Child Emotion Dysregulation Research Articles

Représentations d'attachement, comportements extériorisés et pro-sociaux d'enfants ayant vécu de la maltraitance et issus de la population générale

IntroductionMaltreatment engendered by parental figures may undermine attachment within parent-child relationships and has been associated with the emergence of behavioural problems. These symptoms have been negatively correlated with pro-social behaviour. ObjectiveThis study aims to report attachment representations, behavioural problems and pro-social behaviour of school aged children that have been victims of maltreatment and who receive services from the Enfant and Youth Protection Centre (EYPC) in Quebec and the therapeutic, educative and pedagogic institute (TEPT) in France. The study also aims to examine the links between these variables and to compare these children with the general population (GP) regarding these variables. MethodEighty children, aged 6 to 12 years old, divided in three groups (GP: n = 40; EYPC: n = 27; TEPI: n = 13) participated in the study. Parents and childcare workers completed measures on externalized and pro-social behaviours. Children participated in an activity exploring their attachment representations. ResultsSignificant associations were found between pro-social and externalized behaviors, as well as between attachment representations concerning the child's emotional dysregulation and two other variables: maternal attachment representations (supportive and rejecting) and pro-social behaviour. Furthermore, no significant differences were found between the attachment representations of children from the GP and those that have been victims of maltreatment and who receive services from EYPC and TEPI. However, significant differences were found between these groups regarding pro-social and externalized behaviours. ConclusionThe present study furthers our knowledge about the influence of maltreatment on children's attachment representations and behaviour.

Children’s relationship problems and the role of adaptive functioning, emotion dysregulation and parental cognitive restructuring

ABSTRACT Positive social relationships have been variously linked to mental well-being, and it is therefore important to more fully understand the factors that may impede positive relationship development. The aim of this study was to explore the relationships between elementary school-age children’s emotion regulation, relationship problems, adaptive behaviour (communication, daily living, social skills), and parental emotion regulation. A sample of 210 parents of children ages 7 to 10 years old reported on their child’s socioemotional functioning by completing the Child Behaviour Checklist, Vineland Adaptive Behaviour – III, and the Emotion Regulation Checklist. Parents also reported on their own emotion regulation strategies with the Emotion Regulation Questionnaire. Results showed parental emotion regulation (cognitive restructuring) to be associated both with child emotion regulation and child adaptive functioning. Negative covariance was found between child emotion dysregulation and adaptive functioning ratings. Structural modelling revealed child emotion dysregulation to be the direct predictor of relationship problems.

Methylphenidate Use for Emotional Dysregulation in Children and Adolescents with ADHD and ADHD and ASD: A Naturalistic Study.

Emotional dysregulation (ED) is common in attention-deficit/hyperactivity disorder (ADHD). Nonetheless, research on ADHD in children with autism spectrum disorder (ASD) and ADHD is still ongoing. Several studies suggest that methylphenidate (MPH) may be effective for ED in ADHD, while there is not enough evidence about its use in ASD with comorbid ADHD. This naturalistic study aims to investigate the effectiveness of immediate- and extended-release MPH in the treatment of ED in 70 children and adolescents (6–18 years), with a diagnosis of ADHD (n = 41) and of ASD with comorbid ADHD (n = 29), using the Child Behavior Checklist—Attention/Aggressive/Anxious (CBCL-AAA). Their parents completed the CBCL twice—first during the summer medication-free period, that is, at least one month after drug interruption; and again after three months of treatment restart. Results demonstrate that MPH is associated with a statistically significant reduction in ED in ADHD and ASD, without substantial adverse events, supporting the use of psychostimulants for the treatment of ED in these neurodevelopmental disorders.

Behavioral, cognitive, and socioemotional pathways from early childhood adversity to BMI: Evidence from two prospective, longitudinal studies.

