Psychosocial Adjustment of Institutionalised Children: A Thematic Analysis of Caregiver Perspectives in Delhi

BackgroundAdolescence is a pivotal stage in human development, marked by significant biological, cognitive, and emotional transformations that shape an individual's character and future behaviour. The emotional strategies and behavioural patterns inculcated during this phase become integral aspects of one's personality, influencing how one navigates through various life challenges. For vulnerable adolescents, such as neglected children in institutional care or orphans, negative life experiences can heighten the risk of developing psychological concerns. This heightened vulnerability is often exacerbated by impaired emotional regulation and low resilience, which may contribute to the emergence of internalising disorders.MethodsThe present study was conducted to examine the relationship between meta emotions and difficulties in emotional regulation among neglected adolescents and to analyse the mediating effect of resilience on this relationship. The participants of the study were 667 neglected adolescents: 335 males (50.2%) and 332 females (49.8%) who belong to the age group 13 to 17 years (mean age = 14.60, S.D = 1.16) years from various institutional homes across Bangalore.ResultsThe results of this study confirm that in the presence of increased levels of negative meta emotions in an individual, despite the mediating effects of resilience, difficulties in emotional regulation will be further worsened. This was substantiated by the positive correlation between negative meta emotion and difficulties in emotional regulation. Contrastingly, elevated positive meta emotions in an individual, along with the mediating effects of resilience, reduce the difficulties in emotional regulation. This was also reinforced by the strong relationship between positive meta emotions and difficulties in emotion regulation.ConclusionThe findings of the study highlight the prevalence of increased negative meta emotions and poor emotional regulation among neglected adolescents, which is of utmost importance from a psychological, social and policy-making perspective. This calls for the need for tailored and individual-focused interventional strategies to improve the psychological health of these vulnerable children. Moreover, the critical period of adolescence is a crucial time for implementing effective policies in order to shape the behavioural and cognitive aspects of personality with much-needed care, support, and professional guidance.

Prior research has shown that difficulties in emotion regulation is associated with overall levels of posttraumatic stress symptoms (PTSS). However, it is currently unclear which facets of difficulties in emotion regulation (e.g., lack of emotion regulation strategies, impulse control problems, non-acceptance of emotional responses) are associated with specific PTSS clusters. This information may be valuable in refining treatment approaches in PTSS. The aim of the current study was to use structural equation modeling to test the relationships between Difficulties in Emotion Regulation Scale (DERS) subfactors and PTSS in a trauma-exposed community sample (N = 746). Results indicated that impulse control difficulties were most consistently associated across PTSS clusters (i.e., re-experiencing, avoidance, and hyperarousal), while lack of emotion regulation strategies and emotional clarity were uniquely associated with numbing symptoms, after covarying for neuroticism. However, other facets of difficulties in emotion regulation (i.e., non-acceptance of emotional responses and difficulties engaging in goal-directed behavior while upset) were not associated with PTSS. These findings provide further support for the role of difficulties in emotion regulation in specific PTSS clusters. Additionally, they suggest that impulse control problems may be important in the development of most PTSS and thus most beneficial to target clinically, while lack of emotional clarity and effective emotion regulation strategies may be specific to numbing symptoms.

