Emotion regulation difficulties in traumatized youth: a meta-analysis and conceptual review.

This article provides a quantitative and conceptual review of emotion regulation difficulties in trauma-exposed young people, and informs future directions in the field. Despite long-standing interest in the influence of emotion regulation difficulties on different internalizing and externalizing psychiatric disorders in childhood, several questions remain unresolved with respect to children and adolescents with PTSD (post-traumatic stress disorder). Meta-analytic data from adult victims suggest that emotion regulation problems are associated with PTSD, but this has never been studied in children and young people. We therefore provide a conceptual review of features related to the phenomenology, assessment, severity and treatment of emotion regulation difficulties in trauma-exposed children and young people. We combine this with a meta-analysis of published literature. We searched studies in Medline, PsychINFO, and Embase databases based on pre-selected criteria. Eight hundred and eighty-six papers were identified and 41 were included. We found that children and adolescents with a diagnosis of PTSD reported more emotion regulation difficulties than those who did not develop PTSD, and that the overall association between the two symptom dimensions was moderately strong. We identify a number of research priorities: the development of instruments to assess emotion regulation difficulties in children, the design of studies that describe its prevalence in young epidemiological traumatized samples, its predictive role in the onset, severity and persistence of post-traumatic symptoms, and its relevance as a moderator, outcome or treatment target for young survivors.

Consistency in diagnoses for a sample of adolescents at a private psychiatric hospital.

The consistency of psychiatric, psychological, and discharge diagnoses for a sample of 97 adolescent inpatients at a private psychiatric and substance abuse hospital in the Mid-South was investigated. Percentage agreement between the initial evaluations, psychological evaluations, and the exit evaluations ranged from 61.7% to 81.6%. Agreement, however, varied by diagnosis. The findings revealed relatively strong interrater agreement from the psychiatric diagnosis to the discharge evaluation for depression, but interrater agreement for the nondepression diagnoses was highly inconsistent. Assessment specialists and persons who work with at-risk adolescents are encouraged to evaluate carefully the consistency of diagnostic decisions on adolescents with whom they work.