Childhood adversity is associated with higher adult weight, but few investigations prospectively test mechanisms accounting for this association. Using two socioeconomically high-risk prospective longitudinal investigations, the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA; N = 267; 45.3% female) and the Fragile Families and Child Wellbeing Study (FFCWS; n = 2,587; 48.5% female), pathways between childhood adversity and later body mass index (BMI) were tested using impulsivity, emotion dysregulation, and overeating as mediators. Childhood adversity from 0 to 5 years included four types of adversities: greater unpredictability, threat/abuse, deprivation/neglect, and low socioeconomic status. Parents reported on child impulsivity, emotion dysregulation, and overeating. Height and weight were self-reported and measured at 32 and 37 years in MLSRA and at 15 years in FFCWS. FFCWS results indicated that threat, deprivation, and low socioeconomic status predicted greater impulsivity and emotion dysregulation at 5 years, which in turn predicted greater overeating at 9 years and higher BMI z-score at 15 years. Early unpredictability in FFCWS predicted higher BMI through greater impulsivity but not emotion dysregulation at age 5. MLSRA regression results replicated the threat/abuse → emotion dysregulation → overeating → higher BMI pathway. These findings suggest that different dimensions of early adversity may follow both similar and unique pathways to predict BMI.

ADHD Symptoms, Peer Problems, and Emotion Dysregulation as Longitudinal and Concurrent Predictors of Adolescent Borderline Personality Features

Objective: ADHD and borderline personality (BP) disorder are highly comorbid and characterized by emotion dysregulation and peer problems. However, limited research has examined social and emotional predictors of BP features in samples that include youth with ADHD. Method: Using a sample of 124 youth with and without ADHD (52% female), ADHD symptoms, peer problems, and emotion dysregulation were assessed in childhood (8–13 years) and in adolescence, along with BP features (13–18 years). Results: In addition to the significant effect of ADHD symptoms, teacher-rated child peer victimization and adolescent-reported peer victimization, poorer close friendships, and emotion dysregulation domains significantly predicted adolescent BP features. Greater parent-rated child and adolescent emotion dysregulation domains also significantly predicted adolescent BP features, with ADHD symptoms no longer significant. Conclusion: Even for youth with ADHD, peer and emotional vulnerabilities in childhood and adolescence may serve as important markers of risk for adolescent BP features.

Pandémie de COVID-19 : attachement, anxiété, régulation émotionnelle et stratégies de coping chez les enfants d’âge scolaire

IntroductionAn impact of the COVID-19 pandemic on the emotions and behaviors of children has been found in several studies. However, this impact is not found in all studies. Attachment could be linked to different reactions and levels of anxiety. ObjectiveThe main aim of this study was to analyze the links between children's insecure attachment and variables related to anxiety, emotional and behavioral management of children during the pandemic. MethodStudy participants (n=83 parents and their child aged 6 to 12) completed anonymously online questionnaires assessing attachment insecurity, state-anxiety, coping strategies and emotional regulation. They also answered socio-demographic questions related to their context of life and experience of the pandemic. ResultsState-anxiety is significantly related to children's emotional dysregulation but not to emotion-oriented coping strategy. Significant links were observed between attachment insecurity on the one hand, and children's state-anxiety, emotion-oriented coping strategy and children's emotional dysregulation on the other hand. Emotional dysregulation mediates the link between disorganized attachment and state anxiety. ConclusionThe links between attachment insecurity and children's state-anxiety on the one hand, and the emotion-oriented coping strategy on the other hand highlight the importance of taking individual and interactional factors into account in children's socio-emotional manifestations during the COVID-19 pandemic.

A PROMIS®ing New Measure for Quantifying Emotion Dysregulation in Toddlers and Preschoolers: Development of the Emotion Dysregulation Inventory-Young Child.

The Emotion Dysregulation Inventory (EDI) was designed and validated to quantify emotion dysregulation (ED) in school-age children, with a particular emphasis on capturing ED in youth with ASD. We saw a need to adapt the EDI for use in young children (ages 2-5) given early childhood is a formative time for emotion regulation development. The present study discusses the adaptation process for the EDI-Young Child (EDI-YC), including item refinement/generation and cognitive interviews (N = 10 with ASD), consistent with the Patient-Reported Outcomes Measurement Information System (PROMIS®) methodology. The item bank was piloted in a sample of 2-year-olds with and without ASD (N = 31), which provided initial support for the EDI-YC as a valid and reliable measure.

Household Food Insecurity Is Associated with Symptoms of Emotional Dysregulation in Children with Attention Deficit Hyperactivity Disorder: The MADDY Study.

