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How do I feel right now? Emotional awareness, emotion regulation, and depressive symptoms in youth

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Abstract

Decreased emotional awareness contributes to the risk of internalizing disorders, such as depression. Although emotional awareness may be especially important during adolescence, a developmental period in which emotional arousal is high and the risk of depression rises dramatically, little research has examined the mechanisms linking emotional awareness to depression. Starting from affect regulation models, the current study proposes emotion regulation (ER) as a key underlying mechanism in the emotional awareness—depression relationship. The current study investigated whether maladaptive and adaptive ER strategies mediate the relationship between emotional awareness and depressive symptoms among youth using a cross-sectional design. Participants were 220 youth (65% girls; \(M_{\text{age}}\) = 11.87, SD = 1.94) who filled out a set of questionnaires assessing emotional awareness, ER strategies, and depressive symptoms. Results revealed no direct relationship between emotional awareness and depressive symptoms. However, emotional awareness yielded a significant mediation effect through total adaptive ER strategies on higher depressive symptoms. No evidence was found for the mediating role of maladaptive ER strategies in this relationship. The current study provides further support for affect regulation models positing that emotional awareness may be a basic skill that is required for learning adaptive ER skills, and thus call for greater attention to adaptive ER strategies.

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References

  1. Mathers C (2008) The global burden of disease: 2004 update. World Health Organization, Geneva

    Book  Google Scholar 

  2. Association AP (2013) Major depressive disorder and the “bereavement exclusion”. American Psychiatric Publishing, Washington, DC (Retrieved July 24:2013)

    Google Scholar 

  3. Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson B (1996) Childhood and adolescent depression: a review of the past 10 years. Part I. J Am Acad Child Adolesc Psychiatry 35(11):1427–1439

    Article  PubMed  CAS  Google Scholar 

  4. Balázs J, Miklósi M, Keresztény Á, Hoven CW, Carli V, Wasserman C, Apter A, Bobes J, Brunner R, Cosman D (2013) Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk. J Child Psychol Psychiatry 54(6):670–677

    Article  PubMed  Google Scholar 

  5. Kessler RC, Avenevoli S, Merikangas KR (2001) Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 49(12):1002–1014

    Article  PubMed  CAS  Google Scholar 

  6. Jaycox LH, Stein BD, Paddock S, Miles JN, Chandra A, Meredith LS, Tanielian T, Hickey S, Burnam MA (2009) Impact of teen depression on academic, social, and physical functioning. Pediatrics 124(4):e596–e605

    Article  PubMed  Google Scholar 

  7. Thapar A, Collishaw S, Pine DS, Thapar AK (2012) Depression in adolescence. Lancet 379(9820):1056–1067

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tuisku V, Kiviruusu O, Pelkonen M, Karlsson L, Strandholm T, Marttunen M (2014) Depressed adolescents as young adults–predictors of suicide attempt and non-suicidal self-injury during an 8-year follow-up. J Affect Disord 152:313–319

    Article  PubMed  Google Scholar 

  9. Cuijpers P, de Graaf R, van Dorsselaer S (2004) Minor depression: risk profiles, functional disability, health care use and risk of developing major depression. J Affect Disord 79(1):71–79

    Article  PubMed  Google Scholar 

  10. Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL (2005) Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch Gen Psychiatry 62(1):66–72

    Article  PubMed  Google Scholar 

  11. Berking M, Whitley B (2014) Affect regulation training. In: Handbook of emotion regulation. Springer, New York

  12. Larsen RJ, Diener E, Lucas RE (2002) Emotion: models, measures, and individual differences. In: Emotions in the workplace: understanding the structure and role of emotions in organizational behavior. Jossey-Bass, San Fransisco, pp 64–106

  13. Saarni C (1999) The development of emotional competence. Guilford Press, New York

    Google Scholar 

  14. Smith CA, Lazarus RS (1990) Emotion and adaptation. Handbook of personality: theory and research. Guilford Press, New York, pp 609–637

    Google Scholar 

  15. Lambie JA, Marcel AJ (2002) Consciousness and the varieties of emotion experience: a theoretical framework. Psychol Rev 109(2):219

