ORI GIN AL ARTICLE

Emotion Regulation and Depressive Symptomsin Preadolescence

Shannon Siener • Kathryn A. Kerns

� Springer Science+Business Media, LLC 2011

Abstract This study examined associations among several measures of emotion regu-

lation, and their links to depressive symptoms, in a sample of children ages 10–12 years

old (N = 87). Both temporal features of emotion regulation and regulation processes

involved in the evaluation, monitoring, and modification of emotion were assessed through

parent and child report and behavioral observation. Children also completed a self-report

measure of depressive symptoms. Children with more depressive symptoms were reported

by mothers and rated by observers as having higher levels of negative affect intensity.

Regarding emotion regulation processes, children with more depressive symptoms reported

more biased interpretations of emotionally charged situations, less awareness of their

emotions, and their mothers reported that they utilized less problem-focused coping and

positive reframing when coping with upsetting events. Findings suggest that children with

depressive symptoms experience a wide range of difficulties with emotion regulation.

Keywords Emotion regulation � Depressive symptoms � Preadolescence �Behavioral observation

Childhood depressive symptomatology has received more attention in recent years. It is

now widely recognized that depressive disorders and symptoms occur during childhood

[1]. Although a diagnosed depressive disorder is rare [2, 3], experiencing depressive

symptoms is more common as approximately 10–15% of prepubescent children experience

moderate to severe depressive symptomatology [4]. Moreover, Hankin et al. [5] found that

depression in children is a dimensional rather than a categorical construct. Hence, the

experience of depressive symptoms would fall along a continuum with depressive disor-

ders, which makes symptomatology important to study further.

Depression in childhood increases the risk of experiencing episodes of depression in

adulthood. Further, depression in childhood and adolescence is associated with many

negative outcomes such as academic problems, high-risk sexual behavior, and impaired

S. Siener (&) � K. A. KernsDepartment of Psychology, Kent State University, Kent Hall, Kent, OH 44242, USAe-mail: ssiener@kent.edu

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Child Psychiatry Hum DevDOI 10.1007/s10578-011-0274-x

social relationships [6]. Due to these associated risks, it is important to study the causes and

correlates of depression and depressive symptoms in children and adolescents. Etiological

models of the development of childhood depression have to date commonly focused on

cognitive [7], genetic [8], and familial factors [9]. In addition, gender differences in

depression begin to emerge around 12 or 13 years of age as girls begin experiencing more

depressive symptoms and clinical depression than do boys [10], and by age 15, females are

twice as likely to be depressed as males [1]. More recently, difficulties in emotion regulation

have gained interest as a possible vulnerability factor for psychopathology, and empirical

evidence has emerged which links emotion regulation to depression [e.g., 11, 12]. The main

goal of this study was to extend our understanding of the relations between emotion reg-

ulation and depressive symptoms in later middle childhood. Emotion regulation is a broad

construct, and we assessed both affect intensity and process-oriented aspects of emotion

regulation, including aspects not yet studied in relation to depression. A secondary goal of

this study was to examine associations among the measures of emotion regulation.

Many different definitions of emotion regulation have been proposed. Shields and

Cicchetti [13] characterized emotion regulation as efforts to regulate emotion with the goal

of modifying arousal to achieve optimal engagement with the environment. Further, they

proposed that temporal features of emotion such as lability and flexibility reflect emotion

regulation processes. Other definitions of emotion regulation concentrate more on the

mechanisms and processes involved in regulating one’s emotions. Gross [14] defines

emotion regulation as processes that influence which emotions individuals experience, as

well as when and how they express their emotions. Gross notes that both positive and

negative emotions can be regulated, and regulation can occur without conscious awareness.

Thompson [15] suggested that emotion regulation processes include both extrinsic and

intrinsic processes that aid in monitoring, evaluating, and modifying emotional responses

in order to achieve one’s goals. This includes regulating emotional arousal through

enhancement and maintenance as well as the inhibition of emotional arousal. While many

conceptualizations of emotion regulation have been utilized, all of the definitions of

emotion regulation emphasize that the ability to successfully coordinate one’s emotions

with the varying stresses of the environment is essential to adaptive functioning [12]. This

paper’s assessment of emotion regulation was broad, to capture affect intensity as well as

several processes involved in the regulation of emotion. Further, we used Thompson’s [15]

definition of emotion regulation to guide our selection of regulation processes.

Durbin and Shafir [12] proposed that children who typically experience more intense

and frequent emotions are more prone to experiencing symptoms of depression. Consistent

with this hypothesis, the experience of internalizing symptoms has been linked to temporal

features of children’s emotion regulation including the frequency, duration, intensity, and

recovery of expressed emotions. Specifically, children in fourth and fifth grade with

internalizing symptoms have been found to have a higher level of fear affect intensity [16].

Another study found that children 5–8 years old with internalizing symptoms are more

likely to express their anger and sadness in ways that are excessive and not constructive

[17]. Specific to depression, depressive symptoms in early to mid adolescence were linked

to experiencing greater lability and intensity of sadness, anger, and anxiety [18]. Addi-

tionally, Larson et al. [19] also found that adolescents who reported greater emotional

intensity and lability reported increased depressive symptoms.

