The Role of Emotion Regulation in the Treatment of Child Anxiety Disorders

Abstract

In this review, we examine the role of emotion regulation in the treatment of children with anxiety disorders. Cognitive-behavioral therapy (CBT) has been shown to "work" for children with anxiety disorders and it has been categorized as an evidence-based treatment. However, most studies have shown that the treatment is effective for about 60-70% of children, leaving the remaining children symptomatic and oftentimes with persisting psychological disorders. Of importance, it has also been shown that many children with anxiety disorders demonstrate poor emotion regulation skills. Despite these findings, little attention has been directed toward incorporating emotion regulation strategies into these relatively effective cognitive-behavioral treatments. It is possible that CBT programs do not work as well for a portion of children because their emotion regulation deficits, if present, are not being targeted sufficiently. In this review, it is suggested that adding an emotion regulation component could increase treatment efficacy. In addition, strategies aimed at improving emotion regulation at the individual level and at the family level are introduced. Details of how improved emotion regulation skills could be beneficial in bringing about change are discussed. Finally, issues of measurement and the clinical implications for research and practice are considered.

The Development of Anxiety Disorders: Considering the Contributions of Attachment and Emotion Regulation

“…Studies that have investigated childhood anxiety, as well as its accompanying symptoms, have focused on a panoply of factors. These include a temperamental style of behavioral inhibition (Weems and Silverman 2006), difficulties with emotion regulation (e.g., Calkins and Hill 2007;Hannesdottir and Ollendick 2007;Suveg et al 2007), and information-processing and attention biases (Hadwin et al 2006;Reinholdt-Dunne et al 2011). Other studies have focused on the contribution of family factors, such as rearing style, marital conflict, and parental beliefs about the child (e.g., Bögels et al 2006;McLeod et al 2011), as well as insecure attachment (e.g., Colonnesi et al 2011), parenting practices (Ginsburg et al 2004), and heredity (Angold et al 1999;Bögels et al 2006;Schreier et al 2008;Weems and Silverman 2008).…”

“…The different models suggest a synergistic effect between the concepts on a theoretical level (e.g., Cassidy 1994;Mikulincer et al 2003;Thompson 2001). Empirical studies and comprehensive reviews on the links between either two of the three constructs also exist (e.g., Bögels et al 2006;Brumariu and Kerns 2010;Colonnesi et al 2011;Hannesdottir and Ollendick 2007). However; to the best of our knowledge, the interrelations between all three concepts have not yet been reviewed with regard to the empirical data substantiating their relations with one another.…”

Social functioning of students with internalizing behavioral problems

“…Most often they avoid situations in which one can see their lack of social competence and self-efficacy (Alfano, Beidel & Turner, 2006;Smari, Pétursdóttir & Porsteinsdóttir, 2001), making it difficult to acquire a positive self-image (Oland & Shaw, 2005). They are extremely careful with social norms and show excessive self-control (Hannesdottir & Ollendick, 2007), they are unsure when they run into obstacles, withdrawn, easily confused, and show a lack of self-confidence (Greco & Morris, 2005). Feelings of powerlessness and fear of failure, rigidity, excessive self-criticism, negative expectations and low self-esteem contribute to the avoidance of redressing the reluctance of contact with other people (Mahon et al, 2006).…”

Physiological Response to Negative Emotions in Children with Anxiety Symptoms: Many Steps Still to be Taken

“…Thus, understanding the underlying etiological processes represents an important research task in the field (2)(3)(4). Evidence show that emotion dysregulation is a fundamental feature of anxiety disorders (5). Despite the large amount of literature available on adults, only few studies focused on the psychophysiological response induced by emotion triggering stimuli in children with anxiety (6).…”