we aim to include 138 adolescents, aged 13–19 years, referred for treatment and diagnosed with depressive and/or anxiety disorder. Participants will be allocated to either CBT or CBT + E-TRAIN. Assessments will take place at baseline, and at 3 (T1), 6 (T2) and 12 (T3) months after baseline. We will conduct multi-informant assessments: the adolescent, a parent/caregiver, and the CBT therapist will be asked to fill in questionnaires. The continuous primary outcome measure is self-reported depressive and anxiety symptoms at six months after baseline, measured with the RCADS25. Secondary outcome measures include anxiety or depression diagnosis based on a semi-structured clinical interview, emotion (dys) regulation, and parent-report measures of anxiety, depression and emotion (dys) regulation. Discussion This study is the first randomized controlled trial to examine the additional value of a guided internet-based emotion regulation training to regular CBT in adolescents with depressive and/or anxiety disorders. If this intervention is effective, it can be implemented in mental health care and improve treatment for these young people. Trial registration Registered on June 23, 2021 in The Netherlands Trial Register (NL9564). Retrospectively registered. Recruitment started in May 2021 and is ongoing.

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A Meta-Analytic Review of Emotion Regulation Focused Psychosocial Interventions for Adolescents

Cited by 33 publications

References 79 publications

A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD

A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD

Feasibility and Acceptability of a School-Based Emotion Regulation Prevention Intervention (READY-Nepal) for Secondary School Students in Post-Earthquake Nepal

Effectiveness of an add-on guided internet-based emotion regulation training (E-TRAIN) in adolescents with depressive and/or anxiety disorders: study protocol for a multicenter randomized controlled trial

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