Longitudinal Relations Between Childhood Maltreatment, Emotion Regulation Difficulties, and Suicidal Ideation and Non-Suicidal Self-Injury: An 18-Month Investigation of Psychiatrically Hospitalized Adolescents.

Within the Dimensional Model of Adversity and Psychopathology, extant research shows that exposure to threat-including emotional, physical, and sexual abuse-is linked to psychopathology among adolescents; problems with emotion regulation may, at least in part, explain this association. Both theoretical and empirical work also suggests that emotion regulation difficulties-particularly access to emotion regulation strategies-may mediate the relation between threat and self-injurious thoughts and behavior, though no studies to date have explicitly tested this model. The current study tested relations between threat, limited access to emotion regulation strategies, and self-injurious thoughts and behaviors among high-risk youth across an 18-month follow-up. The sample consisted of 180 adolescents (Mage = 14.89; SD = 1.35; ages 12-17; 71.7% female; 78.9% White; 55.0% heterosexual) recruited from an inpatient psychiatric unit. Threat was assessed at baseline using the abuse subscales from Childhood Trauma Questionnaire. Access to emotion regulation strategies was assessed using the Difficulties in Emotion Regulation Scale at baseline, 6-, and 12-months. Presence (versus absence) of non-suicidal self-injury and suicidal ideation severity were assessed at baseline, 12-, and 18-months using the Self-Injurious Thoughts and Behaviors Interview and the Suicidal Ideation Questionnaire-JR, respectively. After accounting for baseline levels of the mediator, outcome, and depressive symptoms, structural equation models supported the role of 12-month access to emotion regulation strategies as a mediator between baseline threat and 18-month suicidal ideation and non-suicidal self-injury. Treatment aimed at bolstering access to emotion regulation strategies may help reduce suicide risk among youth who have experienced childhood abuse.

The Affective Consequences of Minority Stress Among Bisexual, Pansexual, and Queer (Bi+) Adults: A Daily Diary Study.

Bisexual, pansexual, and queer (bi+) individuals are at increased risk for depression and anxiety. These disparities are hypothesized to be due to the unique, minority-specific stressors that they experience. Prior research supports that bi+ stressors are associated with depression and anxiety, but nearly all studies have been cross-sectional, limiting our understanding of how experiencing bi+ stress influences individuals' levels of depression and anxiety as they occur in their day-to-day lives. To address this gap, we examined the daily associations between bi+ stressors (discrimination, internalized stigma, rejection sensitivity, and identity concealment) and depressed/anxious mood in a 28-day diary study. Participants were 208 bi+ individuals who completed daily measures of bi+ stressors and depressed/anxious mood. We tested unlagged (same-day) and lagged (next-day) associations, and we also tested whether internalized stigma, rejection sensitivity, and identity concealment functioned as mechanisms underlying the daily associations between discrimination and depressed/anxious mood. Participants reported higher depressed/anxious mood on days when they reported higher discrimination, internalized stigma, rejection sensitivity, and identity concealment. There were significant unlagged indirect effects of discrimination on depressed and anxious mood via internalized stigma and rejection sensitivity, and there was also a significant unlagged indirect effect of discrimination on anxiety via identity concealment. However, none of the lagged associations were significant. Results suggest that bi+ stress is related to same-day, but not next-day, depressed/anxious mood. The nonsignificant lagged associations could reflect that bi+ individuals are using adaptive coping skills in response to bi+ stress, or that other experiences throughout the day have stronger influences on next-day mood.

Task-based functional connectivity patterns: Links to adolescent emotion regulation and psychopathology.

Adolescence is a developmental period characterized by heightened emotional reactivity, neurobiological changes, and increased rates of anxiety and depression. Emotion regulation (ER) difficulties-or the inability to effectively regulate one's emotions-have been theoretically and empirically conceptualized as a transdiagnostic factor implicated in virtually all forms of psychopathology among youth. The current fMRI study investigates how young adolescents' ER abilities longitudinally mediate the relationship between their task-based (n=67) limbic-prefrontal functional connectivity values and subsequent levels of internalizing and externalizing symptoms. Findings revealed that adolescents with stronger limbic-prefrontal connectivity when viewing negative emotional images reported more ER difficulties one year later which, in turn, predicted higher levels of adolescent-reported internalizing and externalizing symptoms (with the exception of ADHD) two years later. This is the only study to date that provides compelling-albeit preliminary-evidence that ER problems longitudinally mediate the association between task-based functional connectivity patterns and future psychological symptoms among adolescents. Of note, participants were only scanned at baseline, limiting our ability to assess change in adolescents' task-based functional connectivity patterns as a function of developing ER abilities or burgeoning psychological symptomology. In sum, rather than conferring risk for any particular disorder, our results suggest that functional connectivity and subsequent ER abilities may serve a transdiagnostic risk factor for psychopathology. These findings may inform future emotion-focused prevention and intervention efforts aimed at youth susceptible to future internalizing and externalizing problems.

Sexual Identity and its Association with Trajectories of Depressive Symptoms and Emotion Regulation Difficulties from Early to Middle Adolescence.

Few studies have examined how changes in sexual identity impact trajectories of depressive symptoms and emotion regulation difficulties. The current study addresses this gap in the literature by examining these associations over a three-year period in a community sample of adolescents (N = 177; Mage = 12.56; SD = 0.60; nmale = 95). Multilevel modeling revealed that youth who consistently held sexual minority identities from early to middle adolescence-but not youth with inconsistent sexual identity-demonstrated increases in depressive symptoms and emotion regulation difficulties relative to their heterosexual peers. Findings suggest that treatments that bolster emotion regulation abilities and address depressive symptoms may be of particular benefit to youth with consistent sexual minority identities from early to middle adolescence.

