The Contribution of Deficits in Emotional Clarity to Stress Responses and Depression

Preadolescent Suicidal Thoughts and Behaviors: An Intensive Longitudinal Study of Risk Factors

OBJECTIVE

Dramatic increases in rates of suicidal thoughts and behaviors (STBs) among youth highlight the need to pinpoint early risk factors. This study used intensive longitudinal sampling to assess what the concurrent associations were between risk factors and STB status, how proximal changes in risk factors were related to STB status, and how risk factors prospectively predicted changes in STB status in a preadolescent sample enriched for early childhood psychopathology.

METHOD

A total of 192 participants were included from the Parent-Child Interaction Therapy-Emotional Development (PCIT-ED) Study, a longitudinal study of children with and without preschool depression. Participants 7 to 12 years of age completed a diagnostic interview, followed by 12 months of intensive longitudinal sampling, assessing experiences of suicidal ideation and 11 psychosocial variables with known links to STBs in adolescents and adults. Preadolescents with STB history (high-risk) received surveys weekly, and those without STB history (lower-risk) received surveys monthly.

RESULTS

Female sex, elevated depressive symptoms, greater use of expressive suppression and rumination, emotional clarity, and perceived burdensomeness were uniquely concurrently associated with the likelihood of STB endorsement. Within the high-risk group, (1) increases in depression, expressive suppression, rumination, and perceived burdensomeness, and decreases in positive affect from weekt to weekt+1 were associated with a higher likelihood of a positive STB status at weekt+1; and (2) higher expressive suppression, perceived burdensomeness, and caregiver criticism and conflict at weekt compared to participants' mean levels prospectively predicted increases in the likelihood of a positive STB report from weekt to weekt+1.

CONCLUSION

Psychosocial factors influencing STBs in adolescents and adults also affect preadolescents in day-to-day life. Expressive suppression and perceived burdensomeness consistently emerged as novel risk indicators and potential targets for treatment. In addition, increases in depression, rumination, and caregiver criticism and conflict, as well as decreases in positive affect, might prompt heightened STB screening and assessments for preadolescents with a history of STBs.

PLAIN LANGUAGE SUMMARY

There have been large increases in rates of suicidal thoughts and behaviors (STBs) among youth, highlighting the need to identify early risk factors in preadolescents. Over one year, 192 seven- to 12-year-old Midwestern children, some of whom had a history of STBs, repeatedly reported on several risk factors and occurrence of STBs over the previous week or month. Suppressing one's emotions and feeling like a burden emerged as risk factors and predicted the increased likelihood of the emergence of STBs, suggesting these may be potential targets for treatment. Findings also suggest that increases in depression, rumination, and caregiver criticism and conflict, as well as decreases in positive emotion, should prompt STB screening and assessments for preadolescents with a history of STBs.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Examining the association among adolescents' emotional clarity, emotion differentiation, and the regulation of negative and positive affect using a daily diary approach

Emotional clarity and emotion differentiation (ED) are two core aspects of the application of emotional knowledge. During adolescence, novel emotional experiences result in temporary decreases of differentiation and clarity. These temporary difficulties might profoundly impact choices of regulatory strategies. And indeed, prior research has shown that lower emotional clarity and emotion differentiation are each associated with higher use of putatively maladaptive emotion regulation strategies in youth. The two constructs, however, are rarely examined together, and it remains unclear how they are associated in daily life, particularly in children and adolescents. In addition, previous studies have focused on the regulation of negative but not positive affect. To address these gaps, the present study used an intensive longitudinal design in youth. Between June 2021 and March 2022, 172 children and adolescents (M = 12.99 years) completed a 28-day diary (> 3,500 entries in total) reporting daily affect, emotional clarity, and the use of five emotion regulation strategies in response to negative and positive affect (i.e., rumination, dampening, behavioral avoidance, negative and positive suppression). As predicted, on both between- and within-person levels, higher emotional clarity was associated with decreased use of all maladaptive emotion regulation strategies after adjusting for mean affect intensity. Results for emotion differentiation were mostly nonsignificant. Only higher daily positive emotion differentiation was associated with decreased rumination. In sum, this innovative study explores multiple aspects of emotional knowledge usage and regulation during a critical developmental stage and emphasizes the role of emotional clarity in the regulation of negative and positive affect. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Cultivating emotional resilience in adolescent girls: Effects of a growth emotion mindset lesson

To address the widespread mental health crisis facing adolescent girls, this study examined whether a growth emotion mindset lesson can enhance emotional competence. During 2018-2022, adolescent girls (Mage = 15.68 years; 66.3% White) were randomized to a growth mindset (E-MIND; N = 81) or brain education (control; N = 82) lesson, completed the Trier Social Stressor Test, and reported on various aspects of emotional competence. Compared with the control group, the E-MIND group reported more adaptive emotion mindsets, higher emotion regulation self-efficacy, and more proactive in vivo and daily efforts to regulate emotions (effect sizes = small-to-medium to medium), with several differences remaining 4-month later. Findings provide novel insight into one promising approach for cultivating emotional resilience among adolescent girls.

Differential Impact of Parental Practices and Parental Emotional Clarity on Child Symptoms in Single-Child vs. Multiple-Child Divorced Families

OBJECTIVE

The main objective of this study was to analyze the differences in parental emotional clarity and parental practices among families with a single child and families with more than one child, and their relationship with the children's internalizing and externalizing symptomatology, specifically, anxiety-depression and aggressive behavior in a conflictive divorce context.

METHODS

The participants were 247 Spanish divorced parents. In total, 62% of the participants reported being the parents of one child and 38% of two children. All participants answered questionnaires that measured the variables investigated in this study.

RESULTS

The results supported the working hypothesis that families with more than one child present with less emotional clarity, which, concatenated with critical and rigid parental guidelines, is associated with children's greater presence of anxious-depressive and aggressive symptoms.

CONCLUSIONS

Families with more than one child have less positive parental guidelines and so their children express more symptoms.

Higher inflammatory proteins predict future depressive symptom severity among adolescents with lower emotional clarity

BACKGROUND

A growing body of work has implicated inflammation in the pathogenesis of depression. As not all individuals with heightened levels of peripheral inflammation develop symptoms of depression, additional work is needed to identify other factors that catalyze the relationship between inflammation and depressive symptoms. Given that elevated levels of inflammatory activity can induce a variety of emotional changes, the present study examined whether emotional clarity, the trait-like ability to identify, discern, and express one's emotions, influences the strength of the association between inflammatory signaling and concurrent and prospective symptoms of depression.

METHODS

Community adolescents (N = 225, Mage = 16.63 years), drawn from a larger longitudinal project investigating sex and racial differences in depression onset, provided blood samples to determine peripheral levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) at a baseline visit, along with self-report measures of emotional clarity and depressive symptom severity. Depressive symptom severity was assessed again at a follow-up visit approximately 5-months after baseline.

RESULTS

Hierarchical multiple regressions detected a significant interaction between inflammatory markers and emotional clarity on future depression severity, controlling for baseline depressive symptoms. Specifically, among adolescents with low levels of emotional clarity, higher levels of IL-6, CRP, and inflammatory composite scores were significantly associated with greater future depression severity.