Internalizing symptoms may also be related to processes involved in regulating emo-

tions, including how children evaluate, monitor, and modify emotions. When evaluating

emotions, more depressed children may process emotional events in a biased way. For

example, depressed children ages eight to sixteen have difficulties inhibiting the processing

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of negative emotional information in order to concentrate on another task [20]. Another

way in which children may engage in biased evaluations is through making cognitive

errors. Based on Beck’s [21] model of depression, Leitenberg [22] proposed four common

errors (i.e., overgeneralization, catastrophizing, personalization, and selective abstraction)

in the thinking of depressed children. For example, overgeneralization occurs when an

individual assumes that an outcome in one situation will always occur in responses to that

situation and similar situations in the future. Increased cognitive errors have been linked to

both depressive symptomatology and clinical depression in middle childhood [22–25].

Further, cognitive errors explain unique variability in depressive symptomatology above

and beyond both the perceived and actual competence of the child [23]. Consistent with

this research, adolescents who report increased depressive symptoms are also less likely to

engage in cognitive reappraisal (i.e., changing the way one thinks about a situation to alter

its emotional effect) [27].

Another aspect of emotion regulation that may be related to depressive symptoms is the

monitoring of one’s emotions. Monitoring one’s emotional states includes having an

awareness and clarity of one’s emotions [15] as well as the ability to understand the source

of one’s emotions. Individuals who struggle to identify their emotions may consequently

experience difficulties in the coherent regulation and expression of these emotions, which

may also affect their susceptibility to developing depression [27]. For example, children

who successfully monitor their emotions may be more able to consider strategies which

allow the individual to better cope with the emotion-evoking situation [28]. Poor moni-

toring of one’s emotions has been found to be related to increased internalizing symptoms,

and specifically, depressive symptomatology [26, 29]. Additionally, Ciarrochi et al. [30]

found that poor ability to identify one’s emotions was associated with increased negative

affect in adolescents (ages 13–16).

Emotion regulation also refers to processes that can modify emotion, such as coping

strategies [15]. Children who are not able to effectively modify their negative emotions

may be more at risk for experiencing depressive symptoms. Coping refers to the efforts

made by children to regulate responses which may arise due to stressful events, including

their emotions, cognitions, and behavioral and physiological responses [31]. Coping has

been further delineated as engagement responses (i.e., responses targeting the cause of the

stress) versus disengagement responses (i.e., orienting away from the cause of the stress).

In a review of the literature, Compas et al. [31] found that disengagement coping strategies

have been linked to increased depressive symptoms in children and adolescents. Whereas

engagement coping has been associated with fewer symptoms of depression in children and

adolescents [11]. Thus, there is evidence that disengagement coping is associated with the

experience of more depressive symptoms in children, whereas engagement strategies have

been found to be more adaptive.

A major limitation to prior studies of emotion regulation and childhood depression is

that they have heavily relied on child self-reports to assess emotion regulation constructs.

For example, studies of affect intensity, emotional awareness, cognitive bias, and child

coping have relied almost exclusively on child questionnaires. Compas et al. [11]

emphasize the importance of utilizing multiple methods to assess emotion regulation

constructs. Thus far, there has been a limited amount of research using observational

methods to measure emotion regulation in the laboratory. In one observational study [32],

children whose mothers had a history of depression underwent a mood induction in the

laboratory while experiencing a delay of gratification task. Children who were observed to

be positively anticipating the reward during the delay (e.g., exhibiting joy, information

gathering) were less likely to experience depressive symptoms. Silk et al. [33] also

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observed emotion regulation strategies during a delay of gratification task in which they

found that children of parents with a history of depression used less active strategies for

regulating their emotion (e.g., waiting passively for the toy or cookie rather than distracting

themselves or refocusing their attention). Similarly, Garber et al. [34] found that children

of depressed parents were able to produce fewer emotion regulation strategies for hypo-

thetical emotional scenarios and their strategies were rated as being less effective by

independent observers. Thus far, much of the evidence for a link between childhood

depression and behavioral indicators of emotion regulation is indirect in that studies have

included children of depressed mothers, rather than directly assessing child depression or

depressive symptoms.

While both affect intensity and emotion regulation are associated with internalizing

symptoms, it also important to consider how the two may operate together. Affect intensity

may act as a set point for the experience of emotions. Once an emotion is experienced, the

child must engage in efforts to modify the emotion relative to the individual and situation.

If emotion regulation efforts are successful, then the intensity of the emotion may be

modified (e.g., child feels less intense negative affect). That is, it is possible that emotion

regulation abilities moderate the impact of affect intensity such that greater affect intensity

is more strongly related to depression when children are less able to effectively regulate

their emotions [12, 35, 36]. Previous research has suggested that affect intensity and

emotion regulation may interact. For example, neuroticism has been found to interact with

low effortful control to predict internalizing symptoms [37]. This raises the possibility that

depressive symptoms may be most likely to occur when an individual has both a tendency

to experience higher levels of negative emotions and difficulties in regulating emotions.

