Levels Of Emotion Dysregulation Research Articles

Exploring Addictive Online Behaviors in Patients with Narcolepsy Type 1.

Narcolepsy type 1 (NT1) is a rare neurological sleep disorder caused by the loss of neurons that produce hypocretin-a peptide that plays a crucial role in addictive behaviors. We aimed to compare, for the first time, levels of problematic online gaming, problematic social media use, and compulsive Internet use between NT1 patients and healthy controls (HC), and to evaluate the association between anxiety, depression, and emotion dysregulation with addictive online behaviors in NT1 patients. A total of 43 patients with NT1 and 86 sex- and age-matched HC participated in an online cross-sectional survey. NT1 patients did not differ from HC in terms of problematic social media use and compulsive Internet use but displayed higher levels of problematic online gaming compared to HC. Higher levels of emotion dysregulation were significantly associated with higher levels of problematic social media use and compulsive Internet use, while none of the tested factors were associated with problematic online gaming. NT1 patients and HC had similar levels of problematic social media use and compulsive Internet use, but NT1 patients showed higher levels of problematic online gaming. Emotion dysregulation might be an intervention target for reducing compulsive Internet use and problematic social media use.

Borderline personality disorder in adolescence: The role of narrative identity in the intrapsychic reasoning system.

Borderline personality disorder (BPD) manifests in adolescents, serving as a forerunner for later dysfunctionality and life constraints. BPD is characterized by multiple difficulties in understanding the self and others, and it has been implied that intrapsychic processes of reasoning might be the primary driver of these disturbances. In this study, we examined the role of narrative identity, the dynamic and evolving story people construct about their personal pasts, presents, and futures, as a potentially important but largely overlooked aspect of temporal reasoning within the intrapsychic system of adolescents with BPD features. A total of 174 American inpatient adolescents (Mage = 15.12 years, SD = 1.52) completed self-report measures of BPD upon hospital admission. Adolescents' narrative identity (i.e., themes/future wishes of agency and communion), mentalizing, and emotion dysregulation were assessed. Results showed that narrative identity (i.e., thwarted themes of agency and communion) was associated with lower mentalizing and higher emotional dysregulation capacities, supporting narrative identity's relation to other relevant aspects of intrapsychic processes of reasoning in BPD. Regression analyses showed that both higher levels of emotion dysregulation and more thwarted narrative themes of agency (but not mentalizing) were significantly associated with BPD features. Intriguingly, narrative identity (i.e., thwarted themes of agency) showed incremental validity in accounting for features of BPD, over and above emotion dysregulation. It is concluded that disturbances related to narrative identity might be a prominent component of the intrapsychic reasoning system in BPD and should be included in future work on the topic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotional Dysregulation and Trauma Symptoms Mediate the Relationship Between Childhood Abuse and Nonsuicidal Self-Injury in Adolescents.

BackgroundNonsuicidal self-injury (NSSI) is common in adolescents. Emotion dysregulation has been identified as a core mechanism in the development and maintenance of NSSI and it is therefore an important target when addressing NSSI. The pathogenic connection between different kinds of childhood abuse, difficulties in emotion regulation and NSSI needs further investigation. The objective of this study was to examine whether difficulties with emotion regulation and trauma symptoms, separately and together, mediate the relationships between sexual, physical and emotional abuse and NSSI.MethodCross-sectional data was collected from 3,169 adolescent high-school students aged 16–19 years (M = 18.12, SD = 0.45). Data from self-reported experiences of childhood abuse, current difficulties with emotion regulation (measured with the Difficulties with Emotion Regulation Scale, DERS-16) and trauma symptoms (measured with the Trauma Symptom Checklist for Children, TSCC), and NSSI were collected. Structural Equation Modeling (SEM) was used to test the proposed relationships between variables.ResultsThe prevalence of life-time NSSI was 27.4%. Prevalence of reported childhood abuse was 9.2, 17.5, and 18.0% for sexual, physical, and emotional abuse, respectively. Childhood abuse, difficulties with emotion regulation and trauma symptoms exhibited significant positive associations with NSSI in adolescents. Emotional dysregulation and trauma symptoms were both found to mediate the relationship between childhood abuse and NSSI. Latent variable models were found to fit data well.ConclusionResults indicate that increased levels of emotional dysregulation and trauma symptoms in relation to childhood abuse contribute to the increased risk of NSSI. Further, results point to some aspects of emotional dysregulation and trauma symptoms being more important in this regard. Clinical implications are discussed.