CONCLUSIONS

These results indicate that low emotional clarity and high inflammatory signaling may jointly confer risk for prospective depressive symptom severity among adolescents. Therapeutic interventions that improve emotional clarity may reduce risk of depressive symptoms among adolescents with low-grade peripheral inflammation.

Emotional self-knowledge profiles and relationships with mental health indicators support value in 'knowing thyself'

"Know thyself" may be indicated by a balanced high pairing of two emotional self-knowledge indicators: attention to emotions and emotional clarity. Closely associated but often evaluated separately, emotional clarity is consistently, inversely associated with psychopathology, while evidence regarding attention to emotions is less consistent. Variables of high/low emotional clarity and attention to emotions yielded four emotional self-knowledge profiles which were analyzed for associations with mental health indicators (depression and anxiety symptoms, self-esteem, self-schema, resiliency, transcendence) in n = 264 adolescents. Here we report regression models which show that compared with neither, both high (attention + clarity) show higher positive self-schema (B = 2.83, p = 0.004), more resiliency (B = 2.76, p = 0.015) and higher transcendence (B = 82.4, p < 0.001), while high attention only is associated with lower self-esteem (B = - 3.38, p < 0.001) and more symptoms (B = 5.82, p < 0.001 for depression; B = 9.37, p < 0.001 for anxiety). High attention only is associated with most severe impairment all indicators excepting transcendence. Profiles including high clarity suggest protective effects, and 'implicit' versus 'explicit' emotional awareness are discussed. Balanced vs. imbalanced emotional self-awareness profiles dissimilarly affect mental health, which have implications for treatment and policy.

The relationship of negative life events, trait-anxiety and depression among Chinese university students: A moderated effect of self-esteem

BACKGROUND

Negative life events are major triggers for depression. How individual physical qualities and psychological resources affect the relationship between negative life events and depression in college students remains to be studied. Therefore, we constructed a structural equation model to explore the mediating effect of trait anxiety and the moderating effect of self-esteem in the relationship between negative life events and depression among college students.

METHODS

A total of 6224 Chinese college students (aged 16-25) in Jiangxi Province in the central area of China completed the online survey. A moderated mediation model was tested to verify the hypothesis.

RESULTS

The mediation analysis showed a significant indirect effect of negative life events on depression through trait-anxiety. Mediation was moderated by self-esteem, which significantly interacted with negative life events to reduce their effect on both anxiety and depression.

LIMITATIONS

All measures were self-reported. The cross-sectional design only provides evidence of correlation.

CONCLUSIONS

The results in this study revealed that self-esteem as a component of psychological defense mechanism to reduce the harm of environmental threats to individuals. Low self-esteem college students are more likely to have adverse effects when experiencing low-level life events. University mental health education reduces the effects of negative life events on trait anxiety and depression of college students by raising their self-esteem levels.

Systematic Review: Questionnaire-Based Measurement of Emotion Dysregulation in Children and Adolescents

OBJECTIVE

Emotion dysregulation, understood as a critical transdiagnostic factor in the etiology and maintenance of psychopathology, is among the most common reasons youth are referred for psychiatric care. The present systematic review examined 2 decades of questionnaires used to assess emotion (dys)regulation in youth.

METHOD

Using "emotion (dys)regulation," PsycINFO, PubMed, and Web of Science were searched for empirical, peer-reviewed journal studies published before May 2021 in clinical and/or nonclinical youth. A total of 510 studies met selection criteria and were included.

RESULTS

Across the literature, 115 distinct self-, parent-, or other informant-reported measures of emotion (dys)regulation were used in cross-sectional (67.1%), longitudinal (22.4%), intervention (9.0%), and mixed design (1.6%) studies. Out of 115 different questionnaires, a subset of 5 measures of emotion (dys)regulation were used in most of the literature (ie, 59.6% of studies). Moreover, reviewed studies examined emotion (dys)regulation in more than 20 distinct clinical groups, further supporting emotion dysregulation as a transdiagnostic construct.

CONCLUSION

Numerous themes emerged. Broadly, measures differed in their ability to capture internal vs external components of emotion dysregulation, the use of adaptive vs maladaptive responses, and subjective experiences more broadly vs particular affective states. These findings serve to guide researchers and clinicians in selecting appropriate measurement tools for assessing specific domains of child and adolescent emotion dysregulation.

Evaluating Covariate Effects on ESM Measurement Model Changes with Latent Markov Factor Analysis: A Three-Step Approach

Invariance of the measurement model (MM) between subjects and within subjects over time is a prerequisite for drawing valid inferences when studying dynamics of psychological factors in intensive longitudinal data. To conveniently evaluate this invariance, latent Markov factor analysis (LMFA) was proposed. LMFA combines a latent Markov model with mixture factor analysis: The Markov model captures changes in MMs over time by clustering subjects' observations into a few states and state-specific factor analyses reveal what the MMs look like. However, to estimate the model, Vogelsmeier, Vermunt, van Roekel, and De Roover (2019) introduced a one-step (full information maximum likelihood; FIML) approach that is counterintuitive for applied researchers and entails cumbersome model selection procedures in the presence of many covariates. In this paper, we simplify the complex LMFA estimation and facilitate the exploration of covariate effects on state memberships by splitting the estimation in three intuitive steps: (1) obtain states with mixture factor analysis while treating repeated measures as independent, (2) assign observations to the states, and (3) use these states in a discrete- or continuous-time latent Markov model taking into account classification errors. A real data example demonstrates the empirical value.

Changes in Affect Integration and Internalizing Symptoms After Time-Limited Intersubjective Child Psychotherapy—A Pilot Study

Time-limited intersubjective child-psychotherapy (TIC) is an intensive, structured right-brain oriented therapeutic approach for children and caregivers aimed at both symptom reduction and strengthening core developmental processes such as affect integration. This is the first study to investigate changes in internalizing symptoms and affect integration after TIC. Thirty-three children between 9 and 13 years with internalizing difficulties were assessed after 10 h of TIC. Internalizing symptoms were assessed through the child behavior checklist and affect integration with the affect consciousness interview (ACI). Scores from the children with internalizing difficulties were modeled in a mixed linear model along with data from a control group without internalizing difficulties (n = 24) to control for effects of time and learning. Affect integration increased significantly from time 1 to time 2 in the children with internalizing problems, but not in the control children. Internalizing symptoms were also significantly reduced in the children with internalizing difficulties from time 1 to time 2. The results indicate that TIC may contribute to a decrease in symptoms along with an increase in affect integration in children with internalizing difficulties, making the children better able to notice, tolerate and communicate affective states. This can, in turn, aid development and day-to-day regulation and interactions. The article explores key elements of TIC, such as affective attunement, relational repair, and work with caregivers using one of the individual therapies in the study as an example. The article argues that TIC represents a right-hemisphere to right-hemisphere therapeutic approach to healing that can both enhance important common therapeutic factors such a relation and alliance and bring about growth-promoting change.

