Dysregulation In Adolescents Research Articles

New precursors of ill mental health and the “at risk” adolescent brain: Implication for prevention

Precursors are evoked upstream of the Capgras’ syndrome. Then, an analogy is suggested between the need for prognostic classification linked to the saturation of the asylum population at the dawn of the 20th century, and the current overflow of the psychiatric healthcare system. The contemporary situation justifies the search for information useful to mitigate ill mental health in at-risk adolescents. The article presents recent research reports on adolescents at-risk of emotional dysregulation, stemming from a longitudinal cohort database of European adolescents. The database analyses have revealed new brain and psychometric predictors of emotional dysregulation in adolescents. New early indicators were derived from easy-to-administer questionnaires, exploring emotions, affective symptoms and traits, sleep, early adversity and stress, puberty. Findings suggest that the physiology and stages of brain development could be taken into account for decisions regarding Mental Health. Studies on adolescent brain development have implications for public health, in terms of the age of protection for adolescents, and targeted prevention upstream of care.

Alcohol Abuse and Physical Violence towards a Partner: How Can We Attenuate the Relationship? A Study on Emotional Dysregulation in Adolescents.

The previous literature has revealed the relationship between alcohol abuse and violent behaviours; however, the results are not always conclusive, highlighting the need to explore other variables that allow us to establish risk profiles. The goal is to examine whether the relation between alcohol abuse and physical violence towards a partner can be influenced (moderate) by difficulties in emotional regulation. A public high school in Manabí (Ecuador). A total of 1519 high school students with ages between 14 and 18 years (mean = 15.77, SD = 1.22), with 54% (n = 820) being male. The measures we observed were alcohol abuse (i.e., frequency of alcohol abuse in the past 30 days), physical violence exercised towards a partner (Violence Received, Exercised and Perceived in Dating Relationships of Young People and Adolescents) and emotional dysregulation (Difficulties in Emotional Regulation Scale; DERS). It is observed that there exists significantly higher alcohol abuse in males, regardless of their age, as well as more physical violence by adolescent males towards their partners. Direct effects of alcohol abuse on physical intimate partner violence are observed in males from the age of 16 and in females from the age of 14. Moreover, the direct effects of different emotional dysregulation strategies on physical violence depend on gender. The moderating effects of emotional dysregulation strategies between alcohol abuse and physical intimate partner violence are observed only in the case of adolescent females (16-17 years). In particular, emotional dysregulation variables such as non-awareness, impulse, nonacceptance, or lack of strategies interfere as moderators in the relationship between excessive alcohol abuse and physical violence towards a partner. In the case of non-awareness, contrary to the other three, when scores are low or moderate, a statistically significant relationship between alcohol abuse and violence is observed.

Sub-groups of emotion dysregulation in youth with nonsuicidal self-injury: latent profile analysis of a randomized controlled trial

ABSTRACT Psychological treatments targeting emotion dysregulation in adolescents reduce nonsuicidal self-injury (NSSI) but predicting treatment outcome remains difficult. Identifying sub-groups based on repeated measurements of emotion dysregulation pre-treatment may guide personalized treatment recommendations. We used data from a recent trial evaluating internet-delivered emotion regulation therapy for adolescents with NSSI (n = 138). Latent profile analysis was used to identify sub-groups based on pre-treatment responses on the 16-item version of the Difficulties in Emotion Regulation Scale. The primary outcome was self-rated NSSI frequency during treatment, and secondary outcome was the proportion of participants with no NSSI 1-month post-treatment. Three sub-groups of emotion dysregulation were identified: low variability and low mean (Group 1), low variability and high mean (Group 2), and high variability and low mean (Group 3). Sub-groups did not differ in NSSI frequency during treatment (Group 2 IRR = 1.06 [95% CI 0.49–2.29], p = .88; Group 3 IRR = 1.22 [95% CI 0.31–4.76], p = .77). However, more participants in Group 1 compared to Group 2 abstained from NSSI at 1-month post-treatment (OR = 3.63 [95% CI 1.16–11.33], p = 0.01). Latent profile analysis identified sub-groups predictive of NSSI absence post-treatment, demonstrating clinical utility.