The who and what of validation: an experimental examination of validation and invalidation of specific emotions and the moderating effect of emotion dysregulation

BackgroundTheory and research indicate that validation is associated with reductions in negative emotions, whereas invalidation is associated with escalation of negative emotions. However, it remains unclear whether these effects are consistent across emotions, and/or moderated by an individual’s levels of emotion dysregulation. The present study experimentally examines the effects of validation and invalidation across emotions and as moderated by emotion dysregulation.MethodsOne hundred twenty-six participants completed a measure of emotion dysregulation, and then listened to a rejection-themed imagery script after which they reported the intensity of several emotions. Participants were then presented with either validating or invalidating feedback about their most intense self-reported emotion, depending on their counterbalancing order. They then repeated the procedure for the other condition. Self-reported negative emotions via continuous rating dial, heart rate (HR), and skin conductance level (SCL) were monitored throughout.ResultsHigher emotion dysregulation was associated with greater increases in self-reported positive emotion when shame or sadness was validated and lesser increases when fear was validated. There were no significant moderating effects of emotion dysregulation in response to invalidation for any emotion on any index.ConclusionsThe effects of validation appear emotion specific and dependent on levels of emotion dysregulation. These findings may help inform more strategic use of validation in psychotherapeutic interventions.

Moderating effects of emotion regulation difficulties and resilience on students’ mental health and well-being during the COVID-19 pandemic

This study examined whether emotion regulation difficulties and resilience in college students moderated changes in mental health over the course of the COVID-19 pandemic. Participants (N = 321) completed surveys assessing mental health, in addition to levels of emotion dysregulation, and resilience during the pandemic, then utilized an anchoring prompt to recall mental health experiences before the pandemic. Correlations revealed participants with higher levels of emotion dysregulation also reported lower levels of resilience. Analyses using the SPSS Macro MEMORE (Montoya, 2019) revealed participants with higher levels of emotion regulation difficulties had greater increases in depression and insomnia, and greater decreases in well-being over the course of the COVID-19 pandemic, while participants with lower levels of resilience had greater increases in depression, anxiety, and insomnia over the course of the pandemic. These results highlight the importance of additional support services and mental health training at universities to meet college students’ immediate and long-term emotional needs stemming from the pandemic.

Markers of emotion regulation processes: A neuroimaging and behavioral study of reappraising abilities

Emotion regulation (ER) is a core element for individual well-being, and dysregulated emotional states are prominent in several mental disorders. Moreover, dispositional use of adaptive ER strategies, such as cognitive reappraisal, is usually associated to better psychological outcomes and less emotional problems. Thus, identifying markers of emotion dysregulation could serve as a key point for developing treatments against risks of psychopathological outcomes. Neuroimaging techniques could represent a useful tool within these aims, focusing on neurobiological markers of psychopathological illness. Given the well known gender differences in using ER strategies, we examined behavioral and neuroimaging patterns associated with dispositional use of reappraisal among a non-clinical female sample. We found that the individual predisposition to use cognitive reappraisal as an emotion regulation strategy was associated with decreased levels of dysregulation. From a neurobiological perspective, difficulties in using reappraisal were associated with decreased resting-state functional connectivity (rs-FC) between the Middle Temporal Gyrus and occipito-parietal regions. Moreover, rs-FC between prefrontal and occipito-parietal brain regions was negatively associated with emotion dysregulation levels. Microstructural anomalies across white matter tracts connecting temporal, parietal, and occipital brain regions were associated to difficulties in using reappraisal. Our findings suggest that specific behavioral and neurobiological substrates are linked to reappraising abilities. Furthermore, the ability to implement adaptive ER strategies could serve as protective factor against developing emotion dysregulation.

