Emotion Regulation Mediates the Link Between Exposure to Childhood Adversity and Transdiagnostic Symptom Domains in Youth

Objective: Emotion dysregulation is recognized as a transdiagnostic feature common to child psychopathology. This study examined the unique association between emotion regulation difficulties and specific strategies (suppression, reappraisal) with transdiagnostic symptom domains of attention, externalizing, and internalizing problems in youth. This study also tested for the mediating role of emotion regulation between domains of childhood adversity (family conflict and negative life events) and transdiagnostic symptoms. Method: In a sample of 9,057 children aged 12 to 13 years in the Adolescent Brain Cognitive Development℠ (ABCD) Study (47.21% female), linear mixed-effects models were used to examine the association between emotion regulation difficulties and specific regulation strategies with transdiagnostic symptoms. Follow-up analyses tested replication of findings retrospectively and prospectively. Structural equation modeling was used to test whether emotion regulation mediated the association between childhood adversity (family conflict, negative life events) and symptom severity. The Child Behavior Checklist was used as a continuous measure of symptom severity. Results: Greater severity of emotion dysregulation was associated with severity of each transdiagnostic symptom domain, and these associations were replicated both retrospectively and prospectively. Sex-specific longitudinal patterns emerged for attention and externalizing problems. Emotion regulation difficulties mediated the association between childhood adversity (family conflict, negative life events) and all symptom domains, with strategy-specific patterns emerging only for internalizing problems. Conclusion: These findings have implications for developing targeted interventions to address broad emotion dysregulation as an underlying mechanism of child psychopathology linked to exposure to childhood adversity.