Exposure to Depression Memes on Social Media Increases Depressive Mood and It Is Moderated by Self-Regulation: Evidence From Self-Report and Resting EEG Assessments

This study aimed to investigate the effects of depression memes, spread mainly on social media, on depressive mood, and the moderating role of self-regulation based on self-report and electrophysiological (resting EEG frontal alpha asymmetry) assessments. We conducted a semi-online crossover study; first, we collected brain activity data from healthy young adults (n = 32) who were subsequently provided a link to the online experiment. Each participant participated in both the neutral and meme conditions. We also evaluated their level of depressive mood immediately before and after exposure to the stimuli. We further conducted a series of linear mixed effects model analyses and found that depression memes contributed to an increase in depressive symptoms. Specifically, lack of emotional clarity, difficulties in goal-directed behaviors in emotional distress, and impulse control difficulties were linked to greater depressive mood in the case of exposure to depression memes compared with neutral images. However, time interactions were insignificant. These results mainly indicate the centrality of behavioral problems during times of emotional distress caused by depression memes. Lastly, although frontal alpha asymmetry did not predict a change in depressive mood or significantly differ across conditions, lower inhibitory control may result in increased processing of depression memes as negative stimuli. This result is consistent with our self-report results (e.g., impulsivity) as well as other related studies in the literature. However, further research is needed to verify these frontal alpha asymmetry results.

Social emotional ability development (SEAD): An integrated model of practical emotion-based competencies

Social emotional abilities (i.e., specific skills), defined as the set of cognitive abilities, emotion-based knowledge, and behavioral competencies (i.e., skill levels) that facilitate adaptively employing prosocial processes and behaviors (i.e., "actions"), such as emotional regulation and sympathetic and empathetic response behaviors, is contemporarily modeled and measured as emotional intelligence. This conceptualization can be problematic, however, as the two concepts are not the same and traditional methods of measuring emotional intelligence can have limited practical utility. The social emotional ability development (SEAD) theoretical model introduced in this treatise represents a pragmatic and simplified approach to the development of social emotional ability and competency as abstracted from constructs of emotional intelligence, social intelligence, and sociocultural learning theory. Further, the SEAD model reaches beyond the individual as the unit of analysis to explore, conceptualize, differentiate, investigate, and define the hierarchal, bi-directional, and contextual nature of the dimensions of social emotional ability within close relationships. Implications for how the SEAD model can be used by researchers, practitioners, educators, individuals, families, and couples across a broad spectrum of domains and interventions are discussed.

Differences in affect integration in children with and without internalizing difficulties

Background:

Affect represents an important source of information about our internal state and the external world that can motivate and vitalize us. When affect is poorly integrated, this can lead to problems with self-regulation and psychopathology. Few studies have investigated affect integration in children.

Objective:

This study investigates differences in affect integration in children with and without internalizing difficulties.

Method:

Thirty-three Norwegian children (aged 9–13) with and 24 children without internalizing difficulties were interviewed with the Affect Consciousness Interview (ACI), a measure of affect integration. Data from the ACI was analyzed across nine affective categories (Interest/Excitement, Enjoyment/Joy, Fear/Panic, Anger/Rage, Shame/Humiliation, Sadness/Despair, Envy/Jealousy, Guilt/Remorse, and Tenderness/Care), and four dimensions (Awareness, Tolerance, Emotional, and Conceptual expressivity).

Results:

The children differed significantly in affect integration across all dimensions and all assessed affects, both positive and negative. Emotional Expressivity, Anger/Rage, and Sadness/Despair were particularly less integrated in the children with internalizing problems.

Conclusions:

Assessment of affect integration can provide useful information on possible underlying factors in internalizing problems in children and may help guide and personalize therapeutic interventions. Based on knowledge from empirical infant psychology interventions mimicking rich, early intersubjective experiences are recommended to increase affect integration.

Irritability and mood symptoms in adolescent girls: Trait anxiety and emotion dysregulation as mediators

BACKGROUND

Irritability is a common symptom in youth that is thought to be predictive of mood disorders. Its effects on mood are likely to be age-dependent, with direct and indirect mediators. We assessed age-related effects and mediators of irritability in adolescent girls with subthreshold depressive and manic symptoms.

METHODS

We analysed the irritability item from the Mood Disorder Questionnaire in 3 cohorts of girls aged 12-18years (N=229); 12-13years (N=82); 14-15years (N=68); and 16-18years (N=79). They also completed mood, anxiety and emotion regulation questionnaires. MANOVA, correlations and bootstrapped mediation analyses were performed with SPSS®v25 and Hayes Processv3.5®.

RESULTS

Overall, irritable girls had higher depressive and manic symptoms, trait anxiety and emotion dysregulation than those who were not irritable. Significantly higher rates of irritability were observed in mid-adolescents (aged 14-15years; p = 0.001). Notably, irritability exerted effects on depressive symptoms via trait anxiety, non-acceptance of emotions and dysregulation in emotion clarity throughout adolescence. However, irritability directly exerted effects on manic symptoms in mid-adolescence but in older adolescents, their relationship was indirect via impulse control dysregulation.

LIMITATIONS

The cross-sectional design and non-clinical sample limit generalisability of our findings.

CONCLUSIONS

Irritability is involved in subthreshold depressive symptoms, via trait anxiety and perceptual emotion dysregulation. On the other hand, irritability is directly and indirectly associated with subthreshold manic symptoms via dysregulated impulse control depending on age. Therefore, screening for irritability, trait anxiety and emotion dysregulation throughout adolescence may facilitate the early detection of subthreshold depressive and manic symptoms, and the implementation of preventive strategies.

Are emotions better left unknown? Sex-specific effects of emotional awareness and daily hassles on internalizing symptoms among college students

Amid growing concern about internalizing disorders on college campuses, few researchers have examined the ways emotional awareness deficits may contribute to risk. We examined the effect of the interaction between daily hassles, emotional awareness, and sex on depression and anxiety symptoms. Participants: Data were collected from 196 college students (M_age = 19.6, SD_age = 2.26) at a large university in June 2016. Methods: Participants completed online surveys to assess daily hassles, emotional awareness, and internalizing symptoms. Results: Daily hassles were significantly associated with internalizing symptoms, p < .01. For women, daily hassles were significantly associated with internalizing symptoms at all levels of emotional awareness, ps < .05. For men, daily hassles were significantly associated with internalizing symptoms only at high levels of emotional awareness, ps < .05. Conclusion: Future researchers could examine the context in which emotional awareness may be most beneficial to college students.

Emotion regulation abilities as a predictor of anxiety, positive emotions, heart rate, and alpha asymmetry during an impromptu speech task

BACKGROUND AND OBJECTIVES

Recent approaches suggest that emotion regulation (ER) abilities represent potential predictors of emotional response among youths navigating stressful situations. To test this, we investigated whether ER abilities predicted the subjective and physiological emotional response experienced by youths during a stressful situation.

DESIGN

A cross-sectional design was employed.

METHOD

One hundred and thirty-four youths completed measures of ER abilities (emotional awareness, anxiety sensitivity, emotional control) and were asked to deliver a speech while their anxiety, positive emotions, heart rate, and alpha asymmetry were collected at four time points: baseline, anticipation, speech, and post-recovery.

