Social anxiety disorder and emotion regulation problems in adolescents

Petra Sackl-Pammer; Rebecca Jahn; Zeliha Özlü-Erkilic; Eva Pollak; Susanne Ohmann; Julia Schwarzenberg; Paul Plener; Türkan Akkaya-Kalayci

doi:10.1186/s13034-019-0297-9

Social anxiety disorder and emotion regulation problems in adolescents

Child Adolesc Psychiatry Ment Health. 2019 Sep 30:13:37. doi: 10.1186/s13034-019-0297-9. eCollection 2019.

Authors

Petra Sackl-Pammer^#¹, Rebecca Jahn^#², Zeliha Özlü-Erkilic³, Eva Pollak¹, Susanne Ohmann¹, Julia Schwarzenberg¹, Paul Plener¹, Türkan Akkaya-Kalayci³

Affiliations

¹ 1Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
² 2Department for Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
³ 3Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.

^# Contributed equally.

Abstract

Background: Social anxiety disorder (SAD) in adolescents may be associated with the use of maladaptive emotion regulation (ER) strategies. The present study examined the use of maladaptive and adaptive ER strategies in adolescents with SAD.

Methods: 30 adolescents with SAD (CLIN) and 36 healthy adolescents for the control group (CON) aged between 11 and 16 years were assessed with the standardized questionnaires PHOKI (Phobiefragebogen für Kinder und Jugendliche) for self-reported fears as well as FEEL-KJ (Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen) for different emotion regulation strategies.

Results: Compared to controls, adolescents with SAD used adaptive ER strategies significantly less often, but made use of maladaptive ER strategies significantly more often. There was a significant positive correlation between maladaptive ER and social anxiety in adolescents. Examining group differences of single ER strategy use, the CLIN and CON differed significantly in the use of the adaptive ER strategy reappraisal with CLIN reporting less use of reappraisal than CON. Group differences regarding the maladaptive ER strategies withdrawal and rumination, as well as the adaptive ER strategy problem-solving were found present, with CLIN reporting more use of withdrawal and rumination and less use of problem-solving than CON.

Conclusions: Promoting adaptive emotion regulation should be a central component of psychotherapy (cognitive behavioral therapy-CBT) for social anxiety in adolescents from the beginning of the therapy process. These findings provide rationale for special therapy programs concentrating on the establishment of different adaptive ER strategies (including reappraisal). As an increased use of maladaptive ER may be associated with SAD in adolescents, it may be paramount to focus on reduction of maladaptive ER (for example withdrawal and rumination) from the beginning of the psychotherapy process. Incorporating more ER components into psychotherapy (CBT) could increase the treatment efficacy. Further investigations of the patterns of emotion regulation in specific anxiety groups like SAD in adolescents is needed to continue to optimize the psychotherapy (CBT) concept.

Keywords: Adaptive emotion regulation; Adolescents; Emotion regulation; Maladaptive emotion regulation; Psychotherapy (cognitive behavioral therapy-CBT); Social anxiety disorder (SAD).