BackgroundEmotion regulation difficulties have been identified as an underlying mechanism in the development and maintenance of psychopathology. The need to improve our understanding of emotion regulation difficulties to accurately assess and treat adolescents in child and adolescent psychiatric settings is essential.MethodIn the first part of the study, the psychometric qualities of the Difficulties in Emotion Regulation Scale, 16-item version (DERS-16) were examined in a clinical child and adolescent psychiatric (CAP) sample. In the second part, the DERS-16 was used to examine emotion regulation difficulties in the CAP sample (N = 281, 15-19-year-olds, 77.6% female) and in a community sample of adolescents (N = 3,169, 16-19-year-olds, 55.6% female). Subgroups were further explored in the CAP sample by two-step cluster analysis with log-likelihood distance measures.ResultsDERS-16 showed satisfactory psychometric qualities in the CAP sample. DERS-16 successfully distinguished adolescents in the clinical sample from adolescents in the community sample. Results showed significantly higher levels of self-reported emotion regulation difficulties in the CAP sample and in females. The two-step cluster analysis resulted in three clusters, named Minor, Moderate and Severe emotion regulation difficulties. Adolescents with the highest levels of emotion regulation difficulties had significantly more risk behaviors such as nonsuicidal self-injury and drug use, depression and anxiety, exposure to abuse, and higher levels of comorbidity.ConclusionsDERS-16 successfully distinguished clinical from community adolescents. The results illustrate the importance of identifying adolescents with high levels of emotion regulation difficulties in child and adolescent psychiatry due to higher levels of comorbidity and risk behaviors.

Difficulties with emotion regulation have been identified as an underlying mechanism in mental health. This pilot study aimed at examining whether group skills training in emotion regulation for adolescents and parents as an add-on intervention was feasible in an outpatient child and adolescent psychiatric clinic. We also investigated if the treatment increased knowledge and awareness of emotions and their functions, increased emotion regulation skills and decreased self-reported symptoms of anxiety and depression. Six skills training groups were piloted with a total of 20 adolescents and 21 adults. The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired-samples t test was used to compare differences between before-and-after measures for adolescents and parents separately. The primary outcome measure, Difficulties in Emotion Regulation Scale, showed significant improvement after treatment for both adolescents and parents. For adolescents, measures of alexithymia were significantly reduced. Also, emotional awareness was significantly increased. Measures of depression and anxiety did not change. In conclusion, group skills training as an add-on treatment can be feasible and effective but further studies are needed.

BackgroundEmotion regulation difficulties underlie several psychiatric conditions, and treatments that focus on improving emotion regulation can have an effect on a broad range of symptoms. However, participants in-depth experiences of participating in emotion regulation treatments have not been much studied. In this qualitative study, we investigated participants experiences of a joint emotion regulation group skills training in a child and adolescent psychiatric outpatient setting.MethodsTwenty-one participants (10 adolescents and 11 parents) were interviewed about their experiences after they had participated in a seven-session transdiagnostic emotion regulation skills training for adolescents and parents. The aim of the skills training was to decrease emotion regulation difficulties, increase emotional awareness, reduce psychiatric symptoms, and enhance quality of life. The skills training consisted of psychoeducation about emotions and skills for regulating emotions. The interviews were transcribed and analysed using reflexive thematic analysis.ResultsThe analysis resulted in three overarching themes: Parent - Child processes, Individual processes, and Group processes. The result showed that participants considered an improved parent-child relationship to be the main outcome. Increased knowledge, emotion regulation skills and behavioural change were conceptualised as both mechanisms of change and outcomes. The group format, and the fact that parents and adolescents participated together, were seen as facilitators. Furthermore, the participants experienced targeting emotions in skills training as meaningful and helpful.ConclusionThe results highlight the potential benefits of providing emotion regulation skills training for adolescents and parents together in a group format to improve the parent-child relationship and enable the opportunity to learn skills.