RESULTS

Pearson r correlations showed that poor emotional control and awareness, as well as high anxiety sensitivity were related to greater anxiety and lower positive emotions experienced during the speech. Hierarchical multiple regressions also revealed that emotional control and emotional awareness predicted greater speech anxiety and lower positive emotions. Moreover, anxiety sensitivity was related to and predicted an increased heart rate experienced during speech.

CONCLUSIONS

Findings suggest that difficulties in emotional awareness, anxiety sensitivity, and emotional control predict the emotional response experienced by youths during a stressful situation. Interventions delivered by clinicians/teachers that target ER difficulties may be effective in improving emotional functioning when navigating stressful situations.

Pubertal Timing and Substance use in Adolescence: an Investigation of Two Cognitive Moderators

Off-time pubertal development is a predictor of substance use among adolescents. Early-maturing girls and early- and late-maturing boys appear to be at greater risk for substance use, although findings are more consistent for girls. Although cognitive factors are also important in the etiology of adolescent substance use, few studies have investigated potential cognitive risk and protective factors in these associations. The current study tested whether future orientation or cognitive style (e.g., attributions youth make about the causes and consequences of negative life events) moderated the association between pubertal timing and substance use two years later and whether this effect was stronger for females. Multiple linear regressions revealed cognitive style and future orientation significantly moderated the association between pubertal timing and substance use, and these effects did not differ by sex. Importantly, the pattern of these interactions differed, such that early pubertal timing predicted more substance use in the context of more negative and moderate cognitive styles and greater and moderate future orientation. Follow-up analyses revealed that an adolescent's attributions about the consequences, globality, and self-worth implications of negative life events significantly moderated the pubertal timing - future substance use association. Furthermore, the pattern of these interactions predicted each of the four types of substances assessed in the context of cognitive style, but only predicted nicotine and marijuana use in the context of future orientation. These results highlight which cognitive factors may influence risk for substance use for early-maturing youth.

The perils of murky emotions: Emotion differentiation moderates the prospective relationship between naturalistic stress exposure and adolescent depression

Negative emotion differentiation (NED) refers to the ability to identify and label discrete negative emotions. Low NED has been previously linked to depression and other indices of low psychological well-being. However, this construct has rarely been explored during adolescence, a time of escalating depression risk, or examined in the context of naturalistic stressors. Further, the association between NED and depression has never been tested longitudinally. We propose a diathesis-stress model wherein low NED amplifies the association between stressful life events (SLEs) and depression. A sample of 233 community-recruited midadolescents (Mage 15.90 years, 54% female) completed diagnostic interviews and reported on mood and daily stressors 4 times per day for 7 days. SLEs were assessed using a semistructured interview with diagnosis-blind team coding based on the contextual threat method. Follow-up interviews were conducted 1.5 years after baseline. Low NED was correlated with depression but did not predict prospective changes in depression as a main effect. Confirming predictions and supporting a diathesis-stress model, low NED predicted (a) within-subjects associations between daily hassles and momentary depressed mood, (b) between-subjects associations between SLE severity and depression, and (c) prospective associations between SLE severity and increases in depression at follow-up. Results were specific to negative (vs. positive) emotion differentiation. Results suggest that low NED is primarily depressogenic in the context of high stress exposure. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Responses to academic stress mediate the association between sleep difficulties and depressive/anxiety symptoms in Chinese adolescents

OBJECTIVE

Sleep difficulties are pervasive in Chinese adolescents, which exert aversive influence on their emotional health. However, the underlying mechanisms of this effect remain unclear. This study addressed whether stress responses mediate the concurrent and prospective relationship between sleep difficulties and depressive/anxiety symptoms in Chinese adolescents.

METHOD

17,946 adolescents (14-18 years-old) were administrated the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Revised Children's Manifest Anxiety Scale and the Responses to Stress Questionnaire. Further, 710 of them finished the one-year follow-up assessments. Structural equation models were conducted to determine the concurrent and prospective mediation effects of stress responses and the moderated effect of gender and age.

RESULTS

Involuntary engagement and disengagement responses, as well as engagement coping, significantly mediated the cross-sectional relationship between sleep difficulties and depressive/anxiety symptoms. Moreover, sleep difficulties at baseline predicted enhanced involuntary engagement responses but reduced the use of engagement coping strategies one year later, resulting in an elevated level of depressive/anxiety symptoms. Finally, females and younger adolescents with greater sleep difficulties were more likely to generate maladaptive stress responses.

LIMITATIONS

First, sleep difficulties were only measured using self-reported approaches. Second, potential confounding variables (e.g., socioeconomic status) were not adjusted for. Third, our study only focused on typically-developing youth samples rather than clinical samples.

CONCLUSIONS

Our findings highlight the important role of stress responses in the relationship between sleep difficulties and depressive/anxiety symptoms. The findings might also shed some light on the psychological intervention of sleep difficulties and mood disorder in adolescent populations.

Emotion regulation strategies in mania risk: A systematic review

OBJECTIVES

Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess how emotion regulation strategies reported by individuals at risk of mania compare with clinical and nonclinical controls.

METHODS

Search terms relating to mania risk and emotion regulation were entered into three databases. Sixteen studies were included.

RESULTS

Mania risk was typically associated with overall endorsement of emotion regulation strategies, particularly dampening, and positive and negative rumination.

CONCLUSIONS

Findings were limited by overall lack of evidence for individual strategies, lack of consideration of key mediating factors and reliance upon self-report designs.

The Association Between Juvenile Onset of Depression and Emotion Regulation Difficulties

Juvenile onset of Major Depressive Disorder (MDD) is associated with increased likelihood of recurrent episodes of depression and more detrimental clinical trajectories. The aim of the current study was to investigate the effect of juvenile onset of MDD on emotion regulation as measured by self-report and Heart Rate Variability (HRV). Furthermore, we wanted to assess whether juvenile onset impacted the association between rumination and depressive symptoms. Sixty-four individuals with at least three prior episodes of MDD were recruited and filled out self-report questionnaires measuring rumination and emotion regulation abilities. In addition, electrocardiographic assessments were used to calculate HRV. Based on self-reported age of MDD onset, individuals were divided in two groups: Juvenile onset of MDD (first MDD episode before the age of 18, n = 30) and adult onset of MDD (first MDD episode after the age of 18, n = 34). Results showed that individuals whose first depressive episode occurred in childhood and adolescence reported more rumination and less emotional clarity compared to individuals who had their first episode of MDD in adulthood. Moreover, the tendency to ruminate was strongly associated with depressive symptoms in the juvenile onset of MDD group, whereas no such association was found in the adult onset group. There was no significant group difference for HRV. The findings are discussed in light of existing literature, in addition to suggesting how our findings may inform clinical practice and future research. We conclude that juvenile onset of MDD may lead to difficulties in emotion regulation and that these difficulties may increase depressive symptoms and vulnerability for relapse in this particular subgroup.