    Article  PubMed  Google Scholar 

  16. Lane RD, Schwartz GE (1987) Levels of emotional awareness: a cognitive-developmental theory and its application to psychopathology. Am J Psychiatry 144(2):133–143

    Article  PubMed  CAS  Google Scholar 

  17. McRae K, Misra S, Prasad AK, Pereira SC, Gross JJ (2011) Bottom–up and top–down emotion generation: implications for emotion regulation. Soc Cogn Affect Neurosci 7(3):253–262

    Article  PubMed  PubMed Central  Google Scholar 

  18. Somerville LH, Jones RM, Casey B (2010) A time of change: behavioral and neural correlates of adolescent sensitivity to appetitive and aversive environmental cues. Brain Cogn 72(1):124–133

    Article  PubMed  Google Scholar 

  19. Arnett JJ (1999) Adolescent storm and stress, reconsidered. Am Psychol 54(5):317

    Article  PubMed  CAS  Google Scholar 

  20. Larson R, Ham M (1993) Stress and” storm and stress” in early adolescence: the relationship of negative events with dysphoric affect. Dev Psychol 29(1):130

    Article  Google Scholar 

  21. Steinberg L (2005) Cognitive and affective development in adolescence. Trends Cogn Sci 9(2):69–74

    Article  PubMed  Google Scholar 

  22. Buckley M, Saarni C (2006) Skills of emotional competence: developmental implications. Emot Intell Everyday Life 2:51–76

    Google Scholar 

  23. Burnett S, Thompson S, Bird G, Blakemore S-J (2011) Pubertal development of the understanding of social emotions: implications for education. Learn Individ Differ 21(6):681–689

    Article  PubMed  PubMed Central  Google Scholar 

  24. Halberstadt AG, Denham SA, Dunsmore JC (2001) Affective social competence. Soc Dev 10(1):79–119

    Article  Google Scholar 

  25. Spear LP (2000) The adolescent brain and age-related behavioral manifestations. Neurosci Biobehav Rev 24(4):417–463

    Article  PubMed  CAS  Google Scholar 

  26. Lane RD, Reiman EM, Axelrod B, Yun L-S, Holmes A, Schwartz GE (1998) Neural correlates of levels of emotional awareness: evidence of an interaction between emotion and attention in the anterior cingulate cortex. J Cogn Neurosci 10(4):525–535

    Article  PubMed  CAS  Google Scholar 

  27. Craig A (2003) Interoception: the sense of the physiological condition of the body. Curr Opin Neurobiol 13(4):500–505

    Article  PubMed  CAS  Google Scholar 

  28. Critchley HD (2005) Neural mechanisms of autonomic, affective, and cognitive integration. J Comp Neurol 493(1):154–166

    Article  PubMed  Google Scholar 

  29. Damasio AR (1994) Descartes’ error and the future of human life. Sci Am 271(4):144

    Article  PubMed  CAS  Google Scholar 

  30. Morris AS, Silk JS, Steinberg L, Myers SS, Robinson LR (2007) The role of the family context in the development of emotion regulation. Soc Dev 16(2):361–388

    Article  PubMed  PubMed Central  Google Scholar 

  31. Quinn MM, Kavale KA, Mathur SR, Rutherford RB Jr, Forness SR (1999) A meta-analysis of social skill interventions for students with emotional or behavioral disorders. J Emot Behav Disord 7(1):54–64

    Article  Google Scholar 

  32. Eastabrook JM, Flynn JJ, Hollenstein T (2014) Internalizing symptoms in female adolescents: associations with emotional awareness and emotion regulation. J Child Fam Stud 23(3):487–496

    Article  Google Scholar 

  33. Sendzik L, Schäfer JÖ, Samson AC, Naumann E, Tuschen-Caffier B (2017) Emotional awareness in depressive and anxiety symptoms in youth: a meta-analytic review. J Youth Adolesc 46(4):687–700

    Article  PubMed  Google Scholar 

  34. Rieffe C, De Rooij M (2012) The longitudinal relationship between emotion awareness and internalising symptoms during late childhood. Eur Child Adolesc Psychiatry 21(6):349–356

    Article  PubMed  PubMed Central  Google Scholar 

  35. Herbert BM, Herbert C, Pollatos O (2011) On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness? J Pers 79(5):1149–1175

