‘The Ripple Effect?’: Exploring the Potential Effects of Extrinsic Dysregulation on Youth Mental Health

By Evelyn Mary-Ann Antony

Introduction

Prior research has suggested that emotional dysregulation is a key characteristic of youth psychopathological issues, including ADHD, depression and anxiety. Emotional dysregulation can be understood as “emotional expressions and experiences that are excessive in relation to social norms and context-inappropriate; rapid, poorly controlled shifts in emotion (‘lability’); and the anomalous allocation of attention to emotional stimuli” (Shaw et al., 2014, p. 276). During my three-phased PhD on emotional dysregulation symptoms, ADHD symptoms and parenting practices across middle childhood (ages 6-12), the concept of extrinsic dysregulation emerged, following the completion of my first study, as well as my ongoing second study. Middle childhood is often an overlooked period of youth development, with researchers referring to it as “the forgotten years” (Mah & Ford-Jones, 2012, p.81). In my first study, I wanted to look at how emotional dysregulation is conceptualised, with middle childhood in mind, as well as a holistic context of youth psychopathology. I conducted a scoping review, which aimed to look at the breadth of literature that exists around this topic (Antony et al., 2024, under revision). Interestingly, middle childhood or youth development, as a whole, was not one of the key characteristics for emotional dysregulation conceptualisations. Considering social and emotional development, including the ability to socialise, rationalise emotions and developing a sense of self can vary across individuals and within two groups of the same age, these results were not surprising. Furthermore, the scoping review indicated several factors such as parental upbringing, culture, socioeconomic status and adverse childhood experiences (ACES), may play a key role in shaping children’s emotional dysregulation trajectories.

During my Masters, I wrote a discussion paper around framing childhood resilience using Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1979), where the child is at the ‘centre’ of its surrounding ‘systems’, including parents, teachers, schools, the community and media (to name a few), and it soon became evident that children’s external influences and its environment in which they play, socialise and interact with others, was crucial for positive child development and wellbeing (Antony et al., 2022). It was here that I began to think: how may children’s parents who are experiencing distress and negative affect, influence or change, young people’s existing emotional dysregulation symptoms (linked to youth mental health issues including ADHD)? This very thought will be informing my third and final study of my PhD, where I plan on devising a theoretical framework, linked to the above question and in turn, develop a novel intervention for young people to self-manage emotional dysregulation symptoms, particularly those with ADHD.

In this blog, I will introduce a novel concept, extrinsic dysregulation, based on the collective findings from my three-phased PhD (Study 1 and ongoing Study 2), with a specific focus on middle childhood (ages 6-12) and youth mental health issues, namely ADHD. By addressing extrinsic dysregulation, researchers can grasp a better understanding of how parents’ emotional issues (i.e., parental conflict ), alongside parental mental health may influence and change another individual’s, in this case the child, emotional dysregulation symptoms.   

Understanding the origins of extrinsic dysregulation

Before getting into the new concept of extrinsic dysregulation, we must first understand what emotion regulation is. Emotion regulation consists of the extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features, to accomplish one’s goals (Thompson, 1994). In other words, emotion regulation can be separated into two distinct categories: how individuals regulate their own emotions (intrinsic), and how an individual attempts to regulate the emotions of others (extrinsic).Recent literature has started to shift and explore more of the extrinsic processes of how one person aims to increase individual’s positive emotions or to decrease their negative emotions (Nozaki & Mikolajczak, 2020). The concept of extrinsic regulation has been discussed more recently in areas such as romantic relationship (i.e., Walker et al., 2023) and early childhood development (i.e., Kiel et al., 2020). However, little is known about the influence of parental emotional dysregulation on their children’s emotional regulatory systems, particularly in the context of childhood ADHD.

Putting extrinsic dysregulation into practice

Let’s put the concept of extrinsic dysregulation into an everyday example. Picture this: a child screaming and crying on the floor of your local supermarket, near the checkout counter, all over the bar of chocolate their parent won’t buy. This is seen all too often by many busy shoppers, day in and day out. The parent does not want to put up with this malarkey and their patience runs thin, resulting in the parent shouting at their child: ‘Oh won’t you snap out of it!’ The already exacerbated, red-eyed and snotty child continues to cry and scream the shops down until they can get what they want: getting their own way and most importantly, their parents’ attention. Imagine that one of the parents has also had the worst day in the office, or perhaps has a few other kids in tow during the shopping trip. How might Mum or Dad’s emotions get the better of them, specifically in the context of their child being emotionally distressed over not getting their own way? From the example at the beginning, we can see that the child was already upset over not getting their chocolate bar and is now more upset that their Mum or Dad has screamed at them to ‘be quiet!’, subsequently going unheard. For children with ADHD, characterised by constant fidgeting, being restless and being overactive, this can lead to further emotional dysregulation symptoms for the child, such as temper tantrums, outbursts, becoming distressed or worried, and becoming upset more easily. Furthermore, parental mental health, including those with ADHD and symptoms of emotional dysregulation, may also play a key role in shaping children’s emotional dysregulation symptoms – and there is much more to be investigated in this area. Indeed, factors such as parental conflict and familial issues can overflow into a child’s life.