The association of household food insecurity with symptoms of attention deficit hyperactivity disorder (ADHD) and emotional dysregulation in children was examined in this study. We utilized baseline data from 134 children aged 6–12 years who were enrolled in a clinical trial investigating multinutrient supplementation as a treatment for ADHD and emotional dysregulation. Household food security status was assessed using the 18-item US Household Food Security Survey Module. The symptoms of ADHD and emotional dysregulation disorders (oppositional defiant disorder (ODD) and disruptive mood dysregulation disorder (DMDD)) were assessed using the Child and Adolescent Symptom Inventory-5 and other comorbid emotional dysregulation symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). Multiple linear regression determined associations between household food security status and symptoms of ADHD, ODD and DMDD, emotional symptoms and conduct problems. Household food insecurity was associated with more severe emotional symptoms (β = 2.30; 95% CI = 0.87–3.73; p = 0.002), conduct problems (β = 1.15; 95% CI = 0.01–2.30; p = 0.049) and total difficulties scores (β = 4.59; 95% CI = 1.82–7.37; p = 0.001) after adjusting for covariates (child’s sex, parent marital status, household income, parental anxiety and other parental psychopathology). In unadjusted analyses, household food insecurity was also associated with increased ODD (β = 0.58; 95% CI = 0.21–0.95; p = 0.003) and DMDD symptoms (β = 0.69; 95% CI = 0.20–1.19; p = 0.006), but these associations attenuated to non-significance after adjusting for all covariates. Household food insecurity was associated with more severe emotional dysregulation symptoms. Discussing and addressing food insecurity may be appropriate initial steps for youths with ADHD and emotional dysregulation.

Pain sensitivity and perceptual sensitivity are associated with severity of emotional dysregulation in children with ADHD: a cross-sectional analysis using the Temperament in Middle Childhood Questionnaire

Purpose Nearly 50% of children with attention-deficit/hyperactivity disorder (ADHD) experience emotional dysregulation or sensory over-responsiveness; this study examines their association. Methods This cross-sectional analysis (n = 124) used data from the Micronutrients for ADHD in Youth (MADDY) Study, which enrolled children aged 6–12 with ADHD and emotional dysregulation. Sensory responsiveness was assessed using two subscales from the factor-analyzed Temperament in Middle Childhood Questionnaire: Pain Sensitivity and Perceptual Sensitivity. Emotional dysregulation was assessed using the Emotional-Problems and Conduct-Problems subscales from the Strengths and Difficulties Questionnaire and a composite score from the Child & Adolescent Symptom Inventory-5. Multivariable linear regression measured the association of pain and perceptual sensitivity with the severity of emotional dysregulation. Results In adjusted models, pain sensitivity was positively associated with Emotional Problems (β = 0.97; 95% CI: 0.52, 1.41; p < 0.0001), Conduct Problems (β = 0.83; 95% CI: 0.44, 1.21; p = 0.0001), and CASI-5 composite (β = 0.25; 95% CI: 0.16, 0.34; p < 0.0001). Perceptual sensitivity was positively associated with Emotional Problems (β = 0.75; 95% CI: 0.15, 1.35; p = 0.01) but not Conduct Problems (β = 0.27; 95% CI: −0.24, 0.77; p = 0.30) or CASI-5 composite (β = 0.12; 95% CI: −0.01, 0.24; p = 0.07). Conclusion Pain sensitivity was associated with the severity of emotional dysregulation in this ADHD sample. To better understand possible causal links, longitudinal studies are warranted. Implications for rehabilitation Emotional dysregulation and sensory over-responsiveness are both common in children with ADHD and contribute to added challenges in school and family life. Two types of sensory over-responsiveness, pain sensitivity and perceptual sensitivity, were associated with emotional dysregulation in children with ADHD in our study. Sensory over-responsiveness may be a modifiable treatment target.