The main goal of the current study was to extend our understanding of depressive

symptomatology and emotion regulation in middle childhood. We focused on middle

childhood because this is an age by which depressive symptomatology is present in a

sizable proportion of children [38] and emotion regulation abilities become more advanced

and more related to competence [13]. We considered how both affect intensity and emotion

regulation are related to depressive symptomatology, and also explored possible interaction

effects. We measured emotion regulation using multiple methods and multiple sources.

Measuring multiple emotion regulation processes also allowed us to examine the associ-

ations among the different processes (i.e., a secondary goal of the study). We were par-

ticularly interested in whether children high on negative affect would also show difficulty

in regulating their emotions, as suggested by Durbin and Shafir [12].

Our first hypothesis was that children who report experiencing more depressive

symptoms would show greater intensity in the expression of negative emotions. We tested

this hypothesis using both observational and maternal reports to assess child affect

intensity. Our second hypothesis was that more depressed children would have difficulty

monitoring their emotions. Specifically, we expected that they would report poorer

awareness of their emotional states, and would be rated by observers as showing less

congruence between their affect and behavior. Our third hypothesis was that more

depressed children would show more biased processing of emotional events in that they

would exhibit more cognitive errors. Our fourth hypothesis was that more depressed

children would utilize more passive coping strategies such as avoidance or disengagement

from tasks rather than more active strategies such as direct attempts at problem-solving and

positive reframing. We evaluated this hypothesis by collecting mothers’ reports of child

coping as well as coding the child’s engagement in a conflict task with his or her mother.

For descriptive purposes, we looked collectively at how much variance in depression was

explained by our set of emotion regulation variables. Finally, we tested whether regulation

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processes interacted with affect intensity such that greater negative affect intensity is more

strongly related to depression when children are less able to effectively regulate their

emotions. Additionally, although gender differences in depression do not typically emerge

until early adolescence [1, 10], we conducted exploratory analyses examine potential

gender differences in our findings.

Method

Participants

Invitation letters were distributed through local schools and fliers were posted in local

clinics. The final sample included 87 children with an age range of 122–154 months (48

girls, 39 boys, mean age = 11.32 years) and their mothers. Most families were recruited

from local schools (5% of the sample was recruited from local mental health clinics).

According to mothers’ reports, 14% of children had some form of psychopathology. Two

identified their children as having a mood disorder (one Major Depressive Disorder, a

second Pediatric Bipolar Disorder), and 10 mothers indicated that their children had

another form of psychopathology (e.g. attention deficit disorder, anxiety disorders).

Approximately 67% of the children were Caucasian, 17% African American, 6% American

Indian, 1% Hispanic, and 9% mixed or biracial. While 60% of the children came from

intact homes, 33.3% came from single-parent homes, and 7% had a step-parent in the

household. The families’ SES was computed using the Hollingshead’s Four Factor Index of

Social Status [39], which has a potential score range of 8–66 (sample mean = 41.17,

SD = 12.40, range 12–66). Approximately 16% of families fell into the category of major

business and professionals, 37% were identified as medium business and professionals,

27% as skilled workers, 13% as semiskilled workers, and 3% as unskilled laborers.

Procedure

As a part of a larger study, each child came to a campus laboratory with his or her mother

for a single 2 h visit. Children and their mothers independently filled out questionnaires

assessing a variety of constructs, and were videotaped in a series of interaction tasks. The

latter included an 8 min interaction between the mother and child in which the dyad was

asked to discuss an important problem in their relationship, including why it was a

problem, their feelings about the problem, and any possible solutions. This session was

then coded using a modified coding system [40] for the child’s level of affect intensity and

the congruence and coherency of the child’s emotions. Additionally, the child’s level of

engagement with his or her mother throughout the interaction was also rated using an

adapted rating system [41]. Children were given $20 for their participation, and mothers

were given $10.

Measures

Depressive Symptoms

Children completed the Children’s Depression Inventory Short Form (CDI-S) [42] to

assess depressive symptoms in children. This measure was designed for children

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7–17 years of age. Children answered 10 items on which they rated their depression on a

scale from 0 to 2, where a higher rating indicates more severe depressive symptoms. The

CDI-S, which is based on the widely-used Children’s Depression Inventory, also has

previously demonstrated good internal consistency (e.g., a = .79–.94) [43–45]. Internal

consistency in the current sample was adequate (a = .60).

Negative Affect Intensity

The School-Age Temperament Inventory [46] was filled out by mothers to assess intensity

of negative affect. This questionnaire consists of 21 items, which are answered on a Likert

scale ranging from 1 (never) to 5 (always). The scale examining negative reactivity, which

has 12 items, was chosen as an indicator of negative affect intensity because the authors

describe the scale as depicting ‘‘the intensity and frequency with which the child expresses

negative affect’’ [47]. This scale has previously demonstrated adequate reliability and

validity properties [46, 47]. The internal consistency in the current sample was found to be

a = .92.