This dissertation was constructed to better understand the role that emotion regulation(ER) difficulties have in the lives of children diagnosed with autism spectrum disorder (ASD). Three research methods were utilized and are presented in this order: secondary data analysis, systematic literature review, and a cross-sectional observational study. The secondary data analysis (chapter one) aimed to understand the association between family conflict, child ER, parent perceived stress, and ASD-related social responsiveness in a sample of 2,229 children included in a nationwide longitudinal study. Findings suggest that higher social responsiveness scores predict more ER difficulties as reported by a parent. Parent perceived stress and child ER were positively associated. The findings regarding social responsiveness and ER in a typically developing sample prompted a review of the ER literature specifically pertaining ASD symptoms specifically. A systematic literature review (chapter two) examined literature from 30 articles about ER difficulties in school aged children with an ASD diagnosis. General findings suggest that this population often struggles with ER difficulties and there are many mechanisms which contribute to troubles regulating emotions. Poor outcomes have been associated with ER difficulties and a variety of clinical interventions have been created to improve ER for this population. There is some research regarding parent involvement in coregulation, specifically regarding parents engaging in scaffolding and supportive behaviors when children are experiencing strong emotional states, but the parent’s own ER efforts are not often studied. These findings led to an examination of child and parent ER through cross-sectional data collection (chapter three). Data were collected from 173 parents, whose children have an ASD diagnosis, about their own and their child’s ER difficulties, their child’s ASD symptom severity, and information regarding other mechanisms that could be associated with ER. Findings suggest that more severe ASD symptoms predict both parent and child ER. Signs of mutual influence between parents and children regarding ER difficulties were found, but the strength and direction of these relationships did not align with hypotheses. Overall, studying dyadic ER in ASD families is important to build context for the ER difficulties children typically experience. Gaining a better understanding of dyadic ER may help us to continue building interventions that provide ER support for the entire family. Continued research is needed to examine the role of dyadic ER longitudinally, which would allow for a more complex exploration of the role dyadic ER may have on general family functioning and cohesion.

Prior research indicates that emotion regulation (ER) difficulties may contribute to or maintain eating disorders (EDs), and that sexual minorities (SM) are at elevated risk for both phenomena. However, limited research has examined the dimensional variability of ER in SM individuals with EDs. Patients from an ED partial hospitalization program (N = 344) completed surveys of ED symptoms and ER difficulties at treatment admission. SM patients with EDs reported greater difficulties in ER compared to non-clinical SM participants from a previous study (ps < .001). Patients with EDs that identified as a SM demonstrated greater difficulties compared heterosexual patients across all ER dimensions (ps < .018); however, the effect sizes were smaller when comparing SM patients to heterosexual patients with EDs. ER difficulties were significantly associated with more severe ED symptoms across all dimensional scores. However, DERS Clarity was the only ER dimension that demonstrated a significant interaction effect with sexual orientation (p = .048), such that difficulties identifying one’s emotions was only significantly associated with ED symptom severity in heterosexual patients (p = .027). Findings help provide additional context regarding ER difficulties in SM patients with EDs.

Background: Adolescence is a sensitive developmental period marked by heightened emotional reactivity and increasing demands on emotion recognition and regulation. Although alexithymia has been associated with less adaptive and avoidant coping tendencies in adolescents, most prior research has relied on descriptive or bivariate approaches, leaving the underlying processes and model-based pathways insufficiently clarified. In particular, the explanatory role of difficulties in emotion regulation in the association between alexithymia and coping strategies remains underexplored. This study aimed to address this gap by examining whether difficulties in emotion regulation mediate the relationship between alexithymia and coping strategies in adolescents. Methods: In this cross-sectional study, 1415 adolescents (13-17 years) from public high schools in Central Anatolia, Türkiye, completed the Toronto Alexithymia Scale (TAS-20), the Difficulties in Emotion Regulation Scale (DERS-16), and the Coping Strategies Indicator (CSI). Pearson correlations were calculated. Mediation analyses were conducted using PROCESS Macro (Model 4) with 5000 bootstrap samples, adjusting for age, gender, academic achievement, and family type. Results: Alexithymia was moderately associated with emotion regulation difficulties (r = 0.49, p < 0.001). Mediation analyses revealed significant indirect effects for seeking social support (B = -0.068, 95% CI [-0.087, -0.051]) and problem solving (B = -0.067, 95% CI [-0.086, -0.049]), with direct effects remaining significant, indicating inconsistent (competitive) mediation patterns. For avoidance coping, the indirect effect was significant (B = -0.072, 95% CI [-0.090, -0.055]), whereas the direct effect became non-significant, consistent with an indirect-only mediation pattern. Correlations involving coping outcomes were small in magnitude. According to Cohen's criteria, the association between alexithymia and emotion regulation difficulties was moderate in magnitude, whereas correlations involving coping outcomes were small. Conclusions: Difficulties in emotion regulation emerged as a statistical mediator within the proposed model, demonstrating systematic associations between alexithymia and distinct coping patterns in adolescents. These findings underscore the relevance of emotion regulation-focused prevention and intervention efforts in school settings. By examining multiple coping outcomes simultaneously within a covariate-adjusted mediation framework in a large community adolescent sample, this study offers an integrative, model-based perspective on how alexithymic traits are linked to coping through regulatory difficulties.

