Emotion Regulation and Aggression: A Systematic Review and Meta‐Analysis

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience difficulties with emotion regulation. Specific use of cognitive emotion regulation strategies may contribute to these challenges, albeit research in this area remain limited. Self-rated and task-specific use of adaptive and maladaptive cognitive emotion regulation strategies was assessed in children and adolescents with ADHD and typically developing controls (N=176, 10-17 years, 55.1% girls; subsample for self-rated use: N=94, 13-17 years, 61.7% girls). Self-rated use was measured with the short version of the Cognitive Emotion Regulation Questionnaire. Task-specific use was assessed by an experimental task involving viewing emotion-eliciting photos. Regression analyses were utilized to assess associations between ADHD and cognitive emotion regulation. Effects of sex and age were explored. Adjustments were made for co-occurring psychiatric symptoms. ADHD was associated with lower self-rated (β =-0.21, p = .044) and task-specific (β =-0.09, p = .015) use of adaptive strategies, and greater use of self-rated maladaptive strategies (β =0.27, p = .010). No associations remained after adjusting for co-occurring psychiatric symptoms and multiple comparisons. Rather, depressive symptoms may contribute to the self-rated use of maladaptive strategies. Post-hoc analyses revealed that ADHD was robustly linked to less self-rated use of acceptance (β =-0.38, p = .005). Lower use of self-rated acceptance may be characteristic for ADHD. Depressive symptoms may play a more vital role for maladaptive cognitive emotion regulation than ADHD. More studies are needed to explore the longitudinal relation between ADHD, emotion regulation and depression.

Emotion regulation (ER) plays a crucial role in children and adolescents' emotional well-being. However, the use of adaptive strategies often remains challenging during early adolescence, partly because cognitive functions that support adaptive ER, such as executive functions, are still developing. In addition, individual differences, such as temperament (positive and negative emotionality) and emotional awareness, play a key role in shaping how youth engage with ER strategies. This study investigated how temperament and emotional awareness are associated with the use of adaptive and maladaptive ER strategies in youth, and whether emotional awareness moderates these relationships. In a cross-sectional design, 220 children and adolescents (age 8-15) from the general population completed self-report questionnaires measuring temperament, emotional awareness, and ER strategy use. Analyses revealed a significant interaction between negative emotionality and emotional awareness in predicting maladaptive ER strategies. Contrary to expectations, emotional awareness did not act as a consistent protective factor in youth: those high in both negative emotionality and emotional awareness still reported greater use of maladaptive strategies. These findings suggest that emotional awareness plays a complex role in ER among youth with temperamental vulnerability. Rather than functioning as a uniformly protective factor, its influence appears to depend on emotional context and temperament.

Many psychological disorders are characterized by difficulties in emotion regulation. It is unclear, however, whether different disorders are associated with the use of specific emotion regulation strategies, and whether these difficulties are stable characteristics that are evident even after recovery. It is also unclear whether the use of specific strategies is problematic across all disorders or whether disorders differ in how strongly strategy use is associated with symptom severity. This study investigated (1) the specificity of use of emotion regulation strategies in individuals diagnosed with current major depressive disorder (MDD), with social anxiety disorder (SAD), and in never-disordered controls (CTL); and (2) the stability of strategy use in formerly depressed participants (i.e., remitted; RMD). Path analysis was conducted to examine the relation between strategy use and symptom severity across diagnostic groups. Compared to the CTL group, participants in both clinical groups endorsed more frequent use of rumination and expressive suppression, and less frequent use of reappraisal. Specific to SAD were even higher levels of expressive suppression relative to MDD, as well as a stronger relation between rumination and anxiety levels. In contrast, specific to MDD were even higher levels of rumination and lower levels of reappraisal. Interestingly, elevated rumination, but not decreased reappraisal, was found to be a stable feature characterizing remitted depressed individuals. These results may provide insight into ways in which emotion regulation strategy use maintains psychological disorders.

