Emotion dysregulation and anxiety in children and adolescents: Gender differences

Abstract

An increasing number of studies has shown that emotion dysregulation plays a key role in relation to childhood anxiety. While gender differences are commonly associated with emotional competence, no study has yet examined whether the relation between emotion dysregulation and anxiety is the same for girls as it is for boys. The present study investigated the possibility of gender differences in the relation between emotion dysregulation and anxiety in a community sample of 544 children and adolescents (298 girls and 246 boys) in the age of 9–16 years. Anxiety was assessed using the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-R). Emotion dysregulation was measured by the Difficulties in Emotion Regulation Scale (DERS). Four results emerged from this study. In accordance with previous research, (1) girls experience more anxiety and greater difficulties regulating their negative emotions than boys, and (2) emotion dysregulation has a significant impact on anxiety. Not previously shown, (3) emotion dysregulation is more predictive of anxiety in girls than in boys, and (4) different types of emotion regulation difficulties account for anxiety in girls and boys. Participants’ age did not have an impact on anxiety scores. Findings are discussed with respect to clinical implications and future directions.

Introduction

The link between anxiety and emotion dysregulation has become increasingly apparent within the literature (e.g., Stegge & Meerum Terwogt, 2010). For example, research has shown that children with anxiety exhibit greater difficulties employing contextually effective emotion regulation strategies, as well as lower emotion regulation self-efficacy than their non-anxious counterparts (Carthy, Horesh, Apter, & Gross, 2010). Conceptualizations have been put forth, which consider anxiety disorders to be characterized by essentially emotional distress (Barlow, 1991) and an inability to elect adaptive or inhibit maladaptive responses (Thayer & Lane, 2000). In line with this, it has been proposed that emotion dysregulation may play a key role in the etiology of anxiety disorders (Cisler, Olatunji, Feldner, & Forsyth, 2010). Weems (2008) argues that childhood anxiety, regardless of DSM-subclassification, may be best conceptualized as being primarily a dysregulation of anxiety responses (e.g., disabling worry that does not serve the anticipation of real future dangers, or intense fear in the absence of true threat), as well as general negative affect (e.g., the experience of “negative emotions”, being upset or concerned).

A recent development within the literature on childhood anxiety constitutes the increasing interest in gender differences across the various aspects of the disorder (Zahn-Waxler, Shirtcliff, & Marceau, 2008). Some remark that research investigating gender differences in the prevalence of childhood anxiety has produced mixed results (Feng, Shaw, & Silk, 2008). However, a number of studies have shown a higher frequency and intensity of anxiety symptoms in female respondents, and so others argue that anxiety problems, even at an early age, are more common in girls than in boys (Zahn-Waxler et al., 2008). Given the link between anxiety and emotion dysregulation, this may point to the possibility that girls have greater difficulties regulating their negative emotions than boys. Indeed, recent research has shown that female adolescents indicate greater emotional non-acceptance, lower emotional clarity, less access to effective emotion regulation strategies, as well as greater difficulties engaging in goal-oriented behavior when experiencing distress than male adolescents (Neumann, van Lier, Gratz, & Koot, 2010).

Very recently, Zlomke and Hahn (2010) investigated the relation between cognitive emotion regulation strategies and anxiety in adults and found that strategies involving rumination and catastrophizing were predictive of worry in both male and female participants. However, a number of other cognitive strategies were gender-specific in their relation to worry and anxiety. For males only, increased attention to and thinking about how to handle negative events was related to lower levels of anxiety and worry. Strategies involving acceptance of emotions and positive reappraisal were related to lower levels of worry in female adults only. This suggests that different cognitive emotion regulation strategies may be helpful to men and women, respectively, when experiencing anxiety-provoking emotional responses.

Considering these findings from the adult literature, we asked whether the relation between emotional dysregulation and anxiety, observed in both children and adolescents, would reveal gender differences, as well. It is important to note that the term emotion dysregulation in the present study does not refer to specific regulatory strategies. Although some strategies, such as suppression and rumination have been found to relate to anxiety (Amstadter, 2008), it can be argued that specific emotion regulation techniques are not adaptive or maladaptive per se. Rather, excessive reliance on singular techniques, as well as an inability to elect strategies consistent with the particular circumstances of a given emotional response may be considered a dysregulation of emotion (Gratz & Roemer, 2004).

In summary, this study addressed the following questions. Can the impact of emotion dysregulation on anxiety be replicated in the present sample of typical children and adolescents? Can the finding that girls report more anxiety, as well as greater difficulties regulating their negative emotions than boys be replicated in the current study? And especially, what is the impact of gender on the relation between emotion dysregulation and anxiety in children and adolescents?