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Emotion Regulation Flexibility in Adolescents: A Systematic Review from Conceptualization to Methodology

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Considerable attention has been devoted to the concept of flexible emotion regulation, which de-emphasizes the importance of any specific regulatory strategy in favor of the flexible deployment of strategies in response to specific situational challenges. The bulk of research in this area has been conducted on adult samples. Research on emotion regulation flexibility (ERF) in youth has been documented in only a limited number of studies and using various definitions. This systematic review aims to gather and summarize different conceptualizations and methodological approaches of adolescent ERF. We incorporate these findings into a general framework to understand ERF and its role in adolescents’ emotional, behavioral and social functioning. Adhering to the PRISMA guidelines, 11 studies were included in the review. While ERF has been defined in various and inconsistent ways, the included studies utilized conceptualizations from two overarching domains: the regulation of expressed emotion and the repertoire of emotion regulation strategies. Promising approaches and future directions will be highlighted.
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Vol.:(0123456789)
Clinical Child and Family Psychology Review (2024) 27:697–713
https://doi.org/10.1007/s10567-024-00483-6
Emotion Regulation Flexibility inAdolescents: ASystematic Review
fromConceptualization toMethodology
Ann‑ChristinHaag1,2,3 · RohiniBagrodia1· GeorgeA.Bonanno1
Accepted: 21 April 2024 / Published online: 14 July 2024
© The Author(s) 2024
Abstract
Considerable attention has been devoted to the concept of flexible emotion regulation, which de-emphasizes the importance
of any specific regulatory strategy in favor of the flexible deployment of strategies in response to specific situational chal-
lenges. The bulk of research in this area has been conducted on adult samples. Research on emotion regulation flexibility
(ERF) in youth has been documented in only a limited number of studies and using various definitions. This systematic
review aims to gather and summarize different conceptualizations and methodological approaches of adolescent ERF. We
incorporate these findings into a general framework to understand ERF and its role in adolescents’ emotional, behavioral
and social functioning. Adhering to the PRISMA guidelines, 11 studies were included in the review. While ERF has been
defined in various and inconsistent ways, the included studies utilized conceptualizations from two overarching domains:
the regulation of expressed emotion and the repertoire of emotion regulation strategies. Promising approaches and future
directions will be highlighted.
Keywords Emotion regulation· Flexibility· Adolescents
Introduction
Decades of research on adults and youth has linked skills
in emotion regulation (ER) with psychological well-being
(reviewed Aldao etal., 2010; Gross, 2008) and healthy
development (Calkins, 1994; Cole etal., 2004). ER in youth
has been substantially studied given its role in psychological
adjustment (reviewed in Adrian etal., 2011; Zeman etal.,
2006), and well-being or psychopathology that appear
later in adulthood (reviewed in Mullin & Hinshaw, 2007).
Lower levels of youth ER abilities have been associated with
internalizing and externalizing problems both cross-section-
ally and longitudinally (Calkins & Howse, 2004; Eisenberg
etal., 2001; Mullin & Hinshaw, 2007; Rothbart etal., 1994;
Rydell etal., 2003) and across clinical outcomes (reviewed
in Villalta etal., 2018; Silk etal., 2003; Connelly etal.,
2012). Although ER in adults has similarly been linked to
various facets of healthy adjustment, research in this area
has observed variation in strategy efficacy across different
situational characteristics, such as degree of control (Troy
etal., 2013) or emotional valence of the context (Kalokeri-
nos etal., 2017). As a result, ER in adults has increasingly
been couched within the framework of flexible self-regula-
tion (Bonanno etal., 2004). Although the ability to flexibly
regulate emotions across childhood and adolescence can
have important implications for mental health, physical well-
being, and even resilience (Bonanno, 2021), research on ER
in children and adolescents has been slow to incorporate this
development. There is a lack of knowledge of what consti-
tutes emotion regulation flexibility (ERF) in adolescents and
how this is associated with outcomes of emotional, behavio-
ral and social functioning. This is mostly due to inconsisten-
cies in how ERF has been defined and assessed in adoles-
cents. Accordingly, this review aims to systematically assess
the literature on ERF in adolescents to date, particularly on
Ann-Christin HaagandRohini Bagrodiacontributed equally.
* Ann-Christin Haag
ann-christin.haag@uniklinik-ulm.de;
ah3784@tc.columbia.edu
1 Department ofCounseling andClinical Psychology,
Teachers College, Columbia University, 525 West 120th
Street, Box102, NewYork, NY10027, USA
2 Department ofChild andAdolescent
Psychiatry/Psychotherapy, University ofUlm,
Steinhövelstrasse 5, 89075Ulm, Germany
3 German Center forMental Health, DZPG, Ulm, Germany
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698 Clinical Child and Family Psychology Review (2024) 27:697–713
how it has been conceptualized and operationalized, in order
to ultimately advance future research in this area.
Emotion Regulation Flexibility inAdults
Research and theory have identified a large variety of ER
strategies that individuals can use to modify or control their
emotional experiences. Historically, these strategies have
been categorized as either adaptive (i.e., reappraisal) or
maladaptive strategies (i.e., suppression) (Aldao etal., 2010;
Gross, 2015; Marroquín etal., 2017). As greater emphasis
has been paid to the constantly changing contextual demands
of one’s environment, current theory and research on ER
have focused on the flexible use of strategies, rather than
the adaptiveness of any specific strategy (Bonanno etal.,
2004, 2007; Coifman & Bonanno, 2010; Kalokerinos etal.,
2017). A burgeoning body of research has highlighted the
importance of ERF, in particular the ability to accommodate
and if needed modify strategy use in relation to the specific
context in which they are applied (Aldao etal., 2015; Birk
& Bonanno, 2016; Bonanno & Burton, 2013; Hollenstein,
2015; Kashdan & Rottenberg, 2010). As elaborated in a
heuristic review by Bonanno and Burton (2013), regulatory
flexibility can be conceptualized in three serially related
yet functionally independent steps. Understood as the first
step in regulatory flexibility, context sensitivity, involves
the ability to evaluate contextual cues and demands of the
stressor situation. Research has shown that greater context
sensitivity, in particular the ability to identify the absence
of threatening cues, is associated with fewer psychopathol-
ogy symptoms (Bonanno etal., 2018). The subsequent step
in this sequence, repertoire, involves the ability to access
a wide range of strategies that may be implemented to meet
such demands. Findings have shown better adjustment fol-
lowing stressful and potentially traumatic events is associ-
ated with use of a greater number of strategies (Orcutt etal.,
2014), increased temporal variability (Cheng, 2001), and
higher categorical variability (Chen etal., 2018). Finally, a
third step, feedback responsiveness, involves the capacity
to monitor the efficacy of a chosen strategy and modify or
replace the strategy as needed. Research using real-time eco-
logical momentary assessment (EMA) data has shown that
the ability to discontinue situationally maladaptive strategies
and switch to an alternative strategy is associated with fewer
depressive symptoms (Chen etal., 2024). Other research
has shown that certain strategies may be better suited to the
situation depending on the controllability of the stressor or
the intensity of physiological reactivity, where frequency
of switching from reappraisal to distraction predicted better
psychological adjustment (Birk & Bonanno, 2016).
