Emotion Regulation as a Mediator of Adolescent Developmental Proc

Appen _____________________________________________________ e1 1 Teen Teen Report e2 1 Attachment Relationship e3 1 Teen 1 e4 1 Fl ex ibi lity e5 1 Parent Report Teen Rel ations hi p Cohesion 1 Parent Fl ex ibil ity Parent Cohesion 1 1 Temperament Poor E Regu e7 Adaptability Positivity e9 1 1 Mean Distress Rhythmicity General Tolerance e6 1 Baseline RSA 1 e12 Figure 8. RSA Hypothesis 8: Emotion Regulation Mediates the Tee with Peers (model failed to run).

133 ndix T _____________________________________________________ 1 e10 Physical Aggression toward Peers 1 e13 Emotion ulation Stress RSA 1 e11 en-Parent Relationship and Temperament in predicting Aggression

Appen _____________________________________________________ e5 Teen .89 Teen Report e4 Cohesion Relati onship e3 .91 Teen .5 6 e2 Flexi bility e1 -.18 Teen Attachment .75 Parent .60 Parent Cohesion .54 Report Relationship Parent Flexibili ty -.30 Baseline .15 Cortisol .02 Figure 9. Cortisol Hypothesis 1: The Teen-Parent Relationship will * p < .05. ** p < .01. *** p < .001.

134 ndix U _____________________________________________________ -.1 1 Stress Cortisol .34 .2 5 e7 -.17 .14 Hours Awake predict Emotion Regulation.

Appen _____________________________________________________ Hours Aw ake e1 1 Baseline Cortisol 1 Low Adaptability Tem peram ent Low Rhythm icity e2 1 1 e3 Figure 10. Cortisol Hypothesis 2: Temperament will Predict Emotio

135 ndix V _____________________________________________________ e4 1 Stress Cortisol t on Regulation (model failed to run).

Appen _____________________________________________________ e1 1 Teen Teen Report e2 1 Attachm ent Relationship e3 1 e4 1 Teen 1 e5 1 Flexibility Parent Report Teen 1 Relationship Co hes i on Parent Flexibility Parent Cohesion 1 Low Adaptability 1 Tem peram ent Low Rhythm icity Hours Awake e7 1 e8 e6 1 Baseline Cortisol Figure 11. Cortisol Hypothesis 3: The Teen-Parent Relationship and failed to run).

136 ndix W _____________________________________________________ e9 1 Total Depressive Sym ptoms d Temperament will predict Teen Depressive Symptoms (model

Appen _____________________________________________________ e1 1 Teen Teen Report e2 1 Attachment Rel ati onshi p e3 1 Teen 1 e4 1 Flexibil ity e5 1 Parent Report Teen Relationship Cohesion 1 Parent Flexibili ty Parent Cohesi on 1 1 Temperament 1 e6 Low Adaptability e7 Low Rhythmicity e8 1 Baseline Cortis ol Hours Awake Figure 12. Cortisol Hypothesis 4: Emotion Regulation Mediates the Depression (model failed to run).

137 ndix X _____________________________________________________ e9 1 Total Depressive Symptoms Stress Corti sol 1 e10 e Teen-Parent Relationship and Temperament in predicting

Appen _____________________________________________________ e1 1 Teen Teen Report e2 1 Attachment Relationship e3 1 e4 1 Teen 1 e5 1 Flexibility Parent Report Teen 1 Relationship Cohesion Parent Flexibility Parent Cohesion 1 Low Adaptability Temperament Low Rhythmicity e7 1 1 Hours Awake e8 e6 1 Baseline Cortisol Figure 13. Cortisol Hypothesis 5: The Teen-Parent Relationship and to run).

138 ndix Y _____________________________________________________ e9 1 Total Alcohol Problems d Temperament will predict Teen Alcohol Problems (model failed

Appen _____________________________________________________ e1 1 Teen Teen Report e2 1 Attachment Relations hi p e3 1 Teen 1 e4 1 Flexibility e5 1 Parent Report Teen Rel ations hi p Cohesion 1 Parent Flexibility Parent Cohesion 1 1 Temperament 1 e6 Low Adaptability e7 Low Rhythmicity e8 1 Baseline Cortisol Hours Awake Figure 14. Cortisol Hypothesis 6: Emotion Regulation Mediates the Problems (model failed to run).

