Intervention impact on the perceived emotion regulation repertoire of adolescents at-risk for risky sexual behaviors.

Recent calls have been made to evaluate the range, rather than the frequency of use, of strategies within adolescents' emotion regulation repertoire. It is unknown whether an emotion regulation intervention may increase adolescents' emotion regulation repertoire. To examine the direct effect of an emotion regulation intervention on adolescents' perceived emotion regulation repertoire from baseline to immediately postintervention, when controlling for baseline problems with emotional awareness and participant sex. Seventh-grade students (N = 420) participated in a 6-week emotion regulation and sexual health promotion randomized control trial. Adolescent-report measures of emotion regulation and problems with emotional awareness were collected. On average, adolescents used one additional strategy after completing the intervention; they endorsed using four (out of eight) strategies at baseline and five strategies immediately after the intervention. Emotion regulation interventions may expand adolescents' repertoire. Future research should explore whether such expansion may guide downstream effects on psychosocial functioning and prevent health risk behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

What is the effect of personalized cognitive strategy instruction on facilitating return-to-learn for individuals experiencing prolonged concussion symptoms?

The purpose of this study was to evaluate the degree to which personalized cognitive strategy instruction (PCSI) assisted students with prolonged concussion symptoms (PCS) to achieve functional and academic-related goals. It was hypothesized that goal attainment on collaboratively developed functional goals and selected scores on the pre/post outcome measurements would improve following the delivery of PCSI. A non-concurrent multiple baseline design was utilized across three female participants ages 13-16. The weekly status tracking measurement of participant performance served as the primary measurement analysed to determine the existence of a functional relation between the addition of PCSI to psychoeducation and the achievement of participant outcome. Although visual analysis of the plotted status tracking data did not support the existence of a functional relation, all three participants met or exceeded functional goals on their goal attainment scales. A Tau-U analysis supported a small treatment effect. The positive response to the intervention from two of the three participants in addition to goal attainment for all three participants suggests PCSI has potential to mitigate cognitive challenges in adolescents with PCS. Implications for future research and methods to promote ecological measurement of intervention effects are discussed.

Using Virtual Reality to Examine the Association Between Respiratory Sinus Arrhythmia and Adolescent Substance Use.

Early substance use is associated with long-term negative health outcomes. Emotion regulation (ER) plays an important role in reducing risk, but detecting those vulnerable because of ER deficits is challenging. Respiratory sinus arrhythmia (RSA), a biomarker of ER, may be useful for early identification of substance use risk. To examine this, we enrolled 23 adolescents (Mage = 14.0; 56% minority) with and without a history of substance use and collected RSA during a neutral baseline, virtual reality challenge scene, and neutral recovery. ANOVAs indicated that adolescents who reported having used a substance were not different from non-using peers on baseline or challenge RSA but demonstrated lower RSA during recovery. This suggests that adolescents with a history of substance use exhibit slower return to baseline RSA after experiencing a challenging situation compared to non-using peers. RSA, an index of ER, may be useful in identifying adolescents at risk for early substance use.

A Pilot Study of a Tablet-Based Emotion Regulation Intervention for Early Adolescents.

OBJECTIVE: This study examined the feasibility, acceptability, and preliminary outcomes of internet-based Talking About Risk and Adolescent Choices (iTRAC), a tablet intervention designed to promote emotion regulation (ER) skills among middle schoolers as a strategy for reducing risk behaviors. METHODS: Adolescents (12-14 years) were recruited from 3 urban US schools for advisory groups (n = 15), acceptability testing (n = 11), and pilot testing (n = 85). Youth advisory boards and expert panels tailored content, resulting in an animated intervention of instructional videos, games, and activities designed to teach ER strategies to young adolescents. Eighty-five adolescents were randomized to the 4-module digital iTRAC intervention or a wait-list control group. Adolescents and 1 parent completed baseline and 3-month follow-up questionnaires examining ER attitudes and behaviors; adolescents also completed behavioral tasks related to distress tolerance. RESULTS: Among those randomized to iTRAC, 88% completed all modules. Moderate effect sizes ( d ≥ 0.36) were found from baseline to follow-up on adolescents' beliefs in the controllability of emotions, awareness of emotions, self-efficacy for managing emotions, perceived access to ER strategies, and use of ER strategies. Parent measures of adolescent regulation showed mixed results. CONCLUSION: A digital intervention to enhance ER skills for youth in early adolescence was feasible and demonstrated promising indicators of impact on emotional competence. Increasing adolescents' awareness of and access to ER strategies could reduce decisions driven by transient emotions, which in turn may reduce engagement in risk behaviors and resultant negative health outcomes. This brief tablet-based intervention has the potential to be self-administered and used to increase emotional competency.

Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: A multi-informant qualitative approach.

The U.S. Preventive Services Task Force (USPSTF) has set forth recommendations for clinicians to screen youth (6-18 years) for obesity. Those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behaviour (ie, diet, physical activity, behaviour change). However, these recommendations are primarily based upon outcomes from randomized controlled trials and the feasibility of meeting these guidelines for adolescents in a clinical setting is unknown. The present study employed a multi-informant qualitative approach with adolescents, parents, and physicians, to identify and understand multiple perspectives on the feasibility and acceptability of implementing the USPSTF guidelines. In-depth interviews with seven adolescents, seven parents, and four physicians were analysed. Generally, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs, indicating that it would be difficult for many adolescents to participate in a program that was not tailored to their needs and resources. Future research should focus on adapting clinical weight management programs to meet both USPSTF guidelines and the needs of adolescents and their families.

Web-based virtual reality to enhance behavioural skills training and weight loss in a commercial online weight management programme: The Experience Success randomized trial.

OBJECTIVE: Commercial online weight management programmes are popular and easily accessible but often lack training in empirically validated behaviour change strategies and produce suboptimal outcomes. This study evaluated the effects of a Web-based virtual reality (VR) programme for enhancing behavioural skills training and weight loss when offered as an adjunct to a commercial online weight management programme. METHODS: N = 146 adults with overweight/obesity (body mass index [BMI] 27-40 kg/m2) were randomized to 6 months of no-cost access to the Weight Watchers (WW) online platform alone or enhanced with the Experience Success (WW + ES) programme, consisting of four Web-based VR sessions for training in behavioural weight-loss skills related to the home environment, the workplace, physical activity and social situations (i.e., a party at a friend's house). Weight was measured at the research centre at baseline, 3 and 6 months. RESULTS: Both groups achieved statistically significant weight loss across the trial, with no difference in mean ± standard error (SE) weight loss between WW and WW + ES at 3 months (2.7 ± 1.1 kg vs. 4.2 ± 1.1 kg, respectively; P = .086) but greater weight loss in WW + ES at 6 months (2.6 ± 1.3 kg vs. 4.9 ± 1.3 kg, respectively; P = .042). CONCLUSIONS: This study demonstrates the potential of Web-based VR skills training to enhance outcomes of commercial online weight management programmes that are widely accessible. Compared with traditional didactic methods for online skills training, VR simulation provides opportunities to learn behavioural skills via modelling and experiment with skills in real-world situations. More research is needed to identify specific behavioural mechanisms by which ES may improve outcomes.

Preliminary Impact of an Adapted Emotion Regulation Intervention for Adolescents with Overweight and Obesity Attempting to Lose Weight.

