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Title: Refining a new screening measure for youths at risk of emotional dysregulation.

Ethics Approval Number: 2012/097

Researchers: Amy Cleator, Sarah Keating, Louise McLaughlin, Saowalak Isramongkonpan and Elaine Alcorn

Supervisor: Dr Suzanne Dziurawiec

Background

Being able to understand and manage our emotions has been described as an important developmental process that continues to progress until late adulthood. The effective management of emotions, or emotion regulation (ER) is thought to be essential for all types of social interactions, in addition to helping every individual maintain good mental health. However, not every individual is able to effectively manage their emotion or emotional responses, particularly when faced with strong emotion (e.g. depression, anxiety, anger, fear).

In fact, many recent studies have found that individuals who are not able to regulate their emotions in a normal, healthy way, are more likely to be vulnerable to negative health outcomes such as depression, anxiety or extreme anger issues (Berg, Shapiro, Chambless & Ahrens, 1998; Williams, Chambless & Ahrens, 1997). In recent years, many studies have investigated the relationship between poor ER and the development of mental illness, but this research has primarily focussed on children and adults, which has neglected an important developmental group, adolescents.

Many studies on this age group have noted that adolescents tend to experience more frequent and intense emotions than children and adults, due to their rapidly changing physical, mental and social outlook (Maris, Berman & Silverman, 2000; McLaughlin, Hatzenbuehler, Mennin & Nolen-Hoeksema, 2011). The period of adolescence, therefore, represents a crucial time in which to study the relationship between ER and the development of negative health outcomes.

To date, the existing research on ER during adolescence has been held back by a number of issues. There are many different theories about the development of unhealthy emotion regulation, and it remains unclear which specific stage of the ER process leads to negative health outcomes (Cole, Martin & Dennis, 2004). There has also been a lack of age appropriate measurement tools to assess ER in the adolescent age group (Geddes, Dziuraweic & Lee, 2007). For this reason, the purpose of the current study, was to modify an existing adolescent ER questionnaire, the Modified Affective Control Scale for Adolescents (MACS-A; Geddes et al., 2007), into a shorter version named the 16-item MACSA-Revised.

The Current Study

The primary goal of the 16-item MACSA-R was to determine if adolescents were fearful of experiencing strong emotion (e.g. depression, anxiety, anger), and whether this fear could increase the risk of developing mental health issues such as depression and anxiety. More specifically, the 16-item MACSA-R aimed to assess an individual's overall fear of emotion by asking about their fear of experiencing depression, anxiety and anger, in addition to asking how well they thought they were able to control emotion.

To determine if the 16-item MACSA-R would work effectively in a group of late adolescents and young adults (18-19 years), the newly modified questionnaire was compared to other known measures of ER and mental illness, the MACS-A, the DASS-21 (Lovibond & Lovibond, 1995) and the Buss and Perry Anger scale (1992). All four questionnaires, and an additional question assessing control of emotion, were combined into an online survey package named the 'Adolescent Emotion Survey'. The survey package was advertised through a number of different methods (e.g. Facebook, advertising posters) to attract young adults (18-19 years) from Murdoch University and other locations. Participation was voluntary and resulted in a total of 73 participants (22 males, 49 females, 2 gender unknown).

When the analysis of all responses was complete, it was established that the 16-item MACSA-R was strongly related to the MACS-A, the DASS-21 and the Anger Scale. This indicated that the different components of the 16-item MACSA-R worked well together and individually to measure the different components of fear of emotion (e.g. fear of depression, fear of anxiety, fear of anger, control of negative emotion), as experienced by this group of late adolescents.

In addition, it was found that the female participants in the study were more likely to fear the expression of depression and anxiety compared to the male participants. Females also reported having less overall control over strong emotion compared to males. In contrast, the male participants reported having greater fear of the experience of anger, but more overall control of strong emotion. These findings are similar to results found with the MACS-A and other ER studies.

The initial results with the newly refined 16-item MACSA-R were very positive, and future use with adolescents and young adults to build on and extend on this research is recommended.