Emotion Dysregulation in Adolescents Exhibiting Depression with Elevated Anxiety: Prevalence and Associated Factors

Emotion Dysregulation in Adolescents Exhibiting Depression with Elevated Anxiety: Prevalence and Associated Factors

Efficacy of Dialectical Behavioral Therapy Skills in Addressing Emotional Dysregulation Among Adolescents: A Systematic Literature Review

Adolescence is marked by significant emotional challenges, with mood disorders becoming increasingly prevalent, necessitating effective interventions. Dialectical Behavioral Therapy (DBT) skills have emerged as promising tools for addressing emotional dysregulation in adolescents. This systematic literature review aims to evaluate the effectiveness of DBT skills in managing emotional dysregulation and reducing mood disorder symptoms among adolescents. Through meticulous analysis of existing research, this review highlights the substantial impact of DBT interventions in decreasing the frequency and intensity of maladaptive behaviors associated with emotional dysregulation. Drawing from studies involving 908 adolescents aged 12 to 18, compelling evidence suggests notable improvements in mood and related symptoms following participation in DBT skills programs. These findings underscore the potential of DBT interventions as valuable resources in supporting adolescents through their emotional challenges. Furthermore, this review emphasizes the urgent need to integrate DBT approaches into mental health interventions tailored to the unique needs of this vulnerable population. Overall, this review contributes to the growing body of literature on adolescent mental health, providing insights into the efficacy of DBT skills in promoting emotional regulation and enhancing overall well-being during this critical developmental phase.

0126 Adverse Life Events and Emotion Dysregulation in Adolescents: Sleep Disturbances as a Potential Moderator

0126 Adverse Life Events and Emotion Dysregulation in Adolescents: Sleep Disturbances as a Potential Moderator

Neural correlates of automatic emotion regulation and their association with suicidal ideation in adolescents during the first 90-days of residential care

Background: Suicide is the second leading cause of death for adolescents in the United States. However, relatively little is known about the forms of atypical neuro-cognitive function that are correlates of suicidal ideation (SI). One form of cognitive/affective function that, when dysfunctional, is associated with SI is emotion regulation. However, very little work has investigated the neural correlates of emotion dysregulation in adolescents with SI. Methods: Participants (N = 111 aged 12-18, 32 females, 31 [27.9%] reporting SI) were recruited shortly after their arrival at a residential care facility where they had been referred for behavioral and mental health problems. Daily reports of SI were collected during the participants’ first 90-days in residential care. Participants were presented with a task-fMRI measure of emotion regulation – the Affective Number Stroop task shortly after recruitment. Participants were divided into two groups matched for age, sex and IQ based on whether they demonstrated SI. Results: Participants who demonstrated SI showed increased recruitment of regions including dorsomedial prefrontal cortex/supplemental motor area and parietal cortex during task (congruent and incongruent) relative to view trials in the context of emotional relative to neutral distracters. Conclusions: Participants with SI showed increased recruitment of regions implicated in executive control during the performance of a task indexing automatic emotion regulation. Such data might suggest a relative inefficiency in the recruitment of these regions in individuals with SI.

Dialectical Behavior Therapy for Adolescents with Borderline Personality Disorder: Emotion Dysregulation, Abuse, and Treatment Outcomes

ABSTRACT Objective Borderline Personality Disorder (BPD) is characterized by extreme emotional dysregulation. Dialectical Behavioral Therapy (DBT) is an empirically supported and effective treatment for BPD in adolescents and adults. However, the extent to which exposure to childhood abuse (i.e. physical and sexual abuse) impacts treatment outcomes is not well understood. This open trial investigated the effectiveness of an intensive residential DBT program in reducing emotion dysregulation in adolescents with BPD symptoms, as well as the impact that severity and type of childhood abuse had on treatment outcomes. Method Participants (N = 46) were female-identifying adolescents 13–20 years of age enrolled in an intensive residential DBT treatment program. Severity of abuse exposure and abuse subtype (Childhood Trauma Questionnaire, Short Form, CTQ-SF) and difficulties with emotional dysregulation (DERS) were assessed at admission and DERS again after 1 month of treatment. Results Bivariate correlation between DERS Total Score and Abuse Exposure Total Score indicated that severity of abuse exposure had a medium positive association with emotion dysregulation at admission. Mixed model ANOVA results showed significant reductions in emotional dysregulation following 1 month of treatment, with a large effect size. Exploratory analysis testing exposure to different subtypes of childhood abuse as a moderator of treatment effects was non-significant. Conclusions Emotion dysregulation showed significant reductions following intensive residential DBT interventions. Reductions were consistent across subtypes of abuse exposure. Implications for the treatment of adolescents with abuse histories and current BPD-related problems, and the relationship between child abuse exposure and emotional dysregulation overall, are discussed.