Maternal experiences of childhood psychological maltreatment: Relations with toddler emotional regulation

Childhood psychological maltreatment is a prevalent type of maltreatment, but one that is less studied compared to other forms of abuse. The intergenerational effects of psychological maltreatment have yet to be fully explored. This study examined mothers’ recollections of childhood experiences of psychological maltreatment, assessed prenatally, and in relation to their own and their toddler’s emotion regulation. Psychological maltreatment was assessed through a new coding system created for use with Adult Attachment Interviews (AAIs). Using structural equation modeling, we examined the direct effects of mothers’ accounts of psychological and physical maltreatment during childhood on mothers’ emotion dysregulation in a caregiving context and their toddlers’ observed emotional dysregulation. Participants were 125 mother–toddler dyads in central Texas ( Mage = 29.9 years). Mothers completed AAIs prenatally; toddlers completed frustration tasks to assess underregulation at 24 months of age. Maternal experiences of psychological maltreatment, but not physical maltreatment, were related to maternal emotion dysregulation during parenting and their children’s emotional underregulation. Mother and child emotional dysregulation were also related. The effects of mothers’ childhood experiences of psychological maltreatment have specific intergenerational consequences and must be explored separately from their experiences of physical maltreatment.

Parenting practices and dysregulation profile in a sample of Italian children

Backgroundemotional dysregulation is a transdiagnostic factor linked to a heightened risk for psychopathology. A dysregulation profile (DP) derived from the Strenght and Difficulties Questionnaire (SDQ) is often used to indirectly assess emotional dysregulation in children and adolescents. Theoretical models account for parenting as a causal and maintaining factor for emotional dysregulation. Notwithstanding, empirical data are scant. Methods547 students (47.5% males) aged between 9 and 11 years of age (mean age = 9.66, SD = 0.64) were assessed with the SDQ-DP (teacher and parent-reported) and their parents self-reported on their own parenting practices with the Alabama Parenting Questionnaire. Resultsas expected, SDQ-DP teacher-rated was positively associated with maternal and paternal negative parenting practices; SDQ-DP mother and father-rated were both negatively associated with maternal and paternal positive parenting and positively associated with maternal and paternal negative parenting practices. Limitationthe age range is limited to pre-adolescents. The cross-sectional nature of the study precludes inferences on causality. Conclusionsyouth's emotional dysregulation is linked to parenting practices. These findings support the need to include families in the intervention for emotionally dysregulated youths.

Emotion dysregulation in children with autism: A multimethod investigation of the role of child and parent factors

BackgroundChildren with autism have been found to experience greater difficulties with emotion regulation than peers without autism. Characteristics related to autism (i.e., social communication challenges, restricted repetitive behaviours, inhibitory control difficulties) and external parent factors (i.e., parent stress, mindful parenting) have been suggested to contribute to the emotion dysregulation (ED) experienced by youth with autism. MethodThe current study evaluated associations between child and parent factors and two indices of child ED (parent report and observational behaviour coding), in 44 children with autism, ages 8–13 years. ResultsChild autism symptomology, inhibitory control difficulties, parental stress and mindful parenting were all associated with parent reported ED, but not with observed ED. Similarly, linear regressions revealed that these factors jointly predicted parent reported ED, but not observed ED. Restricted interests/repetitive behaviours and inhibitory control difficulties emerged as unique positive predictors of parent reported ED. ConclusionsFindings highlight the importance of using a multimethod approach and of considering child- and parent-level factors when investigating ED in children with autism.

Interparental conflict as a quadratic predictor of children's reactivity to interparental conflict and school adjustment: Steeling effects or risk saturation?

This study examined interparental conflict as a curvilinear predictor of children's reactivity to interparental conflict and, in turn, their school problems across three annual measurements. Participants included 243 preschool children (Mage =4.60years; 56% girls) and their parents from racially (e.g., 48% Black; 16% Latinx) diverse backgrounds. Interparental conflict was a significant quadratic predictor of children's emotional reactivity (β=.23) and behavioral dysregulation (β=.27) to conflict over a 1-year period. The robust association between interparental conflict and behavioral dysregulation weakened at high levels of interparental conflict. In contrast, interparental conflict more strongly predicted children's emotional reactivity as conflict exposure increased. Children's emotional reactivity, in turn, predicted their greater school problems 1year later (β=.25).

