Abstract
Emotion regulation skills develop substantially across adolescence, a period characterized by emotional challenges and developing regulatory neural circuitry. Adolescence is also a risk period for the new onset of anxiety and depressive disorders, psychopathologies which have long been associated with disruptions in regulation of positive and negative emotions. This paper reviews the current understanding of the role of disrupted emotion regulation in adolescent anxiety and depression, describing findings from self-report, behavioral, peripheral psychophysiological, and neural measures. Self-report studies robustly identified associations between emotion dysregulation and adolescent anxiety and depression. Findings from behavioral and psychophysiological studies are mixed, with some suggestion of specific impairments in reappraisal in anxiety. Results from neuroimaging studies broadly implicate altered functioning of amygdala-prefrontal cortical circuitries, although again, findings are mixed regarding specific patterns of altered neural functioning. Future work may benefit from focusing on designs that contrast effects of specific regulatory strategies, and isolate changes in emotional regulation from emotional reactivity. Approaches to improve treatments based on empirical evidence of disrupted emotion regulation in adolescents are also discussed. Future intervention studies might consider training and measurement of specific strategies in adolescents to better understand the role of emotion regulation as a treatment mechanism.
Highlights
Emotion regulation is defined broadly as the capacity to manage one’s own emotional responses.This includes strategies to increase, maintain, or decrease the intensity, duration, and trajectory of positive and negative emotions [1,2,3]
Less use of cognitive reappraisal and greater use of expressive suppression was associated with higher symptoms of depression [46,48], and higher levels of rumination were associated with greater symptoms of social anxiety [39]
This was recently confirmed in a meta-analysis of 35 studies in adolescents, demonstrating that compared to healthy individuals, those with anxiety and depressive disorders engaged in less reappraisal, problem solving, and acceptance and more avoidance, suppression and rumination
Summary
Emotion regulation is defined broadly as the capacity to manage one’s own emotional responses. Studies of typically developing individuals suggest limited efficacy of internal regulatory strategies in early adolescence, shifting towards increased use of adaptive strategies and decreased use of maladaptive strategies with age [5,12]. Investigation of normative development is ongoing, but current theories focus around maturation in activity and connectivity among the prefrontal cortex, striatum and amygdala across adolescence [16,17] These models propose that increasing prefrontal control over emotionally reactive subcortical regions enhances capacities to regulate negative emotions ( fear) and manage impulsive tendencies (reward and approach [15,16,18]). The current paper addresses the evidence linking disrupted emotion regulation to the development of anxiety and depression in adolescence This question has been investigated across different levels of analysis including self-report, behavioral, peripheral psychophysiological and neural measures. Reduced activation of ventral striatum and PFC in response to reward (Forbes, 2011 #123 [68]), regulation not investigated
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