ERF has been predictive of psychological adjustment in
the aftermath of adverse events (Bonanno etal., 2004; Gupta
& Bonanno, 2011; Rodin etal., 2017; Westphal etal., 2010)
and lower levels of psychopathology symptoms (Moore
etal., 2008; Zhu & Bonanno, 2017). Relatedly, use of dis-
tinct repertoires of ER strategies and the differential contex-
tual application has been linked to well-being (Grommisch
etal., 2020) and differentially associated with psychopathol-
ogy profiles (Dixon-Gordon etal., 2015) and neurocognitive
markers (Myruski etal., 2019).
Development ofEmotion Regulation Flexibility
Processes Across Childhood Into Adolescence
Given that one of the most important tasks throughout child-
hood is learning to regulate emotions, there has been con-
siderable interest in ER processes in youth (Zeman etal.,
2006). Successful ER has been linked to positive adjustment
through the lifespan and promotes social and psychological
functioning (reviewed in Compas etal., 2017; Zeman etal.,
2006). Developmental theories and reviews have also sug-
gested that children and adolescents can demonstrate com-
ponents of regulatory flexibility and learn to flexibly regulate
their emotions by increasingly differentiating and matching
the use of and appropriateness of ER strategies to various
contexts as they age and build their strategy repertoire (Cole
etal., 2004; Jones etal., 1998; Raffaelli etal., 2005; Sabatier
etal., 2017; Skinner & Zimmer-Gembeck, 2007).
Much of the research on potential flexibility in youth ER
has focused on early and middle childhood. For example, the
selection between multiple ER strategies to appropriately
regulate negative emotion has been documented in children
as young as pre-schooled age (Dennis & Kelemen, 2009;
Skinner & Zimmer-Gembeck, 2007) and predicted lower
levels of behavior problems when preschool-aged children
were reassessed at kindergarten age (Lunkenheimer etal.,
2011). Similarly, preschool children who were able to report
the use of a variety of ER strategies showed fewer hyperac-
tivity and attentional problems as they grew older (Thomsen
& Lessing, 2020).
In transitions from early to middle childhood, children
have been shown to demonstrate rapid advances in the
ER strategy repertoire, specifically in their knowledge,
size, and effective use of increasingly more sophisticated
ER strategies, including the expansion to cognitive-based
strategies (Rice etal., 2007; Skinner & Zimmer-Gembeck,
2007; Thomsen & Lessing, 2020),and the ability to switch
between strategies as needed (i.e., Parsafar etal., 2019).
Children aged 5 to 6 (Davis etal., 2010) and 7 to 9 (Waters
& Thompson, 2014) were able to demonstrate the differen-
tial selection of ER strategies to effectively regulate spe-
cific emotions elicited across various situations. Further-
more, children, aged 8 to 11 years old, were able to display
context sensitivity, or the awareness that certain ER strate-
gies may be more appropriate in some contexts than others
(Quiñones-Camacho & Davis, 2020). Lastly, ER repertories
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699Clinical Child and Family Psychology Review (2024) 27:697–713
and the potential varied use of strategies has been positively
associated with children’s self-reported empathy and proso-
cial behavior (Gust etal., 2017). Similarly, children aged 10
to11 with attention-deficit/hyperactivity disorder (ADHD)
reported fewer strategies overall and more antisocial strate-
gies than same-age children without ADHD, highlighting
the correlation between access to broader ER strategy reper-
toires and children’s healthy functioning (Babb etal., 2010).
Despite the promising findings on ERF in childhood, sys-
tematic research in adolescence is nonetheless lacking. This
is both surprising and concerning as the appropriate regula-
tion of emotion expression is widely viewed as an important
milestone in both middle childhood and adolescence (Zeman
etal., 2006). Adolescence is often marked by the experience
of greater intensity of emotions and heightened emotional
reactivity (Gullone & Taffe, 2012; Silk etal., 2003; Stifter
& Augustine, 2019; Zeman etal., 2006). Furthermore,
increased sensitivity to the peer evaluation and interpersonal
consequences of particular displays of emotion renders the
ability to flexibly modulate emotion expression as a crucial
developmental skill (Wang etal., 2020). Many individuals
respond to the milestones and challenges of adolescence by
strengthening and refining ER skills, but for some, adoles-
cence is marked by emergent or worsening difficulties with
ER and associated psychopathology (Silvers, 2022). Finally,
adolescence is typically a period where behavior becomes
more flexible as a result of normative maturational pro-
cesses, such as the onset of puberty. These abrupt changes
and increased points of sensitivity are often referred to as
phase transitions in the developmental timeline of an indi-
vidual. During a phase transition, emotional systems can be
reorganized and novel emotional patterns can emerge indi-
cating increased ERF in adolescence (Granic, 2005).
The Current Study
For the purposes of the present review, we focus on adoles-
cent ERF abilities, i.e., the ability to flexibly use available
ER strategies according to situational demands. We do not,
however, include research on affective variability, which
captures the degree of affective fluctuations. In this way,
our review can be differentiated from previous literature that
has highlighted and summarized developmental research on
how affective states change over time and how these emotion
dynamics impact psychosocial adjustment (reviewed in Hol-
lenstein etal., 2013; McKone & Silk, 2022).
Given the fundamental role of ERF in emotional adjust-
ment across the lifespan, in the current study we focus on
a growing body of theory and research that identify meas-
ures of ERF in adolescence and their subsequent impact
on emotional and behavioral functioning. A sizeable body
of research in adults has linked ERF to positive effects on
psychological adjustment in the aftermath of adverse events
as well as lower levels of psychopathology symptoms in
general (e.g., Gupta & Bonanno, 2011; Rodin etal., 2017;
Zhu & Bonanno, 2017). However, considerably less is
known about ERF in adolescents or its associations with
psychological well-being. Both the conceptualization and
the measurement of ERF in adolescence vary broadly. Con-
sequently, there are not yet consensual conclusions about
what constitutes ERF in adolescents and how it could serve
as a potentially protective factor for adolescent functioning.
Addressing these gaps, the present study’s aims are two-
fold. First, this review seeks to identify and summarize
studies that have evaluated the flexible use of ER strategies
in adolescents, and we will present the existing conceptu-
alizations and operationalizations of ERF in adolescents.
Second, the review will describe associations of ERF with
clinical outcomes, including emotional, behavioral and
social functioning.
Methods
A systematic review approach was chosen for the current
study as the relevant literature utilized a variety of opera-
tionalizations of the ERF construct, thus preventing valid
aggregation for statistical approaches, such as meta-analysis.
Eligibility Criteria
The Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines were used to guide
and determine study inclusion. Articles were included in the
present review if the following criteria were met:
(1) The mean age of the sample fell between 11 and
17years of age. We excluded studies of younger chil-
dren given the noticeable lack of research on the ado-
lescent population. Furthermore, research indicates that
there may be developmental differences in the strate-
gies used (Parsafar etal., 2019; Skinner & Zimmer-
Gembeck, 2007), and thus different methodologies to
capture various processes as dictated by age.
