Social contextual links to emotion regulation in an adolescent psychiatric inpatient population: do gender and symptomatology matter?

Background:  The regulation of emotion is essential for adaptive functioning. However, delineating the pathways of emotion regulation (ER) processes that lead to psychological adaptation remains under-studied, with mixed evidence for the specificity vs. generality of ER deficits in relation to specific forms of psychopathology. To examine this issue, this study investigated links among ER, social-contextual factors (family, peer), and psychological adjustment (internalizing, externalizing).
Method:  Participants were 140 adolescents (71% female, 83.3% Caucasian, M age = 16.03 years) who were consecutive psychiatric admissions over a one-year period. Adolescents completed measures on family environment and peer relationship experiences. Both adolescents and parents reported on adolescents' characteristic patterns of ER and psychopathology.
Results:  Discriminant analyses revealed that two functions, ER skills and impulsivity/lability, differentiated among adolescents who were elevated in internalizing symptoms only, in externalizing symptoms only, in both domains, or in neither domain. Regarding social contextual variables, family cohesion was associated with adaptive ER behaviors for girls along the internalizing dimension and all adolescents reporting externalizing behaviors. Relational victimization predicted difficulties with ER in both symptom domains for all adolescents. Within the internalizing domain, friendship support was related to adaptive ER.
Conclusion:  Facets of ER do differentiate between global indices of internalizing and externalizing behaviors and suggest that both general and specific factors contribute to adolescents' unique learning history with emotions and characteristic patterns for managing emotions.     

Psychopathology and short-term emotion: the balance of affects

In this study, the relationship between short-term emotion expressions and dimensional ratings of internalizing and externalizing symptomatology was examined. Short-term emotions, defined as facial or vocal displays of emotion generally lasting less than 10 seconds and elicited by a specific and proximal event, were observed during recess in 71 children from diverse socioeconomic backgrounds, who were between 4 and 8 years old. Internalizing and externalizing symptomatology was assessed through parent and teacher questionnaire. Sociometric ratings were obtained from peers on children's anger and aggression. It was hypothesized following Tomkins (1979) and others that one affect becomes predominant in the emotional experience of the individual. Different operationalizations of this concept were examined. Using regression analyses, externalizing symptomatology was found to be predicted by higher levels of anger, lower levels of happiness, and lower levels of sadness. Internalizing symptomatology was found to be predicted by higher levels of sadness and lower levels of anger. It was concluded on the basis of these data that the relationship between short-term emotion and internalizing and externalizing psychopathology is best understood as the balance between different short-term emotions. Results are discussed in the context of theories of emotion and their functions.     

Agreement Between Parents'' and Teachers'' Ratings of Behavioral/Emotional Problems of Children aged 4–12.

Parents' and teachers' reports of behavioral/emotional problems in 1161 children aged 4-12 from the general population and assessed via the Achenbach Child Behavior Checklist were compared. Low to moderate agreement was found, with parents reporting more problems than teachers. Agreement was higher for externalizing problems than for internalizing problems and higher for children receiving special education than for those receiving regular education. Agreement was slightly higher for older than younger children. Sex of the child did not influence parent-teacher agreement. Teachers scored children higher on problems related to peer relations and on problems interfering with academic functioning, whereas parents scored their children higher on problems associated more strongly with externalizing than with internalizing syndromes.     

Emotion regulation and internalizing symptoms in a longitudinal study of sexual minority and heterosexual adolescents

Background: Sexual minority adolescents appear to be at increased risk for internalizing disorders relative to their heterosexual peers, but there is a paucity of research explaining this elevated risk. Emotion regulation deficits are increasingly understood as important predictors of internalizing psychopathology among general samples of adolescents. The present study sought to examine whether deficits in emotion regulation could account for disparities in internalizing symptoms between sexual minority and heterosexual adolescents. Methods: The present study utilized longitudinal data from a racially/ethnically diverse (68% non‐Hispanic Black and Hispanic/Latino) community sample of 1,071 middle school students (ages 11–14). Results: Adolescents who endorsed same‐sex attraction evidenced higher rates of internalizing symptoms at both time points. Structural equation modeling indicated that sexual minority adolescents exhibited greater deficits in emotion regulation (rumination and poor emotional awareness) than their heterosexual peers. Emotion regulation deficits in turn mediated the relationship between sexual minority status and symptoms of depression and anxiety. Conclusions: The results demonstrate the importance of considering normative psychological processes in the development of internalizing symptomatology among sexual minority adolescents, and suggest emotion regulation deficits as specific targets of prevention and intervention efforts with this population. Future studies are needed to determine whether stigma‐related stressors are responsible for emotion regulation deficits among sexual minority youth.     