Emotions are an individual's reaction to their environment to either maintain or change the environment (Saarni, Mumme, & Campos, 1998) and provide individuals with very useful knowledge about themselves, their environment, and their relationships (Zeman, Cassano, Perry-Parrish, & Stegall, 2006). Emotion regulation is the ability to modify and adapt emotions to the social context (Campos, Mumme, Kermoian, & Campos, 1994). It is described as the intrinsic and extrinsic processes responsible for observing, assessing, and modulating emotional responses for personal purpose and adaptive social functioning (Thompson, 1994). Studies indicated that effective emotion regulation is connected with fewer internalizing and externalizing issues (Rydell, Thorell, & Bohlin, 2007), while ineffective emotion regulation is associated with mental health problems (Gross & John, 2003).The skill to communicate one's emotional experiences to another person develops during late childhood and adolescence (Kopp, 1992). Adolescents experience more frequent and stronger emotions than both younger and older people (Larson & Lampman-Petraitis, 1989). It is important for adolescents to regulate emotions in adaptive ways, without the assistance of the adults who guide them in their childhood (Steinberg & Avenevoli, 2000). Adolescents who were less capable of regulating negative feelings during actual-life emotional experiences mentioned more problems compared with those who handled negative experiences more readily (Silk, Steinberg, & Morris, 2003). In particular, poor emotional understanding and difficulties in regulating negative emotions has been linked to aggression in adolescence (Bohnert, Crnic, & Lim, 2003; Herts, McLaughlin, & Hatzenbuehler, 2012).Indeed, adolescents who are capable of managing their emotional behavior are less likely to act aggressively (Underwood, Coie, & Herbsman, 1992). However, those with great difficulties in emotion regulation had problems with anger control and aggressive behavior (McLaughlin, Hatzenbuehler, Mennin, & Nolen-Hoeksema, 2011). However, only a few studies have researched the relationship between aggression and difficulties in emotion regulation (Laible, Carlo, Panfile, Eye, & Parker, 2010). Because most of the evidence on this topic comes from results that have indicated a relationship between anger control and aggression (Roberton, Daffern, & Bucks, 2012), a better comprehension of difficulties in emotion regulation during adolescence can identify individual differences in aggression at the time of increased risk (Silk, Steinberg, & Morris, 2003).Aggressive behavior is predicted by anger in adolescents. Anger leads to adolescent to misinterpret existing cues, and this misinterpretation is more likely results in physical, verbal, and indirect aggression (Fives, Kong, Fuller, & DiGiuseppe, 2010). The cognitive contents specificity model, the most commonly discussed model, suggests that increased anger results in socially constructed apparent behavioral reactions in the shape of aggression, and these reactions mainly function to remove the anger (Kassinove & Tafrate, 2002). At the same time, research shows that aggressive behavior does not decrease the level of experienced anger. Indeed, conversely, research indicates that discharging aggressive behavior (i.e., kicking a punch-bag) makes the anger worse (Bushman, 2002).It is claimed that individuals with increased anger may become angry because of a lack of emotion regulation ability and, in turn, perpetrate aggression (Harper, Austin, Cercone, & Arias, 2005). Difficulties in emotion regulation are associated with increased anger (Wilkinson & Robinson, 2008) and decreased anger control (McLaughlin et al., 2011), suggesting that a failure to control one's emotions might cause increased anger and then aggression. An understanding of one's own emotions is important for the appropriate expression and management of emotional experiences (Saarni, Mumme, & Campos, 1998). …