(2) Studies were included if they assessed the use of mul-
tiple ER strategies. Given the focus of ERF above and
beyond an individual regulatory strategy, studies were
excluded if they focused only on a specific strategy of
ER.
(3) Studies were included if they provided a definition or
operationalization of ERF.
(4) Studies were excluded if they focused on affective vari-
ability, i.e., emotional states and the degree of their
momentary fluctuations, rather than the active use of
strategies to regulate emotions.
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700 Clinical Child and Family Psychology Review (2024) 27:697–713
(5) Studies were excluded if biological/physiological cor-
relates of ERF were measured as the primary focus of
the study.
(6) Studies were excluded if they involved experimental
manipulation of ER capacity or skill in either clinical
or non-clinical populations (e.g., intervention studies).
(7) Studies were excluded if they assessed broader con-
structs of flexibility beyond ERF, such as psychological
or cognitive flexibility. Studies that measured “affective
flexibility” were evaluated for inclusion adequacy on a
case-by-case basis.
(8) Studies were excluded if they assessed constructs of
flexibility on a dyad or systems-level. Instead, this
review focuses on the systematic presentation of arti-
cles that describe individual-level processes.
(9) Lastly, we limited the search to empirical, English-
language articles published in peer-reviewed journals.
Consistent with previous meta-analytic reviews about
emotion regulation (e.g., Aldao etal., 2010; Compas
etal., 2017), book chapters, non-peer-reviewed jour-
nal articles, review articles, commentaries, abstracts of
conferences and congresses, case-reports and disserta-
tions were not included. By limiting our review to stud-
ies published in peer-reviewed journals we increased
the likelihood that studies would be of acceptable qual-
ity.
Search Strategy
A thorough search of three databases (PsycInfo, Embase,
and PubMed) was conducted in May of 2023. Search terms
were selected by reviewing a collection of relevant articles
and referencing the keywords used in the literature around
emotional flexibility with adult samples. Of note, while the
focus of this review is on adolescent samples, youth and
children search terms were included to ensure the review
of all articles that included the age range of 11 to 17-year-
old participants. Lastly, several expert researchers on these
topics advised before search terms were finalized. Table1
details the search strategy used across the databases, and
articles were filtered based on match to in title and abstract.
In addition, we searched the reference lists of relevant stud-
ies for any additional papers.
Study Selection, Data Extraction andRisk ofBias
Assessment
Each title and abstract were independently reviewed by
two of the authors (RB, AH) using the Covidence System-
atic Review Software (2023). If either primary reviewer of
the studies rated it as of potential relevance, the full text
article was retrieved. The same two reviewers indepen-
dently assessed the full texts against the eligibility criteria.
Any discrepancies were resolved through mediation of an
independent third reviewer (GB). The two primary review-
ers independently extracted data from the retrieved studies.
Data were extracted on the sample, study design, definition
of ERF, measurement of ERF, and primary findings.
The extent to which conclusions about ERF were drawn
for the present review depended on whether data and
results from the included studies are reliable and valid.
Therefore, to evaluate the quality of the included stud-
ies, we used the Newcastle–Ottawa Scale (NOS)—a risk
of bias assessment tool used for both case–control and
longitudinal studies (Margulis etal., 2014). Studies are
rated along three parameters (selection, comparability, and
outcome) divided across eight specific items. Each item on
the scale is scored with one point, except for comparabil-
ity, which can be adapted to the specific topic of interest
to score up to two points. While nine is the maximum
number of points to achieve, less than 5 points indicate
studies being at high risk of bias. Regarding the section
“selection: outcome of interest not present at start”, we
chose to consider this given if a study controlled for previ-
ous levels of the outcome in their analyses. “NAs” were
given for studies with cross-sectional research designs.
Similarly, for cross-sectional studies, “NA” was chosen
for “Outcome: Follow-up long enough”. Lastly, for “Out-
come: Adequacy of follow-up of cohorts” was answered
given the authors management of missing data. A sum-
mary of the results is presented in Fig.1. The three larg-
est areas of concern were (1) the assessment of outcome
variables, with most studies using self-report instead of a
more objective measure, (2) the assessment of the predic-
tor, with the majority of studies relying on self-report, and
(3) the inclusion of additional control variables (except
for age or gender). Handling of missing data also showed
Table 1 Search terms used in
the systematic literature search
Databases: PsycInfo, Embase, PubMed; limiters: peer-reviewed, language: English, * = truncation
“emotion* (dys)regulat*” OR “emotion* control*” OR “emotion*
difficult*” OR “emotion* express*” OR “affect* (dys)regulat*” OR
“affect* control*” OR “affect* difficult*” OR “affect* express*” OR
“coping (dys)regulat*” OR “coping control*” OR “coping difficult*”
OR “coping express*”
AND “switch*” OR “flexibl*” OR "variability" OR "repertoire"
AND “youth” OR “child*” OR “adolescen*”
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701Clinical Child and Family Psychology Review (2024) 27:697–713
elevated risks of bias. Results should be interpreted con-
sidering these limitations regarding the quality of the
included studies.
Results
Included Articles
The initial search yielded 1,074 articles: 506 from Psy-
cInfo, 294 from Embase and 274 from PubMed. One study
was identified via forward citation searching(see Fig.2 for
the PRISMA flow diagram). After the removal of dupli-
cates, 627 articles remained and were screened by title and
abstract. From these 524 were excluded (135 due to non-
relevance to scope or ER or ERF, 38 were not peer-reviewed
empirical articles, 22 examined broader constructs of flex-
ibility outside the scope of the present study, 143 were out-
side our of our desired age range, 59 examined biological
proxy measures of ER, 51 examined the ER role and use
as a features in clinical presentation, 56 evaluated ER as
an outcome measure or within the scope of an intervention
study, 11 studied parental influences on child or adolescent
ER/ERF, and 9 examined specific ER strategies versus the
flexible use of strategies). The remaining 103 studies were
reviewed in full text. Of these, a following 92 were removed
as these articles were found to not include a definition
ofERF (n = 4), explored ERF in a dyadic or family system,
and not on an individual level (n = 3), examined the use of a
specific strategy versus the flexible use of strategies (n = 5),
included ER or ERFas an outcome or part of a larger inter-
vention (n = 7), focused on related constructs (e.g., mood
variability, psychological flexibility) rather than the flexible
use ofER (n = 39), or the sample mean was revealed to be
younger or older, and therefore did not satisfy our inclusion
criteria (n = 34). Based on the inclusion criteria detailed
above, a final 11 articles were included in this systematic
review. Table2 presents the summary of included studies
and relevant study characteristics.
General Study Characteristics
Studies were conducted in a wide variety of locales: Aus-
tralia & New Zealand (n = 2), Belgium (n = 1), Canada
(n = 1), China (n = 4), Netherlands (n = 1), and USA (n = 2).