Emotional Awareness Predicts Specific Cognitive-Behavioral Therapy Outcomes for Anxious Youth

The current study examined emotional awareness as a predictor of differential outcomes for youth treated for an anxiety disorder. 37 youth ages 7-15 received either individual cognitive-behavioral therapy or family cognitive-behavioral therapy to treat generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Diagnoses were determined by independent evaluators, following semi-structured interviews (ADIS-IV-C/P) with youth and their parents. Self-report questionnaires, including the multidimensional anxiety scale for children and the emotion expressivity scale for children, were completed at pre- and posttreatment. Youth with higher levels of pretreatment emotional awareness had better treatment outcomes than youth with lower levels of emotional awareness, with specific regard to improved ability to cope with worry. Findings suggest that higher levels of emotional awareness facilitate better specific outcomes for anxious youth. Findings highlight the importance of understanding the emotions associated with worry during the treatment process.

Exploring emotion regulation as a mediator of the relationship between resilience and distress in cancer

OBJECTIVES

Distress in patients with cancer is a significant problem that affects up to 32% of patients. Yet research indicates that 35% of cancer patients do maintain high levels of well-being. Resilience is one psychological factor implicated as being protective against distress; however, the mechanisms for this relationship are currently unknown. The present study aimed to explore emotion regulation as a potential mediator of the relationship between resilience and distress.

METHODS

A cross-sectional survey examining emotional regulation, resilience, and distress was completed by 227 patients from two hospitals with heterogeneous cancer types. Measures included the Difficulties in Emotion Regulation Scale (DERS), the Connor Davidson Resilience Scale, and the Depression, Anxiety, Stress Scale.

RESULTS

Difficulties in emotion regulation and resilience explained 33.2% of the variance in distress. Resilience had a significant direct effect on distress, accounting for 15.8% of the variance. However, this effect was no longer significant when difficulties in emotion regulation were controlled for. The indirect effect through difficulties in emotion regulation was significant, b = 0.009, 95% CI [-0.013,-0.007], suggesting that the effect of resilience on distress was fully mediated by emotion regulation. Parallel mediation analyses also examined the differential effects of the six DERS subscales on the relationship between resilience and distress.

CONCLUSION

These findings suggest that emotion regulation is an important mediator of resilience in cancer. Hence, in patients with cancer, difficulties in emotion regulation (and the DERS specifically) might be a useful focus for screening for patients at risk of distress.

Parental threats and adolescent depression: The role of emotion dysregulation

Childhood exposure to parental threatening behaviors places adolescents at greater risk for depression. However, the association between parental threatening behaviors and depressive symptoms among trauma-exposed inpatient youth, and potential factors that exacerbate the harmful effects of such parenting, have remained unexplored. One factor that may contribute to depression is low emotional clarity, which is characterized by difficulties recognizing and understanding one's emotions. The current investigation examined the interactive effects of childhood exposure to maternal threatening behaviors and emotional clarity deficits in relation to depressive symptoms among inpatient psychiatric youth who had been exposed to a potentially traumatic event (i.e., exposure to actual or threatened death, serious injury, or sexual violence). Participants (N = 50, M_age = 15.1 years, SD = 0.51, range 12-17) completed measures of emotion dysregulation, childhood exposure to maternal threatening behavior, and depressive symptoms. A significant interaction was found between exposure to maternal threatening behaviors and deficits in emotional clarity in relation to depressive symptom severity. Greater exposure to maternal threatening behaviors was related to more severe depressive symptoms, yet only among children with greater deficits in emotional clarity. Findings underscore the need for interventions that target emotional clarity among trauma-exposed youth who have experienced parental threats.

The temporal association between emotional clarity and depression symptoms in adolescents

INTRODUCTION

Low emotional clarity, that is, problems in understanding and identifying one's own emotions, is generally seen as related to depression. Most empirical studies on this topic focused on the link between low levels of emotional clarity predicting depression problems, fewer studies on depression symptoms predicting low emotional clarity. All studies were restricted to unidirectional associations. The present study evaluated the reciprocal associations between emotional clarity and depression symptoms. Additionally, we tested the role of rumination as a mediator of the links between depression symptoms and emotional clarity.

METHODS

For the main analyses, data of 230 Dutch participants (M_age = 13.40, SD = 2.24; 48% girls) over three time points of a 5-year longitudinal study were used. Depression symptoms, emotional clarity, and rumination were self-reported. Cross-lagged panel analysis was used to test a model of reciprocal associations between depression symptoms and emotional clarity against models of unidirectional associations. The role of rumination as mediator and sex as moderator in the links between depression symptoms and emotional clarity were evaluated in separate analyses on a subsample (n = 151).

RESULTS & CONCLUSIONS

A model of reciprocal associations where depression symptoms and low emotional clarity predict relatively high scores of the other over time offered a good representation of the data. Rumination mediated the link between depression symptoms predicting prospective emotional clarity for both sexes. These findings suggest a vicious cycle between depression symptoms and low emotional clarity. We discuss possible implications of these results for the treatment of depression in youth.

Understanding the Constellation of Adolescent Emotional Clarity and Cognitive Response Styles when Predicting Depression: A Latent Class Analysis

Adolescence is a period of human development associated with increased emotional intensity and heightened vulnerability to developing psychopathology. This study used Latent Class Analysis to identify subgroups of youth based on emotional clarity and cognitive response styles. Participants were 436 adolescents (51.8% female; 48.2% African-American/Black, 47.4% Caucasian/White) who completed measures of emotional clarity, cognitive response styles, and depression at baseline (M = 13.02 years, SD = .83), and at a 1-year and 4-year follow-up. Four classes were identified and used to predict depression outcomes. Overall, youth with above average emotional clarity who reported using a variety of adaptive cognitive response styles also had the lowest level of depressive symptoms at baseline. Class membership did not predict depressive symptoms at any follow-up. The results suggest that the unique profiles based on youth reported levels of emotional clarity and use of problem solving, distraction, and rumination, may not be more predictive of depression outcomes, beyond earlier assessments of depression or by examining these facets in isolation.

Emotional clarity development and psychosocial outcomes during adolescence

Past research on emotional clarity (EC), the ability to identify and label one's own emotions, has illustrated an association between EC deficits and poor psychosocial outcomes during the adolescent years. Although past research has connected EC to psychosocial outcomes during adolescence in cross-sectional and longitudinal designs, no studies have traced the trajectory of EC over time to determine the developmental course of the construct during adolescence. Thus, this study investigated how EC developed over five years during adolescence and what factors were associated with the developmental trajectory of emotional clarity. Participants included a diverse sample of 640 adolescents (M age at Time 1 = 12.55 years; 53.0% female; 52.2% African American; 48.0% eligible for free school lunch). Results indicated that EC tended to decrease over adolescence, and females, on average, had a steeper decline of EC over time than males. The trajectory of EC predicted psychosocial outcomes, including depression and well-being. Results are discussed with the ultimate goal of informing novel prevention and intervention programs to promote adaptive emotional functioning during an influential time in human development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Affect Intensity Moderates the Association of Emotional Clarity with Emotion Regulation and Depressive Symptoms in Unselected and Treatment-Seeking Samples

Depression is associated with subjective difficulties identifying one's emotions, known as low emotional clarity, but the mediators and moderators of this relationship are not well understood. We hypothesized that the role of emotional clarity in emotion regulation and, in turn, depression depends on individual differences in negative affect intensity. In Study 1, conducted in an unselected sample (N=119), low emotional clarity more strongly predicted depression symptoms among individuals higher in affect intensity. In Study 2, conducted in a clinically diagnosed, treatment-seeking sample (N=245), we examined whether affect intensity moderated an indirect path of clarity through emotion regulation strategy use that has emerged in previous work. When affect intensity was very low, emotional clarity did not predict reappraisal, and when affect intensity was very high, emotional clarity did not predict non-acceptance or experiential avoidance. By contrast, rumination mediated associations of emotional clarity with depressive symptoms regardless of affect intensity. Findings support a process model of low emotional clarity in depression that integrates (1) emotion regulatory mediators and (2) moderation by negative affect intensity. Trait differences in affect intensity may determine whether and how emotional clarity and regulation processes factor into mood psychopathology.