To augment the maternal questionnaire, an observational measure of negative affect

intensity was included. This observational measure was coded from the previously men-

tioned interaction task in which the mother and child discussed an important problem in

their relationship. A child high in negative affect intensity demonstrates a low threshold for

the arousal of negative emotions and experiences emotions more intensely. Affect intensity

was rated on a scale ranging from 1 (affectively flat) to 5 (high display of emotion). Two

coders rated nine children until agreement was reached. Inter-rater agreement was then

calculated based on an additional 24 participants. When a discrepancy larger than 1 point

was present, the two coders discussed the interaction until an agreement was reached.

Inter-rater agreement was high for this scale (intraclass correlation = .97). Davila et al.

[40] reported that this measure of affect intensity was related as theoretically expected to

attachment such that adolescents who were more securely attached exhibited less affect

intensity.

Emotion Regulation Processes: Monitoring of Emotions

Children completed the Emotion Expression Scale for Children [29], which consists of 16

items rated on a Likert scale ranging from 1 (not at all true) to 5 (extremely true). The scale

has two components, a factor which measures poor awareness of one’s emotions, and one

that measures expressive-reluctance. The scale which measures poor awareness was of

interest in the current study as it is thought to be an aspect of monitoring. This scale taps

whether children are able to identify and label their emotions. This scale has demonstrated

adequate internal consistency (a = .83) previously [29], and in the current study (a = .78).

Congruence in observed affect and behavior was coded from the mother–child conflict

discussion as a second indicator of emotional monitoring. Although a more indirect

indicator of monitoring, it was expected that children who were better able to monitor their

emotions would show more congruence and coherence between their displayed and stated

emotions during the interaction. Congruence was rated on a scale ranging from 1 (pre-

vailing inconsistencies and incoherence) to 5 (consistent, coherent and genuine). A child

high on congruence would display emotions consistent with what he or she is reporting or

describing. A child low on congruence would be displaying emotions different from those

that he or she is describing (e.g., a child may be talking about feeling angry or sad but is

laughing as he or she does so). Inter-rater agreement was high for this scale (intraclass

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correlation = .96). In a previous study, congruence and affect intensity were related as

theoretically expected to attachment security. That is, adolescent girls who were more

securely attached to their mothers exhibited more congruence and less affect intensity [40].

Emotion Regulation Processes: Evaluation of Emotions

The Children’s Negative Cognitive Error Questionnaire [22] was used to assess a child’s

interpretation of emotionally charged situations. This 24-item questionnaire assesses four

types of cognitive errors based on Beck’s [21] original cognitive theory: catastrophizing,

overgeneralization, personalizing, and selective abstraction. The child is given a hypo-

thetical situation and a statement illustrative of a distorted belief and is asked to rate, on a

5-point likert scale, how similarly he or she would interpret the situation, with higher

scores indicating more similarity. The questionnaire’s reliability and validity have been

established previously [e.g., 22, 23]. The inter-relations between the different types of

errors were relatively high (ranging from .66 to .79), and therefore the mean of all items

was taken for the current study as depressed children are more likely to engage in all four

types of cognitive distortions [22]. Internal consistency in the current sample is good

(a = .92).

Emotion Regulation Processes: Modifying Emotions

The Coping Questionnaire [48] was given to mothers to assess which strategies children

use to cope when distressed. Items were categorized into three subscales based on the most

recent manual [49]: problem-focused coping, avoidant coping, and positive reframing. The

mean of the items for each scale was computed to determine a score for the scale. Problem-

focused coping and positive reframing were included as they both represented coping

strategies in which the child actively engages in the situation. Avoidant coping was

included as it is representative of a child disengaging from the situation. These scales have

previously demonstrated adequate reliability (a = .65–.71) [49]. In the current study, the

scales demonstrated good internal consistencies: problem-focused coping (a = .93),

positive reframing (a = .84), and avoidant coping (a = .85).

To obtain a behaviorally based measure of avoidance versus engagement with problems,

the child’s engagement and involvement with his or her mother when discussing the

relationship conflict was coded. A very engaged child would show a good deal of interest

and curiosity in the task, whereas a disengaged child would not be interested in the

mother’s contributions and/or may appear distracted, bored, or withdrawn. The scale

ranged from 1 (lack of interest) to 5 (high and genuine interest). This scale has demon-

strated adequate reliability when used in a previous study [41]. Inter-rater agreement in the

current study was high for this scale (intraclass correlation = .93).

Results

Associations of Affect Intensity and Emotion Regulation

Prior to addressing our main question regarding associations between depressive symptoms

and emotion regulation, we examined associations among the affect intensity and process-

oriented measures of emotion regulation. Zero-order correlations among the emotion

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regulation variables were examined (see Table 1). The affect intensity measures of emo-

tion regulation were significantly related to each other, with children who were rated

higher by mothers on negative affect intensity also exhibiting higher levels of negative

affect intensity during the mother–child interaction task. Although neither the question-

naire measure nor the observational measure of negative affect intensity were related to

cognitive errors, children who scored higher on these constructs exhibited less congruence

between their emotions and behaviors and were less likely to utilize problem-focused

coping strategies. Furthermore, children higher on negative affect intensity used more

avoidant coping, were less likely to be engaged in the discussion of conflict with their

mothers, and were less likely to use positive reframing coping strategies. Children

who were higher on observed affect intensity also reported poorer awareness of their

emotions.

