Children who struggle to regulate their emotions at the age of seven are more likely to experience anxiety and depression throughout adolescence, even when pre-existing mental health problems are taken into account, a new study published in the journal Affective Disorders Journal.
Anxiety and depression are among the major health burdens facing young people around the world. These symptoms often emerge or worsen during the transition from childhood to adolescence, a developmentally sensitive period when the brain is rapidly changing and young people face increased social and academic pressures. One strong candidate that makes adolescents vulnerable to these mental health conditions is emotional regulation. That is, the ability to manage and respond to emotional experiences in healthy and appropriate ways.
Previous research has linked poor emotional regulation, such as rapid mood swings, acting without thinking, and being easily overwhelmed, to mental health problems in young people. However, most studies are short-term or unable to distinguish true causality from the effects of other variables (such as poverty or harsh home environments) that influence both emotional development and mental health.
Researchers led by Aja Murray from the University of Edinburgh’s School of Psychology sought to investigate whether emotional dysregulation in early life actually causes internalizing problems later in life, and whether addressing it early could be a meaningful prevention goal.
The research team used data from the British Millennium Cohort Study, a large, nationally representative study that follows thousands of children born in the UK at the beginning of this century. Analyzes included between 6,394 and 11,178 children, depending on age and data source for each outcome.
Emotion dysregulation was assessed by parents when the child was 7 years old. They then measured mental health outcomes at ages 11, 14, and 17 using a widely used questionnaire that captures symptoms such as frequent worrying, being unhappy, nervousness in new situations, and unexplained physical complaints. Assessments were provided by parents, teachers, and the youth themselves at various times.
Rather than use standard statistical techniques, which are susceptible to confounding by background factors, Murray and her team employed a sophisticated technique known as counterfactual analysis. This approach is designed to mimic the conditions of a randomized controlled trial as closely as possible. The algorithm mathematically grouped children who shared similar backgrounds and childhood experiences but differed in how well they were able to regulate their emotions at age seven, taking into account potential confounding factors such as previous mental health, parenting style, socio-economic disadvantage, sleep habits and cognitive ability.
The results showed a consistent and statistically significant relationship. Children who showed greater emotional dysregulation at age 7 had higher levels of anxiety and depression at ages 11 (parent-rated), 14 (parent-rated), and 17 (both parent- and youth-rated).
Although 11-year-old teacher reports did not reach significance, the researchers attributed this primarily to the small sample size available rather than a true lack of effect.
“Emotion (dys)regulation disorders in childhood may contribute to internalizing problems in adolescence and therefore may represent a promising target for intervention,” the authors concluded. “Although the effect was present up to age 17, suggesting sustained benefits from good emotional regulation in early childhood, its magnitude was modest, highlighting that targeting emotion (dys)regulation alone is unlikely to protect young people from the onset and spread of internalizing problems in adolescence.”
Murray and his colleagues noted some limitations, including the inability to completely rule out unmeasured confounders, a challenge inherent in all observational studies. The study also relied on extensive questionnaire measures that could not distinguish between anxiety and depression separately. Finally, the researchers cautioned that because they relied heavily on parent reports to determine both children’s emotion regulation and resulting mental health outcomes, the data were subject to “common rater bias” and could artificially exaggerate the strength of the relationship.
The study, “Is childhood emotion dysregulation a precursor to internalizing problems in adolescence?” was authored by Aja Murray, Helen Wright, Hannah Casey, Josiah King, Xinxing Zhu, Yi Yang, Zuoni Xiao, and Xuefei Li.
