Positive and Negative Emotion Regulation in Adolescence: Links to Anxiety and Depression

Abstract

Emotion regulation skills develop substantially across adolescence, a period characterized by emotional challenges and developing regulatory neural circuitry. Adolescence is also a risk period for the new onset of anxiety and depressive disorders, psychopathologies which have long been associated with disruptions in regulation of positive and negative emotions. This paper reviews the current understanding of the role of disrupted emotion regulation in adolescent anxiety and depression, describing findings from self-report, behavioral, peripheral psychophysiological, and neural measures. Self-report studies robustly identified associations between emotion dysregulation and adolescent anxiety and depression. Findings from behavioral and psychophysiological studies are mixed, with some suggestion of specific impairments in reappraisal in anxiety. Results from neuroimaging studies broadly implicate altered functioning of amygdala-prefrontal cortical circuitries, although again, findings are mixed regarding specific patterns of altered neural functioning. Future work may benefit from focusing on designs that contrast effects of specific regulatory strategies, and isolate changes in emotional regulation from emotional reactivity. Approaches to improve treatments based on empirical evidence of disrupted emotion regulation in adolescents are also discussed. Future intervention studies might consider training and measurement of specific strategies in adolescents to better understand the role of emotion regulation as a treatment mechanism.

Keywords: adolescence; anxiety; depression; emotion regulation; fMRI; psychological treatment; psychophysiology.

Figure 1

Patterns of altered neural activation and connectivity during emotion regulation in adolescents with depression. Overall, studies to date have demonstrated altered activation and connectivity in the amygdala and across regions of prefrontal cortex. The directionality of effects (greater or lesser in depressed compared to non-depressed participants), and the specific set of regions involved however varies across studies. (PFC: prefrontal cortex, dm/dlPFC: dorsomedial/dorsolateral PFC)