Non-Pharmaceutical Interventions for Self-Regulatory Failures in Adolescents Suffering from Externalizing Symptoms: A Scoping Review

Abstract

Introduction: Deficits of self-regulation (SR) are a hallmark of externalizing (EXT: offending or aggressive behaviors) symptoms in adolescence. Objectives: This scoping review aims (1) to map non-pharmaceutical interventions targeting SR processes to reduce EXT symptoms in adolescents and (2) to identify research gaps, both of which will provide recommendations for future studies. Methods: Systematic searches were carried out in eight bibliographic databases up to March 2021, combining the following concepts: self-regulation, externalizing symptoms, adolescents, and non-pharmaceutical interventions. Results: We identified 239 studies, including 24,180 youths, mainly from North America, which described a plethora of non-pharmaceutical interventions targeting SR to alleviate EXT symptoms in adolescents (10–18 years of age). The majority of studies (about 70%, k = 162) represent samples with interventions exposed to “selective” or “indicated” prevention. Curriculum-based (i.e., multiple approaches targeting several domains such as emotion, cognition, and social) interventions (31.4%) were the most common type of intervention. Moreover, studies on cognitive-based interventions, mind-based interventions, and emotional-based interventions have increased over the last decades. Network analyses allowed us to identify several hubs between curriculum-based interventions, cognitive SR processes, as well as aggressiveness, conduct problems, and irritability/anger dysregulation. In addition, we identified gaps of studies concerning the physiological SR processes and on some types of interventions (i.e., body-based interventions and externally mediated interventions) or, more specifically, on promising tools, such as biofeedback, neurofeedback, as well as programs targeting neuropsychological processes (e.g., cognitive remediation). Conclusions: This scoping review stresses the plethora of interventions, identified hubs, and emerging fields, as well as some gaps in the literature, which together may orient future studies.

Good Traits, Bad Traits, and ‘Ugly’ Behavior: Relations between the Dark Triad, Honesty-Humility, Other HEXACO Personality Traits, and Externalizing Problems in Adolescents

“…This might not only be relevant for researchers but also for clinicians as the indications for treatment of externalizing problems may critically depend on youths' underlying traits. Although it is generally recommended to adopt some kind of family-or system-based approach for adolescents with this type of psychopathology (Von Sydow et al, 2013), a self-regulation intervention could be added for young persons who display a reactive/disinhibited type of externalizing (Brown, 2005;Constantly et al, 2021). However, for adolescents exhibiting traits subserving the proactive/antagonistic type other, more cognitive psychotherapeutic interventions might be indicated (Hawes et al, 2014), such as mental models therapy (Salekin et al, 2012) or schema-focused therapy (Van Wijk-Herbrink et al, 2017).…”

Examination of the importance of anger/irritability and limited prosocial emotion/callous-unemotional traits to understand externalizing symptoms and adjustment problems in adolescence: A 10-year longitudinal study

“…In particular, many different psychotherapeutical approaches exist to help individual regulate their anger and irritability. A scoping review ( 75 ) listed the existing interventions for self-regulatory control processes (including anger regulation and irritability) in youth with externalizing behaviors. However, many interventions involve parents, such as parent management training or cognitive-behavioral therapy [for a review see Sukhodolsky et al ( 76 )], which may be difficult in adolescents in institutions.…”

The role of self-regulatory control processes in understanding aggressive ideations and behaviors: An experience sampling method study

“…Taking into account our results, future studies should include the within-person variability when studying the role of self-regulatory control in violence and develop specific interventions besides already existing treatment [for a scoping review see ( 94 )], especially innovative interventions including naturalistic components [see ( 80 )]. This represents an important line of future research regarding the importance of the different components of self-regulatory control (i.e., self-control, anger states, and rumination) to understand violence and, thus, develop progressively specific interventions to reduce it.…”