Attenuated positive emotions and difficulties in regulating emotions are frequently observed in individuals with autism spectrum disorders (ASD) and are linked to increased risk of affective disorders, problematic behaviors, and impaired socio-emotional functioning. As such, interventions specifically focused on positive emotion regulation (ER) skills could be very valuable for individuals with ASD, their caregivers, and therapists. However, the field of positive ER in ASD is under-researched. The present study aimed at testing the practical potential and the preliminary effects of a brief novel psycho-educational training program on positive ER for individuals with ASD. Thirty male participants with ASD (aged 10–35years; Ntraining=14, Nwaitlist=16) underwent a three-session program on the use of adaptive positive ER strategies (i.e., attentional deployment, cognitive change, and response modulation). Participants rated the program as easy to understand, interesting, pleasant, and likable. No dropouts or adverse effects were observed. The training group showed a significant increase in the self-reported use of the ER strategies compared to the waitlist group. The increase in the use of ER strategies maintained up to 7 weeks in the overall sample. Having reached high satisfaction rates and the intended effects in this proof of concept study, this novel program represents a promising tool to support ER. Future research should next investigate the efficacy of the intervention on day-to-day emotional experience and wellbeing.Clinical Trial Registration:ClinicalTrials.gov # NCT02898298

Benefits of Planning as an emotion regulation strategy in obsessions and compulsions (OC): Implication of the perfectionism level in the Planning-OC relationship

Emotion regulation has recently been suggested to predict parental burnout, a prevalent syndrome in parenting. However, a substantial theory-method gap exists, as most studies have relied on cross-sectional data and between-person analyses. In this study, we aimed to illuminate the longitudinal associations between two powerful cognitive emotion regulation strategies-cognitive reappraisal and rumination-and parental burnout from both between- and within-person perspectives. We hypothesised reciprocal relationships between the use of emotion regulation strategies and parental burnout. To fulfill our objectives, we conducted a 9-month three-wave panel study (September 2023-May 2024) in a sample of 1373 U.S. parents and analysed the data with latent cross-lagged panel models (CLPMs) and random intercept cross-lagged panel models (RI-CLPMs). Our between-person (i.e., CLPM) analysis revealed that higher rumination predicted greater parental burnout over time, and vice versa. In contrast, cognitive reappraisal negatively predicted parental burnout, but not vice versa. Our within-person (i.e., RI-CLPM) results showed that temporal changes in parents' levels of parental burnout predicted subsequent changes in their use of both emotion regulation strategies, but not vice versa. These findings imply that the role of emotion regulation in parental burnout should be reconsidered. Early identification of parents at risk of emotion regulation difficulties and parental burnout is critical. Parenting programs that incorporate emotion regulation strategies, including those that are less reliant on cognitive processes, may be particularly beneficial. Future studies are encouraged to replicate our findings using more diverse samples that vary in parents' age, cultural background, ethnicity, education, and socioeconomic status.

People living with Human Immunodeficiency Virus (PLHIV) have been reported to show poor facial emotion recognition. However, these studies presented participants with facial emotion photographs whereas in real life facial emotion recognition hardly involves inferring emotions from static faces. Moreover, emotion recognition from other sensory modalities, such as auditory, has hardly been explored. There’s also a dearth of studies examining emotion regulation difficulties in this group. The present study, thus, explored facial (using facial emotion videos) and auditory emotion recognition as well as difficulties in emotion regulation (using the Hindi version of Difficulties in Emotion Regulation Scale) in 60 PLHIV and 60 people without HIV (PWoHIV). Additionally, the association of HIV duration (duration since diagnosis of HIV), viral load, and Clusters of differentiation 4 (CD4) count with emotion recognition and regulation difficulties in PLHIV was explored. Findings from one-way ANCOVA (with education and socioeconomic status as covariates) revealed significantly impaired auditory emotion recognition (particularly for fear) among PLHIV than PWoHIV. The former also showed significantly poorer facial emotion recognition for surprise. PLHIV also self-reported significantly more emotion regulation difficulties than PWoHIV, specifically Nonacceptance of their response to negative emotions and limited access to emotion regulation Strategies. CD4 count was negatively correlated with emotion regulation difficulties, particularly for accomplishing goal-directed behaviour when experiencing negative emotions (Goals) and Strategies. Besides the novel addition to the literature regarding impaired auditory emotion recognition in PLHIV, these findings can help develop targeted interventions to improve emotion recognition and emotion regulation for PLHIV.

We conducted a meta-analytic review of 53 studies published between 2000 and 2020 to quantify associations of parents’ emotion regulation with parenting behavior and children’s emotion regulation and internalizing and externalizing symptoms. Twelve meta-analyses, which included between 4 to 22 effect sizes (N from 345 to 3609), were conducted to summarize associations of parent emotion regulation with positive or negative parenting behaviors and child outcomes of emotion regulation, difficulties in emotion regulation, internalizing symptoms, or externalizing behavior. Given the range of behavioral parent emotion regulation measures used across studies, effect sizes for parent emotion regulation strategy use (skill) were analyzed separately from effect sizes for parents’ difficulties with emotion regulation. Summary effect sizes ranged from |.08| to |.28| for relations of parent emotion regulation skill with parenting behaviors and children’s adjustment. Summary effect sizes ranged from |.03| to |.42| for relations of parent emotion regulation difficulties with parenting behaviors and children’s adjustment. In general, parents with better emotion regulation skill or fewer difficulties are higher in positive parenting behaviors and have children with better emotion regulation and fewer internalizing symptoms. Evidence was less clear-cut for child externalizing behaviors. Significant effect size heterogeneity was observed in most analyses, and study characteristics (measures, child age, parent gender, sampling, and region where the study was conducted) were examined as moderators. Measures used, child age, and participant risk status moderated effect size in some analyses.

