Abstract
The present thesis examined the role of emotion regulation in the early intervention and prevention of mental health problems in adolescents. The research literature identifies six principle emotion regulation strategies: cognitive reappraisal, problem-solving, interpersonal emotion regulation, response modulation, acceptance, and up-regulating positive emotions. To date, early intervention and prevention programs have primarily been based on cognitive reappraisal, with few studies that evaluated the others. However, research has indicated that all six strategies are important to manage life adversities and address symptoms of anxiety and depression and thus adolescents may be under-equipped in learning only the strategy of cognitive reappraisal.
The present thesis comprises three studies: a) a feasibility quasi-randomised controlled evaluation of an acceptance-based program derived from acceptance and commitment therapy using a sample of 48 high school students; b) a combined acceptance and up-regulating positive emotions program, Strong Minds, evaluated in a sample of 267 students using a randomised controlled study design; and c) a feasibility study using a randomised controlled design of a comprehensive emotion regulation program based on dialectical behaviour therapy evaluated in a sample of 96 high school students. All three programs were delivered at the school in a large-group format by the PhD candidate. The control condition consisted of students usual classes, either Pastoral Care or career guidance classes.
In all three studies, either qualitative data or effect sizes suggested that compared to the control condition, the program evaluated was beneficial for helping to reduce symptoms of anxiety and depression. Furthermore, in the Strong Minds program, the differences in anxiety and depression scores were statistically significant. Differences were observed between the outcome measures, with scales focused more on symptoms of anxiety and depression demonstrating greater improvement than those that measured presence of emotions such as anger, anxiety, and sadness.
These results suggest that early intervention and prevention programs should consider the range of emotion regulation strategies. Adolescents may need training in all emotion regulation strategies, as well as how to apply them depending on the demands of the situation, to effectively manage life adversities without developing mental health symptoms.