With respect to study design, a majority of the studies were
cross-sectional (n = 7; 63%) and were conducted with a com-
munity sample (n = 9; 81%). Two studies were conducted
including clinical samples: one study included a subsample
of adolescents investigated for child maltreatment (Haag
etal., 2022), and the other included a subsample of ado-
lescents recently hospitalized for psychiatric difficulties
(Schulz etal., 2005). Overall, data was gathered from 3,775
participants (sample size ranged from 17 to 1044 partici-
pants), with adolescents’ mean age being 13.39years. Two
studies did not report the mean ages (Klosowska etal., 2020;
Mooney etal., 2017). To capture the developmental period
of adolescence desired, one study was included where the
age range spanned into children younger than 11years (Haag
etal., 2022) and two studies were included where the age
range spanned into adolescents aged 19years (Klosowska
etal., 2020; Zimmer-Gembeck etal., 2018).
Conceptualization ofEmotion Regulation Flexibility
Across the included studies, ERF was conceptualized
in a variety of ways. For the purposes of this review, we
organized definitions into two categories: (1) regulation
of expressed emotion and (2) repertoire of ER strategies.
ERF was measured in four ways: Informant reports on
Selection
Compar-
ability
Outcome
Representativeness of thesample
Selectionofthe comparison sample
Assessment of thepredictor
Controlling forpreviouslevelsofoutcome
Controllingfor ageorgender
Controlling for additionalvariables
Assessment of outcome
Follow-up periodlong enough
Follow-up sample adequate /Missing data
0% 10% 20% 30% 40% 50%60% 70% 80% 90% 100%
Lowrisk of bias Highriskofbias N/A
Fig. 1 Risk of bias by domain and question across the included studies using the Newcastle–Ottawa Scale
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702 Clinical Child and Family Psychology Review (2024) 27:697–713
questionnaires (n = 6), experimental paradigm (n = 2), as
well as qualitative interview (n = 2), and EMA protocol
(n = 1).
Regulation ofExpressed Emotion
Six studies operationalized ERF as the ability to flexibly
modulate facial expressions of emotion in alignment with
situational demands. One research group established the
concept of expressive flexibility for youth, defined as the
ability to flexibly enhance or suppress facial emotional
expression in line with situational demands (Haag etal.,
2022). Also adhering to this approach, four more studies
defined ERF as expressive flexibility, assessed via either a
laboratory task or a questionnaire (Wang & Hawk, 2019,
2020; Wang etal., 2020, 2022). One additional study defined
ERF similarly and utilized the term modulation of emotional
expression (Schulz etal., 2005).
Regulation of expressed emotion was captured through
methods that spanned experimental paradigms(Wang &
Hawk, 2019; Wang etal., 2020), questionnaires (Haag etal.,
2022; Wang & Hawk, 2020; Wang etal., 2022), and inter-
view (Schulz etal., 2005).
The experimental measure of expressive flexibility in
the form of the Expressive Flexibility Task (EFT) was first
developed and utilized with an adult population (Bonanno
etal., 2004) and repeatedly validated across a wide variety
of various community, veteran and clinical adult populations
(i.e., Gupta & Bonanno, 2011; Rodin etal., 2017; West-
phal etal., 2010). A version of the EFT was adapted for use
with adolescents in China. This study followed the same
instructions as the original task – while viewing emotion-
inducing (positive and negative) pictures, adolescents were
specifically instructed to either express their facial emotion
expressions, suppress their emotional expression, or behave
naturally. Blinded coders recorded the intensity of positive
and negative emotion, and these codes were tabulated to cre-
ate expressive flexibility scores following formulas defined in
the original paradigm (Bonanno etal., 2004; Westphal etal.,
2010). Expressive enhancement, expressive suppression, and
an overall within-subject flexibility score were calculated
(Wang & Hawk, 2019; Wang etal., 2020).
Relatedly, two questionnaires were developed to capture
expressive flexibility in youth. The Flexible Regulation of
Emotional Expression Scale for Youth (FREE-Y; Haag etal.,
2022) was directly adapted from the adult version of the
Studies identified
through database
searching
(n= 1074)
Studies after duplicates
removed
(n= 627)
Studies screened
(n= 627)
Studies excluded
(n= 524)
Full-text articles
assessed for eligibility
(n= 103)
Studies included in
review
(n= 11)
Full-text articles excluded, with reasons
(n= 92)
-No definition (n= 4)
-Use of specific strategy versus
flexible use (n = 5)
-Not on individual level (n = 3)
-Intervention study (n = 7)
-Sample Age (n= 34)
-Focus on related constructs (n= 39)
Included Eligibility ScreeningIdentification
Studies identified
through other
sources
(n= 1)
Fig. 2 PRISMA flow chart for determining study inclusion
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703Clinical Child and Family Psychology Review (2024) 27:697–713
Table 2 Summary of included studies
Authors / Year Location Sample Size Age Mean (SD) Age Range (years) Study Design Definition ERF Measurement of
ERF
Primary Findings
Haag etal. (2022)USA Study 1: 439; Study
2: 172; Study
3: 43
Study 1: 11.42
(1.44); Study
2: 17.05 (1.97);
Study 3: 13.11
(2.62)
8–19 Cross-Sectional
study
Expressive flex-
ibility: Ability to
flexibly enhance or
suppress emotional
expression
Questionnaire
(FREE-Y)
Validity of theFREE-
Y; lower flexibility
scores for mal-
treated versus com-
parison participants
Klosowka etal.
(2020)
Belgium 214 NA 10–18 Cross-Sectional
range of stressor
types (IV); Adjust-
ment outcomes
(DV); ER role
(Moderator)
Ratio of maladap-
tive/adaptive
ER strategies to
represent how ER
operates in one
participant; both
the use and the
adaptability of ER
strategies depend
on the specific
context in which
they are used
Questionnaire
(FEEL-KJ)
Impact of stressors
on psychological
and physiological
outcome moderated
by flexibility scores
Lougheed and Hol-
lenstein (2012)
Canada 177 13.6 (1.1) 12–16.9 Cross-Sectional
study
ER repertoire that
enables flexible
deployment of
multiple strategies
(one at a time or
multiple strategies
at same time)
Questionnaires
(ERQ, ASQ, DERS)
Latent profiles of
five ER strategies.
Greater ER rep-
ertoire associated
with lower levels
of internalizing
problems
McKone etal., 2022 USA 129 12.26 11–13 Ecological momen-
tary assessment
(EMA)
Switching emotion
regulation strate-
gies
Self-report in EMA Individuals differed
in the extent of
strategy switching.
Switching strategies
was associated with
age & individual
and within-person
differences in
perceived control-
lability, emotional
intensity, and co-
regulatory support
Mooney etal.
