A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings

Abstract Background Difficulties in emotion regulation (DER) are widely considered to underlie anxiety and depression. Given the prevalence of anxiety and depression in adolescents and the fact that adolescence is a key period for the development of emotion regulation ability, it is important to exa...

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Main Authors: Qian-Nan Ruan, Yu-Hsin Chen, Wen-Jing Yan
Format: Article
Language:English
Published: BMC 2023-02-01
Series:Child and Adolescent Psychiatry and Mental Health
Subjects:
Online Access:https://doi.org/10.1186/s13034-023-00574-2
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author Qian-Nan Ruan
Yu-Hsin Chen
Wen-Jing Yan
author_facet Qian-Nan Ruan
Yu-Hsin Chen
Wen-Jing Yan
author_sort Qian-Nan Ruan
collection DOAJ
description Abstract Background Difficulties in emotion regulation (DER) are widely considered to underlie anxiety and depression. Given the prevalence of anxiety and depression in adolescents and the fact that adolescence is a key period for the development of emotion regulation ability, it is important to examine how DER is related to anxiety and depression in adolescents in clinical settings. Methods In the present study, we assessed 209 adolescents in clinical settings using the Difficulties in Emotion Regulation Scale (DERS) and the Hospital Anxiety and Depression Scale (HADS) and examined the associations between six components of DER and 14 symptoms of anxiety and depression. We used network analysis, constructed circular and multidimensional scaling (MDS) networks, and calculated network centrality, bridge centrality, and stability of centrality indices. Results The results showed that: (1) The global centrality index shows that the Strategy component (i.e., lack of access to strategies) is the center in the whole network, ranking highest in strength, closeness, betweenness, and expected influence. (2) The MDS network showed a closeness of anxiety and depression symptoms, while Awareness component (i.e., lack of emotional awareness) stayed away from other DER components, but Awareness is close to some depression symptoms. (3) The bridge nodes of three groups, Strategy from DERS, Worry and Relax from anxiety symptoms, and Cheerful and Slow from depression symptoms, had the strongest relationships with the other groups. Conclusion Lack of access to strategies remains in the center not only in DER but also in the DER-anxiety-depression network, while lack of awareness is close to depression but not to anxiety. Worrying thoughts and inability to relax are the bridging symptoms for anxiety, while lack of cheerful emotions and slowing down are the bridging symptoms for depression. These findings suggest that making emotion regulation strategies more accessible to patients and reducing these bridging symptoms may yield the greatest rewards for anxiety and depression therapy.
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spelling doaj.art-d50b706de7574097b15b0e3629aaaf642023-03-22T10:26:21ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002023-02-0117111110.1186/s13034-023-00574-2A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settingsQian-Nan Ruan0Yu-Hsin Chen1Wen-Jing Yan2Wenzhou Seventh People’s HospitalSchool of Mental Health, Wenzhou Medical UniversitySchool of Mental Health, Wenzhou Medical UniversityAbstract Background Difficulties in emotion regulation (DER) are widely considered to underlie anxiety and depression. Given the prevalence of anxiety and depression in adolescents and the fact that adolescence is a key period for the development of emotion regulation ability, it is important to examine how DER is related to anxiety and depression in adolescents in clinical settings. Methods In the present study, we assessed 209 adolescents in clinical settings using the Difficulties in Emotion Regulation Scale (DERS) and the Hospital Anxiety and Depression Scale (HADS) and examined the associations between six components of DER and 14 symptoms of anxiety and depression. We used network analysis, constructed circular and multidimensional scaling (MDS) networks, and calculated network centrality, bridge centrality, and stability of centrality indices. Results The results showed that: (1) The global centrality index shows that the Strategy component (i.e., lack of access to strategies) is the center in the whole network, ranking highest in strength, closeness, betweenness, and expected influence. (2) The MDS network showed a closeness of anxiety and depression symptoms, while Awareness component (i.e., lack of emotional awareness) stayed away from other DER components, but Awareness is close to some depression symptoms. (3) The bridge nodes of three groups, Strategy from DERS, Worry and Relax from anxiety symptoms, and Cheerful and Slow from depression symptoms, had the strongest relationships with the other groups. Conclusion Lack of access to strategies remains in the center not only in DER but also in the DER-anxiety-depression network, while lack of awareness is close to depression but not to anxiety. Worrying thoughts and inability to relax are the bridging symptoms for anxiety, while lack of cheerful emotions and slowing down are the bridging symptoms for depression. These findings suggest that making emotion regulation strategies more accessible to patients and reducing these bridging symptoms may yield the greatest rewards for anxiety and depression therapy.https://doi.org/10.1186/s13034-023-00574-2Emotion regulationNetwork analysisAnxietyDepressionAdolescent
spellingShingle Qian-Nan Ruan
Yu-Hsin Chen
Wen-Jing Yan
A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings
Child and Adolescent Psychiatry and Mental Health
Emotion regulation
Network analysis
Anxiety
Depression
Adolescent
title A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings
title_full A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings
title_fullStr A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings
title_full_unstemmed A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings
title_short A network analysis of difficulties in emotion regulation, anxiety, and depression for adolescents in clinical settings
title_sort network analysis of difficulties in emotion regulation anxiety and depression for adolescents in clinical settings
topic Emotion regulation
Network analysis
Anxiety
Depression
Adolescent
url https://doi.org/10.1186/s13034-023-00574-2
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