Background: Childhood maltreatment and difficulties in emotion regulation are common in patients with Borderline Personality Disorder (BPD) and Depressive Disorders (DD). Objective: This study examines differences between patients with BPD and patients with DD, regarding childhood maltreatment and difficulties in emotion regulation as well as the mediating effect of different aspects of emotion regulation deficits on the association between childhood maltreatment and BPD-symptoms. Method: A total of 305 participants, 177 with BPD and 128 with DD completed an assessment including the Childhood Trauma Questionnaire (CTQ), the Emotion Regulation Scale (DERS), the Brief Symptom Inventory (BSI), and the Structured Clinical Interview for DSM-IV (SCID). Data was analyzed using multiple analyses of variances and mediation analyses. Results: Patients with BPD reported more childhood maltreatment and more difficulties in emotion regulation than patients with DD. When general symptom severity, age, and gender were included in the analysis as covariates only group differences regarding ‘impulse control difficulties’ (F(1,299) = 38.97, p < .001, ηp 2 = .115), ‘limited access to emotion regulation strategies’ (F(1,299) = 4.66, p = .032, ηp 2 = .015), and ‘lack of emotional clarity’ (F(1,299) = 9.38, p = .002, ηp 2 = .030) remained statistically significant. A mediation analysis, including above-mentioned covariates, indicated an association between emotional abuse and BPD-symptoms, which was mediated by difficulties in emotion regulation (indirect effect B = .012, 95% CI [.001; .031], R2 = .429). Subscale analyses revealed ‘impulse control difficulties’ as the aspect of difficulties in emotion regulation that has the greatest impact on this association (B = .021, 95% CI [.003; .045]). Conclusions: Patients with BPD display more childhood maltreatment and difficulties in emotion regulation than patients with DD. Difficulties in emotion regulation, especially difficulties in impulse control, seem to play an important role in the association between childhood emotional abuse and BPD-symptoms.

Objective Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. This study aimed to explore to what extent parental psychological distress contributes to difficulties in emotion regulation, the way parents respond to children’s expression of negative emotions and whether two emotion regulation strategies are mediating mechanisms through which psychological distress affects parental responses. Method A sample of 307 Australian parents with children aged 3 to 10 years completed an online questionnaire that explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression and cognitive reappraisal as emotion regulation strategies, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. Results Parents who reported higher levels of depression, anxiety, and stress reported more frequent use of expressive suppression and less frequent use of cognitive reappraisal as emotion regulation strategies. Mixed findings were noted, with expressive suppression and cognitive reappraisal acting as mediators of depression and stress symptoms but not anxiety. Conclusion The findings highlight the need for targeting overarching factors such as difficulties in parental emotion regulation, not only as intervention for parental psychological distress but also for detection and prevention of maladaptive parenting practices. KEY POINTS What is already known about this topic: (1) Parental emotion socialisation is of key importance to children’s development. (2) Parental emotion regulation is a vital component of adaptive parenting. (3) Psychological distress compromises emotion regulation and functional parenting behaviour. What this topic adds: (1) Maladaptive emotion regulation may be present even at subclinical levels of emotional distress, thus highlighting the need for emotion regulation skills to be addressed preventatively. (2) Emotion regulation skills training in interventions with parents experiencing psychological distress may offer benefit in terms of parenting and child outcomes. (3) Cognitive reappraisal and expressive suppression may be two underlying processes which predict subsequent problems with parental emotion socialisation.