Are sibling relationships protective? A longitudinal study

BACKGROUND: Although the protective effects of familial and parental support have been studied extensively in the child psychopathology literature, few studies have explored the protective quality of positive sibling relationships. METHODS: A two-wave longitudinal design was used to examine the protective effect of positive sibling relationships on child adjustment for children experiencing stressful life events. Mothers reported on stressful life events and child adjustment. Older siblings assessed the quality of relationship between themselves and target children. RESULTS: Sibling affection moderated the relationship between stressful life events and internalizing symptomatology but not the relationship between stressful life events and externalizing symptomatology. Notably, the protective effect of sibling affection was evident regardless of mother-child relationship quality. CONCLUSIONS: Positive sibling relationships are an important source of support for children experiencing stressful life events. Implications for intervention are discussed.     

Emotionsregulationsdefizite im Kindesalter

Emotion regulation

The ability to regulate emotions represents an important developmental step in childhood. Emotion regulation is significantly influenced by various factors, such as neurological development, child’s temperament, and parenting behavior.

Deficits in emotion regulation

Current research shows that deficits in emotion regulation (i.e., the frequent use of dysfunctional regulation strategies and a lack of use of functional strategies) are associated with psychosocial impairment. In addition, a basic association could be detected between emotion regulation deficits and externalizing and internalizing disorders in childhood.

Therapy

By focusing on emotion regulation in well-directed treatment approaches, promising effects can be observed. A crucial task for future research is to further investigate the specific function of emotion regulation for psychopathology and to integrate this ability into treatment approaches for children.     

Effects of chronic maltreatment and maltreatment timing on children’s behavior and cognitive abilities

Background: Chronic maltreatment has been associated with the poorest developmental outcomes, but its effects may depend on the age when the maltreatment began, or be confounded by co‐occurring psychosocial risk factors. Method: We used data from the National Survey of Child and Adolescent Well‐Being (NSCAW) to identify four groups of children who varied in the timing, extent, and continuity of their maltreatment from birth to 9 years. Internalizing and externalizing problems, prosocial behavior, and IQ were assessed 21 months, on average, following the most recent maltreatment report. Results: Children maltreated in multiple developmental periods had more externalizing and internalizing problems and lower IQ scores than children maltreated in only one developmental period. Chronically maltreated children had significantly more family risk factors than children maltreated in one developmental period and these accounted for maltreatment chronicity effects on externalizing and internalizing problems, but not IQ. The timing of maltreatment did not have a unique effect on cognitive or behavioral outcomes, although it did moderate the effect of maltreatment chronicity on prosocial behavior. Conclusion: There is a need for early intervention to prevent maltreatment from emerging and to provide more mental health and substance use services to caregivers involved with child welfare services.     

Annotation: Recent research examining the role of peer relationships in the development of psychopathology

This Annotation highlights recent research on the role of peer group and friendship factors in the development of psychopathology in childhood and adolescence. Several processes are considered. including peer rejection (e.g., exclusion and victimization), social withdrawal and avoidance of peer interaction, and the socialization of deviant behavior and internalizing problems. The mediating influences of several proximal components are examined, including cognitive-perceptual factors and emotion regulation. In addition, the moderating influences of close friendship, age, gender, ethnicity, and group norms are considered. Several promising avenues for future directions in research are highlighted, including the examination of heterogeneity in developmental processes, further investigation of gender-based norms, and the application of multi-level modeling techniques and gene-environment process models.     