OBJECTIVE: This study examines the acceptability, feasibility, and preliminary impact of a program (HealthTRAC) combining 2 efficacious interventions (one targeting emotion regulation [TRAC] and the other a standardized behavioral weight management intervention [SBWC]) to improve weight management outcomes among a sample of adolescents with overweight and obesity. METHOD: Adolescents with overweight or obesity (N = 38), ages 13 to 17 years, were enrolled and randomized into either the SBWC or HealthTRAC. Data were collected at baseline (before intervention), at the end of the 16-week intervention (postintervention), and 4 months after completing the intervention (4 months). Assessments included adolescent self-reports of intervention acceptability and reported emotion regulation (ER) abilities and caregiver report of adolescent ER skills. Body mass index (BMI) was used to examine the impact on adolescent weight outcomes. Analyses of covariance controlling for baseline values were used to evaluate study outcomes. RESULTS: Eighty-four percent (n = 32) of participants completed the immediate postintervention and 4-month follow-up assessments. Adolescents in both conditions reported high treatment satisfaction. Adolescents randomized to HealthTRAC demonstrated greater reductions in BMI relative to SBWC and reported greater use of emotion regulation skills. Finally, caregivers of adolescents randomized to HealthTRAC also reported greater improvements in emotion regulation abilities among their adolescents at the 4-month follow-up. CONCLUSION: Findings suggest that the HealthTRAC intervention was acceptable, feasible to deliver, and demonstrated a positive impact on BMI and emotion regulation abilities. These data suggest that ER is related to health decision-making and is relevant to most overweight/obese adolescents seeking to lose weight.

Negative childhood experiences and disordered eating in adolescents in a weight management program: The role of depressive symptoms.

OBJECTIVE: Stress negatively impacts adolescent weight status and eating behaviors. Previous research investigating this association has focused on traumatic events in childhood, but little is known about the impact of commonly experienced stressful life events and weight-related outcome. The aim of this cross-sectional study was to examine the association between negative life events and weight-related outcomes (i.e., weight status, disordered eating behaviors, insulin sensitivity) in a sample of treatment-seeking adolescents with overweight and obesity. A further aim of the study was to examine the potential mediating role of depression. METHOD: Adolescents (N = 170; M age = 14.8; 62% female) presenting to an interdisciplinary weight management program completed measures related to negative life events, disordered eating patterns, and depressive symptoms prior to initiating treatment. Weight status and insulin sensitivity (using fasting glucose and fasting insulin) were objectively measured. RESULTS: Stressful experiences during childhood were significantly related to weight status, F = 2.78, p < .05, and disordered eating, F = 5.51, p < .001, in regression analyses. Stressful life events were not related to insulin sensitivity. Depressive symptoms mediated the association between stressful experiences and disordered eating (b = 0.001, [CI = 0.0002, 0.0011]). Depressive symptoms did not mediate this association for weight status or insulin sensitivity. DISCUSSION: Findings from the present study suggest that relatively common stressful events may be associated with development of disordered eating patterns in adolescents with overweight or obesity presenting to treatment. Providers working in weight management settings should consider assessing a range of potentially stressful life events and their potential weight-related implications.

Qualitative Assessment of Emotion Regulation Strategies for Prevention of Health Risk Behaviors in Early Adolescents.

The ability to regulate emotions has been linked to a variety of adolescent health risk behaviors, including sexual risk behaviors, especially for adolescents who are experiencing mental health symptoms. However, there is limited information available on intuitive emotion regulation strategies for early adolescents with mental health symptoms to facilitate the adaptation of emotion regulation interventions for psychopathology to health risk behavior prevention. For example, interventions to prevent sexual risk behaviors in early adolescence have yet to specifically target emotion regulation. This paper describes the use of focus groups to identify emotion regulation strategies that were understood by and acceptable to early adolescents with mental health symptoms who are also more likely to engage in risky health behaviors. Qualitative data were collected through focus groups (k=5 groups) with 15 early adolescents with mental health symptoms. The most commonly generated emotion regulation strategies were leaving the situation, distraction, physical release, expressing oneself to someone, positive thinking, and considering other options. Translation of these findings for use in preventive health-risk behavior interventions (including for sexual risk) is discussed.

Evaluating the Role of Family Context Within a Randomized Adolescent HIV-Risk Prevention Trial.

Project STYLE is a multi-site 3-arm RCT comparing family-based, adolescent-only, and general health promotion interventions with 721 adolescents in mental health treatment. This study reports 12-month outcomes for family context and sexual risk behaviors, and explores the role of baseline family context in modifying treatment response. Using the full sample, there were sustained benefits for parent-reported sexual communication (d = 0.28), and adolescent-reported parental monitoring (d = 0.24), with minimal differences in risk behaviors. Latent profile analysis identified four family context classes: struggling (n = 177), authoritative (n = 183), authoritarian (n = 175), and permissive (n = 181). The authoritarian and permissive classes were also distinguished by disagreement between parent and adolescent report of family context. Classes differed in terms of baseline mental health burden and baseline sexual risk behavior. Classes showed different patterns of treatment effects, with the struggling class showing consistent benefit for both family context and sexual risk. In contrast, the authoritarian class showed a mixed response for family context and increased sexual risk.