Sex-Differentiated Associations among Negative Parenting, Emotion-Related Brain Function, and Adolescent Substance Use and Psychopathology Symptoms.

Parenting is a critical factor in adolescent social-emotional development, with maladaptive parenting leading to risk for the development of psychopathology. However, the emotion-related brain mechanisms underlying the influence of parenting on psychopathology symptoms are unknown. The present study utilized functional magnetic resonance imaging and laboratory measures to examine sex-differentiated associations among parenting, adolescent emotion-related brain function, and substance use and psychopathology symptoms in 66 12-14 year olds. Maternal parenting behaviors (warmth, negative parenting) were observed in a laboratory task. Adolescent brain responses to negative emotional stimuli were assessed in emotion processing regions of interest (left [L] and right [R] amygdala, anterior insula, anterior cingulate cortex [ACC]). Adolescents reported on substance use and depressive, anxiety, and externalizing symptoms. Maternal negative parenting predicted adolescent brain activation differently by sex. For girls, negative parenting predicted heightened R ACC activation to negative emotional stimuli. For boys, negative parenting predicted blunted L and R anterior insula and L ACC activation. Furthermore, for girls, but not boys, heightened L anterior insula and heightened L and R ACC activation were associated with substance use and depressive symptoms, respectively. Findings suggest neural response to negative emotion as a possible sex-specific pathway from negative parenting to psychopathology.

Adolescents' Reward-related Neural Activation: Links to Thoughts of Nonsuicidal Self-Injury.

Adolescence is a critical developmental period marked by an increase in risk behaviors, including nonsuicidal self-injury (NSSI). Heightened reward-related brain activation and relatively limited recruitment of prefrontal regions contribute to the initiation of risky behaviors in adolescence. However, neural reward processing has not been examined among adolescents who are at risk for future engagement for NSSI specifically, but who have yet to actually engage in this behavior. In the current fMRI study (N = 71), we hypothesized that altered reward processing would be associated with adolescents' thoughts of NSSI. Results showed that NSSI youth exhibited heightened activation in the bilateral putamen in response to a monetary reward. This pattern of findings suggests that heightened neural sensitivity to reward is associated with thoughts of NSSI in early adolescence. Implications for prevention are discussed.

Associations Between Parent Emotional Arousal and Regulation and Adolescents' Affective Brain Response.

Parents' emotional functioning represents a central mechanism in the caregiving environment's influence on adolescent affective brain function. However, a paucity of research has examined links between parental emotional arousal and regulation and adolescents' affective brain function. Thus, the present study examined associations between parents' self-rated negative emotion, parent emotion regulation difficulties, and adolescent brain responsivity to negative and positive emotional stimuli. Participants included 64 12-14 year-old adolescents (31 females) and their female primary caregivers. Adolescents viewed negative, positive, and neutral emotional stimuli during an fMRI scanning session. Region of interest analyses showed that higher parent negative emotion was related to adolescents' greater ACC and vmPFC response to both negatively- and positively-valenced emotional stimuli; whereas, parent negative emotion was related to adolescents' greater amygdala response to negative emotional stimuli only. Furthermore, parent emotion regulation moderated the association between parent negative emotion and adolescents' brain response to negative emotional stimuli, such that parents with high negative emotion and high emotion regulation difficulties had adolescents with the greatest affective brain response. Findings highlight the importance of considering both parent emotional arousal and regulation in understanding the family affective environment and its relation to adolescent emotion-related brain development.

Adolescent Substance Use & Psychopathology: Interactive Effects of Cortisol Reactivity and Emotion Regulation.

How are emotional processes associated with the increased rates of substance use and psychological disorders commonly observed during adolescence? An index of emotion-related physiological arousal-cortisol reactivity-and subjective emotion regulation have both been independently linked to substance use and psychological difficulties among youth. The current study (N = 134 adolescents) sought to elucidate the interactive effects of cortisol reactivity following a stressful parent-child interaction task and self-reported emotion regulation ability on adolescents' substance use and externalizing and internalizing behavior problems. Results revealed that adolescents with low levels of cortisol reactivity and high emotion regulation difficulties were more likely to use substances, and also had the highest parent-reported symptoms of oppositional defiant disorder. With respect to internalizing symptoms, high emotion-related physiological reactivity coupled with high emotion regulation difficulties were associated with higher self-reported major depression symptoms among youth. Findings reveal that different profiles of HPA axis arousal and emotion regulation are associated with substance use and symptoms of psychopathology among adolescents.

A longitudinal examination of emotion regulation: pathways to anxiety and depressive symptoms in urban minority youth.

BACKGROUND: Difficulty regulating emotions is a symptom of many psychological disorders yet little research has examined the longitudinal relations of particular facets of emotion regulation (ER) that may differentiate between internalizing symptoms. METHOD: At-risk youth (n = 102; 44.1% boys, 77.5% Black; Mage  = 9.65) and caregivers (n = 74; 87.1% mothers) participated in a 2-year longitudinal study. Children reported on their ER, and children and caregivers on symptomatology. RESULTS: Different patterns, varying by emotion facet (dysregulation, inhibition, coping) and type (anger, sadness, worry), predicted anxiety and depression symptoms. CONCLUSIONS: Anxiety and depression are entities with distinct patterns of emotion-related antecedents.