Inter-parent Agreement and Discrepancy on Core Symptoms and Externalizing Problems in School-age Children With Attention Deficit/Hyperactivity Disorder

Objectives: Inter-parent agreement and discrepancy on core symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) and related externalizing problems can have clinical implications for the diagnosis of the disorder. This study aims to examine inter-parent agreement and discrepancy on ratings of hyperactivity/impulsivity, inattention, behavior problems, and emotion dysregulation in children with ADHD. Methods: This is a descriptive correlational study. The study population consists of children with ADHD aged 6-10 years who referred to child and adolescent psychiatric clinics in Tehran, Iran. Of these, 51 children were selected using a convenience sampling method. They were separately assessed by their parents using the Swanson, Nolan and Pelham-IV (SNAP-IV) Questionnaire, Eyberg Child Behavior Inventory, Emotion Regulation Checklist, and the Parenting Stress Index- Short Form. Results: Parents had a moderate agreement on all scales/subscales except on emotion dysregulation which was fair. Mothers rated higher than fathers in all areas except for the inattention subscale. Mother’s parenting stress and educational level could predict inter-parent discrepancy on ratings. Conclusion: Mother-father discrepancy on the symptoms and problems of ADHD is clinically significant. Clinicians should take it to account when interpreting results of rating scales in children with ADHD. Multiple informants are suggested in using rating scales for ADHD assessment.

A Review of the Evidence Base for Psychosocial Interventions for the Treatment of Emotion Dysregulation in Children and Adolescents.

Many children with a range of psychiatric diagnoses manifest impaired levels of emotion dysregulation (ED). Over the past decade, there has been increasing examination of psychosocial interventions for ED. We found preliminary evidence of positive effects for a wide range of psychosocial treatments that were associated with improvements in emotion recognition, emotional reactivity, and emotion regulation. More studies are needed because results are limited by the small number of controlled trials, heavy reliance on parent ratings, and heterogeneity of the samples.

Treatment of Childhood Emotion Dysregulation in Inpatient and Residential Settings.

Children hospitalized in inpatient and residential treatment facilities often present with severe emotion dysregulation, which is the result of a wide range of psychiatric diagnoses. Emotion dysregulation is not a diagnosis but is a common but inconsistently described set of symptoms and behaviors. With no agreed upon way of measuring emotion dysregulation, the authors summarize the existing contemporary treatment focusing on proxy measures of emotion dysregulation in inpatient and residential settings. Interventions are summarized and categorized into individual- and systems-level interventions in addressing aggressive behaviors. Going forward, dysregulation will need to be operationalized in a standard way.

Emotional Dysregulation in Preschool Age Predicts Later Media Use and Gaming Disorder Symptoms in Childhood.

Background: The aim of this study was to evaluate the role of early Emotional Dysregulation (ED) at preschool age as a risk factor or predictor of later media use behavior and Gaming Disorder (GD) in school age.Methods: 80 patients (63.7% male; mean age = 4.2, SD = 1.23) who had attended a special outpatient program for preschoolers at measuring point time t1 were contacted at measuring point time t2 (mean age = 9.2, SD = 2.03). At t1, the comprehensive clinical assessment comprised Child Behavior Checklist—Dysregulation Profile (CBCL-DP). At t2, parents completed a questionnaire on their children's media availability, usage times, and GD.Results: ED predicts a more intense use of digital media in the future. The daily average screen-use time at t2 varies significantly between the groups (148 min for children with ED at t1 and 85 min for children without ED at t1). The intensity of media use can be considered a significant predictor for the presence of a GD in dimensional assessment. When GD is classified categorically, according to the DSM-5 criteria, there is no significant correlation between ED and later GD diagnosis, neither between screen-use time and GD diagnosis. However, at dimensional level, preschool children with ED show significantly higher GD symptom scores at 9 years of age.Conclusion: ED at preschool age is strongly associated with time spent video gaming and GD symptoms 5 years later. Our results strongly indicate that emotion dysregulation in preschool children is a risk factor for later problematic video game playing behavior. This strengthens the concept of ED in the etiology of media use and provides potential targets for early GD prevention.

FAMILY COHESION, INTERPERSONAL COMMUNICATION, AND SMARTPHONE ADDICTION: DOES IT AFFECT CHILDREN’S EMOTIONAL DYSREGULATION?

