Profiles of Emotion Regulation in Young People Accessing Youth Mental Health and Drug Treatment

  • Elise SloanEmail author
  • Kate Hall
  • George J. Youssef
  • Richard Moulding
  • Helen Mildred
  • Petra K. Staiger
Original Article


Deficits regulating emotions are a core process underlying both substance use and mental health disorders. Research has focused on identifying one-to-one associations between individual emotion regulation (ER) strategies and mental health symptoms. Consequently, little is known about how patterns of ER relate to a broad range of psychopathology, in treatment seeking young people. Latent class analysis was used to examine patterns of ER strategies and their relationship with symptoms of depression, anxiety, eating disorders, substance use and borderline personality disorder, in a sample of young treatment seekers. Participants were young people (N = 306, M = 20.8 years) accessing youth advocacy and support or mental health services in Australia. Participants recalled an emotionally-arousing event experienced when on their own and indicated their use of 14 possible ER responses in an online questionnaire. Symptoms of mental health and substance use were measured. The LCA identified three distinct classes of ER responses: Ruminators/avoiders (n = 76), active regulators (n = 81), and low regulators (n = 129). The ruminators/avoiders endorsed the most severe symptom picture across all disorders except alcohol use. Within this cohort, distinct patterns of ER responding had unique relationships with symptoms of psychopathology. The deleterious impact of heightened maladaptive ER strategies (rumination and avoidance) in the absence of adaptive strategies was highlighted.


Emotion regulation Youth Psychopathology Latent class analysis Profile 



The authors would like to acknowledge the support of the Youth Support and Advocacy Service and Headspace Australia.

Compliance with Ethical Standards

Conflict of Interest

Elise Sloan, Kate Hall, George J. Youssef, Richard Moulding, Helen Mildred and Petra K. Staiger declares that they have no conflict of interest.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10608_2019_10003_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 KB)


