Profiles of Emotion Regulation in Young People Accessing Youth Mental Health and Drug Treatment
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.
KeywordsEmotion 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.
This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 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
- 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. https://doi.org/10.1037/1040-35188.8.131.52.Google Scholar
- 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. https://doi.org/10.1007/s10608-014-9655-3.Google Scholar
- 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. https://doi.org/10.1016/j.jad.2017.08.015.Google Scholar
- 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
- 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
- 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
- Clark, S., & Muthen, B. O. (2009). Relating latent class analysis results to variables not included in the analysis. Retrieved from http://www.statmodel.com/download/relatinglca.pd.
- 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. https://doi.org/10.1007/s00787-006-0535-6.Google Scholar
- 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. https://doi.org/10.1111/j.1742-9544.2010.00003.x.Google Scholar
- 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. https://doi.org/10.1016/j.comppsych.2015.07.014.Google Scholar
- 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. https://doi.org/10.1046/j.1360-0443.1995.9056072.x.Google Scholar
- 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
- 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
- Kring, A. M., & Sloan, D. S. (2009). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. New York: Guilford Press.Google Scholar
- 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. https://doi.org/10.1016/j.cpr.2015.05.010.Google Scholar
- 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. https://doi.org/10.1016/0005-7967(94)00075-U.Google Scholar
- 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
- 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. https://doi.org/10.1016/j.childyouth.2016.06.016.Google Scholar
- 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
- 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. https://doi.org/10.1521/pedi.2009.23.3.281.Google Scholar
- Schwartz, G. (1978). Estimating the dimension of a model. Annals of Statistics, 6, 461–464.Google Scholar
- 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. https://doi.org/10.1016/j.cpr.2017.09.002.Google Scholar
- 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