    Article  PubMed  Google Scholar 

  36. Foran HM, O’Leary KD (2013) The role of relationships in understanding the alexithymia–depression link. Eur J Pers 27(5):470–480

    Google Scholar 

  37. Desrosiers A, Klemanski DH, Nolen-Hoeksema S (2013) Mapping mindfulness facets onto dimensions of anxiety and depression. Behav Ther 44(3):373–384

    Article  PubMed  PubMed Central  Google Scholar 

  38. Raes F, Griffith JW, Van der Gucht K, Williams JMG (2014) School-based prevention and reduction of depression in adolescents: a cluster-randomized controlled trial of a mindfulness group program. Mindfulness 5(5):477–486

    Article  Google Scholar 

  39. Kranzler A, Young JF, Hankin BL, Abela JR, Elias MJ, Selby EA (2016) Emotional awareness: a transdiagnostic predictor of depression and anxiety for children and adolescents. J Clin Child Adolesc Psychol 45(3):262–269

    Article  PubMed  Google Scholar 

  40. Honkalampi K, Tolmunen T, Hintikka J, Rissanen M-L, Kylmä J, Laukkanen E (2009) The prevalence of alexithymia and its relationship with Youth Self-Report problem scales among Finnish adolescents. Compr Psychiatry 50(3):263–268

    Article  PubMed  Google Scholar 

  41. Gottman JM, Katz LF, Hooven C (1997) Meta-emotion: how families communicate emotionally. Psychology Press, London

    Google Scholar 

  42. Koole SL (2010) The psychology of emotion regulation: an integrative review. Cognition and emotion. Psychology Press, London, pp 138–177

    Google Scholar 

  43. Gross JJ (1999) Emotion regulation: past, present, future. Cogn Emot 13(5):551–573

    Article  Google Scholar 

  44. Cracco E, Van Durme K, Braet C (2015) Validation of the FEEL-KJ: an instrument to measure emotion regulation strategies in children and adolescents. PLoS One 10(9):e0137080

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  45. Schäfer JÖ, Naumann E, Holmes EA, Tuschen-Caffier B, Samson AC (2017) Emotion regulation strategies in depressive and anxiety symptoms in youth: a meta-analytic review. J Youth Adolesc 46(2):261–276

    Article  PubMed  Google Scholar 

  46. Aldao A, Nolen-Hoeksema S, Schweizer S (2010) Emotion-regulation strategies across psychopathology: a meta-analytic review. Clin Psychol Rev 30(2):217–237

    Article  PubMed  Google Scholar 

  47. Compare A, Zarbo C, Shonin E, Van Gordon W, Marconi C (2014) Emotional regulation and depression: a potential mediator between heart and mind. Cardiovasc Psychiatry Neurol. https://doi.org/10.1155/2014/324374

    Article  PubMed  PubMed Central  Google Scholar 

  48. Cracco E, Goossens L, Braet C (2017) Emotion regulation across childhood and adolescence: evidence for a maladaptive shift in adolescence. Eur Child Adolesc Psychiatry 26:1–13

    Article  Google Scholar 

  49. Zimmermann P, Iwanski A (2014) Emotion regulation from early adolescence to emerging adulthood and middle adulthood: age differences, gender differences, and emotion-specific developmental variations. Int J Behav Dev 38(2):182–194

    Article  Google Scholar 

  50. Izard CE, Woodburn EM, Finlon KJ, Krauthamer-Ewing ES, Grossman SR, Seidenfeld A (2011) Emotion knowledge, emotion utilization, and emotion regulation. Emot Rev 3(1):44–52

    Article  Google Scholar 

  51. Mayer JD, Salovey P, Caruso DR, Sitarenios G (2001) Emotional intelligence as a standard intelligence. Emotion 3:232

    Article  Google Scholar 

  52. Vine V, Aldao A (2014) Impaired emotional clarity and psychopathology: a transdiagnostic deficit with symptom-specific pathways through emotion regulation. J Soc Clin Psychol 33(4):319–342

    Article  Google Scholar 

  53. Boden MT, Thompson RJ (2015) Facets of emotional awareness and associations with emotion regulation and depression. Emotion 15(3):399

