Emotion regulation training as a treatment element for externalizing problems in adolescence: A randomized controlled micro-trial

Lysanne W Te Brinke; Ankie T A Menting; Hilde D Schuiringa; Maja Deković; John R Weisz; Bram O de Castro

doi:10.1016/j.brat.2021.103889

Emotion regulation training as a treatment element for externalizing problems in adolescence: A randomized controlled micro-trial

Behav Res Ther. 2021 Aug:143:103889. doi: 10.1016/j.brat.2021.103889. Epub 2021 May 26.

Authors

Lysanne W Te Brinke¹, Ankie T A Menting², Hilde D Schuiringa³, Maja Deković⁴, John R Weisz⁵, Bram O de Castro⁶

Affiliations

¹ Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands. Electronic address: L.W.teBrinke@uu.nl.
² Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands. Electronic address: A.T.A.Menting@uu.nl.
³ Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands. Electronic address: H.D.Schuiringa@uu.nl.
⁴ Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands. Electronic address: M.Dekovic@uu.nl.
⁵ Department of Psychology, Harvard University, 33 Kirkland Street Cambridge, MA, 02138, United States. Electronic address: John_Weisz@harvard.edu.
⁶ Department of Developmental Psychology, Utrecht University, 80125, 3508, TC, Utrecht, the Netherlands. Electronic address: B.Castro@uu.nl.

PMID: 34111699
DOI: 10.1016/j.brat.2021.103889

Abstract

Improving interventions for externalizing problems in adolescence may require determining which treatment elements actually produce change. In this micro-trial, we tested a treatment element addressing one widely-hypothesized mechanism underlying externalizing problems: emotion regulation. We tested whether emotion regulation could be improved via training, whether adolescents who received such training would subsequently show reduced externalizing problems, and which training approach and sequence was most effective. We randomized 108 adolescents with elevated externalizing problems (71.3% boys, M_age = 13.66, SD = 1.10) to a control condition or an experimental condition teaching emotion regulation through either a cognitive or behavioral approach, in alternated sequences. Effects of the modules were assessed before and after the modules, and with weekly assessments. The results showed a positive effect of the experimental training on self-reported use of adaptive emotion regulation strategies. However, self-reported externalizing problems decreased more in the control condition than in the experimental condition. No mediation, approach (cognitive versus behavioral) or sequence (cognitive-behavioral versus behavioral-cognitive sequence) effects were found. These findings illustrate that change in a proposed mechanism may not be accompanied by change in targeted problems; this highlights the importance of testing the hypothesized impact of specific treatment elements on targeted mental health problems. TRIAL REGISTRATION: This trial was registered in the Dutch Trial Register (NTR7334, July 10th, 2018) and the study protocol was published (te Brinke, Schuiringa, Menting, Deković, & de Castro, 2018).

Keywords: Adolescence; Aggression; Cognitive behavior therapy; Emotion regulation; Externalizing behavior; Intervention elements.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Emotional Regulation*
Female
Humans
Male