Difficulties in emotion regulation: The role of repetitive negative thinking and metacognitive beliefs

BackgroundUsing the Self-Regulatory Executive Function model as a basis, this study explored whether, in both general population and clinical samples, metacognitive beliefs and repetitive negative thinking (i.e., rumination and worry) are associated with higher levels of emotion dysregulation. Methods395 participants from the general population and 388 outpatients seeking psychological treatment were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, depression, personality disorders were assessed. ANOVA and Welch's tests, correlation and path analyses were run. ResultsRepetitive negative thinking was found to play a mediating role in the relationship between metacognitive beliefs and emotion dysregulation in both general population and clinical samples. Moreover, metacognitive beliefs were found to be directly associated to emotion dysregulation. LimitationsThe cross-sectional design. ConclusionsEmotion dysregulation appears to be associated with the tendency to engage in repetitive negative thinking and metacognitive beliefs. Repetitive negative thinking and metacognitive beliefs could be a suitable therapeutic target to reduce difficulties in emotion regulation.

Alexithymia and aggressiveness in old age: Mediation by impulsivity and emotion dysregulation

Aggressiveness is prevalent in old age, and to adapt treatments and diminish the accompanying damage to the self and others, it is important to understand aggressiveness predictors. Poor emotional awareness, impulsivity, and emotion dysregulation are potential mechanisms influencing aggressiveness. The present study examines whether alexithymia, emotion dysregulation, and impulsivity influence aggressiveness in older adults; and whether the effect of alexithymia is conditioned by emotional dysregulation and impulsivity after controlling for probable confounders. The sample consisted of 326 Portuguese older adults (63.2% female) aged 60-96 years from residential care homes and the community. Participants completed report instruments measuring alexithymia, emotional dysregulation, impulsivity, and aggressiveness. Results of the mediation analysis showed that older adults who had more alexithymia tended to report higher levels of emotional dysregulation and impulsivity, which in turn accounted for higher reported aggressiveness. All these effects were independent of cognitive functioning and depressive symptoms. This study suggests the relevance of evaluating and intervening on alexithymia, impulsivity, and emotion dysregulation to reducing aggressiveness in older people.

Pain Intensity, Emotion Dysregulation, and Hazardous Drinking Among Adults With Chronic Pain

Chronic pain and hazardous alcohol use (i.e., a pattern of alcohol consumption that increases risk for harmful consequences) are prevalent and frequently comorbid conditions that have been posited to interact in a bidirectional manner, leading to greater pain and heavier drinking. Despite evidence that emotion dysregulation (i.e., difficulty modulating emotional responses when experiencing negative emotions) is independently associated with both greater pain and greater alcohol consumption, we are not aware of any previous research examining relations between emotion dysregulation, pain intensity, and hazardous alcohol use among individuals with chronic pain. Participants included 125 past-month alcohol users with chronic musculoskeletal pain (38.4% female; mean age = 32.97 years; mean drinks/day = 1.62) who were recruited for an online survey study of pain and substance use. As expected, emotion dysregulation was positively associated with increased odds of hazardous alcohol use. We also observed a significant indirect association, such that higher levels of emotion dysregulation were associated with greater pain intensity, which in turn was associated with a greater likelihood of scoring above the Alcohol Use Disorders Identification Test cutoff for hazardous alcohol use. These findings suggest that emotion dysregulation may contribute to hazardous drinking among individuals with chronic pain, perhaps indirectly via pain amplification. Emotion dysregulation warrants consideration as a potential transdiagnostic vulnerability factor in comorbid chronic pain and hazardous drinking. Future prospective research is needed to examine causal pathways and establish temporal precedence.

Grief Responses during the COVID-19 Pandemic: Differences in Attachment and Emotion Regulation

This study assessed grief reactions amongst individuals who lost a loved one to COVID-19. Differences in attachment-related anxiety, avoidance, and emotion dysregulation were compared between absence, delayed, prolonged, and resolved grief reactions. 146 participants completed self-report measures after they experienced the loss of a parent, sibling, child, or spouse. A series of one-way analyses of variance indicated that there were significant differences in emotion dysregulation and attachment-related anxiety between grief reactions. Additionally, the resolved grief group had the lowest levels of emotion dysregulation. The findings highlight the importance of examining relational and emotional factors in the context of bereavement.