(2017)
New Zealand 38 NA 5–15 Longitudinal/
Descriptive
phenomenological
framework (inter-
views)/Qualitative
coding
Varied use of
multiple coping
strategies to better
manage diverse
challenges
Interview coding Greater coping
abilities and post-
disaster adjustment
were associated
with employment
and use of diverse
set of strategies
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704 Clinical Child and Family Psychology Review (2024) 27:697–713
Table 2 (continued)
Authors / Year Location Sample Size Age Mean (SD) Age Range (years) Study Design Definition ERF Measurement of
ERF
Primary Findings
Schulz etal. (2005)USA 72 14.6 14–15 Longitudinal Study Modulation of
emotional expres-
sion: the ability
to modulate emo-
tional expressions
and responses
Interview coding Better ability to
modulate emotional
expressions when
negatively aroused
was associated with
lower hostility when
parents displayed
hostile behavior
toward each other
Wang and Hawk
(2019)
China 368 12.21 (1.58) 9–15 Longitudinal/
Experimental /
Lab-based task
Expressive Flex-
ibility: flexible
modulation of
emotion expres-
sions to align
with situational
demands
Experimental
Paradigm (adapted
from adult EFT)
Expressive flexibility
was associated with
positive peer rela-
tions
Wang and Hawk
(2020)
China Study 1: 549; Study
2: 248, Study 3:
199; Study 4: 48
Study 1: 12.42
(1.70); Study
2: 12.74 (0.38);
Study 3: 13.57
(0.63); Study 4:
12.43 (0.38)
8–16 Cross-Sectional/
Validation of
Measure/ Experi-
mental
study
Expressive Flex-
ibility: flexible
modulation of
emotion expres-
sions to align
with situational
demands
Questionnaire
(CAFE)
Validity of CAFE
scale; lower flex-
ibility scores were
observed across
clinical outcome
variables (depres-
sion, problem
behaviors)
Wang etal. (2020) China Study 1: 147; Study
2: 100
12.42 (0.38) 12–14 Cross-Sectional/
Experimental
Manipulation
Paradigm
Expressive Flex-
ibility: flexible
modulation of
emotion expres-
sions to align
with situational
demands
Experimental
Paradigm (adapted
from EFT)
Bidirectional effects
were observed
between expressive
flexibility and peer
acceptance
Wang etal. (2022) China 274 13.56 (0.63) 12–15 Longitudinal Study Expressive flex-
ibility: flexible
modulation of
emotion expres-
sions to align
with situational
demands
Questionnaire
(CAFE)
Friendship quality
positively predicted
expressive flex-
ibility; expressive
flexibility was a
positive predictor
for friendship qual-
ity for participants
with lower social
anxiety
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705Clinical Child and Family Psychology Review (2024) 27:697–713
scale (Burton & Bonanno, 2016). Referring to Bonnano’s
paradigm of expressive flexibility (Bonanno etal., 2004),
researchers in China developed the Child and Adolescent
Flexible Expressiveness (CAFE) scale (Wang & Hawk,
2020). Both self-report instruments are based on a scenario
approach where adolescents rate their perceived ability to
modulate (i.e., enhance and suppress) their displayed emo-
tion across different hypothetical social scenarios. A flexibil-
ity score is derived from the enhancement and suppression
scores.
Similarly, open-ended interviews of adolescents were
transcribed and coded using the Haan Q-sort of Defending
and Coping Processes (Haan, 1993). Of the 60 descriptors,
eight captured an individual’s ability to modulate emotional
and behavioral reactions, especially when challenged by
difficulty or when experiencing distress. A higher score of
modulation of emotions expression was indicative of greater
ERF (Schulz etal., 2005).
Repertoire ofEmotion Regulation Strategies
Five studies defined ERF as the demonstration and varied
use of a repertoire of diverse ER strategies (Klosowska etal.,
2020; Lougheed & Hollenstein, 2012; McKone etal., 2022;
Mooney etal., 2017; Zimmer-Gembeck etal., 2018). How-
ever, these studies slightly differ in their approaches. One
study defined ERF as the ability to demonstrate the develop-
ment of ER repertories and to determine at any particular
moment whether the use of singular or multiple strategies
was most needed (Lougheed & Hollenstein, 2012). Three
other studies used this definition but expanded upon the role
of context. Specifically, these studies defined ERF as the
ability to demonstrate varied use of multiple strategies and
successful determination of strategies that would be most
adaptive across various contextual demands (Klosowska
etal., 2020; McKone etal., 2022; Mooney etal., 2017).
This definition highlights not only the variation in strategy
use that may be most beneficial to an individual but also
the necessity of evaluating context. Similarly, another study
defined ERF as the ability to access a range of strategies
that can be flexibly deployed to match changing demands of
stressful situations (Zimmer-Gembeck etal., 2018).
In studies where ERF was based on a repertoire of ER
strategies, the construct was measured via three methodo-
logical approaches: the use of questionnaires (n = 3), qualita-
tive interview coding (n = 1), and EMA ( n= 1). The three
studies utilized self-report questionnaires to measure ado-
lescent ERF (Klosowska etal., 2020; Lougheed & Hollen-
stein, 2012; Zimmer-Gembeck etal., 2018). Klosowska etal.
(2020) assessed ERF via the Dutch version of the German
scale Fragebogen zur Erhebung der Emotionsregulation bei
Kindern und Jugendlichen (FEEL-KJ; Cracco etal., 2015)
to calculate the ratio of putative maladaptive ER strategy
Table 2 (continued)
Authors / Year Location Sample Size Age Mean (SD) Age Range (years) Study Design Definition ERF Measurement of
ERF
Primary Findings
Zimmer-Gembeck
etal. (2018)
Australia 558 16.0 (1.50) 12–19 Cross-Sectional
study
Access to a range of
coping responses
that can be flexibly
deployed to match
changing demands
of stressful epi-
sodes
Questionnaire
(SFCS)
Validity of the SFCS;
lower scores were
linked with greater
anxiety and depres-
sive symptoms,
problem behaviors,
and lower self-
worth
FREE-Y Flexible Regulation of Emotional Expression Scale – Youth, FEEL-KJ Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen, SPANE Scale of Positive &
Negative Experiences, EFT Expressive Flexibility Task, CAFE Child & Adolescent Flexible Expressiveness Scale, SFCS Self-Perception of Flexible Coping with Stress, ERQ Emotion Regula-
tion Questionnaire, ASQ Affective Style Questionnaire, DERS Difficulties in Emotion Regulation Scale, NA not available
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
706 Clinical Child and Family Psychology Review (2024) 27:697–713
use to putative adaptive ER strategy use. Although the theo-
retical underpinnings of ERF eschew categorizing strate-
gies as uniformly adaptive or maladaptive (referred to as
the fallacy of uniform efficacy, Bonanno & Burton, 2013),
the FEEL-KJ calculates both a total score for putatively
adaptive and maladaptive strategies and a ratio of maladap-
tive ER strategy use over adaptive ER strategy use for each
individual. Zimmer-Gembeck etal. (2018) developed a new
measure, the Self-Perception of Flexible Coping with Stress
(SFCS) scale that assesses the range of ER strategies and
the extent to which they were flexibly deployed to match
changing demands with three dimensions: multiple coping
strategy use, situational coping, and coping rigidity. Multi-
ple ER strategy use was measured as the extent to which an
individual endorsed confidence in using multiple and new
strategies; situational coping was represented by items that
recorded the extent to which an individual understood the
use of different ER strategies for different situations; and
lastly, coping rigidity was measured by items that captured
the extent to which an individual utilized the same ER strat-
egy or demonstrated a lack of ability to change strategies.