139 ndix Z _____________________________________________________ e9 1 Total Alcohol Problems Stress Cortisol 1 e10 e Teen-Parent Relationship and Temperament in predicting Alcohol

Append _____________________________________________________ e1 1 Teen Teen Report e2 1 Attachment Relationship e3 1 Teen 1 e4 1 Flexibility e5 1 Parent Report Teen Relationship Cohesion 1 Parent Flexibility Parent Cohesion e6 1 1 Temperament e7 1 Low Adaptability Low Rhythmicity e8 1 Baseline Cortisol Hours Awake Figure 15. Hypothesis 7: The Teen-Parent Relationship and Temper

140 dix AA _____________________________________________________ e9 1 physical aggression Stress Cortisol 1 e10 rament will predict Peer Aggression (model failed to run).

Append _____________________________________________________ e1 Teen .56 Teen Report e2 Attachm ent .91 Rel ations hip e3 e4 Teen .89 e5 Flexibility .69 e6 Teen e7 Cohesion -.37 Parent .44 Parent Report Flexibility .73 Relationship Parent -.83 Cohesion .14 .71 Tem peram ent Low Adaptability .29 .05 Low Rhythmicity .33 e8 Baseline -.18 Cortis ol .08 Hours Awake Figure 16. Cortisol Hypothesis 8: Emotion Regulation Mediates the Aggression with Peers (model failed to run).

141 dix BB _____________________________________________________ -.66 e9 1 .85 physical aggression 4 .07 1 .53 Stres s .15 Cortis ol e10 e Teen-Parent Relationship and Temperament in predicting

Append _____________________________________________________ -.42* Baseline RSA Attachm e1 .82 *** Stress RSA .28 * Distres -.07 .26 e3 * Tim e 1 Depressive Sym ptoms Figure 17. Post-Hoc Test: Emotion Regulation Mediates the Relatio * p < .05. ** p < .01. *** p < .001.

142 dix CC _____________________________________________________ .06 -.37 * m ent Insecurity .45 *** Fam ily Cohesion Parent Report e2 .11 ss Tolerance on between Developmental Factors and Depressive Symptoms.

Append _____________________________________________________ -.39 Baseline RSA Attachm e1 .82* RSA_target .18 .05 Distres .23 e3 Time 1 Depressive Symptoms .31* e4 Time 2 Depres Figure 18. Post-Hoc Test: Emotion Regulation Mediates the Relatio Symptoms Over Time. * p < .05. ** p < .01. *** p < .001.

143 dix DD _____________________________________________________ .07 -.32 ment Insecurity .45* Family Cohesion Parent Report e2 .07 ss Tolerance .30 * 4 ssive Symptoms on between Developmental Factors and Change in Depressive

Append _____________________________________________________ PA_Flexibility -.26 * e DTS_APPRA .19 .40* -.15 e1 -.15 BORI_INSECURE -.14 LASHOUT_FR_T .11 .12 -.02 .27 * cort_base .12 .05 hou rs _aw ak e Figure 19. Post-Hoc Test: Emotion Regulation Mediates the Relatio * p < .05. ** p < .01. *** p < .001.

144 dix EE _____________________________________________________ e2 AISAL -.12 e3 ** T1 .52 *** Total Alcohol Problems on between Developmental Factors and Alcohol Problems.

Appen _____________________________________________________ Alcohol Problems 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 Low Lashing Out (- 1 SD) High Lashing Out (+ 1 SD Figure 20. Negative appraisals of distress tolerance moderate the eff

145 ndix FF _____________________________________________________ Appraisals -1 SD Appraisals +1 SD D) fects of lashing out on adolescent alcohol problems.

App _________________________________________________ Attachm ent Insecurity .21 -.21 -.26* -.42 Fam ily Flexibility -.0 5 Parent Report .0 6 .10 V Baseline RSA Figure 21. Post-Hoc Test: Emotion Regulation Mediates the Relatio * p < .05. ** p < .01. *** p < .001.

146 pendix GG ______________________________________________________ e2 Negative Distress A ppraisal s -.23 e3 .42*** e1 .59*** Physical Aggression with Peers Verbal Lashing Out w hen Distressed on between Developmental Factors and Peer Aggression.