Challenging assumptions from emotion dysregulation psychological treatments

BACKGROUND

Contemporary treatments assume that the inability to downregulate negative emotional arousal is a key problem in the development and maintenance of psychopathology and that lack of effective regulation efforts and a preference to use maladaptive regulation strategies is a primary mechanism. Though ubiquitous, there is limited empirical evidence to support this assumption. Therefore, the aim of the current study was to examine whether self-reported emotion dysregulation equated to difficulties reducing emotional arousal during a behavioral task and to primary use of maladaptive strategies to manage negative emotions.

METHODS

44 anxious and depressed adults with high emotion dysregulation induced negative distress using autobiographic memory recall. After induction, participants were instructed to downregulate but were not provided any specific instructions in strategies to use. Self-reported emotional arousal was assessed before and after induction and after regulation. Qualitative descriptions of regulation efforts were collected and codedinto effective and maladaptive strategies.

RESULTS

The task was successful in inducing emotional arousal and participants were successful in their efforts to down regulate negative emotions. Additionally, effective regulation strategies were used more frequently than maladaptive strategies.

LIMITATIONS

Data collected was exclusively self-report and the sample size was small.

CONCLUSION

Adults who report high emotion dysregulation may still have effective emotion regulation strategies in their behavioral repertoire and are more likely to engage in these effective strategies when given an unspecific prompt to regulate negative emotional arousal. Despite reporting problems with emotion regulation, adults with anxiety and depression can successfully downregulate distress when prompted to do so.

5-HTTLPR moderates the association between attention away from angry faces and prospective depression among youth

Attention bias to emotion has been studied as a risk factor associated with depression. No study has examined whether attention bias within the context of measured genetic risk leads to increased risk for clinical depressive episodes over time. The current study investigated whether genetic risk, as indexed by the serotonin-transporter-linked polymorphic region (5-HTTLPR), moderated the relationship between attention bias to emotional faces and clinical depression onset prospectively across 18-months in a community sample of youth (n = 428; mean age = 11.97, SD = 2.28; 59% girls). Youth who attended away from angry emotional faces and were homozygous for the S allele of the 5-HTTLPR polymorphism were at greater risk for prospective depressive episode onset. The current study's findings highlight the importance of examining risk for depression across multiple levels of analysis and demonstrate attention away from threat as a possible point of intervention related to attention bias modification and depression treatment among youth.

Neural activation during cognitive reappraisal in girls at high risk for depression

OBJECTIVE

Although emotion dysregulation, one of the core features of depression, has long been thought to be a vulnerability factor for major depressive disorder (MDD), surprisingly few functional magnetic resonance imaging (fMRI) studies have investigated neural correlates of emotion regulation strategies in unaffected high risk individuals.

METHOD

Sixteen high risk (RSK) young women and fifteen matched low risk controls (CTL) were scanned using fMRI while performing an emotion regulation task. During this task, participants were instructed to reappraise their negative emotions elicited by International Affective Picture System images (IAPS). In addition, Difficulties in Emotion Regulation Strategies Scale (DERS) was used to assess participants' emotion dysregulation levels.

RESULTS

Both RSK and CTL individuals show increased amygdala activation in response to negative emotional stimuli, however no difference was found between groups in using cognitive reappraisal strategies and functions of brain regions implicated in cognitive reappraisal. Interestingly, our psychometric test results indicate that high risk individuals are characterised by lower perceived emotional clarity (EC).

CONCLUSION

Results of the current study suggest depression vulnerability may not be linked to the effectiveness of cognitive reappraisal. Alternatively, lower EC may be a vulnerability factor for depression.

Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review

In this meta-analytic and narrative review, we examine several overarching issues related to the study of coping, emotion regulation, and internalizing and externalizing symptoms of psychopathology in childhood and adolescence, including the conceptualization and measurement of these constructs. We report a quantitative meta-analysis of 212 studies (N = 80,850 participants) that measured the associations between coping and emotion regulation with symptoms of internalizing and externalizing psychopathology. Within the meta-analysis we address the association of broad domains of coping and emotion regulation (e.g., total coping, emotion regulation), intermediate factors of coping and emotion regulation (e.g., primary control coping, secondary control coping), and specific coping and emotion regulation strategies (e.g., emotional expression, cognitive reappraisal) with internalizing and externalizing symptoms. For cross-sectional studies, which made up the majority of studies included, we examine 3 potential moderators: age, measure quality, and single versus multiple informants. Finally, we separately consider findings from longitudinal studies as these provide stronger tests of the effects. After accounting for publication bias, findings indicate that the broad domain of emotion regulation and adaptive coping and the factors of primary control coping and secondary control coping are related to lower levels of symptoms of psychopathology. Further, the domain of maladaptive coping, the factor of disengagement coping, and the strategies of emotional suppression, avoidance, and denial are related to higher levels of symptoms of psychopathology. Finally, we offer a critique of the current state of the field and outline an agenda for future research. (PsycINFO Database Record

Emotional Clarity as a Mechanism Linking Emotional Neglect and Depressive Symptoms during Early Adolescence

The present study examined whether emotional abuse and neglect differentially predicted decreases in emotional clarity, and whether emotional clarity, in turn, predicted increases in depressive symptoms. Participants included 204 early adolescents (52% African-American; 54% female; Mean age= 12.85 years) who completed four assessments with measures of depressive symptoms, emotional clarity, and emotional abuse and neglect. Hierarchical linear regressions indicated that emotional neglect significantly predicted decreases in emotional clarity, whereas emotional abuse did not. Further, mediational analyses revealed that decreases in emotional clarity mediated the relationship between emotional neglect and increases in depressive symptoms. The current study suggests that emotional neglect (more so than emotional abuse) may hinder an individual's ability to identify his or her own emotions, which may increase the risk of depressive symptoms during adolescence. These findings have significant implications for the development of intervention and prevention programs for depression.