Urgency as a predictor of change in emotion dysregulation in adolescents.

Adolescence is a key developmental period characterized by increased maladaptive risky behaviors. Two related but distinct constructs, urgency (the tendency to act rashly in response to strong negative or positive emotions) and emotion dysregulation, are important risk factors for engaging in maladaptive risky behaviors. Thus far, research has largely agreed that these two risk factors are highly correlated. However, the causal direction between these constructs is less understood. The goal of the current study is to determine whether urgency predicts emotion dysregulation change among adolescents. This project is an analysis of 544 youth (49.8% female, Mage=14.22, SD=0.52). We tested whether urgency at baseline predicts change in emotion dysregulation over a nine-week period, and whether that relationship differs across boys and girls. Two multigroup latent change score path analyses found that negative, but not positive, urgency significantly predicted emotion dysregulation change (negative urgency: b= -0.57, p=0.001; positive urgency: b=0.22, p=0.06). There was no evidence of moderation by gender. This work provides initial evidence of a temporal relationship between higher negative urgency and increased emotion dysregulation. The next step is to determine whether negative urgency imparts risk for maladaptive behaviors through its effect on emotion dysregulation. The long-term goal of this program of research is to design and test interventions to reduce the impact of negative urgency for adolescent risk-taking.

Longitudinal Associations Between Nonsuicidal Self-Injury, Depressive Symptoms, Hopelessness, and Emotional Dysregulation in Adolescents

Nonsuicidal self-injury (NSSI) in adolescents has been associated with increased depressive symptomatology, hopelessness, and emotional dysregulation; however, few studies have examined longitudinal associations between NSSI and these problems. This study examines the longitudinal relationships among these variables in community adolescents and whether the pattern of relationships varies between boys and girls. The participants were 785 adolescents (57.1% girls) aged 13 to 18 years (M = 15.64; SD = 1.08) who completed self-reported measures of NSSI, depression, hopelessness, and emotional dysregulation at least once at two moments separated by 1 year. The longitudinal model was tested through structural equation modeling and multiple group analysis. NSSI predicted increased depressive symptoms, hopelessness, and emotional dysregulation; depressive symptoms predicted NSSI; hopelessness predicted depressive symptoms; and emotional dysregulation predicted depressive symptoms and hopelessness. The pattern was similar for girls and boys, although girls scored higher on all variables. The results underscore the important bidirectional associations between NSSI and other risk factors throughout adolescence. These findings will support prevention and interventions for NSSI and internalizing symptoms in adolescents in school and clinical settings.

Racial Discrimination and Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Adolescents With Overweight and Obesity: Does Context Matter?

In adolescents at higher risk for chronic disease, the role that context of a discriminatory event may play on cortisol dysregulation is unclear. The purpose of this study was to perform a cross-sectional analysis examining the association between racial discrimination context (peer, educational, institutional, and cumulative) and diurnal cortisol patterning in adolescents with overweight and obesity. One hundred adolescents (13-19 years; 49% non-Hispanic Black; 65% female; body mass index percentile = 93.9% [4.14%]) were included in this analysis. Racial discrimination context was measured using the self-reported Adolescent Discrimination Distress Index. Salivary cortisol, collected across 3 days at five time points during the day, was used to calculate Δ 0-30 minutes, diurnal slope, and average total diurnal cortisol area under the curve. Sixteen separate multivariable linear regression models were performed to analyze the relationship between racial discrimination and diurnal cortisol patterns. Primary findings show that cumulative racial discrimination and peer discrimination were associated with a greater diurnal slope (cumulative: β = 0.010 ± 0.004, p = .03; peer: β = 0.023 ± 0.010, p = .026). Findings from this study identified cross-sectional associations between racial discrimination experienced among peers and diurnal cortisol patterns in adolescents with overweight/obesity. If our findings were to be confirmed in longitudinal analyses, evidence-based programs should be considered to buffer the effects of discrimination on adolescent health, and more importantly, policy makers should work to eliminate discrimination exposure.

Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging.