The relations among the emotion regulation processes were also examined, and 9 of 21

correlations were significant. Of these, 6 involved poor awareness of emotions or problem-

focused coping. Children who reported less awareness of their emotions exhibited less

congruence between their emotions and behavior and were less likely to engage in prob-

lem-focused coping. In addition, children who utilized problem-focused coping strategies

were less likely to make cognitive errors and exhibited more congruence between

expressed emotions and their behaviors. They also exhibited more engagement in the

discussion of conflict with their mothers and were more likely to utilize positive reframing.

Finally, children who were more engaged in the conflict discussion also exhibited more

congruence between their emotions and behavior and were more likely to engage in

positive reframing coping strategies.

Depression: Associations with Negative Affect Intensity and Emotion Regulation

Correlations of the emotion regulation variables with the measure of depressive symptoms

revealed support for some of the hypotheses. As shown in Table 2, 6 of 9 correlations were

significant (ps \ .05). These correlations ranged from .23 to .43, which according to

Cohen’s criteria [50], exhibited small to medium effect sizes.

Table 1 Correlations among the measures of affect intensity and emotion regulation

2. 3. 4. 5. 6. 7. 8. 9.

Temporal features

1. Negative affect intensity .24* .21 -.22* .19 -.45** -.45** .27* -.30**

2. Observed affect intensity .28** -.25* .01 -.27* -.20 .07 .18

Emotion regulation processes

3. Poor awareness -.28** .41** -.25* -.16 .12 -.20

4. Observed congruence -.12 .27* .16 -.15 .27*

5. Cognitive errors -.22* -.17 .09 -.19

6. Problem-focused coping .74** -.14 .23*

7. Positive reframing .10 .23*

8. Avoidance -.09

9. Observed engagement

* p \ .05, ** p \ .01

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Hypothesis 1: Negative Affect Intensity

We had hypothesized that children reporting more depressive symptoms would show

greater intensity of negative affect. This hypothesis was supported, as children experi-

encing greater depressive symptoms exhibited more intense negative emotions as reported

by their mothers as well as rated by the observers.

Hypothesis 2: Monitoring of Emotions

We had hypothesized that more depressed children would experience difficulties in

monitoring their emotions as reflected in poor awareness of emotions and less congruence

between their stated and observed affect. There was some support for this hypothesis.

Specifically, children who reported more depressive symptoms had poorer awareness of

their emotions. However, there was not a significant relationship between the observational

measure of congruence and the child’s report of depressive symptoms.

Hypothesis 3: Evaluation of Emotions

We had hypothesized that more depressed children would show more biased processing of

emotional events. Specifically, we proposed that they would make more cognitive errors in

emotionally charged situations. This hypothesis was supported as children who reported

more depressive symptoms also reported increased cognitive errors.

Hypothesis 4: Modification of Emotions

We had hypothesized that children reporting more depression would utilize less con-

structive coping strategies (i.e., they would utilize avoidance or disengagement rather than

more active strategies such as problem-solving and positive reframing). Partial support was

found for this hypothesis. Specifically, while depressive symptoms were not significantly

associated with the use of avoidant coping or observed engagement during the interaction,

Table 2 Correlations of depres-sive symptoms with emotionalityand emotion regulation

* p \ .05, ** p \ .01; thecorrelations in parentheses areafter controlling for gender

Depressive symptoms

Temporal features

Negative reactivity .23* (.22*)

Observed emotionality .40** (.30**)

Monitoring of emotions

Poor awareness .43** (.39**)

Observed congruence -.15 (-.09)

Evaluation of emotions

Cognitive errors .25* (.19)

Modification of emotions

Problem-focused coping -.33** (-.36**)

Positive reframing -.26** (-.29**)

Avoidance .09 (.17)

Observed engagement -.07 (-.12)

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children reporting more depressive symptoms were reported by their mothers as less likely

to engage in both problem-focused and positive reframing coping strategies.

Hypothesis 5: Interaction Between Affect Intensity and Emotion Regulation

It was hypothesized that greater negative affect intensity would be more strongly related to

depression when children were less able to effectively regulate their emotions. Regressions

were conducted testing interaction terms to determine if emotion regulation processes acted

as potential moderators between reported or observed negative affect intensity and depres-

sive symptoms. In a series of regression analyses, the two measures of negative affect

intensity and the seven measures of emotion regulation were entered on Step 1. Individual

interaction terms, reflecting the interaction between either reported or observed negative

affect intensity and one of the measures of emotion regulation processes, were entered on

Step 2. Thus, a total of 14 tests of significant interactions were conducted. An examination of

the F change test at Step 2 demonstrated that none of the tested interactions were significant.

Potential Gender Differences

Because gender differences do not typically emerge in depression until early adolescence [1,

10], we had not expected differences in the current sample (ages 10–12). However, we

conducted exploratory analyses to ensure that this was not an issue in the current study.