Moving Beyond Role-Play: Evaluating the Use of Virtual Reality to Teach Emotion Regulation for the Prevention of Adolescent Risk Behavior Within a Randomized Pilot Trial.

OBJECTIVE: The purpose of the current pilot study was to evaluate the acceptability and preliminary impact of using immersive virtual reality environments (IVREs) paired with a brief emotion regulation and risk reduction intervention (ER + IVRE) relative to this same intervention content paired with role-plays (ER + RP). METHODS: Eighty-five adolescents attending middle school (grades 6th-8th; ages 12-15 years) in an urban northeast city were recruited and randomized to ER + IVRE (n = 44) or ER + RP (n = 41) and had complete data. Data examining acceptability, feasibility, sexual knowledge and attitudes, and ER were collected at baseline and 3 months after intervention completion. Analyses of covariance controlling for baseline scores were used to evaluate study outcomes. Within and between intervention effect sizes were calculated with effect sizes ≥.20 considered meaningful. RESULTS: At the 3-month follow-up assessment, several within intervention condition effect sizes were found to exceed d = 0.20 across the measured sexual attitudes and ER outcomes. Between intervention analyses found that adolescents randomized to ER + IVRE attended more intervention sessions, reported less difficulty accessing ER strategies (d = 0.46), and reported higher emotional self-efficacy (d = 0.20) at the 3-month follow-up relative to adolescents randomized to the ER + RP intervention. CONCLUSIONS: This study provides preliminary evidence that using virtual reality environments to enhance ER skill building in risk situations was acceptable, feasible to deliver, and positively impacted ER abilities.

The longitudinal impact of a family-based communication intervention on observational and self-reports of sexual communication.

Parents can play a vital role in shaping teenagers' sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent-adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent adolescent sexual communication was examined at 12-months among adolescents with mental health problems. Of the 721 parent- adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent-adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent Body-Language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11 hours of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12-months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent-adolescent sexual communication among a mental health sample.

Sexual Risk Outcomes of an Emotion Regulation Intervention for At-Risk Early Adolescents.

OBJECTIVE: With this study, we examined the efficacy of a health intervention program that was focused on emotion regulation (ER) skills in reducing sexual risk behaviors among early adolescents with suspected mental health symptoms. METHODS: Seventh grade adolescents with suspected mental health symptoms participated in a 6-week, after-school sexual risk prevention trial in which a counterbalanced, within-school design comparing an ER focused program to a time- and attention-matched comparison group was used. Adolescents completed a computer-based survey regarding their sexual behavior at 6-month intervals for 2.5 years. RESULTS: Adolescents who received ER skills training exhibited a delay in the transition to vaginal sex over 30 months compared with those in the comparison condition (adjusted hazard ratio = 0.61; 95% confidence interval [0.42 to 0.89]). They also reported fewer instances of condomless sex over the follow-up period (adjusted rate ratio = 0.36; 95% confidence interval [0.14 to 0.90]). Among those who were sexually active, those in the ER condition reported fewer instances of vaginal or anal sex (adjusted rate ratio = 0.57; 95% confidence interval [0.32 to 0.99]). CONCLUSIONS: An intervention used to teach ER skills for the context of health decision-making resulted in lower risk among young adolescents with suspected mental health symptoms by delaying the onset of vaginal sex as well as reducing penetrative acts without a condom. Incorporating emotion education into health education may have important health implications for this age group.

Relationship Between Unsupervised Time and Participation in an Emotion Regulation Intervention and Risk Outcomes.