Psychiatric comorbidity in children and adolescents with reading disability

This study investigated the association between reading disability (RD) and internalizing and externalizing psychopathology in a large community sample of twins with (N = 209) and without RD (N = 192). The primary goals were to clarify the relation between RD and comorbid psychopathology, to test for gender differences in the behavioral correlates of RD, and to test if common familial influences contributed to the association between RD and other disorders. Results indicated that individuals with RD exhibited significantly higher rates of all internalizing and externalizing disorders than individuals without RD. However, logistic regression analyses indicated that RD was not significantly associated with symptoms of aggression, delinquency, oppositional defiant disorder, or conduct disorder after controlling for the significant relation between RD and ADHD. In contrast, relations between RD and symptoms of anxiety and depression remained significant even after controlling for comorbid ADHD, suggesting that internalizing difficulties may be specifically associated with RD. Analyses of gender differences indicated that the significant relation between RD and internalizing symptoms was largely restricted to girls, whereas the association between RD and externalizing psychopathology was stronger for boys. Finally, preliminary etiological analyses suggested that common familial factors predispose both probands with RD and their non-RD siblings to exhibit externalizing behaviors, whereas elevations of internalizing symptomatology are restricted to individuals with RD.     

Psychopathology in thalassemia major

Background: Thalassemia major (TM) is a chronic disease with adverse emotional effects on both the child and the family. The aim of this study was to investigate the psychiatric state and behavioral problems of children with TM. Methods: Twenty children diagnosed with TM and 34 healthy children were enrolled in this study carried out by the Pamukkale University Faculty of Medicine, Department of Pediatrics. Mothers of the children of both the groups were handed a child behavior check‐list for 4–18‐year‐old children and adolescents as well as a short questionnaire requesting demographic information. Results: The psychiatric diagnosis was significantly higher in the children with TM (55.0%) as compared to the control group (14.7%). The thalassemic children showed an anxiety disorder frequency of 30.0% and a depressive disorder frequency of 15.0%. T scores of the indicators of internalizing problems, externalizing problems, attention problems and social problems contained in the child behavior check‐list were shown to be higher in children with TM than in the control group. The TM group demonstrated significantly higher problems in peer relationships and educational success in comparison with the controls. Conclusion: Children with TM are posed with an increased risk of psychopathology.     

Maternal emotion coaching,adolescent anger regulation,and siblings’ externalizing symptoms

Background: Increases in externalizing behaviors during the transition to adolescence may put children at risk for developing mental disorders and related problems. Although children’s ability to regulate their emotions appears to be a key factor influencing risk for maladjustment, emotion processes during adolescence remain understudied. In this longitudinal study, we examined a multi‐level mediational model in which emotion coaching by parents was posited to influence the ability of adolescents to regulate their emotions, which in turn influences their expression of problem behaviors. Methods: We recruited a representative community sample of 244 families with biological sibling pairs comprising a child in late elementary school and a child in middle school. Maternal meta‐emotion interviews were coded for mother emotion coaching and adolescent difficulty with anger. Mothers also completed questionnaires on adolescent irritability. Ratings of adolescent problem behaviors were obtained from mother and teacher questionnaires completed at two time points. Using structural equation modeling, constructs were partitioned into components across older and younger siblings to examine shared and nonshared variance and contextual effects. Results: Cross‐sectional data indicated that mothers' emotion coaching of anger was related to better anger regulation in adolescent siblings, which was, in turn related to less externalizing behavior. Although support for mediational effects was limited in the longitudinal data, both older and younger siblings' difficulties in regulating anger predicted adolescent externalizing behavior three years later. Additional longitudinal predictors of externalizing behavior were observed for younger siblings. In particular, emotion coaching of anger by mothers was associated with decreased externalizing behavior, while conversely, older siblings' externalizing behavior was associated with increased externalizing behavior in the younger siblings over time. Conclusions: The findings highlight the importance of considering family emotion processes in understanding adolescent problem behavior. Both maternal emotion coaching of adolescent anger and adolescent difficulty in regulating anger influenced adolescent externalizing behavior. Emotion coaching interventions seem worthy of consideration for enhancing the impact of prevention and intervention programs targeting youth externalizing behaviors.     

Ecological influences on the sequelae of child maltreatment: a review of the literature

Numerous studies indicate that child maltreatment increases the risk for the development of internalizing and externalizing behavior problems. Great variations in outcome, however, have been noted among victims of maltreatment. From an ecological perspective, this review examines how the effects of maltreatment may be influenced by the contexts in which children develop, including their families, peer groups, schools, and communities. The literature reviewed suggests that contextual factors not only influence the incidence of maltreatment but also may moderate its developmental effects, thereby accounting for some of the heterogeneity in the outcomes associated with abuse and neglect. Closer examination of the influence contextual factors exert on the psychosocial sequelae of maltreatment will better inform the interventions, treatments, and public policies directed toward the maltreated population. Methodological considerations for conducting research in this area are also discussed.     