Individual and Day-to-Day Differences in Active Coping Predict Diurnal Cortisol Patterns among Early Adolescent Girls

Prior work has identified alterations in activity of the hypothalamic-pituitary-adrenal axis as a potential mechanism underlying stress-induced emotional health problems, which disproportionately impact girls beginning in mid-adolescence. How adolescent girls differ from one another in dispositional coping tendencies and shift specific coping strategies in response to varying stressors have been theorized as important predictors of their adaptation, health, and well-being during this dynamic period of development. The goal of this study was to examine whether individual and day-to-day (within-person) differences in adolescent girls' coping responses are associated with daily patterns of hypothalamic-pituitary-adrenal axis activity, indexed by cortisol. Participants were 122 early adolescent girls (M _age = 12.39) who provided three saliva samples per day for 3 days and completed daily coping reports, as well as a standard coping survey. Participants and primary caregivers also completed objective life stress interviews. On average, girls who were more likely to respond to interpersonal stress with voluntary engagement (active) coping exhibited generally adaptive daily physiological regulation-steeper diurnal cortisol slopes, lower total diurnal cortisol output, and lower cortisol awakening responses. Chronic interpersonal stress level significantly moderated these associations in different ways for two distinct components of the diurnal pattern-the slope and cortisol awakening responses. Regarding within-person differences, using active coping more than usual was associated with higher waking cortisol the following morning, which may help to prepare adolescent girls for perceived daily demands. These findings highlight the interactive influence of stress and coping in the prediction of daily hypothalamic-pituitary-adrenal axis activity and support the stress-buffering role of active coping for adolescent girls.

Pubertal Development, Emotion Regulatory Styles, and the Emergence of Sex Differences in Internalizing Disorders and Symptoms in Adolescence

Adolescence marks the emergence of sex differences in internalizing symptoms and disorders, with girls at increased risk for depression and anxiety during the pubertal transition. However, the mechanisms through which puberty confers risk for internalizing psychopathology for girls, but not boys, remain unclear. We examined two pubertal indicators (pubertal status and timing) as predictors of the development of emotion regulation styles (rumination and emotional clarity) and depressive and anxiety symptoms and disorders in a three-wave study of 314 adolescents. Path analyses indicated that early pubertal timing, but not pubertal status, predicted increased rumination, but not decreased emotional clarity, in adolescent girls, but not boys. Additionally, rumination mediated the association between early pubertal timing and increased depressive, but not anxiety, symptoms and disorder onset among adolescent girls. These findings suggest that the sex difference in depression may result partly from early maturing girls' greater tendency to develop ruminative styles than boys.

Adolescent Depression and Negative Life Events, the Mediating Role of Cognitive Emotion Regulation

BACKGROUND

Depression during adolescence is a serious mental health problem. Difficulties in regulating evoked emotions after stressful life events are considered to lead to depression. This study examined if depressive symptoms were mediated by various cognitive emotion regulation strategies after stressful life events, more specifically, the loss of a loved one, health threats or relational challenges.

METHODS

We used a sample of 398 adolescents (Mage = 16.94, SD = 2.90), including 52 depressed outpatients, who all reported stressful life event(s). Path analyses in Mplus were used to test mediation, for the whole sample as well as separately for participants scoring high versus low on depression, using multigroup analyses.

RESULTS

Health threats and relational challenging stressful life events were associated with depressive symptoms, while loss was not. More frequent use of maladaptive strategies was related to more depressive symptoms. More frequent use of adaptive strategies was related to less depressive symptoms. Specific life events were associated with specific emotion regulation strategies. The relationship between challenging, stressful life events and depressive symptoms in the whole group was mediated by maladaptive strategies (self-blame, catastrophizing and rumination). No mediation effect was found for adaptive strategies.

CONCLUSION

The association between relational challenging, stressful life events and depressive symptoms was mediated by maladaptive, cognitive emotion regulation strategies.

The Relationship Between Family Functioning and Adolescent Depressive Symptoms: The Role of Emotional Clarity

Emotion regulation has been implicated in the etiology of depression. A first step in adaptive emotion regulation involves emotional clarity, the ability to recognize and differentiate one's emotional experience. As family members are critical in facilitating emotional understanding and communication, we examined the impact of family functioning on adolescent emotional clarity and depressive symptoms. We followed 364 adolescents (ages 14-17; 52.5% female; 51.4 % Caucasian, 48.6% African American) and their mothers over 2 years (3 time points) and assessed emotional clarity, depressive symptoms, and adolescents' and mothers' reports of family functioning. Emotional clarity mediated the relationship between adolescents' reports of family functioning and depressive symptoms at all time points cross-sectionally, and according to mothers' reports of family functioning at Time 1 only. There was no evidence of longitudinal mediation for adolescents' or mothers' reports of family functioning. Thus, family functioning, emotional clarity, and depressive symptoms are strongly related constructs during various time points in adolescence, which has important implications for intervention, especially within the family unit.

The cyclical nature of depressed mood and future risk: Depression, rumination, and deficits in emotional clarity in adolescent girls

Deficits in emotional clarity, the understanding and awareness of one's own emotions and the ability to label them appropriately, are associated with increased depressive symptoms. Surprisingly, few studies have examined factors associated with reduction in emotional clarity for adolescents, such as depressed mood and ruminative response styles. The present study examined rumination as a potential mediator of the relationship between depressive symptoms and changes in emotional clarity, focusing on sex differences. Participants included 223 adolescents (51.60% female, Mean age = 12.39). Controlling for baseline levels of emotional clarity, initial depressive symptoms predicted decreases in emotional clarity. Further, rumination prospectively mediated the relationship between baseline depressive symptoms and follow-up emotional clarity for girls, but not boys. Findings suggest that depressive symptoms may increase girls' tendencies to engage in repetitive, negative thinking, which may reduce the ability to understand and label emotions, a potentially cyclical process that confers vulnerability to future depression.

Emotional awareness as a pathway linking adult attachment to subsequent depression

Although research links insecure adult attachment with depression, the emotional processes accounting for this association over time remain relatively unexplored. To address this gap, this study investigated whether deficits in emotional awareness serve as one explanatory process. Adult female caregivers (N = 417, Mage = 37.83) completed questionnaires annually for 3 years. As anticipated, attachment avoidance exerted an indirect effect on depression via emotional awareness. Attachment anxiety directly predicted subsequent depression, but the indirect effect through emotional awareness was nonsignificant. These results suggest that an avoidant attachment style interferes with the effective processing of emotions, thereby placing women at risk for depression. This research implicates emotional awareness as a potential target for interventions aimed at reducing depressive symptoms in mothers with avoidant attachment styles.

Emotion regulation in bipolar disorder: profile and utility in predicting trait mania and depression propensity

Current emotion regulation research in BD has tended to focus on the extent to which patients control their emotions using different cognitive strategies. Fewer studies have investigated whether patients with BD have difficulties in regulating other dimensions of emotion that serve a functional purpose and are thereby more amenable to change. To overcome this paucity of research we utilised a multi-dimensional measure of emotion regulation to characterise the emotion regulation profile of BD, and examine its utility in predicting trait mania and depression propensity. Fifty BD patients and 52 healthy controls completed the Difficulties in Emotion Regulation Scale (DERS) and the General Behaviour Inventory (GBI). Results indicated that patients had difficulties in emotion regulation across a range of dimensions. Impulse control difficulties most parsimoniously predicted trait (hypo)mania propensity in BD patients, whilst poor access to mood regulation strategies predicted depressive propensity. Predictors of the propensity to experience these moods differed in the control group. These findings represent an important step toward informing the development of new treatment strategies to remediate emotion regulation difficulties and improve BD symptomatology.