The goal of this study was to investigate age differences in emotional experience after a day of work, and the role of emotion-regulation strategy use in shaping emotional experience. Based on the lifespan literature, we predicted that older workers enjoy higher emotional well-being, in particular in terms of higher levels of low-arousal positive emotions and lower levels of high-arousal negative emotions, than young workers. We further predicted that age differences in emotional experience are mediated by a more adaptive profile of habitual emotion-regulation strategy use in older compared to young workers. Multilevel mediation analysis of 832 daily surveys completed by 92 healthcare professionals failed to provide evidence of age differences in after-work emotions. Yet, age was indirectly associated with emotional experience via enhanced use of adaptive strategies (e.g., positive reappraisal, savoring) and lower use of maladaptive strategies (e.g., rumination, fault finding). Overall, findings support an older-age advantage in emotion regulation, which in turn, benefits emotional well-being in the evening, a time of day that is essential for recovery from work demands.

The role of maternal child maltreatment history and unsupportive emotion socialization in the intergenerational transmission of emotion regulation difficulties

Following stroke, individuals often experience reduced social participation, regardless of physical limitations. Impairments may also occur in a range of cognitive and emotional functions. Successful emotion regulation, which has been identified as important in psychological adaptation to chronic illness, is associated with better perceived psychological well-being and social functioning. However, there is little evidence about the effect of stroke on emotion regulation difficulties, and associated impact on important outcomes in recovery from stroke. The objectives were (1) to determine whether people who have had a stroke reported greater difficulties in emotion regulation than controls and (2) to establish whether emotion regulation difficulties relate to social participation. 75 stroke and 40 healthy participants completed measures of emotion regulation (DERS), social participation (Modified Functional Limitation Profile [mFLP], WHOQoL-Bref) and activity limitations (mFLP). Stroke participants were seen at the acute stage (63 days post-stroke) for Study 1 and 18 months post-stroke for Study 2. In Study 1, acute-stage stroke patients had significant impairments on impulse control, awareness of emotions, and strategies for emotion regulation. There was also evidence that emotion regulation difficulties (impulse control, awareness and clarity about emotions) were associated with social participation in the stroke sample, even after controlling for potential confounders. In Study 2, there was evidence that, in the chronic-stage post-stroke, difficulties with strategy and acceptance of emotions were associated with social participation restrictions. Whilst emotion regulation as a whole in the acute phase predicted social participation in the chronic phase of stroke, no one domain of emotion regulation was a significant predictor of social participation >1 year later. These results indicate that multiple aspects of emotion regulation are impaired following stroke, with implications for social participation and recovery. This research highlights the following important clinical implications: Following a stroke, emotion regulation can be immediately and persistently affected, with post-stroke individuals experiencing greater difficulties with their emotion regulation than control participants. Emotion regulation can significantly predict important stroke outcomes including social participation and quality of life, over and above physical limitations and other post-stroke confounders. This study highlights the potential for developing a behaviour change intervention to address emotion regulation difficulties and thus ensuring individuals maximize their potential rehabilitation outcome. Cautions of the study for consideration: Emotion regulation was a self-report measure, and proxy measures would have been desirable. We are unable to establish if the post-stroke individuals differed from the controls on their emotion regulation prior to stroke.

Research conducted over the past decade indicates that difficulties in emotion regulation are more prevalent among those who have been abused than in individuals with no such experiences. Emotional Schema Therapy (EST), which is an integration of cognitive and metacognitive models as well as acceptance-based approaches, specifically targets content of beliefs about emotions and dysfunctional coping strategies to deal with difficult emotions. This study provides an initial evaluation of the efficacy of EST in addressing difficulties in six dimensions of emotion regulation in women with a history of child abuse or neglect. The statistical population consisted of all female residents of Isfahan, Iran, aged above 18 years. Five hundred volunteer women responded to a Child Abuse and Neglect questionnaire. Individuals who had higher scores on this questionnaire were invited to participate in the research project. Thirty volunteer participants were randomly assigned into experimental and control groups (n1 = n2 = 15). The intervention was a 15-session group therapy consisting of cognitive, behavioral, experiential, and mindfulness techniques. Participants completed the Difficulties in Emotion Regulation Scale (DERS) 2 weeks before and after the treatment and at 2 months follow-up. The same assessments were conducted with the control group. Data were analyzed by Mann-Whitney U Test, Friedman Test, and Wilcoxon Signed-Rank Test. Results showed that EST significantly improved acceptance of emotional responses, goal-directed behaviors, impulse control, and adaptive emotion regulation strategies in both post-test and follow-up assessments in the experimental group. In contrast, the control group did not have any significant changes on these variables. Significant changes were not detected for lack of emotional awareness and lack of emotional clarity in both groups. These findings indicate that EST is a potential effective treatment to improve aspects of emotion regulation in women with a history of child abuse and neglect.

Difficulties in emotion regulation, repetitive negative thinking, and sexual and psychological distress: a two-wave longitudinal mediation study using a transdiagnostic approach