Impulsivity and Emotional Dysregulation Predict Choice Behavior During a Mixed-Strategy Game in Adolescents With Borderline Personality Disorder.

Impulsivity and emotional dysregulation are two core features of borderline personality disorder (BPD), and the neural mechanisms recruited during mixed-strategy interactions overlap with frontolimbic networks that have been implicated in BPD. We investigated strategic choice patterns during the classic two-player game, Matching Pennies, where the most efficient strategy is to choose each option randomly from trial-to-trial to avoid exploitation by one’s opponent. Twenty-seven female adolescents with BPD (mean age: 16 years) and twenty-seven age-matched female controls (mean age: 16 years) participated in an experiment that explored the relationship between strategic choice behavior and impulsivity in both groups and emotional dysregulation in BPD. Relative to controls, BPD participants showed marginally fewer reinforcement learning biases, particularly decreased lose-shift biases, increased variability in reaction times (coefficient of variation; CV), and a greater percentage of anticipatory decisions. A subset of BPD participants with high levels of impulsivity showed higher overall reward rates, and greater modulation of reaction times by outcome, particularly following loss trials, relative to control and BPD participants with lower levels of impulsivity. Additionally, BPD participants with higher levels of emotional dysregulation showed marginally increased reward rate and increased entropy in choice patterns. Together, our preliminary results suggest that impulsivity and emotional dysregulation may contribute to variability in mixed-strategy decision-making in female adolescents with BPD.

Self-compassion and complete perinatal mental health in women at high risk for postpartum depression: The mediating role of emotion regulation difficulties.

There is evidence suggesting that self-compassion is linked to key mechanisms in emotion regulation models of depression and anxiety. However, the majority of prior research has targeted community samples and overlooked the analysis of such mechanisms in relation to positive mental health. This study sought to examine the direct and indirect effects, via emotion regulation difficulties, of self-compassion on the complete mental health outcomes of women at high risk for postpartum depression (PPD). Cross-sectional, correlational study. The sample for this study comprised 1053 postpartum women presenting high risk for PPD, as determined by the clinical cut-off score obtained through the Postpartum Depression Predictors Inventory-Revised. The assessment protocol further included self-report measures of self-compassion, depression and anxiety symptoms, flourishing and emotion regulation difficulties. Correlation analyses were conducted to ascertain associations between variables, and path analysis was performed to examine direct and indirect effects. Difficulties in emotion regulation mediated the links between self-compassion and negative (distress) and positive (flourishing) mental health outcomes. The overall mediation model explained 48% and 39% of variance for psychological distress and flourishing/positive mental health respectively. These findings support the applicability of an emotion regulation model of self-compassion to women identified as being at high risk of developing PPD. Self-compassion interventions directed at these women are likely to decrease their levels of emotion dysregulation and to improve their complete mental health outcomes.

Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting.

BackgroundEmotional dysregulation in psychiatric disorders contributes to morbidity, mortality and healthcare costs. Dialectical behaviour therapy (DBT) is effective in addressing this, but is complex and costly to implement. Recent literature indicates that DBT can be modified for use in resource-limited settings, but little is known about its implementation in African settings.AimTo describe the demographic and clinical characteristics of participants in a modified DBT-ST (skills training) programme at a South African psychiatric hospital.SettingThe study was conducted at Stikland Hospital, a public psychiatric hospital in the Western Cape province, South Africa.MethodsA retrospective, cross-sectional chart review of patients included in a modified inpatient DBT-ST programme between 30 June 2014 and 30 June 2019 was conducted. Descriptive analyses were performed on the data both as a complete set and after division into several subgroups.ResultsWe included 349 records. Two-thirds of the patients completed the programme. Major depressive disorder, borderline personality disorder and substance use disorder were the most prevalent diagnoses. Most patients had psychiatric comorbidities. A total of 90.61% (n = 309) of the patients were exposed to at least one traumatic event and three-quarters (n = 261) had attempted suicide at least once before.ConclusionsThe demographics of our sample did not differ markedly from the international literature. Rather, what stood out was that modified DBT-ST could be a choice in resource-limited settings for a diagnostically heterogeneous group that displayed significant clinical complexity and high levels of emotional dysregulation. Our findings might suggest that the intervention was well tolerated and possibly most appropriately delivered at the first admission, although further research is required.