    Article  PubMed  Google Scholar 

  54. Aldao A, Nolen-Hoeksema S (2012) When are adaptive strategies most predictive of psychopathology? J Abnorm Psychol 121(1):276

    Article  PubMed  Google Scholar 

  55. Brans K, Koval P, Verduyn P, Lim YL, Kuppens P (2013) The regulation of negative and positive affect in daily life. Emotion 13(5):926

    Article  PubMed  Google Scholar 

  56. Yap MB, Allen NB, Sheeber L (2007) Using an emotion regulation framework to understand the role of temperament and family processes in risk for adolescent depressive disorders. Clin Child Fam Psychol Rev 10(2):180–196

    Article  PubMed  Google Scholar 

  57. Hollingshead AB (1975) Four factor index of social status. Yale University, New Haven

    Google Scholar 

  58. Van Beveren M-L, Mezulis A, Wante L, Braet C (2016) Joint contributions of negative emotionality, positive emotionality, and effortful control on depressive symptoms in youth. J Clin Child Adolesc Psychol. https://doi.org/10.1080/15374416.2016.1233499

    Article  PubMed  Google Scholar 

  59. Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 26(1):41–54

    Article  Google Scholar 

  60. Neumann A, van Lier PA, Gratz KL, Koot HM (2010) Multidimensional assessment of emotion regulation difficulties in adolescents using the difficulties in emotion regulation scale. Assessment 17(1):138–149

    Article  PubMed  Google Scholar 

  61. Grob A, Smolenski C (2005) Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen (FEEL-KJ). Verlag Hans Huber, Bern

    Google Scholar 

  62. Braet C, Cracco E, Theuwis L, Grob A, Smolenski C (2013) FEEL-KJ: vragenlijst over emotieregulatie bij kinderen en jongeren. Hogrefe, Amsterdam

    Google Scholar 

  63. Braet C, Theuwis L, Van Durme K, Vandewalle J, Vandevivere E, Wante L, Moens E, Verbeken S, Goossens L (2014) Emotion regulation in children with emotional problems. Cogn Ther Res 38(5):493–504

    Article  Google Scholar 

  64. Schmitt K, Gold A, Rauch W (2012) Deficient adaptive regulation of emotion in children with ADHD. Zeitschrift fur Kinder-und Jugendpsychiatrie und Psychotherapie 40(2):95–102 (quiz 102-103)

    Article  PubMed  Google Scholar 

  65. Kovacs M (1992) Children’s depression inventory: manual. Multi-Health Systems, Toronto

    Google Scholar 

  66. Timbremont B, Braet C (2002) Children’s depression inventory, Nederlandstalige versie (Children’s Depression Inventory, Dutch version)

  67. Craighead WE, Smucker MR, Craighead LW, Ilardi SS (1998) Factor analysis of the Children’s Depression Inventory in a community sample. Psychol Assess 10(2):156

    Article  Google Scholar 

  68. Little RJ (1988) A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc 83(404):1198–1202

    Article  Google Scholar 

  69. Bollen KA (2014) Structural equations with latent variables. Wiley, New York

    Google Scholar 

  70. Schafer JL (1997) Analysis of incomplete multivariate data. CRC Press, Boca Raton

    Book  Google Scholar 

  71. Muthén L, Muthén B (2012) Mplus statistical modeling software: release 7.0. Muthén & Muthén, Los Angeles

    Google Scholar 

  72. Hyde JS, Mezulis AH, Abramson LY (2008) The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev 115(2):291

    Article  PubMed  Google Scholar 

  73. Mankus AM, Boden MT, Thompson RJ (2016) Sources of variation in emotional awareness: age, gender, and socioeconomic status. Pers Individ Differ 89:28–33

    Article  Google Scholar 

  74. Thayer JF, Rossy LA, Ruiz-Padial E, Johnsen BH (2003) Gender differences in the relationship between emotional regulation and depressive symptoms. Cogn Ther Res 27(3):349–364

    Article  Google Scholar 

  75. Marsh HW, Hau K-T, Wen Z (2004) In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Struct Equ Model 11(3):320–341

    Article  Google Scholar 

  76. Hayes AF (2009) Beyond Baron and Kenny: statistical mediation analysis in the new millennium. Commun Monogr 76(4):408–420