Contrary to our expectations, a one-way ANOVA revealed significant gender differences,

F (1, 85) = 15.73, p \ .01, with girls reporting more depressive symptoms (M = .24,

SD = .21) than did boys (M = .09, SD = .11). Partial correlations, controlling for gender,

were conducted to examine associations between the measures of emotion regulation and

depressive symptoms (see Table 2). These analyses demonstrated that only one of six

significant correlations was no longer significant after controlling for gender (the associa-

tion between the presence of depressive symptoms and cognitive errors was .19 rather than

.25 when controlling for gender). As a check to see whether gender moderated the links

between emotion regulation and depressive symptoms, exploratory analyses were con-

ducted examining correlations separately for boys and girls, followed by tests of whether

correlations differed in magnitude for boys and girls. Only one of nine pairs had a significant

difference. The correlation between depressive symptoms and observed negative affect

intensity was significantly higher for girls (r = .42, p \ .01) than for boys (r = .02,

p = .91), (z = 1.91, p \ .05). Given the modest sample size, and the fact that only one

significant gender difference was found, this result should be interpreted with caution.

For descriptive purposes, a multiple regression was conducted to examine how much

variance in depressive symptoms was explained by our set of emotion regulation variables.

Gender was entered on Step 1, and negative affect intensity and emotion regulation

variables were entered on Step 2. On Step 1 gender accounted for 15% of the variance in

depression, F (1, 85) = .14.87, p \ .01. The negative affect intensity and emotion regu-

lation variables explained an additional 21.5% of the variance in depression after con-

trolling for gender, F change (9, 75) = .22, p \ .01.

Discussion

This study examined negative affect intensity and several different emotion regulation

processes in relation to depressive symptoms in children. Using Thompson’s [15]

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definition of emotion regulation as a guide, we distinguished between emotion regulation

processes that are involved in the monitoring, evaluation, or modification of emotions. By

measuring multiple processes of emotion regulation, we were also able to examine the

associations among the different processes, which have not yet been extensively investi-

gated. Further, we extended the current literature on depression and emotion regulation by

utilizing multiple methods to capture emotion regulation, and gathering information from

multiple sources. Both mothers and children reported on different aspects of emotion

regulation, and observational coding provided a more objective assessment of some

aspects. We found that children who reported experiencing more depressive symptoms

were higher on affect intensity and were also more likely to experience difficulties in

adaptively monitoring, evaluating, and modifying their emotions. Results were, for the

most part, similar for boys and girls.

Children with more depressive symptoms were both reported by their mothers and rated

by observers as showing greater intensity of negative emotions. While a small number of

studies have shown that higher levels of affect intensity are linked to depression [16–18],

the current study includes an observational method of assessing affect intensity. Our

findings are consistent with the suggestion that negative affect intensity, along with

emotion regulation processes, may serve as a risk factor for depression [12]. For example,

it may be that a tendency to experience emotions intensely makes it more likely that a child

will experience depressive feelings when a stressor occurs.

Difficulties in regulating emotions may also contribute to depressive feelings [12]. We

examined processes relevant to the monitoring of emotions. We found that the question-

naire measure of poor awareness and the observational measure of congruence between

emotions and behavior were significantly related to one another. Yet, depressive symptoms

were only found to be related to awareness, not congruence. Although the correlation

between poor awareness and congruence was significant, it was not large in magnitude. It

is possible that our measure of congruence, which reflected consistency in expressed and

stated emotions, may capture multiple emotion regulation processes. For example, it may

reflect not just monitoring, but also efforts to modify or mask the expression of negative

feelings. As this measure is new, additional research is needed to clarify the meaning of

emotional congruence.

In the current study, the measure of awareness taps clarity of emotions in that it involves

the child being able to both identify and describe his or her emotional experiences [29].

This study suggests it may be that children who have difficulties with both identifying and

labeling their emotions are more prone to depression. Specifically, poor awareness of one’s

emotions may interfere with voluntarily engaging in strategies geared toward the particular

emotion being experienced. That is, if children are not able to identify their emotions, they

may not be able to choose suitable ways to modify them.

In the current study, cognitive errors in emotionally charged situations were included as

a measure of evaluating one’s emotions. As has been previously found [23, 25, 51],

children who reported making more cognitive distortions in emotionally-salient situations

were also more likely to report experiencing depressive symptoms, which is consistent

with Beck’s [21] cognitive theory of depression. Although this effect was only marginally

significant when controlling for gender, it seems that children experiencing depressive

symptoms may not be able to evaluate their emotions in a non-biased way, which may

contribute to either the development or maintenance of depression. For example, the biased

way in which they process emotional experiences may cause them to select poor emotion

regulation strategies such as remaining passive to avoid further distress rather than trying

to address the emotion or situation.

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Finally, we examined one of the emotion regulation processes involved in modifying

one’s emotions, specifically, coping strategies. Children reporting more depressive

symptoms were less likely to engage in problem-focused coping strategies or positive

reframing strategies. This is consistent with previous evidence that attempting to either

change the situation or one’s fit to the situation are associated with better psychological

adjustment in children [31]. Interestingly, children experiencing depressive symptoms

were not more likely to utilize avoidance coping or to be less engaged in discussing a

recent conflict situation. As noted earlier, the success of a coping strategy is often thought

to depend on the personal controllability of the stressor [11]. Thus, in future studies it

might be useful to have children report coping with specific stressors in situations that vary

in controllability to identify whether depressed children’s use of problem solving and

avoidant coping varies with the situation. Additionally, there is a need to further explore

other maladaptive coping strategies depressed children might use. For example, the present

study did not include a measure of rumination, which has been found to be consistently

related to depression, even in non-clinically depressed youth [52].

