Reappraisal is an effective emotion regulation strategy in children with Tourette syndrome and ADHD. (September 2020)

• Record Type: Journal Article
• Authors: Hagstrøm, Julie; Maigaard, Katrine; Pagsberg, Anne Katrine; Skov, Liselotte; Plessen, Kerstin Jessica; Vangkilde, Signe
• Is Part Of: Journal of behavior therapy and experimental psychiatry. Volume 68(2020)
• Publication Date: 2020-09
• Subjects: Emotion regulation -- Tourette syndrome -- ADHD -- Reappraisal -- Reactivity; Behavior therapy -- Periodicals; 616.89142
• DOI: 10.1016/j.jbtep.2019.101541
• Languages: English
• ISSNs: 0005-7916

Abstract

Abstract: Background and objectives: Difficulties in emotion regulation (ER) have been associated with several psychiatric disorders, emphasizing a need for a greater understanding of the concept and its associations with disruptive behavior. We aimed to study the ER strategy of cognitive reappraisal with an experimental test to increase our knowledge of emotional processes in child psychopathology. Methods: In the present study, we examined emotional reactivity and cognitive reappraisal with a computer task in 160 medication-naïve children aged 8–12 comprising four groups: Fifty-eight children with Tourette syndrome (TS), 26 children with attention-deficit/hyperactivity disorder (ADHD), 19 children with TS and ADHD, and 57 typically developing controls. Results: The use of cognitive reappraisal reduced negative affect across all participants and the ability to reappraise was positively correlated with age, whereas reactivity was not. Overall, groups did not differ in reactivity or regulation success. Looking at specific differences within groups, however, only the ADHD group did not significantly decrease negative affect when reappraising. Finally, the use of strategies considered to be efficacious was correlated with regulation success, whereas the use of a less adaptive strategy related to suppression was associated with reactivity, but not regulation of emotions. Limitations: The study was limited by small, clinical contrast groups and a lack of blinding to diagnostic status in the coding of verbal strategies employed during the task. Conclusions: Cognitive reappraisal appears to be a beneficial ER strategy for children regardless of diagnostic status. Our findings indicate that children can learn and employ an adaptive ER strategy when instructed in the technique, even in the presence of attention problems, which is highly relevant to therapeutic approaches to dysregulated behavior. Highlights: Cognitive reappraisal is a beneficial emotion regulation (ER) strategy in children. An experimental test of cognitive reappraisal can be used to examine ER in children with Tourette syndrome (TS) and ADHD. Children with ADHD and TS do not perform significantly different from controls. There is a potential for reappraisal to be learned and employed by children with ADHD. Future studies should incorporate physiological measures as a supplement to self-report in the investigation of ER.