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

Abstract

Emotion regulation is theorized to be a transdiagnostic process and has been empirically shown to be associated with various mental health and neurodevelopmental conditions. However, the relationship between emotion regulation and internalizing and externalizing symptoms has yet to be characterized in a sample of individuals spanning normative and atypical development. Therefore, this study aimed to provide initial evidence for emotion regulation as a transdiagnostic process of internalizing and externalizing symptoms in a community sample of adolescents with and without neuropsychiatric and neurodevelopmental conditions. The sample consisted of 1,705 caregivers of adolescents aged between 11 and 17 years (Mage = 14.53, SDage = 1.96). Adolescents were typically developing or had a caregiver-reported diagnosis of autism spectrum disorder, attention-deficit hyperactivity disorder, or anxiety. The typically developing adolescents had significantly better caregiver-reported emotion regulation than adolescents with caregiver-reported neuropsychiatric and neurodevelopmental conditions. Additionally, emotion dysregulation significantly and positively correlated with and predicted internalizing and externalizing symptoms within each subgroup. Importantly, emotion dysregulation had a unique contribution to individual differences in the severity of internalizing and externalizing symptoms, above and beyond the diagnostic status. The research and translational implications of the study findings are discussed.

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

“…Exposure to negative peer behaviors (e.g., physical attacks and relational aggression) can elicit sustained negative emotions that might deleteriously affect adolescents’ emotion regulation capabilities [ 50 ]. In turn, the inability to regulate emotions in an adaptive way contributes to more externalizing problems [ 51 , 52 ].…”

Development and validation of the Executive Functioning Scale

“…Indeed, these processes underpin healthy social and emotional development ( 4 – 6 ) and have been associated with a range of outcomes, including academic performance ( 7 ), healthy habits ( 8 ), and different aspects of quality of life ( 9 ). Conversely, EF and ER impairments have been suggested as critical transdiagnostic risk factors that cut across a range of neurodevelopmental (NDD) and neuropsychiatric (NPD) disorders ( 10 – 14 ). For instance, impairments in these processes are frequent in autism spectrum disorder [ASD; ( 15 , 16 )], attention-deficit/hyperactivity disorder [ADHD; ( 17 , 18 )], schizophrenia ( 19 , 20 ), depression ( 21 , 22 ), obsessive-compulsive disorder [OCD; ( 23 , 24 )] and posttraumatic stress disorder ( 25 ).…”

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

“…Emotion dysregulation (ED)—an impairment in modulating the experience, expression, and intensity of emotions in an adaptable and contextually appropriate manner—is hypothesized to be one underlying transdiagnostic mechanism related to clinically significant behavioral and emotional difficulties (Cai et al, 2021 ; Eisenberg & Spinrad, 2004 ; Weiss, 2014 ). The process of emotion regulation can occur at both conscious and unconscious levels.…”

“…ED often presents as increased reactivity, irritability, mood swings, and difficulty calming down once upset and can include higher rates of anxiety, depression, aggression, self-injury, and temper tantrums (collectively termed irritability Mazefsky et al, 2013 ; Pouw et al, 2013 ; Rieffe et al, 2011 ; Samson et al, 2015 ; Ting & Weiss, 2017 ; White et al, 2014 )). Additionally, ED makes a unique contribution to both internalizing and externalizing symptoms above and beyond a categorical diagnosis when examined in a sample of typical controls and individuals with a psychiatric diagnosis (e.g., Generalized Anxiety Disorder, ADHD, and ASD; (Cai et al, 2021 ). ASD-specific predispositions may increase risk for ED, including alexithymia and difficulty in identifying others’ affect (Rieffe et al, 2007 ), reduced flexibility in behavior and thought, intolerance of uncertainty (Cai et al, 2018a , 2018b ), executive functioning difficulties (Murray, 2010 ), poor problem solving (Cai et al, 2018a , 2018b ), limited coping skills (Jahromi et al, 2012 ), sensory sensitivities (Rogers & Ozonoff, 2005 ), and biological risk (Cai et al, 2018a , 2018b ; Mazefsky et al, 2008 ).…”