Mean dimensions scores were calculated as a representation
of different components of ERF.
McKone and colleagues (2022) employed a daily life
EMA design over the course of 16days to capture ERF, here
broadly defined as ER strategy switching between assess-
ments. At each assessment, adolescents were asked to report
on their most recent negative social interaction and choose
one ER strategy from nine options. ER strategy switching
was then operationalized as reporting a different ER strat-
egy at that assessment compared to the previous assessment.
Defined this way, ER strategy switching produced measur-
able individual differences that were moderated by multiple
individual and contextual factors, including age, emotional
intensity of the negative interpersonal situation, perceived
controllability, and co-regulatory support available (McKone
etal., 2022).
Lougheed and Hollenstein (2012) indirectly measured
ERF by first assessing the endorsement of ER strategies
through various self-report questionnaires. Five ER strate-
gies were captured: Reappraisal and suppression strategies
were assessed with the Emotion Regulation Questionnaire
(ERQ; Gross & John, 2003); Concealing and Adjusting were
assessed and captured by the respective subscales of the
Affective Style Questionnaire (ASQ; Hofmann & Kashdan,
2010); and Emotional engagement was obtained as the index
score across four subscales of the Difficulties in Emotion
Regulation Scale (DERS; Gratz & Roemer, 2004). Using
these data, ERF was then defined as the ability to use mul-
tiple strategies at the sametime. The authors also observed
different patterns of ERF based on Latent Profile Analysis.
One study identified a repertoire of ER strategies and their
use through qualitative coding of interviews conducted with
children and adolescents (Mooney etal., 2017). Systematic
thematic analyses were conducted to identify initial catego-
ries which were then organized into meaningful clusters and
resulted in the identification of six major themes/strategies:
regulating felt emotions, problem-solving, positive appraisal
and reframing, helping others, getting support, and moving
forward. ERF was then measured by the indication of how
many strategies were utilized and when (under what settings)
the different strategies were employed effectively.
Associations ofERF toEmotional, Behavioral
andSocial Functioning
Across all included studies, irrespective of operationalization
and measurement, ERF was positively related to a range of
outcomes of emotional, behavioral, and social functioning.
ERF has been shown to be significantly linked to lower lev-
els of adolescents’ internalizing problems (Lougheed & Hol-
lenstein, 2012), depression and social anxiety (Wang etal.,
2022; Zimmer-Gembeck etal., 2018), higher endorsements of
positive affect and fewer problem behaviors (Wang & Hawk,
2020; Wang etal., 2022), and to greater abilities of adapting to
challenges and coping after an adverse event (Mooney etal.,
2017). Similarly, findings indicated that greater ERF resulted
in better overall management of stressors and various chal-
lenges and that ERF was associated with greater general self-
worth (Zimmer-Gembeck etal., 2018). Furthermore, lower
ERF scores were revealed among youths exposed to maltreat-
ment compared to a healthy control sample and small but sig-
nificant negative correlations were shown between ERF and
depression, social anxiety, and school avoidance (Haag etal.,
2022). The EMA study that captured real-time ERF oversam-
pled for risk of internalizing disorder by screening adolescents
for dispositional fearfulness and shyness and found that higher
dispositional shyness was associated with a lower likelihood
of ER strategy switching (McKone etal., 2022). ERF was sig-
nificantly associated with interpersonal relationship and func-
tioning; in a longitudinal study, greater friendship quality at
time 1 predicted greater ERF at time 2 (Wang & Hawk, 2019;
Wang etal., 2022). In addition, greater peer acceptance was
seen among adolescent participants when ERF was endorsed
by their partner, suggesting that peer exclusion may be linked
to impairments in the development of expressive regulation
(Wang etal., 2020). Regarding parental relationships, ado-
lescents who displayed higher ERF abilities were less likely
to show increased hostility to parental figures (Schulz etal.,
2005).
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707Clinical Child and Family Psychology Review (2024) 27:697–713
Discussion
We sought to provide an overview of the various concep-
tualizations of the ERF construct as it applies to a younger
population, and to evaluate the operationalization of the
construct to date. We found that only a limited number of
studies have investigated and defined adolescent ERF. In
addition, the construct has been defined in various and
inconsistent ways thereby challenging our understand-
ing of what constitutes ERF in adolescents and how it
could serve as a potentially protective factor for adolescent
functioning. Our review identified 11 studies that utilized
two overarching definitions of ERF in adolescents: (a) the
regulation of expressed emotion and (b) repertoire of ER
strategies. A majority of studies focused on the former
definition of investigating individuals’ ability to flexibly
modulate their emotional expression according to situ-
ational demands. This work is compatible with the recent
shift inER research in adults from individual ER strate-
gies viewed as inherently adaptive or maladaptive towards
a more person-situation perspective that emphasizes the
match between strategy use and contextual demands
(Bonanno etal., 2004).
Conceptualizing Adolescent ERF
The studies we identified on youth ERF measured two iso-
lated components, attending to situational demands and
strategy repertoire. Theories of regulatory flexibility in
adults typically encompass more elaborated multi-com-
ponent ERF models. Bonanno and Burton’s (2013) model,
described above, included three serially related component
abilities, later termed the flexibility sequence (Bonanno,
2021): being sensitive to contextual cues, selecting from
a diverse repertoire of ER strategies, and monitoring
and potentially modifying an enacted strategy based on
feedback regarding its efficacy. Not only does this model
include additional components, e.g., use of corrective
feedback, it also specifies the serial relationship of the
components, e.g., the ability to decode the situational con-
text feeds into the choice of strategy during the repertoire
step, which in turn informs the action of the feedback step.
Given that adolescence is characterized by considerable
changes in cognition, emotion, and social relations, such
multi-component serial models would be especially useful
in guiding further research but also valuable to capture the
dynamic nature of adolescence.
Regarding ER strategy repertoire, five studies included
in the present review measured this dimension in terms of
variability in ER strategy use across time and stressor situ-
ation, known as temporal variability (Bonanno & Burton,
2013). While temporal variability captures one aspect of
repertoire, models of ERF have placed critical importance
on the fit between strategy use and situational demands,
i.e., strategy efficacy (Aldao etal., 2015; Bonanno etal.,
2004, 2023; Levy-Gigi etal., 2016). The limitation of
focusing only on strategy variability becomes readily
apparent when its relationship to psychological adjustment
is considered. Whereas conceptualizations of repertoire
that take into account strategy efficacy are linearly related
to adjustment (e.g., Bonanno etal., 2004, 2011; Cheng
etal., 2012; Lenzo etal., 2021), strategy variability by
itself has been shown to exhibit a curvilinear relationship
to adjustment. More specifically, too much or too little
strategy variability has been linked to psychopathology
(Hollenstein etal., 2013; McKone & Silk, 2022).