OBJECTIVE: This study is a secondary analysis of outcomes examining risk behavior in the context of the naturalistic occurrence of parental monitoring and participation in an emotion regulation intervention over a 12-month period. METHOD: Early adolescents with mental health symptoms (N=420), ages 12-14 years, were recruited and randomized into either an Emotional Regulation (ER) or Health Promotion (HP) condition. Assessments included adolescent self-report of unsupervised time, substance use and sexual behavior at baseline, 6-months, and one year post-intervention. Analytic groups were formed by intervention condition (ER or HP) and baseline reports of unsupervised time (≤1× per week or >1× per week of unsupervised time with opposite sex peers) resulting in a total of four groups. Logistic regression and time-to-event analyses were used to test differences in substance use and delay of sexual initiation between the groups. RESULTS: Participation in the ER intervention in the presence of low unsupervised time was superior in reducing both substance use and sexual initiation than either factor alone; and either factor alone was more effective than the absence of both. CONCLUSION: Findings suggest that interventions targeting health risk behaviors, including substance use and sexual risk behavior, among early adolescents with mental health symptoms may be more effective when targeting both internal (e.g., emotional regulation) and external (e.g., unsupervised time spent with peers) protective factors. Limiting unsupervised time spent with peers through parental monitoring may serve to scaffold and reinforce early adolescent acquisition of effective emotion regulation which can be employed during emotionally arousing risk situations.

Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment.

Adolescents with mental health conditions represent a high-risk group for substance use, deliberate self-harm (DSH), and risky sexual behavior. Mental health treatment does not uniformly decrease these risks. Effective prevention efforts are needed to offset the developmental trajectory from mental health problems to these behaviors. This study tested an adjunctive cognitive-behavioral family-based alcohol, DSH, and HIV prevention program (ASH-P) for adolescents in mental healthcare. A two group randomized design was used to compare ASH-P to an assessment only control (AO-C). Participants included 81 adolescents and a parent. Assessments were completed at pre-intervention as well as 1, 6, and 12-months post-enrollment, and included measures of family-based mechanisms and high-risk behaviors. ASH-P relative to AO-C was associated with greater improvements in most family process variables (perceptions of communication and parental disapproval of alcohol use and sexual behavior) as well as less DSH and greater refusal of sex to avoid a sexually transmitted infection. It also had a moderate (but non-significant) effect on odds of binge drinking. No differences were found in suicidal ideation, alcohol use, or sexual intercourse. ASH-P showed initial promise in preventing multiple high-risk behaviors. Further testing of prevention protocols that target multiple high-risk behaviors in clinical samples is warranted.

The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors.

OBJECTIVE: Sexual activity often begins in early adolescence, and adolescents with mental health symptoms are at greater risk for sexual activity and other health risks. This study aimed to evaluate a developmentally targeted intervention designed to enhance early adolescents' emotion regulation competencies as a strategy for reducing health risk behaviors, including sexual initiation. METHOD: Adolescents 12 to 14 years old (N = 420; 53% male) with mental health symptoms participated in either an emotion regulation (ER) or health promotion (HP) intervention consisting of 12 after-school sessions. Participants completed questionnaires on laptop computers at baseline, 2-, 6-, and 12-month follow-ups. RESULTS: Time to event analyses were used to compare intervention conditions on rate of initiation to vaginal sex. Results showed that participants in the ER condition were less likely to transition into vaginal sexual activity by 1-year follow-up than were those in the HP condition (adjusted hazard ratio = 0.58, 95% confidence interval [0.36, 0.94], p = .01). However, those who were sexually active did not report differences in sexual risk behaviors (e.g., condomless sex). Participants in the ER condition were significantly less likely to report violence behaviors and showed improvement on a behavioral measure of emotion identification; however, they did not differ from HP participants on self-reports of emotional competence. CONCLUSIONS: Emotion regulation strategies can be used to delay sexual initiation among early adolescents with mental health symptoms and may have an important role in health education. (PsycINFO Database Record

Work It Out Together: Preliminary Efficacy of a Parent and Adolescent DVD and Workbook Intervention on Adolescent Sexual and Substance Use Attitudes and Parenting Behaviors.