  1. Akaike, H. (1973). Information theory as an extension of the maximum likelihood principle. In B. N. Petrov & F. Csaki (Eds.), Second International Symposium on Information Theory (pp. 267–281). Budapest: Akademiai Kiado.Google Scholar
  2. Aldao, A. (2013). The future of emotion regulation research: Capturing context. Perspectives on Psychological Science, 8(2), 155–172. Scholar
  3. Aldao, A., & Dixon-Gordon, K. L. (2014). Broadening the scope of research on emotion regulation strategies and psychopathology. Cognitive Behaviour Therapy, 43(1), 22–33. Scholar
  4. Aldao, A., & Nolen-Hoeksema, S. (2010). Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behaviour Research and Therapy, 48(10), 974–983. Scholar
  5. Aldao, A., & Nolen-Hoeksema, S. (2012a). The influence of context on the implementation of adaptive emotion regulation strategies. Behaviour Research and Therapy, 50(7–8), 493–501. Scholar
  6. Aldao, A., & Nolen-Hoeksema, S. (2012b). When are adaptive strategies most predictive of psychopathology? Journal of Abnormal Psychology, 121(1), 276–281. Scholar
  7. Aldao, A., & Nolen-Hoeksema, S. (2013). One versus many: Capturing the use of multiple emotion regulation strategies in response to an emotion-eliciting stimulus. Cognition and Emotion, 27(4), 753–760. Scholar
  8. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychological Review, 30(2), 217–237. Scholar
  9. Antony, M. M., Bieling, P. J., Cox, B., Ennis, D., & Swinson, W. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181. Scholar
  10. Barry, A. E., Chaney, B. H., Stellefson, M. L., & Dodd, V. (2013). Evaluating the psychometric properties of the AUDIT-C among college students. Journal of Substance Use, 20(1), 1–5. Scholar
  11. Bonanno, G. A., & Burton, C. L. (2013). Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science, 8, 591–612. Scholar
  12. Buckholdt, K. E., Parra, G. R., Anestis, M. D., Lavender, J., Jobe-Shields, L., Tull, M. T., & Gratz, K. L. (2014). Emotion regulation difficulties and maladaptive behaviors: Examination of deliberate self-harm, disordered eating, and substance misuse in two samples. Cognitive Therapy and Research, 39(2), 140–152. Scholar
  13. Burke, T. A., Anne McArthur, B., Daryanani, I., Abramson, L. Y., & Alloy, L. B. (2018). Latent classes of trait affect and cognitive affective regulation strategies are associated with depression, non-suicidal self-injury, and well-being. Journal of Affective Disorders, 225, 180–187. Scholar
  14. Bush, K., Kivlahan, D. R., & McDonell, M. B. (1998). The AUDIT Alcohol Consumption Questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 3, 1789–1795.Google Scholar
  15. Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief scrrening test for problem drinking. Archives of Internal Medicine, 158, 1789–1795.Google Scholar
  16. Carl, J. R., Soskin, D. P., Kerns, C., & Barlow, D. H. (2013). Positive emotion regulation in emotional disorders: A theoretical review. Clinical Psychology Review, 33(3), 343–360. Scholar
  17. Carpenter, R. W., & Trull, T. J. (2013). Components of emotion dysregulation in borderline personality disorder: A review. Current Psychiatry Reports, 15(335), 1–8. Scholar
  18. Celeux, G., & Soromenho, G. (1996). An entropy criterion for assessing the number of clusters in a mixture model. Journal of Classification, 13, 195–212.Google Scholar
  19. Chesney, S. A., & Gordon, N. S. (2017). Profiles of emotion regulation: Understanding regulatory patterns and the implications for posttraumatic stress. Cognition and Emotion, 31(3), 598–606. Scholar
  20. Clark, S., & Muthen, B. O. (2009). Relating latent class analysis results to variables not included in the analysis. Retrieved from
  21. Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: A clinical perspective. Monographs of the Society for Research in Child Development, 59(2/3), 73–100. Scholar
  22. Couwenbergh, C., van den Brink, W., Zwart, K., Vreugdenhil, C., van Wijngaarden-Cremers, P., & van der Gaag, R. J. (2006). Comorbid psychopathology in adolescents and young adults treated for substance use disorders: A review. European Child Adolescent Psychiatry, 15(6), 319–328. Scholar
  23. Cowdrey, F. A., & Park, R. J. (2011). Assessing rumination in eating disorders: Principal component analysis of a minimally modified ruminative response scale. Eating Behaviors, 12, 321–324. Scholar
  24. Crawford, J. R., Cayley, C., Lovibond, P. F., Wilson, P., & Hartley, C. (2011). Percentile norms and accompanying interval estimates from an Australian general adult population sample for self-report mood Scales (BAI, BDI, CRSD, CES-D, DASS, DASS-21, STAI-X, STAI-Y, SRDS, and SRAS). Australian Psychologist, 43(1), 3–14. Scholar
  25. Dixon-Gordon, K. L., Aldao, A., & De Los Reyes, A. (2014). Repertoires of emotion regulation: A person centered approach to assessing emotion regulation strategies and links to psychopathology. Cognition and Emotion, 29(7), 1314–1325. Scholar
  26. Dixon-Gordon, K. L., Weiss, N. H., Tull, M. T., DiLillo, D., Messman-Moore, T., & Gratz, K. L. (2015). Characterizing emotional dysfunction in borderline personality, major depression, and their co-occurrence. Comprehensive Psychiatry, 62, 187–203. Scholar
  27. Eftekhari, A., Zoellner, L. A., & Vigil, S. A. (2009). Patterns of emotion regulation and psychopathology. Anxiety Stress and Coping, 22(5), 571–586. Scholar
