Does the Transdiagnostic EMOTION Intervention Improve Emotion Regulation Skills in Children?
- 28 Downloads
Emotion regulation is thought to be an important transdiagnostic process across internalizing disorders in youth, and the regulation of emotions is believed to play a central role in both adaptive and maladaptive development. Several preventive interventions focus on improving children’s emotion regulation skills, but research regarding the outcomes of emotion regulation skills are scarce.
We therefore investigated whether a new transdiagnostic indicated prevention intervention for anxiety and depressive symptoms, the EMOTION program, improves emotion regulation skills as reported by parents of children aged 8–12 years. Data from a large national cluster randomized control trial (RCT) study, Coping Kids, performed in Norway were used, including data from 601 children and their parents.
Using mixed models, we found a decrease in dysregulation of emotions (Δ = .06, CI = (0.00 to .11), p = .040) and an increase in emotion regulation (Δ = .11, CI = (0.05 to .17) p < .001) in the intervention group compared to the control group.
The EMOTION intervention has a potential positive effect on children’s emotional regulation skills. One opportunity in transdiagnostic interventions lies in targeting common underlying processes in internalizing disorders and thereby reaching a larger proportion of the youth population than is possible with single-disorder approaches.
KeywordsEmotion regulation Youth Transdiagnostic Internalizing symptoms Prevention
We would like to thank all parents and children who participated in the study, school personnel and project coordinators for their invaluable assistance with the data collection.
This research was funded by the Norwegian Research Council, award number 228846/H10.
M.E.S.L. wrote the paper and performed and interpreted the analyses. A.M.S. and T.R. contributed to critically revising the paper and in interpreting the analyses. S.L. contributed to performing and interpreting the analyses. S.P.N., S.H., K.M., J.P. and F.A. contributed to critically revising the manuscript. In addition, A.M.S., S.P.N., S.H., K.M., J.P. and F.A. contributed to designing the study and collecting the data.
Compliance with Ethical Standards
Conflict of Interest
K.M. receives royalties from the sale of EMOTION manuals in Norway. All the remaining authors declare that they have no conflict of interest.
The study was approved by the regional ethics committee (REC), Region South and East Norway (Registration number: 2013/1909; Project title: Coping Kids: a randomized controlled study of a new indicated preventive intervention for children with symptoms of anxiety and depression).
Written informed consent was obtained from caregivers on behalf of the children participating in our study.
- Angold, A., Costello, E. J., Messer, S. C., & Pickles, A. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5(4), 237–249.Google Scholar
- Compas, B. E., Jaser, S. S., Bettis, A. H., Watson, K. H., Gruhn, M. A., Dunbar, J. P., Thigpen, J. C. (2017). coping, emotion regulation, and psychopathology in childhood and adolescence: a meta-analysis and narrative review. Psychological Bulletin. https://doi.org/10.1037/bul0000110.
- Ehrenreich-May, J., & Chu, B. C. (2014). Overview of transdiagnostic mechanisms and treatmetns. In J. Ehrenreich-May & B. C. Chu (Eds.), Transdiagnostic treatments for children and adolescents: principles and practice. New York: Guilford Press.Google Scholar
- Ehrenreich-May, J., Rosenfield, D., Queen, A. H., Kennedy, S. M., Remmes, C. S., & Barlow, D. H. (2017). An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. Journal of Anxiety Disorder, 46, 46–55. https://doi.org/10.1016/j.janxdis.2016.10.006.CrossRefGoogle Scholar
- Gross, J. J. (2013). Emotion regulation: conceptual and empirical foundations. In J. J. Gross (Ed.), Handbook of Emotion Regulation, Second Edition. New York: The Guilford Press.Google Scholar