The purpose of the current study was to test an interactive DVD and workbook specifically designed for African-American parents and adolescents (ages 13-18), based on an efficacious face-to-face intervention, to address key factors associated with risk. A total of 170 parent-adolescent dyads were enrolled and randomly assigned to receive either the "Work It Out Together" DVD or a General Health Promotion DVD (HP). Parents and adolescents completed measures of HIV knowledge, self-efficacy, and parenting behaviors. Immediately after receiving the Work It Out Together intervention, parents and adolescents demonstrated higher HIV knowledge and greater HIV prevention self-efficacy. Three months after receiving the Work It Out Together intervention, parents and adolescents reported higher levels of parental monitoring and sexually active adolescents reported higher levels of condom use self-efficacy and a lower rate of recent sex. These outcomes provide preliminary evidence that the "Work It Out Together" DVD impacted individual attitudes and protective parenting behaviors.

Commentary: Adolescent Marijuana Use and Mental Health Amidst a Changing Legal Climate.

OBJECTIVE: The purpose of this commentary was to briefly summarize the literature on the relationship between adolescent marijuana use and mental health and how policy changes surrounding marijuana decriminalization and legalization might impact this relationship. METHODS: A comprehensive literature search on adolescent marijuana use, mental health, and the impact of decriminalization and legalization was conducted. Findings are briefly summarized and discussed. RESULTS: Although there is a great deal of ambiguity regarding the causal direction of marijuana use and mental health problems, what can safely be gleaned from this body of research is that early and frequent use of marijuana during adolescence is associated with the development of more psychiatric-related problems than occasional use or nonuse. CONCLUSIONS: Until there is greater clarity in this domain, clinicians should continue to screen adolescent patients for marijuana use as well as mental health difficulties, but may need to be more thoughtful about screening among early adolescents, if in fact a shift in the age of marijuana uptake occurs amidst policy changes.

An Emotion Regulation Intervention to Reduce Risk Behaviors Among at-Risk Early Adolescents.

This study aimed to evaluate an intervention designed to enhance early adolescents' emotion regulation skill use and to decrease risk behaviors. Adolescents 12 to 14 years old (N = 420; 53 % male) with mental health symptoms were referred for participation in either an Emotion Regulation (ER) or Health Promotion (HP) intervention consisting of 12 after-school sessions. Participants completed baseline and follow-up questionnaires on laptop computers. Using a generalized analysis of covariance controlling for baseline scores, participants in the ER intervention were less likely to be sexually active and engage in other risk behaviors, such as fighting, at the conclusion of the program. Additionally, participants in the ER intervention reported greater use of emotion regulation strategies and more favorable attitudes toward abstinence. Interventions directly targeting emotion regulation may be useful in addressing health risk behaviors of adolescents with mental health symptoms.

Relationships of parental monitoring and emotion regulation with early adolescents' sexual behaviors.

OBJECTIVE: The purpose of this study was to examine the moderating influence of parental monitoring (e.g., unsupervised time with opposite sex peers) and adolescent emotional competence on sexual behaviors, among a sample of at-risk early adolescents. METHODS: This study included 376 seventh-grade adolescents (age, 12-14 years) with behavioral or emotional difficulties. Questionnaires were completed on private laptop computers and assessed adolescent Emotional Competence (including Regulation and Negativity/Lability), Unsupervised Time, and a range of Sexual Behaviors. Generalized linear models were used to evaluate the independent and combined influence of Emotional Competency and Unsupervised Time on adolescent report of Sexual Behaviors. Analyses were stratified by gender to account for the notable gender differences in the targeted moderators and outcome variables. RESULTS: Findings indicated that more unsupervised time was a risk factor for all youth but was influenced by an adolescent's ability to regulate their emotions. Specifically, for males and females, poorer Emotion Regulation was associated with having engaged in a greater variety of Sexual Behaviors. However, lower Negativity/Lability and >1× per week Unsupervised Time were associated with a higher number of sexual behaviors among females only. CONCLUSIONS: Based on the findings of this study, a lack of parental supervision seems to be particularly problematic for both male and female adolescents with poor emotion regulation abilities. It may be important to impact both emotion regulation abilities and increase parental knowledge and skills associated with effective monitoring to reduce risk-taking for these youth.