Emotional dysregulation in early childhood has shown various early symptoms, such as aggressiveness, anxiety, short attention span, etc. This study aims to determine the effects of family cohesion, interpersonal communication, and smartphone addiction variables on children's emotional dysregulation. The respondents of this study were 338 students’ parents from Cirebon City, Indonesia. Data were collected by means of online questionnaires distributed individually to each kindergarten selected using proportionate cluster random sampling. The results of this study show that two variables, namely family cohesion (p = .031) and interpersonal communication (p = .016) have negative direct effects on children's emotional dysregulation. Meanwhile, smartphone addiction (p = .000) directly affects children's emotional dysregulation. From the results, it is assumed that children's emotional dysregulation will decrease when there is a focus on improving the quality of family cohesion and on decreasing the level of smartphone addiction. Besides, the government, schools, and parents should concern about and implement a policy to keep on monitoring children when using smartphones and developing positive and harmonious family cohesion.

White matter microstructural integrity correlates of emotion dysregulation in children with ADHD: A diffusion imaging tractography study

BackgroundEmotion dysregulation (ED) is prevalent in youths with attention-deficit hyperactivity disorder (ADHD) and causes more social impairment and poor adaptive function. Alterations in the integrity of white matter (WM) tracts might have important implications for affective processing related to ED. However, little is known about the WM correlates underpinning ED in ADHD. MethodsUsing diffusion spectrum image tractography, we obtained generalized fractional anisotropy (GFA) values of 76 WM tracts in 77 children with ADHD and 105 typically developing controls (TDC). ED severity was defined by the dysregulation profile from the child behavior checklist. Canonical correlation analysis (CCA) was performed to identify modes that relate WM microstructural property to ED severity and cognitive measures. ResultsThe application of CCA identified one significant mode (r = 0.638, FWE-corrected p = 0.046) of interdependencies between WM property patterns and diagnosis, ADHD total symptom levels, dysregulation by diagnosis interaction, and full-scale intellectual quotient (FIQ). GFA values of 19 WM tracts that were linked to affective-processing, sensory-processing and integration, and cognitive control circuitry were positively correlated with ED severity in TDC but negatively correlated with ED severity in ADHD. ADHD symptom severity and diagnosis were negatively associated with the GFA patterns of this set of tract bundles. In contrast, FIQ was positively correlated with this set of tract bundles. ConclusionsThis study used the CCA to show that children with ADHD and TDC had distinct multivariate associations between ED severity (diagnosis by ED interaction) and microstructural property in a set of WM tracts. These tracts interconnect the cortical regions that are principally involved in emotion processing, integration, and cognitive control in multiple brain systems. The WM microstructure integrity impairment might be an essential correlate of emotion dysregulation in ADHD.

Psychiatric basics of alopecia areata in pediatric patients: Evaluation of emotion dysregulation, somatization, depression, and anxiety levels.

Alopecia areata (AA) is a skin disease characterized by sudden-onset hair loss. The relationship between psychiatric status and AA has not been fully elucidated. The aim of this study was to evaluate emotion dysregulation, somatization, depression, and anxiety levels in children and adolescents with AA. The study included 27 patients aged 8-18years diagnosed with AA, and an age and gender-matched control group consisting of 30 cases without a known chronic medical disease. All individuals were screened for existing psychiatric illnesses by a pediatric psychiatrist through the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version (K-SADS-PL). The patients were then evaluated using the Children's Depression Inventory (CDI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), State-Trait Anxiety Inventory for Children (STAI-C), and Children Somatization Inventory (CSI-24). In addition, the patients' parents were asked to complete the Emotion Regulation Checklist-Family Form (ERC). When comparing the scale scores of the AA and control group, there was a statistically significant difference between the groups in terms of the Emotional Lability/Negativity subscale scores on ERC. K-SADSPL ratios denoted features of at least one psychiatric condition in 62.9% and 16.6% of the AA group and control group, respectively. Our results emphasize the importance of psychiatric evaluation in patients with AA. Our study also reveals the need for further studies with a larger sample of AA patients being evaluated in terms of emotion regulation.