Background: The ability to experience and express emotions is considered a key factor in mental health, and difficulty in effective emotion regulation is a major symptom of many psychiatric disorders. Objective: The present study aimed to investigate the role of reality therapy on emotion regulation difficulty and academic self-handicapping in high school students. Materials &amp; Methods: This quasi-experimental research adopted a pretest-posttest control group design. The statistical population included all male high school students of Ahvaz in 2021, 30 of whom were selected through cluster random sampling and were then randomly assigned to an experimental group and a control group (15 participants per group). For the pretest, participants from both groups completed the Self-Handicapping Scale and the Difficulties in Emotion Regulation Scale. The 10-session reality therapy intervention was then implemented in the experimental group, whereas the control group received no intervention. At the end of therapy sessions, the posttest was given to participants in both groups. Data analysis was performed using Analysis of covariance (ANCOVA). Results: The adjusted posttest mean score of difficulty in emotion regulation among intervention and control groups were 77.5 (95%CI: 75.1-79.9) and 113.35 (95%CI: 110.9-115.7), respectively. The values for academic self-handicapping in the intervention and control groups were 75.1 (95%CI: 72.8-78.4) and 97.3 (95%CI: 92.4-99), respectively. According to the result of ANCOVA, reality therapy had significant effects on academic self-handicapping (F=87.79, P=0.001, η2=0.78) and emotion regulation difficulty (F=461.15, P=0.001, η2=0.95) among students. Conclusions: Reality therapy mitigated academic self-handicapping and difficulties in emotion regulation among male high school students. It is recommended that schools help students improve emotion regulation and control self-handicapping by providing appropriate conditions for implementing reality therapy sessions.

EPA-0844 - Emotional and cognitive development in children in foster and institutional care - longitudinal study

Objectives People with dementia (PwD) and their care partners (CP) may have difficulties in emotion regulation, and individual differences in emotion regulation may be related to PwD’s neuropsychiatric symptoms. This study explores whether there is self-awareness of PwD’s difficulties in emotion regulation and whether CP’s emotion regulation relates to the PwD’s neuropsychiatric symptoms, potentially revealing bias or interpersonal effects. Method We used data from the Wish Outcome Obstacle Plan Study with a sample of 45 PwD and their spousal CP (n = 90 individuals). Multivariate linear regression models were used to investigate the associations between the CP-reported neuropsychiatric symptoms in PwD and self-reports of emotion regulation in both dyad members, net of sociodemographic and health factors. Separate analyses were conducted for each neuropsychiatric subsyndrome and each domain of difficulties in emotion regulation. Results Increasing severity of neuropsychiatric symptoms was associated with higher difficulties in emotion regulation in PwD (ß = 1.23, p < 0.05), but not with CP’s difficulties in emotion regulation. When CP reported more severe neuropsychiatric symptoms in PwD, PwD reported that they had difficulties in accepting emotions, controlling impulses, goal-directed behaviors, and accessing emotion regulation strategies, but not in emotion awareness and clarification. Proxy-reports of hyperactivity and psychosis subsyndromes are significantly related to PwD’s self-reported difficulties in emotion regulation. Conclusion PwD reported difficulties in emotion regulation at the early stage of dementia. Proxy-reported neuropsychiatric symptoms may capture PwD’s emotion regulation capability and not be biased by CP’s difficulties in emotion regulation.

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.