Because we measured both affect intensity and emotion regulation processes, we were

also able to consider whether associations between affect intensity and depression depend

on children’s emotion regulation. It has been proposed that children who are higher in affect

intensity may have a higher baseline level of emotion, and therefore an even greater need to

engage in adaptive patterns of emotion regulation [13, 35, 36]. Durbin and Shafir [12]

suggested that this interaction might serve as a risk factor for depression. We had therefore

hypothesized that negative affect intensity would be more strongly associated with the

presence of depressive symptoms when a child also exhibited poorer regulation of emotion.

The results did not support this hypothesis, as we found interactions between affect intensity

and emotion regulation did not predict depressive symptoms. It is worth noting that a larger

sample size is often needed in non-experimental research designs to find significant mod-

erator effects [53]. Therefore, the current sample size of 87 may not have been large enough

to detect the moderation. Alternatively, consistent with our findings, it may be that effective

emotion regulation processes act as a protective factor for all children, regardless of their

level of affect intensity. This would have clinical implications in that it might be beneficial

for all children to receive training in utilizing effective emotion regulation processes rather

than specifically targeting only children high on affect intensity.

A secondary goal of our study was to explore associations among the different emotion

regulation measures. Although we did not find that the interaction between intensity of

negative affect and emotion regulation processes was related to the presence of more

depressive symptoms, we did find that negative affect intensity and emotion regulation

processes were related to each other. The findings were consistent with the idea that

children who are experiencing negative emotions intensely may have more difficulty

effectively regulating their emotions [12]. Children higher on negative affect intensity had

poorer awareness of their emotions, exhibited less congruence between their affect and

behavior, utilized more avoidant coping and disengagement, and were less likely to use

problem-focused coping and positive reframing. Additionally, observed affect intensity

was also related to poorer awareness of emotions, the demonstration of less congruence

between affect and behavior, and the use of less problem-focused coping. It may be that

children with higher levels of emotion become overwhelmed and have difficulty evaluating

and selecting emotion regulation strategies which will be effective. Alternatively, they may

have difficulty executing strategies successfully because of their high levels of arousal.

A strength of this study was the inclusion of multiple emotion regulation processes,

which allowed us to examine how they were related to each other. Our study suggests that

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the different emotion regulation processes are interdependent in that poorer awareness of

emotions and less congruence in expression of emotions were related to less utilization of

problem-focused coping and making more cognitive errors. At the same time, the different

processes were (with one exception) only modestly related to one another, underscoring the

importance of including multiple measures to capture the broad construct of emotion

regulation. Although we did not measure these processes in real time, our findings suggest

that deficits in emotion monitoring may in turn influence how children evaluate and

attempt to modify their emotions. Lane and Schwartz [27] indicated that individuals who

have less awareness of their emotions may experience difficulties in the regulation and

expression of these emotions, which may act as a vulnerability for experiencing depres-

sion. Similarly, Southam-Gerow and Kendall [28] suggested that children who are not able

to identify their emotions are not able to effectively cope. It may be that the ability to

monitor one’s emotions is an important first step in regulating one’s emotions effectively.

Further research should be conducted to explore the special role that monitoring processes

may play in emotion regulation.

The present findings need to be interpreted in the context of the study’s limitations. Our

study was limited in that we measured depressive symptoms only with a child question-

naire. Beginning around 8 or 9 years of age, children are able to provide more accurate

reports of their own emotions as they possess some insight involving what internal pro-

cesses they are experiencing [54], which suggests that questionnaire measures of depres-

sion have some utility. Nevertheless, it would be beneficial to utilize a clinical interview to

provide a more objective measure of depression and diagnostic information. Obtaining

depression diagnoses would be especially important in higher risk samples where higher

rates of depressive disorders would be expected. It should be noted that in the current

study, the CDI-S demonstrated relatively low internal consistency (a = .60), which may

have attenuated some of our findings. The moderate reliability may be due to low vari-

ability in depressive symptoms found within the sample, which was primarily drawn from

local schools. Additionally, as participants self-selected to take part in the study, this may

have had some impact on the findings. While there was a range of depressive symptoms

reported by participants, the proportion of participants reporting a clinical diagnosis of

major depressive disorder was low (see p. 10), but consistent with what would be expected

in a community sample of school aged children, approximately 1% [2]. Additionally, mean

CDI-S values were consistent with previously demonstrated norms [43]. Thus, it does not

seem that participants experiencing psychopathology sought out the study in greater fre-

quency than those not experiencing psychopathology. The results may therefore generalize

well to a community sample. It is possible that testing these hypotheses in a sample that

includes a substantial number of children with clinical levels of depression would provide a

more powerful test in addition to clarifying how emotion regulation is related to clinical

depression.