Deficits in Emotional Clarity and Vulnerability to Peer Victimization and Internalizing Symptoms Among Early Adolescents

Peer victimization is a significant risk factor for a range of negative outcomes during adolescence, including depression and anxiety. Recent research has evaluated individual characteristics that heighten the risk of experiencing peer victimization. However, the role of emotional clarity, or the ability to understand one's emotions, in being the target of peer victimization remains unclear. Thus, the present study evaluated whether deficits in emotional clarity increased the risk of experiencing peer victimization, particularly among adolescent girls, which, in turn, contributed to prospective levels of depressive and anxiety symptoms. In the present study, 355 early adolescents (ages 12-13; 53% female; 51% African American) who were part of the Adolescent Cognition and Emotion project completed measures of emotional clarity, depressive symptoms, and anxiety symptoms at baseline, and measures of peer victimization, depressive symptoms, and anxiety symptoms at follow-up. Moderation analyses indicated that deficits in emotional clarity predicted greater peer victimization among adolescent girls, but not adolescent boys. Moderated mediation analyses revealed that deficits in emotional clarity contributed to relational peer victimization, which, in turn, predicted prospective levels of depressive and anxiety symptoms among adolescent girls, but not boys. These findings indicate that deficits in emotional clarity represent a significant risk factor for adolescent girls to experience relational peer victimization, which, in turn, contributed to prospective levels of internalizing symptoms. Thus, prevention programs should target deficits in emotional clarity to prevent peer victimization and subsequent internalizing symptoms among adolescent girls.

Emotional Awareness: A Transdiagnostic Predictor of Depression and Anxiety for Children and Adolescents

Research increasingly suggests that low emotional awareness may be associated with symptoms of depression and anxiety among children and adolescents. However, because most studies have been cross-sectional, it has remained unclear whether low emotional awareness predicts subsequent internalizing symptoms. The current study used longitudinal data to examine the role of emotional awareness as a transdiagnostic predictor of subsequent symptoms of depression and anxiety. Participants were 204 youth (86 boys and 118 girls) ages 7-16 who completed self-report measures of emotional awareness, depressive symptoms, and anxiety symptoms at baseline, as well as measures of depression and anxiety symptoms every 3 months for a year. Results from hierarchical mixed effects modeling indicated that low baseline emotional awareness predicted both depressive and anxiety symptoms across a 1-year period. These findings suggest that emotional awareness may constitute a transdiagnostic factor, predicting symptoms of both depression and anxiety, and that emotional awareness training may be a beneficial component of treatment and prevention programs for youth depression and anxiety.

Peer victimization in middle childhood impedes adaptive responses to stress: a pathway to depressive symptoms

Although associations between peer victimization in childhood and later psychopathology are well documented, surprisingly little research directly examines pathways accounting for these enduring effects. The present study addresses this issue by examining whether maladaptive responses to peer aggression (less effortful engagement coping and more involuntary responses) mediate associations between peer victimization and later depressive symptoms. Data were collected on 636 children (338 girls, 298 boys; M = 8.94 years, SD = .37) for three consecutive years beginning in 3rd grade. Findings supported the proposition that peer victimization predicts lower levels of effortful engagement coping and higher levels of involuntary engagement and disengagement responses to stress. Moreover, these responses to stress helped to explain the link between 3rd-grade peer victimization and 5th-grade depressive symptoms. No sex differences in these linkages emerged. These findings build on prior theory and research by providing a more nuanced understanding of how and why peer victimization serves as an early risk factor for depressive symptoms.

Emotional intelligence and psychological maladjustment in adolescence: a systematic review

The study of emotional intelligence (EI) and its association with psychological maladjustment in adolescence is a new and active area of research. However, the diverse range of EI measurements and aspects of psychological maladjustment examined make it difficult to synthesize the findings and apply them to practice. Therefore, we conducted a systematic review to summarize the relationship between EI and adolescents' emotional problems, eating disorder symptoms, addictions, and maladaptive coping. Using English and Spanish keywords, we identified 32 studies that found a negative association between EI and internalizing problems, depression, and anxiety. EI was also associated with less substance abuse and with better coping strategies. These associations differed slightly depending on whether EI was evaluated based on self-reporting or by testing maximum performance. We highlight methodological limitations in the literature on EI and adolescence, and we discuss potentially important areas for future research.

A Prospective Examination of Emotional Clarity, Stress Responses, and Depressive Symptoms During Early Adolescence

This study examined the proposal that difficulty understanding one's emotional experiences (i.e., deficits in emotional clarity) would interfere with the formulation of adaptive responses to interpersonal stress, which would then predict depressive symptoms. This process was examined across 3 years (fourth to sixth grade) during early adolescence. Participants included 636 youth (338 girls, 298 boys; X̅ age in fourth grade = 9.95, SD = .37) who completed measures assessing emotional clarity, stress responses, and depressive symptoms. Consistent with the hypothesized model, path analyses revealed that maladaptive interpersonal stress responses partially mediated the prospective contribution of deficits in emotional clarity to depressive symptoms. These findings implicate impairment in emotional understanding as a precursor to emerging interpersonal and psychological difficulties during a developmental stage of heightened vulnerability to depression, the transition to adolescence.

Pubertal timing and vulnerabilities to depression in early adolescence: differential pathways to depressive symptoms by sex

Although research implicates pubertal processes in the emergence of the sex difference in depression during adolescence, few studies have examined how cognitive and affective vulnerabilities influence the effect of pubertal timing on depressive symptoms. The current study prospectively examined whether early pubertal timing predicted increases in depressive symptoms among adolescents with more negative cognitive styles and lower emotional clarity, and whether this risk was specific to adolescent girls. In a diverse sample of 318 adolescents, early pubertal timing predicted increases in depressive symptoms among adolescent boys and girls with more negative cognitive styles and adolescent girls with poor emotional clarity. These findings suggest that earlier pubertal maturation may heighten the risk of depression for adolescents with pre-existing vulnerabilities to depression, and that early maturing adolescent girls with lower levels of emotional clarity may be particularly vulnerable to depressive symptoms, representing one pathway through which the sex difference in depression may emerge.

Adverse life events and emotional and behavioural problems in adolescence: the role of coping and emotion regulation

We tested whether emotion regulation (cognitive reappraisal and expressive suppression) and coping (distraction, avoidance, support seeking and active coping) mediate or moderate the association between change in life stress (change in number of adverse life events) and change in adolescent problem behaviour. We used prospective and retrospective longitudinal data from a community sample. We measured change in problem behaviour as emotional and behavioural problems at Time 2 controlling for emotional and behavioural problems at Time 1, a year earlier. We measured change in life stress as life stress between Times 1 and 2, controlling for total previous life stress (before Time 1). Neither coping nor emotion regulation mediated the association between change in life stress and change in problem behaviour. Avoidance and expressive suppression were related to an increase in problem behaviour. Only cognitive reappraisal moderated the effect of increase in life stress on worsening of problem behaviour, suggesting that, as expected, cognitive reappraisal was a protective factor. In adolescents who reported they habitually reappraise, the association between change in life stress and change in emotional and behavioural problems was non-significant.