Language skills, peer rejection, and the development of externalizing behavior from kindergarten to fourth grade

Background: Children with poorer language skills are more likely to show externalizing behavior problems, as well as to become rejected by their peers. Peer rejection has also been found to affect the development of externalizing behavior. This study explored the role of peer rejection in the link between language skills and the development of externalizing behavior. Methods: Six hundred and fifteen (615) children were followed from kindergarten to grade 4. Receptive language skills were measured with the Peabody Picture Vocabulary Test in grade 2. Teachers reported externalizing behavior and peer reports of social rejection were measured annually. Results: Children with poorer receptive language skills showed increasing externalizing behavior, while children with better receptive language skills showed decreases in externalizing behavior. Children with poorer receptive language skills experienced peer rejection most frequently. The link between receptive language skills and the development of externalizing behavior was mediated by the development of peer rejection. Findings suggested that this mediational link applied mostly to boys. Conclusion: Children with poorer language skills are at increased risk of becoming rejected by mainstream peers, which adds to the development of externalizing behavior.     

Parental emotional support and subsequent internalizing and externalizing problems among children

This study examined the association between early emotional support provided by parents and child internalizing and externalizing problems, using a nationally representative, longitudinal sample of 1361 children. Parental emotional support was assessed using the Home Observation for the Measurement of the Environment, incorporating both parent report and interviewer observation. We found that, controlling for child externalizing problems at age 6 years, parental emotional support at age 6 years was negatively related to child externalizing problems at age 8 years. A developmental model that assessed the timing of the emergence of this relationship was then analyzed by including parental emotional support at ages 2, 4, and 6 years as predictors of child externalizing problems at age 8 years. The developmental model suggested that less parental emotional support as early as age 2 years is associated with later externalizing problems in children. This study discusses the importance of very early parental emotional support in promoting positive child development.     

The impact of peer victimization on later maladjustment: mediating and moderating effects of hostile and self‐blaming attributions

Background: Evidence indicates that being a victim of bullying or peer aggression has negative short‐ and long‐term consequences. In this study, we investigated the mediating and moderating role of two types of attributional mechanisms (hostile and self‐blaming attributions) on children’s maladjustment (externalizing and internalizing problems). Methods: In total, 478 children participated in this longitudinal study from grade 5 to grade 7. Children, parents, and teachers repeatedly completed questionnaires. Peer victimization was assessed through peer reports (T1). Attributions were assessed through self‐reports using hypothetical scenarios (T2). Parents and teachers reported on children’s maladjustment (T1 and T3). Results: Peer victimization predicted increases in externalizing and internalizing problems. Hostile attributions partially mediated the impact of victimization on increases in externalizing problems. Self‐blame was not associated with peer victimization. However, for children with higher levels of self‐blaming attributions, peer victimization was linked more strongly with increases in internalizing problems. Conclusions: Results imply that hostile attributions may operate as a potential mechanism through which negative experiences with peers lead to increases in children’s aggressive and delinquent behavior, whereas self‐blame exacerbates victimization’s effects on internalizing problems.     

Social-psychological correlates of peer victimization in children with endocrine disorders

OBJECTIVE: To examine the relation between victimization by peers and child and parent reports of social-psychological adjustment. STUDY DESIGN: The Social Experience Questionnaire, Children's Depression Inventory, Social Anxiety Scale for Children-Revised, and Asher Loneliness Scale were administered to 93 children diagnosed with various endocrine disorders. The child's parent/guardian completed the Child Behavior Checklist. RESULTS: For the entire sample, peer victimization was positively related to child-reported depression, social anxiety, loneliness, and parent-reported externalizing symptoms. Those children with endocrine disorders without observable features had a stronger relation between peer victimization and depression and internalizing and externalizing behavior problems than did those who had endocrine disorders with observable physical features. CONCLUSIONS: Recognition of the magnitude of the problem and means of evaluating for peer victimization is important for clinicians who see children with chronic diseases.     