Emotional dysregulation symptoms following a concussion are associated with an increased risk for emotional dysregulation disorders (e.g., depression and anxiety), especially in adolescents. However, predicting the emergence or worsening of emotional dysregulation symptoms after concussion and the extent to which this predates the onset of subsequent psychiatric morbidity after injury remains challenging. Although advanced neuroimaging techniques, such as functional magnetic resonance imaging and diffusion magnetic resonance imaging, have been used to detect and monitor concussion-related brain abnormalities in research settings, their clinical utility remains limited. In this narrative review, we have performed a comprehensive search of the available literature regarding emotional regulation, adolescent concussion, and advanced neuroimaging techniques in electronic databases (PubMed, Scopus, and Google Scholar). We highlight clinical evidence showing the heightened susceptibility of adolescents to experiencing emotional dysregulation symptoms following a concussion. Furthermore, we describe and provide empirical support for widely used magnetic resonance imaging modalities (i.e., functional and diffusion imaging), which are utilized to detect abnormalities in circuits responsible for emotional regulation. Additionally, we assess how these abnormalities relate to the emotional dysregulation symptoms often reported by adolescents post-injury. Yet, it remains to be determined if a progression of concussion-related abnormalities exists, especially in brain regions that undergo significant developmental changes during adolescence. We conclude that neuroimaging techniques hold potential as clinically useful tools for predicting and, ultimately, monitoring the treatment response to emotional dysregulation in adolescents following a concussion.

Externalising Behaviours, Impulsivity, Alexithymia, and Emotional Dysregulation in Adolescents' Suicidality.

suicide represents the second leading cause of death among adolescents (WHO, 2021). A deeper understanding of the characteristics that lead to it is crucial to increase the ability of clinicians in evaluating, treating, and preventing it. The objective of this study is to analyze the differences in impulsivity, externalizing behaviors, emotion dysregulation, and alexithymia between two groups of adolescents, the first presenting suicidal ideation (SI), the second presenting at least one suicide attempt (SA), in an ideation-to-action framework. we conducted a retrospective study with 190 adolescents (M= 14.5, SD age = 1.63; SI: n = 97, SA: n = 93). All were hospitalized in the Complex Operative Child Neuropsychiatry Hospital Unit (UOC-NPI) of the Hospital-University of Padua. Data were collected using the Youth Self-Report (YSR 11-18), Barratt's Impulsiveness Scale (BIS-11) and the Toronto Alexithymia Scale (TAS-20) questionnaires. the SA group obtained higher clinical scores in the YSR "rule-breaking behavior" and "conduct problems" scales, and in total TAS-20. the role of externalizing problems and alexithymia could open new frontiers in the understanding of suicide. These new data could be useful for the implementation of early screening protocols and for directing clinical interventions, promoting greater emotion regulation and anger management skills among patients.

Resting Heart Rate Variability and Emotion Dysregulation in Adolescents with Autism Spectrum Disorder.

Emotion dysregulation is common among individuals with autism spectrum disorder (ASD). This study examined the relationship between emotion dysregulation and resting heart rate variability (HRV), a marker of the autonomic nervous system, in ASD adolescents. Resting HRV data were collected from ASD (n = 23) and typically developing (TD) adolescents (n = 32) via short-term electrocardiogram. Parents/caregivers reported participants' level of emotion dysregulation with the Emotion Dysregulation Inventory (EDI). Controlling for the effects of age and gender, regression analyses revealed moderating effects of group, suggesting that lower resting HRV was more strongly associated with greater emotion dysregulation in ASD than TD adolescents. The results support the view that disruptions in autonomic functioning may contribute to emotion dysregulation in ASD.

Altered cortical thickness and emotional dysregulation in adolescents with borderline personality disorder

