Systematic Review: Questionnaire-Based Measurement of Emotion Dysregulation in Children and Adolescents

Abstract

Objective: Emotion dysregulation, understood as a critical transdiagnostic factor in the etiology and maintenance of psychopathology, is among the most common reasons youth are referred for psychiatric care. The present systematic review examined 2 decades of questionnaires used to assess emotion (dys)regulation in youth.

Method: Using "emotion (dys)regulation," PsycINFO, PubMed, and Web of Science were searched for empirical, peer-reviewed journal studies published before May 2021 in clinical and/or nonclinical youth. A total of 510 studies met selection criteria and were included.

Results: Across the literature, 115 distinct self-, parent-, or other informant-reported measures of emotion (dys)regulation were used in cross-sectional (67.1%), longitudinal (22.4%), intervention (9.0%), and mixed design (1.6%) studies. Out of 115 different questionnaires, a subset of 5 measures of emotion (dys)regulation were used in most of the literature (ie, 59.6% of studies). Moreover, reviewed studies examined emotion (dys)regulation in more than 20 distinct clinical groups, further supporting emotion dysregulation as a transdiagnostic construct.

Conclusion: Numerous themes emerged. Broadly, measures differed in their ability to capture internal vs external components of emotion dysregulation, the use of adaptive vs maladaptive responses, and subjective experiences more broadly vs particular affective states. These findings serve to guide researchers and clinicians in selecting appropriate measurement tools for assessing specific domains of child and adolescent emotion dysregulation.

Keywords: adolescent; child; emotion dysregulation; psychopathology; surveys and questionnaires.

Figure 1:. PRISMA Flow Diagram of Study Inclusion Process for Present Review

Note: ^aRecords were identified from PsycINFO, PubMed, and Web of Science for empirical, peer-reviewed journal articles with the search criteria described in the Methods section. ^bRecords were excluded at the first stage of Screening if the abstract indicated the research was not empirical, was conducted with non-human subjects, included participants outside the age range of 6–18, was not written in English, and did not include a measure of emotion (dys)regulation.

Figure 2:. Number of Studies of Emotion Dysregulation Meeting Search Criteria by Year

Note: The 2021a bar should be interpreted as “in progress”, as the corresponding value represents the number of studies published prior to May 2021 that were included in this review.

Figure 3:. Frequency of Ten Most Used Measures

Note: DERS = Difficulties in Emotion Regulation Scale; ERC = Emotion Regulation Checklist; CEMS = Children’s Emotion Management Scale; ERQ = Emotion Regulation Questionnaire; CERQ = Cognitive Emotion Regulation Questionnaire; ERQ-CA = Emotion Regulation Questionnaire for Children and Adolescents; EESC = Emotion Expression Scale for Children; BRIEF = Behavior Rating Inventory of Executive Function; ERICA = Emotion Regulation Index for Children and Adolescents; FEEL-KJ = Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen.

Figure 4:. Most Used Questionnaires of Emotion (Dys)regulation, by Clinical Category

Note: Internalizing includes anxiety, depressive, and obsessive-compulsive disorders; Externalizing includes disruptive mood dysregulation disorder, oppositional defiant disorder, conduct disorder, and substance use; neurodevelopmental disorders (ND) include attention-deficit/hyperactivity disorder (ADHD), learning disorders, intellectual disabilities, and Tourette’s syndrome; Trauma includes war exposure, neighborhood and/or domestic violence exposure, sexual abuse, child maltreatment, natural disaster exposure; Medical includes arterial ischemic stroke, cerebral palsy, cystic fibrosis, TBI, diabetes, obesity, brain tumor, cancer, acne vulgaris, HIV, inflammatory bowel disease, juvenile idiopathic arthritis, sickle cell disease; DERS = Difficulties in Emotion Regulation Scale; ERC = Emotion Regulation Checklist; CEMS = Children’s Emotion Management Scale; ERQ = Emotion Regulation Questionnaire; CERQ = Cognitive Emotion Regulation Questionnaire; ERQ-CA = Emotion Regulation Questionnaire for Children and Adolescents; EESC = Emotion Expression Scale for Children; BRIEF = Behavior Rating Inventory of Executive Function; ERICA = Emotion Regulation Index for Children and Adolescents; FEEL-KJ = Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen.