A Multi-Method Investigation of Parental Responses to Youth Emotion: Prospective Effects on Emotion Dysregulation and Reactive Aggression in Daily Life.

Parental responses to negative emotion, one key component of emotion socialization, may function to increase (or decrease) reactive aggression over time via indirect effects on emotion dysregulation. However, despite its transdiagnostic relevance, very little research has examined this developmental risk pathway, and no studies have done so during the volatile and vulnerable transition to adolescence. The current study uses a sample of clinically referred youth (N = 162; mean age = 12.03 years; 47% female) and their parents to examine supportive and non-supportive parental responses to negative emotion using a multi-method (questionnaire, ecological momentary assessment [EMA], observation), multi-informant approach (child-, parent-, clinician-rated). Emotion dysregulation and reactive aggression were assessed via child report during a 4-day EMA protocol completed concurrently and 9 months later. Multivariate structural equation modeling was used to examine direct and indirect paths from parental responses to emotion to daily reports of emotion dysregulation and reactive aggression. Consistent with hypotheses, parental responses to emotion predicted reactive aggression via effects on emotion dysregulation. This indirect effect was present for supportive and non-supportive parental responses to emotion, such that supportive parental responses decreased risk, and non-supportive responses increased risk. Moreover, findings indicated differential prediction by informant, and this was specific to supportive parental responses to emotion, whereby child-reported support was protective, while parent-reported support, unexpectedly, had the opposite effect. The clinical significance of integrating supportive and non-supportive parental responses to negative emotion into etiological and intervention models of reactive aggression is discussed.

Attachment, mentalizing, and eating disorder symptoms in adolescent psychiatric inpatients and healthy controls: a test of a mediational model.

OBJECTIVE: Research has supported a link between insecure attachment and eating disorders (EDs) in adolescents; however, mechanisms accounting for this association remain unclear. Growing evidence suggests impaired mentalizing as a potential mechanism. Yet, little is known about the relationship between mentalizing and ED symptoms or how it relates to the link between attachment and EDs in adolescents. This study examined mentalizing deficits in adolescents with ED symptoms relative to psychiatric and healthy controls and tested a mediational model, wherein mentalizing capacity mediates the relationship between attachment and ED symptoms. METHOD: Inpatient adolescents with EDs and other pathology (n = 568) and healthy controls (n = 184) were administered the child attachment interview, the movie for the assessment of social cognition and the diagnostic interview schedule for children to assess attachment, mentalizing and ED symptoms, respectively. RESULTS: Inpatients showed lower attachment security and more hypermentalizing than healthy adolescents. Hypermentalizing explained the association between insecure attachment and ED symptoms. CONCLUSIONS: These findings suggest potential utility of targeting mentalizing in prevention and treatment of EDs in adolescents. LEVEL OF EVIDENCE: Level III, case-control analytic study.