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Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review

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Abstract

The role of emotion regulation in subclinical symptoms of mental disorders in adolescence is not yet well understood. This meta-analytic review examines the relationship between the habitual use of prominent adaptive emotion regulation strategies (cognitive reappraisal, problem solving, and acceptance) and maladaptive emotion regulation strategies (avoidance, suppression, and rumination) with depressive and anxiety symptoms in adolescence. Analyzing 68 effect sizes from 35 studies, we calculated overall outcomes across depressive and anxiety symptoms as well as psychopathology-specific outcomes. Age was examined as a continuous moderator via meta-regression models. The results from random effects analyses revealed that the habitual use of all emotion regulation strategies was significantly related to depressive and anxiety symptoms overall, with the adaptive emotion regulation strategies showing negative associations (i.e., less symptoms) with depressive and anxiety symptoms whereas the maladaptive emotion regulation strategies showed positive associations (i.e., more symptoms). A less frequent use of adaptive and a more frequent use of maladaptive emotion regulation strategies were associated with depressive and anxiety symptoms comparably in the respective directions. Regarding the psychopathology-specific outcomes, depressive and anxiety symptoms displayed similar patterns across emotion regulation strategies showing the strongest negative associations with acceptance, and strongest positive associations with avoidance and rumination. The findings underscore the relevance of adaptive and also maladaptive emotion regulation strategies in depressive and anxiety symptoms in youth, and highlight the need to further investigate the patterns of emotion regulation as a potential transdiagnostic factor.

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Notes

  1. Note, that the flexibility with and the context in which an emotion regulation strategy is used, influence their psychopathological outcome as well. The context may determine whether the use of an emotion regulation strategy is effective or even harmful, i.e., the use of a habitually used maladaptive emotion regulation strategy may be advantageous in the short term or a distinct situation, respectively. Relatedly, the use of an emotion regulation strategy that is assumed to be adaptive may be unsuccessful or harmful when used in a rigid manner or an inappropriate context (Aldao 2013).

  2. In the initial search we also included eating disorder and borderline personality disorder symptoms which were not included for further analyses.

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The funders had no role in the design of the review, collection, analysis or interpretation of the literature, writing the manuscript, or the decision to submit the paper for publication. The views expressed in this publication are those of the authors and not necessarily those of the German Scholarship Foundation, the Medical Research Council, or the Swiss National Science Foundation.

Funding

Johanna Schäfer is supported by the German Scholarship foundation. Emily Holmes is supported by the Medical Research Council (United Kingdom) intramural programme [MRC-A060-5PR50]. Andrea Samson is supported by the Swiss National Science Foundation (SNSF) [grant number PZ00P1-154937].

Authors’ Contributions

JS conceived of the study, conducted the literature search and the meta-analytic calculations and wrote the manuscript; EN conceived of the study, conducted the literature search and the meta-analytic calculations and wrote the manuscript; EAH conceived of the study, interpreted the data and wrote the manuscript; BTC conceived of the study, interpreted the data and wrote the manuscript; ACS conceived of the study, interpreted the data and wrote the manuscript. All authors read and approved the manuscript.

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Authors and Affiliations

  1. Department of Clinical Psychology and Psychotherapy, University of Freiburg, Engelbergerstrasse 41, 79106 Freiburg, Germany

    Johanna Özlem Schäfer & Brunna Tuschen-Caffier

  2. Department of Clinical Psychology and Psychotherapy, University of Tübingen, Schleichstraße 4, Room 4231, 72076 Tübingen, Germany

    Eva Naumann

  3. Medical Research Council Cognition and Brain Science Unit, 15 Chaucer Road, Cambridge, CB2 7EF,, UK

    Emily Alexandra Holmes

  4. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Emily Alexandra Holmes

  5. Swiss Center for Affective Sciences, Campus Biotech, University of Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland

    Andrea Christiane Samson

  6. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

    Andrea Christiane Samson

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  1. Johanna Özlem Schäfer
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Correspondence to Johanna Özlem Schäfer.

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Schäfer, J.Ö., Naumann, E., Holmes, E.A. et al. Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review. J Youth Adolescence 46, 261–276 (2017). https://doi.org/10.1007/s10964-016-0585-0

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