  28. Ehring, T., Fischer, S., Schnülle, J., Bösterling, A., & Tuschen-Caffier, B. (2008). Characteristics of emotion regulation in recovered depressed versus never depressed individuals. Personality and Individual Differences, 44(7), 1574–1584. Scholar
  29. Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkle, P. E. (1982). The eating attitudes test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878. Scholar
  30. Gearhardt, A. N., Corbin, W. R., & Brownell, K. D. (2009). Preliminary validation of the Yale food addiction scale. Appetite, 52(2), 430–436. Scholar
  31. Godinho, A., Kushnir, V., & Cunningham, J. A. (2015). Unfaithful findings: Identifying careless responding in addictions research. Addiction, 111(6), 955–956. Scholar
  32. Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., & Strang, J. (1995). The Severity of Dependence Scale (SDS): Psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Society for the Study of Addiction, 90(5), 607–614. Scholar
  33. Gossop, M., Griffiths, P., Powis, B., & Strang, J. (1992). Severity of dependence and route of administration of heroin, cocaine and amphetamines. British Journal of Addiction, 87, 1527–1536.Google Scholar
  34. Harrison, A., Sullivan, S., Tchanturia, K., & Treasure, J. (2009). Emotion recognition and regulation in anorexia nervosa. Clinical Psychology and Psychotherapy, 16(4), 348–356. Scholar
  35. Hofmann, S. G., Sawyer, A. T., Fang, A., & Asnaani, A. (2012). Emotion dysregulation model of mood and anxiety disorders. Depression and Anxiety, 29(5), 409–416. Scholar
  36. Hsu, K. J., Beard, C., Rifkin, L., Dillon, D. G., Pizzagalli, D. A., & Bjorgvinsson, T. (2015). Transdiagnostic mechanisms in depression and anxiety: The role of rumination and attentional control. Journal of affective disorders, 188, 22–27. Scholar
  37. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 617–627. Scholar
  38. Kober, H. (2013). Emotion regulation in substance use disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (2nd ed., pp. 428–446). New York: Guilford Press.Google Scholar
  39. Kring, A. M., & Sloan, D. S. (2009). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. New York: Guilford Press.Google Scholar
  40. Lavender, J. M., Wonderlich, S. A., Engel, S. G., Gordon, K. H., Kaye, W. H., & Mitchell, J. E. (2015). Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clinical Psychology Review, 40, 111–122. Scholar
  41. Lougheed, J. P., & Hollenstein, T. (2012). A limited repertoire of emotion regulation strategies is associated with internalizing problems in adolescence. Social Development, 21(4), 704–721. Scholar
  42. Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. Scholar
  43. Martin, G., Copeland, J., Gates, P., & Gilmour, S. (2006). The Severity of Dependence Scale (SDS) in an adolescent population of cannabis users: Reliability, validity and diagnostic cut-off. Drug Alcohol Dependence, 83, 90–93.Google Scholar
  44. McLaughlin, K. A., & Nolen-Hoeksema, S. (2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49(3), 186–193. Scholar
  45. Mennin, D. S., Holaway, R. M., Fresco, D. M., Moore, M. T., & Heimberg, R. G. (2007). Delineating components of emotion and its dysregulation in anxiety and mood psychopathology. Behavior Therapy, 38(3), 284–302. Scholar
  46. Mitchell, P., Kutin, J. J., Daley, L., Best, D., & Bruun, A. J. (2016). Gender differences in psychosocial complexity for a cohort of adolescents attending youth-specific substance abuse services. Children and Youth Services Review, 68(2016), 34–43. Scholar
  47. Nylund, K. L., Asparouhov, T., & Muthen, B. O. (2007). Deciding on the number of classess in latent class analysis and growth mixtrure modelling: A Monte Carlo simulation study. Structural Equation Modelling, 14, 535–569.Google Scholar
  48. Pfohl, B., Blum, N., St. John, D., McCormick, B., Allen, J., & Black, D. W. (2009). Reliability and validity of the Borderline Evaluation of Severity Over Time (BEST): A self-rated scale to measure severity and change in persons with borderline personality disorder. Journal of Personality Disorders. Scholar
  49. Schwartz, G. (1978). Estimating the dimension of a model. Annals of Statistics, 6, 461–464.Google Scholar
  50. Selby, E. A., Fehling, K. B., Panza, E. A., & Kranzler, A. (2015). Rumination, mindfulness, and borderline personality disorder symptoms. Mindfulness, 7(1), 228–235. Scholar
  51. Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical Psychology Review, 57, 141–163. Scholar
  52. Szasz, P. L., Coman, M., Curtiss, J., Carpenter, J. K., & Hofmann, S. G. (2018). Use of multiple regulation strategies in spontaneous emotion regulation. International Journal of Cognitive Therapy, 11(3), 249–261. Scholar
  53. Watson, D., & Clark, L. A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS Scales. Journal of Personality and Social Psychology, 47, 1063–1070.Google Scholar
  54. Willem, L., Bijttebier, P., Claes, L., & Raes, F. (2011). Rumination subtypes in relation to problematic substance use in adolescence. Personality and Individual Differences, 50(5), 695–699. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Psychology, Faculty of HealthDeakin UniversityGeelongAustralia
  2. 2.Centre for Drug, Alcohol and Addiction Research (CEDAAR)Deakin UniversityGeelongAustralia
  3. 3.Centre for Adolescent HealthMurdoch Children’s Research InstituteParkvilleAustralia
  4. 4.Centre for Youth AOD Practice DevelopmentYouth Support and Advocacy ServiceFitzroyAustralia

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