Impulsivity and compulsivity as parallel mediators of emotion dysregulation in eating‐related addictive‐like behaviors, alcohol use, and compulsive exercise

IntroductionTransdiagnostically relevant psychological traits associated with psychiatric disorders are increasingly being researched, notably in substance use and addictive behaviors. We investigated whether emotion dysregulation mediated by impulsivity and/or compulsivity could explain variance in binge eating, food addiction, self‐starvation, and compulsive exercise, as well as alcohol use (addictive‐like behaviors relevant to the obesity and eating disorder fields).MethodA general population sample of adults (N = 500, mean age = 32.5 years), females (n = 376) and males (n = 124), completed the Difficulties in Emotion Regulation Scale‐16, the Trait Rash Impulsivity Scale, the Obsessive‐Compulsive Inventory—Revised, the Eating Disorders Examination Questionnaire, the Self‐Starvation Scale, the Exercise Dependence Scale, the Yale Food Addiction Scale, and the Alcohol Use Disorders Identification Test online. Besides gender comparisons and intercorrelations between measures, we used predefined multiple mediation models with emotion dysregulation as independent variable, impulsivity and compulsivity as parallel mediators, to investigate whether these factors contributed explanatory power to each addictive‐like behavior as outcome, also using age and body mass index as covariates.ResultsFemales scored higher than males on emotion dysregulation and the eating‐related addictive‐like behaviors food addiction, self‐starvation, and binge eating. Intercorrelations between measures showed that emotion dysregulation and compulsivity were associated with all outcome variables, impulsivity with all except compulsive exercise, and the eating‐related behaviors intercorrelated strongly. Mediation models showed full or partial mediation of emotion dysregulation for all behaviors, especially via compulsivity, suggesting a behavior‐specific pattern. Mediation models were not affected by age or gender.DiscussionAddictive‐like behaviors seemed to be maintained by trait levels of emotion dysregulation, albeit channeled via trait levels of compulsivity and/or impulsivity. The role of emotion dysregulation may help us to understand why addictive‐like behaviors can be difficult to change in both clinical and nonclinical groups, and may be informative for treatment‐planning in patients where these behaviors are present. Our findings support adopting a more dimensional approach to psychiatric classification by focusing psychological facets such as those studied.

Shame coping and psychopathy: A replication and extension in a sample of male incarcerated offenders

PurposeTo extend current knowledge on the role of emotion regulation in psychopathy, the present study sought to examine relationships between maladaptive (Attack Self, Attack Others, Avoidance, Withdrawal) and adaptive shame coping styles and psychopathic traits (interpersonal, affective, lifestyle, antisocial) in incarcerated violent offenders. MethodsA sample of 266 men incarcerated for violent offenses in Italian prisons (Mage = 37.42, SD = 11.85) completed self-reported measures of shame coping styles, psychopathic traits, and emotion dysregulation. A path analysis was conducted to examine multivariate relationships between shame coping styles and psychopathic traits while controlling for levels of emotion dysregulation. ResultsExternalizing shame coping styles (Avoidance, Attack Others) were positively related to psychopathic traits across domains. In addition, internalizing shame coping styles were negatively related to the interpersonal and affective traits (Attack Self) and the antisocial traits of psychopathy (Withdrawal). Finally, affective traits of psychopathy had a negative association with adaptive shame coping style. ConclusionsFindings highlight that, beyond general problems with regulating negative emotional states, psychopathic individuals may use maladaptive strategies to cope with shame-eliciting situations, which could at the same time protect the self from the painful experience of shame while contributing to externalizing behavior.

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.

Maternal mindfulness during pregnancy predicts newborn neurobehavior.