147 GENERAL DISCUSSION

148 As specificity and sophistication in measuring individual differences in the human experience increase, there is a temptation to take a reductionist view of development and psychopathology, such that people are seen as psycho-physiological or neurobiological units. The goal of the current series of studies was to ground specific aspects of the autonomic nervous system within individuals within important interpersonal relationships. We examined the ways in which adolescents’ social, cognitive, behavioral, and psycho-physiological regulation of emotion mediate theoretically early-developing constructs, such as temperament, attachment, and systemic family patterns, and psychopathology. To that end, we first developed a measure of adolescent behavioral co-regulation of distress with same aged peers. This measure, in two versions and across two samples (late adolescent college students and middle to late community adolescents), showed good reliability and validity, and was associated with adolescent functioning in the expected ways. Specifically behaviors that drew peers closer to the distressed adolescent were associated with more positive peer functioning, whereas behaviors that pushed peers away were associated with greater depressive symptoms and poorer resting physiological regulation of distress. Second, we proposed a series of complex statistical models, based on the theory that emotion regulation mediates the documented relations between developmental factors and psychopathology. The proposed models were too complex for the relatively small community sample to support. However, simpler models of emotion regulation mediating the developmental context and depressive symptoms, alcohol problems, and

149 peer aggression, did stand up to cross-sectional empirical testing. Simpler modeling also successfully predicted emotion regulation mediating relations between the developmental context and longitudinal increases in depressive symptoms. This series of studies had several unique aspects, including: 1) measuring adolescents’ interpersonal distress management with peers empirically and in self-report form for the first time, 2) testing the “emotion regulation as mediator” model using self- report and two physiological indicators of adolescent emotion regulation, and 3) being the only known study assessing the joint impact of temperament, developmental context, and emotion regulation on adolescent alcohol problems. The findings presented here may be particularly useful for parents, educators, clinicians, and other mentors working with distressed adolescents. Emotion regulation, although related to ingrained patterns and developmental context, is also its own construct, and may be molded by new experiences and new environments. This, essentially, is the entire point of many types of therapeutic intervention (cite), that is, the co-creation of new interpersonal environment and an understanding and reworking of emotional reactions (cite). Further, repeated experiences of better regulated emotions in a therapeutic context may lead to changes at the behavioral, cognitive, and neurobiological levels, associated with better psychological functioning. Addressing adolescent emotion regulation may be a particularly apt point of intervention and/or prevention, because changing the psychosocial and family environments in dramatic ways is rare and difficult. In addition, with the rise of formal operational thinking and the capacity for abstraction, adolescents who are “coached” on emotion regulation may be better able

150 than younger children to begin to imagine how they might respond differently to emotional provocation. Existing therapeutic techniques, such as those that enhance the capacity to mentalize alternative affective states (e.g., Levy et al., 2006) and Dialectical Behavior Therapy (Linehan, Armstrong, Suarez, Allmon, & Heard, 1991), are just two possibilities for helping adolescents to develop better emotion regulation. In this way, emotion regulation may serve as a buffer for adolescents who are unable to change their environments, particularly those that are chaotic or distressing.

151 REFERENCES Linehan, M.M., Armstrong, H.E., Suarez, A., Allmon, D., & Heard, H.L. (1991). Cognitive-behavioral treatement of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060-1064. Levy, K.N., Meehan, K.B., Kelly, K.M., Reynoso, J.S., Weber, M., Clarkin, J.F., Kernberg, O.F. (2006). Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 74, 1027– 1040.

152 VITA Katherine Claire Little received her B.A. in Psychology from the University of Virginia in Charlottesville, VA, in 2003. In 2005, she entered the doctoral program in clinical psychology at the University of Tennessee, Knoxville. From 2005 to 2011, she worked as a graduate student researcher under the supervision of Dr. Deborah Welsh studying adolescent peer and romantic relationships, sexuality, psychological functioning, and emotion regulation. She also worked part time as a graduate student researcher with Dr. Kristina Coop Gordon, studying marital and couple relationships, and Dr. Debora Baldwin, studying salivary cortisol and the stress response. In addition to research, Katherine worked as a graduate student clinician at the University of Tennessee Psychological Clinic from 2006-2010, as well as at the Knox County Juvenile Court from 2007-2008, and at Peninsula Village adolescent treatment facility from 2008-2009. Katherine taught two undergraduate courses at the University of Tennessee, PSYC 110: Introduction to Psychology and PSYC 330: Abnormal Psychology. In 2010, she married Aaron John Kivisto and changed her name to Katherine Little Kivisto.