Abstract
BackgroundInterventions for adolescents with externalizing behavior problems are generally found to be only moderately effective, and treatment responsiveness is variable. Therefore, this study aims to increase intervention effectiveness by examining effective approaches to train emotion regulation, which is considered to be a crucial mechanism involved in the development of externalizing behavior problems. Specifically, we aim to disentangle a cognitive and behavioral approach to emotion regulation training.MethodsA randomized controlled parallel-group study with two arms will be used. Participants are adolescents between 12 and 16 years old, with elevated levels of externalizing behavior problems. Participants will be randomly assigned to either the control condition or the intervention condition. Participants in the intervention condition receive both a cognitive and behavioral emotion regulation module, but in different sequences. Primary outcome measures are emotion regulation skills, emotion regulation strategies, and externalizing behavior problems. Questionnaires will be completed at pre-test, in-between modules, and post-test. Moreover, intensive longitudinal data is collected, as adolescents will complete weekly and daily measures.DiscussionGaining insight into which approaches to emotion regulation training are more effective, and for whom, is important because it may lead to the adaptation of effective intervention programs for adolescents with externalizing behavior problems. Eventually, this could lead to individually tailored evidence-based interventions.Trial registrationThe trial is registered at the Central Committee on Research Involving Human Subjects (NL61104.041.17, September 20th, 2017) and the Dutch Trial Register (NTR7334, July 10th, 2018).
Highlights
Interventions for adolescents with externalizing behavior problems are generally found to be only moderately effective, and treatment responsiveness is variable
This study aims to increase intervention effectiveness by examining effective approaches to train a crucial mechanism involved in behavior problems: emotion regulation
The goal of the current randomized controlled parallel-group study is to examine the effects of the Think Cool Act Cool emotion regulation training
Summary
Interventions for adolescents with externalizing behavior problems are generally found to be only moderately effective, and treatment responsiveness is variable. This study aims to increase intervention effectiveness by examining effective approaches to train emotion regulation, which is considered to be a crucial mechanism involved in the development of externalizing behavior problems. This study aims to increase intervention effectiveness by examining effective approaches to train a crucial mechanism involved in behavior problems: emotion regulation. Emotion regulation skills entail both the overall trait-level difficulties in regulating emotions (emotion regulation difficulties) and the habitual use of specific adaptive or maladaptive emotion regulation strategies (e.g., rumination) [8] Both aspects of emotion regulation are found to be related to the development of externalizing behavior problems [9]. Emotion regulation difficulties predict increases in aggressive behavior during adolescence [10, 11], whereas the use of adaptive emotion regulation strategies (such as problem solving) are related to less psychopathology [12, 13]. Adolescents who report to use a maladaptive emotion regulation profile (high use of maladaptive emotion regulation strategies combined with the low use of adaptive strategies) are at risk for experiencing externalizing behavior problems [15]
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