Newborn neurobehavioral competencies portend a young child's abilities to modulate their arousal and attention in response to dynamic environmental cues. Although evidence suggests prenatal contributions to newborn neurobehavioral differences, no study to date has examined wellness-promoting traits, such as a pregnant woman's mindfulness, in this association. We examined whether a mother's mindfulness while pregnant related to neurobehavioral outcomes in her neonate, as well as whether maternal mindfulness moderated the link between prenatal maternal emotion dysregulation and newborn neurobehavior. Mothers (N=162) reported on their mindfulness and emotion dysregulation while pregnant. Newborn arousal and attention were assessed at least 24h after birth (M=3.8 days, SD=8.3) using the NICU Network Neurobehavioral Scale (NNNS). Highly mindful pregnant women reported lower levels of emotion dysregulation. Newborns of highly mindful mothers exhibited higher levels of arousal (e.g., excitability, motor activity) but did not differ in regards to attention at birth. Maternal emotion dysregulation while pregnant was associated with blunted newborn attention, but only among mothers who were less mindful. Our findings suggest that a mother's mindfulness while pregnant may influence her fetus' neurobehavioral development in ways that are evident at birth.

Comparison of Emotional Dysregulation Features in Cyclothymia and Adult ADHD.

Background and Objectives: Emotional dysregulation is central to the problem of the overlap between attention-deficit/hyperactivity disorder (ADHD) and cyclothymia. The aim of the study was to evaluate comorbidity rates between ADHD and cyclothymic disorder and to explore demographic and clinical differences among the groups, focusing on affective temperament and emotional dysregulation. Materials and Methods: One hundred sixty-five outpatients attending the Second Psychiatry Unit at the Santa Chiara University Hospital (Pisa) were consecutively recruited: 80 were diagnosed with ADHD, 60 with cyclothymic disorder, and 25 with both conditions. Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-M) and the 40-item version of Reactivity, Intensity, Polarity, and Stability questionnaire (RI-PoSt-40) were administered. Results: Cyclothymic patients were more frequently female and older with respect to the ADHD groups. Both comorbid and non-comorbid ADHD patients showed significantly lower educational attainment and more frequently had substance use disorders. Panic disorder was common in non-comorbid cyclothymic patients, who showed significantly higher rates of familial panic disorder, major depressive disorder and suicide attempts in comparison with patients only diagnosed with ADHD. Cyclothymic patients without ADHD were also characterized by fewer hyperthymic temperamental traits, higher depressive and anxious dispositions, and a greater negative emotionality. No significant differences among groups were observed for cyclothymic temperament and overall negative emotional dysregulation, but comorbid patients with both conditions scored the highest in these subscales. This group also showed significantly higher affective instability with respect to ADHD patients without cyclothymia and was less frequently diagnosed with bipolar disorder type II than patients from both the other groups. Conclusions: ADHD and cyclothymia often co-occur and show similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality in clinical settings. Subjects with “sunny” cyclothymic features might escape the attention of clinicians unless ADHD is present.

Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men.

There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men. Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology. Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation. Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.

Alexithymia is Associated with Emotion Dysregulation in Young People with Autism Spectrum Disorder

Evidence suggests young people with autism spectrum disorder (ASD) have lower levels of emotion regulation than typically developing peers and struggle to modulate the frequency and intensity of their emotions. It may be that these emotion regulation difficulties are a result of co-occurring alexithymia rather than being a core symptom of ASD. We explored the associations between alexithymia and emotion regulation in 43 young people with ASD, aged 10 – 18 years, through self and parent report questionnaires. Parents completed questionnaires measuring the young person’s emotion regulation skills and ASD symptom severity. The young people completed measures of emotion regulation and alexithymia. Correlational analysis and linear regression were used to investigate the relationships between ASD severity, alexithymia and emotion regulation. As predicted, high levels of alexithymia and high level of emotion dysregulation were reported by the young people. Parents also scored the young people as being high on emotion dysregulation. We found statistically significant correlations between alexithymia and emotion regulation, as reported by young people themselves, with some large effect sizes. Parental report of emotion regulation did not correlate with the measure of alexithymia. The source of discrepancies between parent and adolescent perceptions of emotion regulation and emotion recognition are discussed. These results highlighted the key role emotion regulation difficulties play in the lives of young people with ASD and the association with alexithymia. High levels of alexithymia are likely to impinge on the selection of appropriate emotion regulation strategies. The clinical implications for treatment are discussed.