Trajectories of children's internalizing symptoms: the role of maternal internalizing symptoms, respiratory sinus arrhythmia and child sex

Background: We assessed trajectories of children’s internalizing symptoms as predicted by interactions among maternal internalizing symptoms, respiratory sinus arrhythmia (RSA) and child sex. Method: An ethnically and socioeconomically diverse sample of children (n = 251) participated during three study waves. Children’s mean ages were 8.23 years (SD = 0.72) at T1, 9.31 years (SD = 0.79) at T2 and 10.28 years (SD = 0.99) at T3. Results: Multiple‐indicator multilevel latent growth analyses showed maternal internalizing symptoms interacted with child RSA and sex to predict children’s internalizing symptoms. Girls with higher RSA whose mothers had lower levels of internalizing symptoms showed the steepest decline in internalizing symptoms across time. Girls with lower RSA whose mothers had higher levels of internalizing symptoms showed the highest levels of internalizing symptoms at T3, whereas boys with higher RSA whose mothers had higher levels of internalizing symptoms showed the highest levels of internalizing symptoms at T3. Conclusions: Findings build on this scant literature and support the importance of individual differences in children’s physiological regulation in the prediction of psychopathology otherwise associated with familial risk.     

How does longitudinally measured maternal expressed emotion affect internalizing and externalizing symptoms of adolescents from the general community?

Background: In previous studies, maternal expressed emotion (EE) has been found to be a good predictor of the course of adolescent internalizing and externalizing symptoms. However, these studies have been cross‐section as opposed to longitudinal. The goal of this study is to examine longitudinal data of perceived maternal EE and adolescent internalizing and externalizing symptoms to determine if maternal EE affected the course of adolescent symptoms (a parent effect model), or if the course of adolescent symptoms affected maternal EE (a child effect model), or if maternal EE and adolescent symptoms affected one another bidirectionally. Methods: Dutch adolescents (N = 497; 57% boys; M = 13 years) from the general community and their mothers were prospectively studied annually for three years. At all waves the mothers completed the Level of Expressed Emotion (LEE) questionnaire and the adolescents completed self‐rated measures of internalizing and externalizing symptoms. Structural equation modeling (SEM) was used to analyze the longitudinal data. Results: The results of the SEM analyses clearly demonstrate that a child effect model best describes the relationship between maternal EE and the course of adolescent internalizing and externalizing symptoms. Conclusions: This longitudinal study of the mothers’ EE perceptions suggests that it is the course of the internalizing and externalizing symptoms of adolescents from the general community that affects maternal EE, and not the mothers’ perceived EE influencing the course of the adolescents’ symptoms. Since this study was based on adolescents from the general community, it is suggested that these findings should also be replicated in clinical samples of adolescents.     

Preschool developmental pathways to preadolescent internalizing and externalizing problems

The present study investigated longitudinal pathways from specific early preschool behavioral problems (ages 2-3 years) to internalizing and externalizing problems in preadolescence (ages 10-11 years), and the role of social problems at school entry (ages 4-5 years) in such pathways. Path analyses were performed using both parent and teacher reports in a sample of 251 to 346 children from the general population, depending on the availability of parent and teacher data at each time of assessment. Structural equation modeling revealed homotypic internalizing and externalizing pathways, predictions from early preschool externalizing problems to later internalizing problems, and negative predictive paths from early internalizing problems to externalizing problems in preadolescence. Cross-informant predictions spanning 8 years were found between parent-reported aggression and overactivity at ages 2-3 years and teacher-reported externalizing problems at ages 10-11 years. Further, results showed that boys' pathways were more complex and showed greater predictive validity than pathways for girls, and that social problems at school entry played a significant role in pathways to internalizing problems, but only for boys. The results are discussed from a developmental psychopathology perspective.     

Ethnic differences in relations between family process and child internalizing problems

BACKGROUND: Family process variables have been linked to child problem behavior, but recent research suggests that child ethnicity may moderate relations between family process and child outcomes. The current study examined how ethnicity moderates relations between parent conflict, parent-child relationship quality, and internalizing problems. METHODS: A sample of 101 mother-child dyads was drawn from a larger longitudinal study of childhood-onset depression. Maternal reports of family process factors were used with child reports of anxiety and depressive symptoms. RESULTS: The results indicated a moderating effect of ethnicity for multiple indicators of internalizing symptoms, such that child-rearing disagreement and low levels of mother-child openness were associated with internalizing problems only for European American (not African American) children. CONCLUSIONS: Findings suggest that ethnicity moderates the effects of family process factors on child psychopathology. Ethnic differences may be accounted for by the normativeness of family processes and the meaning that children of different ethnic backgrounds assign to these processes.