Another crucial aspect of ERF not yet addressed in the
developmental literature is the role of motivation. ERF is
typically enacted in the context of emotionally evocative or
distressing situations. Engaging with a stressor event to a
sufficient degree to attend to its contextual nuances, enact a
regulatory response, and then monitor its efficacy requires
at least some cognitive and emotional resources (Bonanno
etal., 2023). Although currently available theoretical models
of ERF vary to some extent in their aim and scope, these
models generally agree that engaging the resources required
for ERF requires some degree of motivation (Aldao etal.,
2015; Bonanno & Burton, 2013; Cheng etal., 2014; Kash-
dan & Rottenberg, 2010). At present, measurement of the
motivational component in the adult ERF literature has been
limited to self-report assessments. Nonetheless, it will be
important for future research on ERF in youth to explore the
role of motivation using these or other indices.
Lastly and importantly, future research will have to find
greater consensus regarding the conceptualization of ERF in
adolescents, to use consistent terminology and standardized
measures in order to facilitate comparison across studies,
underscore common patterns and derive the best practices
to support adolescents.
Related Frameworks inDevelopmental Psychology
While our review synthesizes the literature regarding ado-
lescent self-regulation flexibility, it is worth considering
the related concept of emotion dynamics, which has gained
increased attention in recent developmental research. Emo-
tion dynamics research focuses on analyzing how individu-
als’ emotional experiences, i.e., emotional states, change
over time in response to context, and how this impacts psy-
chosocial adjustment (reviewed in Hollenstein, etal., 2013;
McKone & Silk, 2022). Two prominent emotion dynam-
ics constructs have emerged, namely (1) affective vari-
ability, defined as reactivity to the interpersonal situation,
with a focus on the rate of change in emotional states, and
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708 Clinical Child and Family Psychology Review (2024) 27:697–713
(2) socioaffective flexibility, defined as the ability to move
through a range of affective states over time and arange of
emotional states expressed during interpersonal interactions,
usually measured in the context of caregiver–child dyad
interactions. Socioaffective flexibility has also been referred
to as socioemotional flexibility (Hollenstein etal., 2013) or
dyadic affective flexibility (Mancini & Luebbe, 2016). These
constructs reveal an interesting and often neglected aspect
of ER, which is that ER not only manifests on the individual
level, but also on interpersonal levels across systems. Dyadic
approaches are important to consider as they measure two
individuals’ ability to be flexible together across emotional
reactions, can allow dyads to recognize interaction patterns
and can create pathways to explore the influence of both
individual characteristics (e.g., symptomatology) as well as
dynamic family processes (Hollenstein etal., 2004; Mancini
& Luebbe, 2021; Van Bommel etal., 2019). Dyadic or even
triadic (Hollenstein etal., 2015) family-level approaches are
also important as they provide insights into the impact of
caregivers on their offspring’s emotion dynamics and ER
development pertaining to conceptualizations of ER as a
family-level phenomena (e.g., co-regulation; reviewed in
Paley & Hajal, 2022).
A body of affective variability research has amassed that
utilized different operationalizations to capture metrics of
the construct, including the frequency of transitions among
different emotion states and the duration of each emotion
state, measured both on the individual and the dyadic level.
While numerous studies used laboratory observational tasks
to code expressed emotions (e.g., Van Bommel etal., 2018)
and present them on state-space grids (e.g., Hollenstein
etal., 2004, 2013; Mancini & Luebbe, 2021; Van der Gies-
sen & Bögels, 2018; Van der Giessen etal., 2015), recent
approaches also applied more intensive longitudinal data
assessments using daily diary entries to assess daily emo-
tion dynamics (Lichtwarck-Aschoff etal., 2009; Mak etal.,
2023).
Both affective variability and socioaffective flexibility
have been associated with internalizing and externalizing
symptoms in children and adolescents, indicating that lower
levels of (dyadic) affective variability are associated with
greater levels of symptoms (e.g., Hollenstein etal., 2004;
Lougheed & Hollenstein, 2016; Van der Giessen etal.,
2015). However, the directionality of results has not been
consistent across studies and associations between affec-
tive variability and outcomes of psychopathology were not
always linear, but, as described before for temporal variabil-
ity, at times curvilinear (McKone & Silk, 2022).
Operationalization ofAdolescent ERF
Another important area for future research will be to fur-
ther probe the validity of ERF assessment approaches. The
available studies used a broad range of measure to assess
ERF, including questionnaires, observation, interview, diary
coding and experiments. While such methodological variety
has its advantages, the largest proportion of studies included
in our review assessed ERF exclusively from self-report
questionnaires (n = 6, 37.5%). More objective study designs
including naturalistic settings are needed. One study used
an EMA protocol, and only two studies used experimental
approaches. To date the only existing experimental design
to assess ERF is the EFT (Bonanno etal., 2004), which has
been used almost exclusively with adult populations. While
this paradigm was recently adapted for use with Chinese
children and adolescents (Wang & Hawk, 2019), it has yet
to be adapted and validated across diverse cultures and ado-
lescent populations, including both clinical and community
samples. A comparable self-report scale assessing ERF in
youth, the FREE-Y (Haag etal., 2022) was recently adapted
from an adult version. An advantage of this approach is its
high level of external validity through its inclusion of real-
life interpersonal scenarios. It will be critical, however, for
future research to also validate the FREE-Y against more
objective experimental data.
The various types of ERF assessments have different
benefits. While experimental approaches maximize internal
validity, they are limited in ecological validity due to their
artificial nature and are limited in their potential for appli-
cation to longitudinal or prospective field research (Burton
& Bonanno, 2016). Self-report questionnaires, on the other
hand, might represent a better way to capture subjective
experiences and imply greater external validity. Observa-
tional coding of behaviors allows for an assessment of ERF
abilities in naturalistic environments and thus can include
detailed information about the actual context. In addition,
daily diary or EMA study designs appear to be promising
avenues for future research on ERF since they can offer a
more thorough situational assessment. Whereas one-shot
measures of ER, such as questionnaires or experimental
designs, have limited ability to capture important nuances
in the ER process or how individuals use ER abilities across
contexts, naturalistic designs provide informative data on
how ERF abilities might influence social and emotional out-
comes across different social contexts. Lastly, since ERF is
conceptualized primarily as a process, capturing that pro-
cess in real-time in reference to real-life challenges is crucial
(Bonanno etal., 2023).
Associations ofERF andEmotional, Behavioral
andSocial Functioning
In our review we also sought to elucidate the role of ERF
in adolescents’ emotional, behavioral and social function-
ing. Despite their differing conceptualizations of adoles-
cent ERF, the available studies demonstrated associations
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709Clinical Child and Family Psychology Review (2024) 27:697–713
between ERF and more positive outcomes across an array
of variables, including clinical outcomes, such as lower
levels of depression and anxiety or fewer problem behav-
iors, and social outcomes, such as better relationship
quality with caregivers and peers. While ERF research
in adolescence is nascent, these results nonetheless attest
to the potentially beneficial role of ERF supporting ado-
lescent functioning and representing a protective skillset.