Linking extrinsic dysregulation to my PhD

Linking the collective findings from my first study – the scoping review – and my ongoing second study where I am analysing data from two longitudinal secondary data sets: the UK Millennium Cohort Study (see: https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/ ) and the Zurich Project on the Social Development from Childhood to Adulthood (see: https://www.vrc.crim.cam.ac.uk/vrcresearch/z-proso), my final study will be divided into two parts. The first part will be the theoretical framework of extrinsic dysregulation and the other being the practical implications of the framework, in the form of a targeted intervention. Here, I will focus on developing an intervention protocol around minimising emotional dysregulation symptoms for children with ADHD, with an emphasis of self-managing symptoms and empowering young people to recognise different facets of negative emotions (i.e., sadness, anger, worry). Some of the key aims of Study 2 include further investigating what extrinsic dysregulation means in the context of childhood, the extent to which parents’ and teachers’ emotional dysregulation may contribute towards further deterioration of symptoms, and finally exploring some of the cultural differences between the UK and Swiss contexts within extrinsic dysregulation, based on Study 2. Furthermore, other bi-directional relationships of extrinsic dysregulation, such as child to parent, or child to parent to child, may also be interesting to explore in my future research. The implications of extrinsic dysregulation can be extended to beyond child mental health studies, with associations to romantic relationships (i.e., gaslighting and victim-blaming), as well as organisations (i.e., authoritarian leadership style and demoralising employees).

Overall, it is key to acknowledge how parental mental health, parental conflict and familial issues, may lead to further deterioration of children’s emotional dysregulation symptoms. In other words: a potential ‘ripple effect’ from parents’ emotional dysregulation symptoms to children’s existing dysregulation symptoms is key for researchers in youth psychopathology to acknowledge.

References

Antony, E. M.-A. (2022). Framing Childhood Resilience Through Bronfenbrenner’s Ecological Systems Theory: A Discussion Paper. https://doi.org/10.17863/CAM.90564

Antony, E.M.-A, Beckmann, N., & Higgins, S. (2024). Reconceptualising Emotional Dysregulation in the Context of Middle Childhood: A Scoping Review. Manuscript under revision. Journal of Child Psychology and Psychiatry Advances.

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.

Kiel, E. J., Price, N. N., & Premo, J. E. (2020). Maternal comforting behavior, toddlers’ dysregulated fear, and toddlers’ emotion regulatory behaviors. Emotion, 20(5), 793–803. https://doi.org/10.1037/emo0000600

Mah, V. K., & Ford-Jones, E. L. (2012). Spotlight on middle childhood: Rejuvenating the ‘forgotten years’. Paediatrics & Child Health, 17(2), 81–83. https://doi.org/10.1093/pch/17.2.81

Nozaki, Y., & Mikolajczak, M. (2020). Extrinsic emotion regulation. Emotion, 20(1), 10–15. https://doi.org/10.1037/emo0000636

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotional dysregulation and Attention-Deficit/Hyperactivity Disorder. The American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966

UCL. (2012). CLS | Millennium Cohort Study. Retrieved at: https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/

Violence Research Centre, University of Cambridge (n.d.). Zurich Project on the Social Development from Childhood to Adulthood.  Retrieved at: https://www.vrc.crim.cam.ac.uk/vrcresearch/z-proso

Walker, S. A., Pinkus, R., Double, K. S., Xiao, H., & MacCann, C. (2023). It’s What I Think You Do That Matters: Comparing Self, Partner, and Shared Perspectives of What a Romantic Partner Does to Regulate Your Emotions. [PsyArXiv Preprint] https://doi.org/10.31234/osf.io/vzkht

Biography

Evelyn Mary-Ann Antony is a PhD researcher in the School of Education at Durham University. Her research focuses on conducting a multidimensional assessment of emotional dysregulation (a key trait that is prevalent in youth psychopathological illnesses) and its longitudinal associations with ADHD and parenting practices, across middle childhood (ages 6-12). To address this, she is leveraging data from the UK Millennium Cohort Study and the Zurich Project on the Social Development from Childhood to Adulthood. She holds a MPhil in Education (Psychology) at the University of Cambridge and a MA (Honours) degree in Psychology at The University of Edinburgh. Please feel welcome to connect with her here and read about her research here.