Emotion Regulation Moderates the Link Between Exposure to Childhood Adversity and Transdiagnostic Symptom Domains in Youth

Objective: Impairment in emotion regulation is recognized as a transdiagnostic feature common to child psychopathology. This study examined the unique association between emotion regulation impairments and specific strategies (suppression, reappraisal) with transdiagnostic symptom domains of attention, disruptive behavior, and internalizing problems in youth. This study also tested for the mediating role of emotion regulation between domains of childhood adversity (family conflict and negative life events) and transdiagnostic symptoms. Method: In a sample of 9,057 children aged 9-10 years in the Adolescent Brain Cognitive Development (ABCD) Study (47.21% female), linear mixed-effects models were used to examine the association between emotion regulation impairments and specific regulation strategies with transdiagnostic symptoms. Follow-up analyses tested replication of findings prospectively and retrospectively. Structural equation modeling was used to test whether emotion regulation mediates the association between childhood adversity (family conflict, negative life events) and symptom severity. The Child Behavior Checklist was used as a continuous measure of symptom severity. Results: Greater severity of emotion dysregulation was associated with severity of each transdiagnostic symptom domain, with sex-specific patterns emerging for internalizing and disruptive behavior problems. These associations were replicated both retrospectively and prospectively, with emotion regulation impairments consistently predicting symptom severity across timepoints. Emotion regulation impairments mediated the association between childhood adversity (family conflict, negative life events) and all symptom domains, with strategy-specific patterns emerging only for internalizing problems. Conclusion: These findings have implications for developing targeted interventions to address broad emotion dysregulation as an underlying mechanism of child psychopathology linked to exposure to childhood adversity.