It is also important to consider the specificity of these findings to depression. For

example, children who are higher on neuroticism experience greater affect intensity and

lability and are more likely to experience both depression and anxiety [37]. Additionally, it

has been found that neuroticism and effortful control (i.e., self-regulative processes)

interact to predict increased internalizing symptoms [37]. This raises some questions about

whether or not the identified emotion regulation difficulties would also be relevant to

anxiety and more broadly to internalizing symptoms. However, there is some reason to

believe that certain aspects of emotion regulation may be specific to depression or anxiety.

For example, Campbell-Sills and Barlow [55] suggest that avoidance may be manifested

differently in that anxious individuals may be more likely to regulate their emotions by

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choosing only situations in which they do not feel fear, whereas depressed individuals may

engage in avoidance through social withdrawal. Additionally, Brumariu and Kerns [56]

speculate that cognitions regarding emotion may differ in that depressed children may

focus on loss whereas anxious children focus on threat. The present study was not designed

to test these specific hypotheses. A future direction of emotion regulation research involves

investigating the specificity of associations between depression and anxiety and emotion

regulation.

Contemporary etiological models of depression in childhood have begun to incorporate

processes related to emotion [12]. For example, Cicchetti and Toth [57] included a number

of systems and pathways which might influence the development of depression. They

proposed a model which included cognitive (e.g., information processing, attributional

style), socioemotional (e.g., emotion regulation, attachment, self-esteem) representational

(e.g., self-cognitions, internal representational models), and biological domains (e.g.,

genetics, anomalies in brain structure), which are all inter-related. Difficulties with emotion

regulation would interact with biological, cognitive, and representational components to

form a depressotypic organization which might lead to the development of depression.

Brumariu and Kerns [56] posit another etiological model of depression which includes

emotion regulation processes as a core component in several different pathways to the

development of depression. Children may develop a depressogenic inference style when

experiencing attachment insecurity combined with parental rejection. Furthermore, chil-

dren who are previously inclined to have a depressogenic inferential style may become

depressed when they experience a stressor such as personal disappointment or loss because

they utilize ineffective coping strategies (e.g., passive or ruminative coping) to regulate

emotions. While our current findings offer support for these trajectories, to fully support

either of these models, several other factors would need to be included (e.g., attachment,

rejection from parents, rumination, etc.).

These hypothesized pathways are consistent with a predisposition model in which

difficulties with emotion regulation serve as a diathesis for depression [12]. An alternative

model is one in which depression occurs first, and then causes difficulties with emotion

regulation [12]. A third possibility is that reciprocal effects occur over time; for example,

difficulties in emotion regulation in early or middle childhood may predate the emergence

of depression, but once children begin to chronically experience depression, their affective

state may interfere with their ability to generate and enact constructive ways to evaluate or

modify their emotional states [58]. The present study—like most work on depression and

emotion regulation—employed a cross sectional design and thus cannot address questions

of the direction of influence. Longitudinal studies are needed to examine patterns of

influence between emotion regulation and depression over time.

The results of the current study have implications for the development of preventions

and treatments targeted for childhood depression. Addressing cognitive distortions and

teaching children constructive coping strategies such as problem-solving are currently part

of a typical protocol of treating depression in childhood [59], and thus our results lend

further support for current clinical treatments. Additionally, teaching children to be attuned

to and aware of their emotions may also help ameliorate depressed affect. The Fast Track

program is a preventive intervention for conduct problems which aims to increase both

social and emotional competence by addressing concepts such as self-control and emo-

tional awareness and understanding [60]. Given our evidence for a link between emotional

awareness and depression, this program may also be efficacious as a preventative inter-

vention for depression.

Child Psychiatry Hum Dev

123

In conclusion, this study suggests that both affect intensity and emotion regulation

processes play an important role in depressive symptoms in middle childhood. The current

study expanded the existing literature by including a clearer conceptualization of emotion

regulation and utilizing multiple methods of measuring emotion regulation including self-

report, maternal-report, and observational measures. Furthermore, examining multiple

processes of emotion regulation allowed us to examine the associations between them.

Future research should also address additional concepts related to emotion regulation and

its role in depression, such as how parents might socialize aspects of emotion regulation

(e.g., shaping, promoting awareness of emotions or encouraging specific coping strategies).

Additionally, it will be important to understand the different pathways through which

emotion regulation might lead to depression, including how emotion regulation might

interact with other influences to heighten the risk for depression.

Summary

This study aimed to extend our understanding of the relationship between emotion regu-

lation competencies and depressive symptomatology in middle childhood. Both temporal

features of emotion regulation as well as emotion regulation strategies selected based on

Thompson’s [15] definition were assessed. Maternal report, child report, and observational

measures were all utilized in a multiple method approach. Children who reported having

more depressive symptoms were reported by mothers and rated by independent observers

as having higher levels of negative affect intensity. Children with increased depressive

symptomatology also interpreted emotionally salient situations in biased ways and reported

having less awareness of their emotions. Mothers reported that when coping with dis-

tressing events, children with increased symptoms of depression used less problem-focused

coping and positive reframing. Additionally, relationships among different emotion reg-

ulation processes revealed that most were only modestly related, highlighting the impor-

tance of utilizing multiple measures to fully capture emotion regulation.

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