    Article  Google Scholar 

  77. Shrout PE, Bolger N (2002) Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods 7(4):422–445

    Article  PubMed  Google Scholar 

  78. Chen J, Xu T, Jing J, Chan RC (2011) Alexithymia and emotional regulation: a cluster analytical approach. BMC Psychiatry 11(1):33

    Article  PubMed  PubMed Central  Google Scholar 

  79. Swart M, Kortekaas R, Aleman A (2009) Dealing with feelings: characterization of trait alexithymia on emotion regulation strategies and cognitive-emotional processing. PLoS One 4(6):e5751

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  80. Papageorgiou C, Wells A (1999) Process and meta-cognitive dimensions of depressive and anxious thoughts and relationships with emotional intensity. Clin Psychol Psychother 6(2):156–162

    Article  Google Scholar 

  81. Nolen-Hoeksema S, Girgus JS (1994) The emergence of gender differences in depression during adolescence. Psychol Bull 115(3):424

    Article  PubMed  CAS  Google Scholar 

  82. Kashdan TB, Barrios V, Forsyth JP, Steger MF (2006) Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies. Behav Res Ther 44(9):1301–1320

    Article  PubMed  Google Scholar 

  83. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci 3(5):400–424

    Article  PubMed  Google Scholar 

  84. Joormann J, D’Avanzato C (2010) Emotion regulation in depression: examining the role of cognitive processes: Cognition and Emotion Lecture at the 2009 ISRE Meeting. Cogn Emot 24(6):913–939

    Article  Google Scholar 

  85. Salbach-Andrae H, Klinkowski N, Lenz K, Lehmkuhl U (2009) Agreement between youth-reported and parent-reported psychopathology in a referred sample. Eur Child Adolesc Psychiatry 18(3):136–143

    Article  PubMed  Google Scholar 

  86. De Witte NA, Sütterlin S, Braet C, Mueller SC (2016) Getting to the heart of emotion regulation in youth: the role of interoceptive sensitivity, heart rate variability, and parental psychopathology. PLoS One 11(10):e0164615

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  87. Kappes C, Bermeitinger C (2016) The emotional Stroop as an emotion regulation task. Exp Aging Res 42(2):161–194

    Article  PubMed  Google Scholar 

  88. Mayer JD, Salovey P, Caruso DR (2002) Mayer–Salovey–Caruso emotional intelligence test: MSCEIT. Item booklet. MHS, Toronto

    Google Scholar 

  89. Yap MB, Allen NB, O’Shea M, Di Parsia P, Simmons JG, Sheeber L (2011) Early adolescents’ temperament, emotion regulation during mother–child interactions, and depressive symptomatology. Dev Psychopathol 23(1):267–282

    Article  PubMed  Google Scholar 

  90. Butler EA, Wilhelm FH, Gross JJ (2006) Respiratory sinus arrhythmia, emotion, and emotion regulation during social interaction. Psychophysiology 43(6):612–622

    Article  PubMed  Google Scholar 

  91. Axelson DA, Birmaher B (2001) Relation between anxiety and depressive disorders in childhood and adolescence. Depression Anxiety 14(2):67–78

    Article  PubMed  CAS  Google Scholar 

  92. Carthy T, Horesh N, Apter A, Gross JJ (2010) Patterns of emotional reactivity and regulation in children with anxiety disorders. J Psychopathol Behav Assess 32(1):23–36

    Article  Google Scholar 

  93. Garber J, Braafladt N, Weiss B (1995) Affect regulation in depressed and nondepressed children and young adolescents. Dev Psychopathol 7(1):93–115

    Article  Google Scholar 

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Correspondence to Marie-Lotte Van Beveren.

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Prof. Dr. Caroline Braet made an authorized version of the translated Children’s Depression Inventory (CDI) in 2002 and the FEEL-kj in 2013. She receives royalties on the sale of these instruments.

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Van Beveren, ML., Goossens, L., Volkaert, B. et al. How do I feel right now? Emotional awareness, emotion regulation, and depressive symptoms in youth. Eur Child Adolesc Psychiatry 28, 389–398 (2019). https://doi.org/10.1007/s00787-018-1203-3

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