ABSTRACT Background: Emotional dysregulation is a core feature of borderline personality disorder (BPD). Previous studies have reported that abnormal grey matter volume is associated with the limbic–cortical circuit and default mode network (DMN) in patients with BPD. However, alterations of cortical thickness in adolescents with BPD have not been well evaluated. Objective: The aim of this study was to assess cortical thickness and its association with emotional dysregulation in adolescents with BPD. Method: This prospective study enrolled 52 adolescents with BPD and 39 age- and sex-matched healthy controls (HCs). Assessments included brain magnetic resonance imaging (MRI) acquisition with structural and resting-state functional MRI data, and clinical assessment for emotional dysregulation using the Difficulties in Emotion Regulation Scale (DERS). Cortical thickness and seed-based functional connectivity were analysed with FreeSurfer 7.2 software. Correlation analysis between cortical thickness and the scores from emotional assessment was performed with Spearman analysis. Results: Compared to HCs, there was altered cortical thickness in the DMN and limbic–cortical circuit in adolescents with BPD (Monte Carlo correction, all p < .05). These regions with altered cortical thickness were significantly associated with emotional dysregulation (all p < .05). There were also alterations of functional connectivity, i.e. with increased connectivity of the right prefrontal cortex with bilateral occipital lobes, or with the limbic system, and with decreased connectivity among the DMN regions (voxel p < .001, cluster p < .05, family-wise error corrected). Conclusions: Our results suggest that the altered cortical thickness and altered functional connectivity in the limbic–cortical circuit and DMN may be involved in emotional dysregulation in adolescents with BPD.

Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness

BackgroundDysfunctional emotion regulation (ER) is associated with symptoms of depression and anxiety in adolescents. This pilot study aimed to examine the acceptability and feasibility of a guided internet-based emotion regulation training (ERT) added to cognitive behavioral therapy (CBT). Furthermore, we aimed to examine the feasibility of the randomized study design and to provide a first estimate of the effectiveness of CBT + ERT compared with CBT alone in adolescents with depressive or anxiety disorders. MethodsIn a pilot randomized controlled trial (RCT) with a parallel group design, 39 patients (13–18 years) with depressive or anxiety disorder were assigned to CBT + ERT (n = 21) or CBT (n = 18). Assessments at baseline, three-months and six-months follow-up included treatment adherence, satisfaction, depressive symptoms, anxiety symptoms, and ER strategies. ResultsAdherence to ERT was 66.5 %, and treatment satisfaction was adequate. 76.5 % of eligible patients participated in the study. Linear mixed-model analyses showed significantly reduced anxiety symptoms (p = .003), depressive symptoms (p = .017), and maladaptive ER (p = .014), and enhanced adaptive ER (p = .008) at six months follow-up in the CBT + ERT group compared to controls. LimitationsThe sample size was small, and results regarding effectiveness remain preliminary. Data-collection took place during COVID-19, which may have influenced the results. ConclusionsBoth the intervention and the study design were found to be feasible. In a larger RCT, however, improvement of recruitment strategy is necessary. Preliminary results indicate potential effectiveness in decreasing anxiety, depression, and emotion dysregulation in adolescents. The next step should be the development of an improved internet-based ERT and its evaluation in a larger RCT. Trial registrationRegistered on January 14th, 2020 in The Netherlands Trial Register (NL8304).

The Mediating role of Loneliness in the Relationship between Parent-Adolescent Conflict and Emotional Dysregulation in Adolescents

Aim: The aim of this study was to determine the fit of the model of structural relationship between parent-adolescent conflict with emotional dysregulation, with the mediating role of loneliness in adolescents in Tehran.&#x0D; Methods: The statistical population of the study included adolescents aged 13 to 18 years in Tehran. Using available sampling method, 400 people (200 female adolescents and 200 male adolescents) were selected as the sample and used the Asadi and Younesi adolescent parent conflict questionnaire (1390), Russell (1996) revised feelings of loneliness, and Graz and Romer (2004) responded to emotional dysregulation. Structural equation model was used to analyze the data.&#x0D; Findings:The results showed that there was a positive and significant relationship between parent-adolescent conflict and emotion dysregulation (p&lt;0.05). Also, there is a positive and significant relationship between parent-adolescent conflict with emotional dysregulation with the mediating role of loneliness (p&lt;0.05).&#x0D; Conclusion: Based on research findings, it can be concluded that feeling lonely with the occurrence of emotions such as depression, anxiety, and fatigue can play a mediating role between parent-adolescent conflict and emotion disorder.

