Cognitive emotion regulation, depression and anxiety in urban and rural adolescents

Abstract

As many as 14% of teenagers suffer from anxiety and depression. Stress, early onset of puberty, gender, as well as living in rural area's all contribute to these mental health problems. Allthough many children cope very well with these challenges, others find this more difficult. To understand this difference, a lot of research to date has focussed on how young people manage the challenges themselves, but to a much lesser extent research has focused on how adolescents regulate the emotions that are triggered by these challenges. This is surprising, because the inability to manage a range of emotions, such as sadness, anxiety and anger lies at the heart of many mental health problems. The ability to manage emotions has been termed emotion regulation. Unfortunately as this thesis reports, emotion regulation research to date, both in adults, but particularly in adolescents, is characterized by a number of conceptual problems, including unclear definitions of emotion regulation, a lack of differentiation between emotion regulation and related constructs and an over-reliance on the simplistic hedonistic assumption in relation to the motivation behind emotion regulation. This thesis discusses how these conceptual problems have led to a number of methodological problems, particularly in relation to the methods through which emotion regulation has been measured. In fact, this thesis argues that to date there is no technique that comprehensively maps out a clearly defined process of cognitive emotion regulation in teenagers in a standardized, yet naturalistic context, which is representative of their day-to-day lives. This research reports on the development of a new measure and stimulus, which triggers certain emotions in teenagers, and which subsequently follows the process of perceiving and labelling those emotions, interpreting the emotions, and finally regulating those emotions. This technique has been used with 295 young people from secondary schools in urban and rural Australia. In addition, levels of depression and anxiety, as well as the above mentioned variables (stress, socio-economic factors, onset of puberty) have been investigated. Through four studies, analysis of these data, elucidates the different paths teenagers take in relation to managing their feelings. A major new finding is that how teenagers feel about their feelings matters, in terms of risk of depression and anxiety, maybe more so then what they then do with those feelings. To be more specific it was found that those children who reported both greater emotional reactivity (reacting intensely and paying a lot of attention to those feelings) as well as greater emotional discomfort (reporting fear of those feelings and a sense of lack of control over those feelings) also appear to be at greater risk of depression and anxiety. In addition the thesis found that emotional reactivity and emotional discomfort playa central role in the relationship between the above-mentioned risk factors and depression and anxiety in adolescents. These and other findings point to the importance of educating children about the nature of emotions, the usefulness of emotions and the ways in which emotions can be tolerated at the very least and often managed, without being fearful of them and without feeling out of control. Thus, the findings of this thesis support the current developments in the clinical psychological treatment arena of the "third-wave" cognitive behavioural therapies (such as Acceptance and Commitment Therapy, Dialectical Behaviour Therapy and Mindfulness based Cognitive Therapy). Finally limitations of this research and directions for future research are discussed. Show more