Introduction: Individuals with substance use disorder (SUD) often struggle significantly with regulating their emotions and there is a high prevalence of a history of exposure to traumatic events. Difficulties in emotion regulation and PTSD symptom severity contribute to elevated psychological burden, higher dropout rates, and increased risk of relapse. Currently, we still lack a precise understanding of the psychological mechanisms associated with difficulties in emotion regulation in SUD. Objectives: The objective of this study was to examine the magnitude and correlates of difficulties in emotion regulation among patients with SUD who have a history of exposure to traumatic events. We assessed the association between difficulties in emotion regulation and PTSD symptoms, emotional avoidance, shame, guilt, and substance use-related problems. Methods: This cross-sectional observational study was conducted in a naturalistic setting with 74 adult patients in long-term inpatient SUD treatment in Norway, including both sexes. A clinical interview measuring PTSD symptom severity was conducted and participants completed questionnaires about emotion regulation, emotional avoidance, shame, guilt, and substance use-related problems. Additional demographical and descriptive data were collected. Results: The patients reported substantial difficulties in emotion regulation, severe PTSD symptoms, severe emotional avoidance, and strong shame and guilt. Emotional avoidance and shame but not guilt or alcohol or substance use-related problems were associated with greater difficulties in emotion regulation beyond the difficulties contributed by PTSD symptom severity. Conclusions: Difficulties in emotion regulation were highly prevalent in this sample. The findings support targeting difficulties in emotion regulation, emotional avoidance, and shame especially in long-term SUD treatment for patients with a history of exposure to traumatic events. Reducing these factors may help potentially improve treatment outcomes and reduce suffering for this difficult-to-treat patient population.

Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study

Despite a robust association between borderline personality disorder (BPD) and emotion dysregulation, evidence of within-BPD group differences in emotion regulation (ER) difficulties highlights the need to examine factors that increase the risk for ER difficulties within BPD. One factor that warrants consideration is co-occurring avoidant personality disorder (AVPD), the presence of which is associated with worse outcomes in and outside of BPD and theorized to interfere with adaptive ER. Thus, this study examined if co-occurring AVPD among women with BPD is associated with heightened ER difficulties (assessed across self-report, behavioral, and physiological domains). Participants included 39 women with BPD (13 with co-occurring AVPD) and 18 women without BPD. Although results revealed no significant differences in overall self-reported ER difficulties (or the specific dimensions involving emotional clarity and the control of behaviors when distressed) between BPD participants with and without AVPD (with both groups reporting greater ER difficulties than non-BPD participants), other ER difficulties were found to be heightened among BPD participants with AVPD. Specifically, BPD participants with (vs. without) AVPD reported greater difficulties accessing effective ER strategies, evidenced less willingness to experience distress on a laboratory stressor, and exhibited a greater decrease in high frequency heart rate variability in response to this stressor (indicative of poor ER capacity). Findings add to the literature on ER difficulties in BPD, suggesting that co-occurring AVPD within BPD may be associated with a lower capacity for regulating distress and greater difficulties accessing effective ER strategies, potentially leading to greater efforts to avoid emotional distress.

EPA-0845 - Psychopathology in children in foster and institutional care - longitudinal study

Intimate partner aggression (IPA) increased after the onset of the COVID-19 pandemic. Following the Vulnerability-Stress-Adaptation (VSA) model, the current study examined associations among emotion regulation (ER) difficulties (an enduring vulnerability), COVID stress (a current stressor), alcohol use (a maladaptive coping strategy), and physical, psychological, and cyber IPA perpetration during the first eight months of the pandemic. Participants were 215 college students in current relationships from three universities across the US. Results of generalized linear models controlling for pre-COVID IPA perpetration showed a main effect of ER difficulties on physical IPA perpetration (b = .56, p < .001), an ER difficulties X COVID stress X alcohol use interaction on psychological IPA perpetration (b = .01, p = .03), and an ER difficulties X COVID stress interaction on cyber IPA perpetration (b = -.02, p = .02). Specifically, when ER difficulties and alcohol use were low, individuals with high levels of COVID stress were at higher risk of perpetrating psychological IPA relative to individuals with low levels of COVID stress. However, the association between COVID stress and psychological IPA perpetration was not statistically significant when ER difficulties and alcohol use were high. Similarly, when ER difficulties were low, individuals with high levels of COVID stress were at higher risk for perpetrating cyber IPA relative to individuals with low levels of COVID stress. However, when ER difficulties were high, the association between COVID stress and cyber IPA perpetration was not statistically significant. The current findings tentatively implicate COVID stress as a critical correlate of IPA perpetration and suggest that individuals who have fewer existing vulnerabilities (i.e., ER difficulties) and maladaptive processes (i.e., alcohol use) should not be overlooked.