Immune characterization of suicidal behavior in female adolescents

BackgroundTo address the need to identify potential markers of suicide behavior for adolescents (ages 12–18 years), mass cytometry was used to explore the cellular mechanisms that may underpin immune dysregulation in adolescents with recent suicidal behavior. MethodsPeripheral blood mononuclear cell (PBMC) samples from 10 female adolescents with a recent suicide attempt and 4 healthy female adolescents were used. A panel of 30 antibodies was analyzed using mass cytometry. We used two complementary approaches to 1) identify the cell types that significantly differed between the two groups, and 2) explore differences in the expression profile of markers on the surface of these cells. Mass cytometry data were investigated using (Center for Disease Control, 2021) Opt-SNE for dimension reduced (Curtin and Heron, 2019), FlowSOM for clustering, and (Bridge et al., 2006) EgdeR and SAM for statistical analyses. ResultsOpt-SNE (a data driven clustering analysis) identified 15 clusters of distinct cell types. From these 15 clusters, cluster 5 (classical monocytes) had statistically lower abundance in suicidal adolescents as compared to healthy controls, whereas cluster 7 (gamma-delta T cells) had statistically higher abundance in suicidal adolescents compared to healthy control. Furthermore, across the 15 cell types, chemokine receptors, CXCR3 (cluster 5) and CXCR5 (clusters 4, 5, 7, and 9), had an elevated expression profile in those with a recent suicide attempt versus healthy controls. ConclusionThis report demonstrates the utility of high dimensional cell phenotyping in psychiatric disorders and provides preliminary evidence for distinct immune dysfunctions in adolescents with recent suicide attempts as compared to healthy controls.

Sleep disordered breathing symptoms are associated with depressive symptoms: A longitudinal study of Chinese adolescents

BackgroundLittle is known about the prospective association between sleep disordered breathing (SDB) and depressive symptoms in Chinese adolescents. This study examined the independent predictive role of SDB symptoms in depressive symptoms in a large sample of adolescents. MethodsA total of 11831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort and 7072 adolescents who were resurveyed 1 year later were included for the analyses. Adolescents completed a self-administered questionnaire about demographics, mental health, sleep problems, and family environment. SDB symptoms were assessed by 3 items about loud snoring, breathing pauses, and snorting/gasping. The Chinese Youth Self-Report anxious/depressed subscale was used to assess depressive symptoms. ResultsIn the cross-sectional analyses, 11.8% adolescents had depressive symptoms, and elevated frequency of SDB symptoms were significantly associated with depressive symptoms. In the longitudinal study, 4.5% of adolescents had persistent depressive symptoms, the incidence rate of depressive symptoms at 1-year follow-up was 6.5%, and elevated frequency of any SDB symptoms (often: OR=2.23, 95%CI:1.50-3.32) at baseline was significantly associated with incident depressive symptoms after adjusting for potential confounders. The associations between SDB symptoms and depressive symptoms were similar for boys and girls. LimitationSDB symptoms and depressive symptoms were measured by self-report. ConclusionSDB symptoms are an independent and significant predictor of depressive symptoms in adolescents. Further research is needed to understand the biological mechanisms between SDB and mood dysregulation in adolescents.

A novel multidimensional questionnaire for the assessment of emotional dysregulation in adolescents: Reactivity, Intensity, Polarity and Stability questionnaire–youth version (RIPoSt–Y)

BackgroundThe failure to regulate emotions, namely emotional dysregulation (ED), is a relevant construct in adolescent psychiatry, in terms of prognostic and developmental implications. We developed and validated a novel self-report questionnaire for the assessment of ED, the RIPoSt-Y, both in clinical and non-clinical samples. MethodsItems selection and subscales construction were conducted on healthy controls (n=374), while test-retest reliability was evaluated in a subsample (n=72); internal consistency was examined both in the control group and in two clinical samples, respectively including patients with Bipolar Spectrum Disorders (BSD; n=44) and ADHD (n=34). Construct, concurrent and convergent validity were also assessed. ResultsThirty-one items were finally retained, and three subscales were identified (Affective Instability, Emotional Reactivity, Interpersonal Sensitivity). Test-retest was significant for each subscale with moderate-to-good correlations, and internal consistency showed good-to-excellent coefficients. Construct validity was supported by significant differences between patients and controls and gender-related differences. Concurrent validity was confirmed through significant associations with two subscales of the CHT-Q, while convergent validity proved to be significant with the CBCL/YSR dysregulation-profile. Cut-offs were also computed to discriminate clinically significant scores of ED. LimitationsThe use of a school-based survey to recruit controls could have biased our results; gender distributions between clinical and non-clinical samples were significantly different. ConclusionsOur novel questionnaire proved to be a valid and reliable tool able to assess the presence of ED in youths and to characterize this fundamental construct in its multidimensional facets.