- Izard, C. E., King, K. A., Trentacosta, C. J., Morgan, J. K., Laurenceau, J.-P., Krauthamer-Ewing, E. S., & Finlon, K. J. (2008). Accelerating the development of emotion competence in Head Start children: Effects on adaptive and maladaptive behavior. Development Psychopathology, 20(1), 369–397. https://doi.org/10.1017/S0954579408000175.CrossRefGoogle Scholar
- Kendall, P. C., Stark, K. D., Martinsen, K., O’Neil, K. A., & Arora, P. (2013). “Coping Kids” managing anxiety and depression; groupleaders manual. Ardmore,: PA: Workbook Publishing.Google Scholar
- March, J. S., Parker, J. D. A., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 554–565. https://doi.org/10.1097/00004583-199704000-00019.CrossRefGoogle Scholar
- Martinsen, K. D., Kendall, P. C., Stark, K., & Neumer, S.-P. (2016). Prevention of anxiety and depression in children: acceptability and feasibility of the transdiagnostic EMOTION program. Cognitive and Behavioral Practice, 23(1), 1–13. https://doi.org/10.1016/j.cbpra.2014.06.005.CrossRefGoogle Scholar
- Martinsen, K. D., Kendall, P. C., Stark, K. D., Rodriguez, K. A. O. N., & Arora, P. (2014). Mestrende barn, gruppeldermanual barn. Oslo, Norway: Gyldendal Akademisk.Google Scholar
- Martinsen, K. D., Stark, K., Rodriguez, K. A. O. N., Kendall, P. C., & Arora, P. (2014). Mestrende Barn, gruppeledermanual foreldre. Oslo: Gyldendal Akademisk.Google Scholar
- Myles-Pallister, J. D., Ehassan, S., Rooney, R. M., & Kane, R. T. (2014). The efficacy of the enhanced aussie optimism positive thinking skills program in improving social and emotional learning in middlechildhood. Frontiers of Psychology, 5, 909 https://doi.org/10.3389/fpsyg.2014.00909.CrossRefGoogle Scholar
- Patras, J., Martinsen, K. D., Holen, S., Sund, A. M., Adolfsen, F., Rasmussen, L. P., & Neumer, S. P. (2016). Study protocol of an RCT of EMOTION: an indicated intervention for children with symptoms of anxiety and depression. BMC Psychol, 4(1), 48 https://doi.org/10.1186/s40359-016-0155-y.CrossRefGoogle Scholar
- Schneider, R. L., Arch, J. J., Landy, L. N., & Hankin, B. L. (2016). The longitudinal effect of emotion regulation strategies on anxiety levels in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 00(00), 1–14. https://doi.org/10.1080/15374416.2016.1157757.Google Scholar
- Statistics of Norway, S. (2016). Inntekts og formuesstatistikk for husholdninger, 2015. https://www.ssb.no/inntekt-og-forbruk/statistikker/ifhus/aar.
- Statistics of Norway, S. (2017). Befolkningens utdanningsnivå. Tabell 1, utdanningsnivå for menn og kvinner 16 år og over. Aldersgrupper. Antallog prosent. https://www.ssb.no/utdanning/statistikker/utniv/aar.
- Stockings, E. A., Degenhardt, L., Dobbins, T., Lee, Y. Y., Erskine, H. E., Whiteford, H. A., & Patton, G. (2016). Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention. Psychol Med, 46(1), 11 https://doi.org/10.1017/S0033291715001725.CrossRefGoogle Scholar
- Swan, A. J., & Kendall, P. C. (2016). Fear and missing out: youth anxiety and functional outcomes. Vol. 23 pp. 417–435).Google Scholar
- Thompson, R. A., & Goodman, M. (2010). Development of emotion regulation. In A. M. Kring & D. M. Sloan (Eds.), Emotion regulation and psychopathology: a transdiagnostic approach to etiology and treatment. New York: Guilford Press.Google Scholar
- Werner, K., & Gross, J. J. (2010). Emotion regulation and psychopathology: a conseptual framework. In A. M. Kring, D. M. Sloan, (Eds.) Emotion regulation and psychopathology: a transdiagnostic approach to etiology and treatment. New York: Guilford Press.Google Scholar
- Yap, M. B. H., Morgan, A. J., Cairns, K., Jorm, A. F., Hetrick, S. E., & Merry, S. (2016). Parents in prevention: a meta-analysis of randomized controlled trials of parenting interventions to prevent internalizing problems in children from birth to age 18. Clinical Psychology Review, 50, 138–158. https://doi.org/10.1016/j.cpr.2016.10.003.CrossRefGoogle Scholar