These findings also suggest that deficits in ERF abili-
ties, in turn, may serve as transdiagnostic mechanisms in
the development and maintenance of difficulties in emo-
tional, behavioral, and social functioning. Developmental
psychologists have characterized “mature ER ability” as
the ability to deploy various specific strategies in a man-
ner that effectively matches changing situational demands
(Skinner & Zimmer-Gembeck, 2007). Complimentarily,
then, if ER abilities are not maturely developed, ado-
lescents’ ability to flexibly regulate their emotions may
be impeded and, in the extreme, may develop into full-
blown psychopathology. Consistent with this supposition,
one study in our review that included a clinical sample
revealed lower levels of dyadic ERF in caregiver-child
dyads where the child endorsed anxiety (Van der Gies-
sen & Bögels, 2018). There is also evidence that ERF is
reduced in adolescents exposed to maltreatment (Haag
etal., 2022). It will hence be essential for future studies to
investigate ERF in clinical adolescent samples (e.g., ado-
lescents struggling with psychopathology and/or exposed
to adverse events). This will increase our ability to gener-
alize findings across various populations and complement
findings from adult research by further establishing the
buffering role of ERF (e.g., Bonanno etal., 2004; West-
phal etal., 2010).
In terms of clinical implications, the corpus of research
on ERF summarized in our review can inform interven-
tion strategies to foster psychological adjustment and
protect against untoward effects of potentially traumatic
events. Training flexible self-regulation should be a target
of intervention development research as it appears to be
functioning as a transdiagnostic mechanism and could
be applied in psychotherapeutic practice. Improving ERF
skills could either be integrated into existing more global
interventions, such as mindfulness-based stress reduction
or acceptance commitment therapy, or a specific ERF
training program that borrows elements from established
approaches targeting related areas, such as Dialecti-
cal Behavior Therapy (Linehan, 2015). Given that the
effectiveness of ER strategy use is dependent on fit with
situational demands, flexibility interventions should aim
to increase individual’s awareness and understanding of
how they select, implement and, when needed, reviseER
strategies.
Limitations oftheCurrent Review andFuture
Directions
Our review represents the first systematic effort to summa-
rize existing conceptualizations of adolescent ERF to guide
and unify future approaches. However, several important
limitations should be considered. From a methodological
point of view, our review was limited to studies published
in English-language and in peer-reviewed journals in order
to adjudicate quality. As such, there is a risk of reporting
bias, possibly leading to relevant studies not being included
in the present review. Further, the present review focused
only on the existing literature in adolescents between the
ages of 11 and 17years. Future research needs to investi-
gate age-related differences and developmental changes in
ERF across childhood and adolescence and needs to take
into account contextual factors. For example, during adoles-
cence, sensitivity to social feedback increases (Somerville,
2013) as peer relationships become more important and less
stable (Hardy etal., 2002), leaving adolescents vulnerable
to experiences of victimization and rejection by peers. The
use of social scenarios in assessment instruments, such as
the FREE-Y (Haag etal., 2022), to some extent accommo-
dates this sensitivity. However, additional research will be
needed to more fully probe this point. It will also be crucial
to address other key non-social aspects of adolescent ERF.
Finally, it will be important to expand ERF research
beyond individual assessments to encompass the dyadic or
family-level studies, as described above for affective vari-
ability. And, at a broader level, it will be crucial for future
ERF research to probe different units of analyses, e.g.,
dyadic ERF at a caregiver-adolescent or family-system level,
while also elucidating the relationship between adolescent
and caregiver ERF. Such analyses would allow for examina-
tion of potential bidirectional effects, the role of ERF on a
family level, as well as the intergenerational transmission
of ERF abilities. In the same vein, it will be important to
examine the role of socialization processes in the shaping
of adolescent ERF.
Conclusions
In the present review, we summarized 11 studies examining
adolescent ERF from two broad perspectives: the regulation
of expressed emotion and the repertoire of emotion regula-
tion strategies. We highlighted the variety of conceptualiza-
tions and the range of applied methodologies. Future ERF
research focusing on greater conceptual clarity, attention to
research design and contextual demands can advance the
understanding of ERF development and its impact on indi-
vidual trajectories of psychological adjustment throughout
the lifespan. More research is needed to extend the study
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710 Clinical Child and Family Psychology Review (2024) 27:697–713
of adolescent ERF by including the investigation of ado-
lescents’ sensitivity to contextual demands, their use of
feedback processes to adapt the use of ER strategies as well
as motivational aspects of ERF in adolescents, if possible,
within the same data set. It has become increasingly appar-
ent that ERF plays an important role in adjustment to con-
textual challenges related to both development during ado-
lescence in general as well in the context of highly stressful
life events. For this reason alone, it is apparent that amore
comprehensive study of ERF in youth is needed.
Author contributions AH and RB conceptualized the study, conducted
literature searches, and provided summaries of previous research stud-
ies. AH and RB wrote the first draft of the manuscript. GB provided
supervision, editing and critical review of the writing. All authors con-
tributed to and have approved the final manuscript.
Funding Open Access funding enabled and organized by Projekt
DEAL. No funding was received for conducting this study.
Declarations
Competing Interests The authors have no competing interests to
declare that are relevant to the content of this article.
Ethics Approval This is a systematic review. No ethical approval is
required.
Consent This is a systematic review. No consent is required.
Open Access This article is licensed under a Creative Commons Attri-
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... While adolescents tend to prefer informal help and studies demonstrate the potential benefits of best friend support (Ali et al. 2015;Singh et al. 2019;Smit et al. 2022), these benefits may be decreased or even disappear at when adolescents start to co-ruminate. Adolescents may therefore benefit from support in recognizing when they are engaging in co-rumination and learning to flexibly adapt their emotion regulation strategies to fit situational demands by building a diverse repertoire of (dyadic) strategies, such as co-reappraisal and co-problem-solving with friends (Do et al. 2023;Haag et al. 2024). ...
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Decades of research have consistently shown that the most common outcome following potential trauma is a stable trajectory of healthy functioning, or resilience. However, attempts to predict resilience reveal a paradox: the correlates of resilient outcomes are generally so modest that it is not possible accurately identify who will be resilient to potential trauma and who not. Commonly used resilience questionnaires essentially ignore this paradox by including only a few presumably key predictors. However, these questionnaires show virtually no predictive utility. The opposite approach, capturing as many predictors as possible using multivariate modelling or machine learning, also fails to fully address the paradox. A closer examination of small effects reveals two primary reasons for these predictive failures: situational variability and the cost-benefit tradeoffs inherent in all behavioural responses. Together, these considerations indicate that behavioural adjustment to traumatic stress is an ongoing process that necessitates flexible self-regulation. To that end, recent research and theory on flexible self-regulation in the context of resilience are discussed and next steps are considered.
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Daily emotion dynamics provide valuable information about individuals’ emotion processes as they go about their lives. Emotion dynamics such as emotion levels (mean), emotion variability (degree of fluctuation), and emotion network density (strength of temporal connections among emotions) are associated with risks for various psychopathology in youth and adults. Prior work has shown that caregivers and friends play crucial socializing roles in adolescent emotional well‐being, but less is known about their roles in daily emotion dynamics. This study examined whether caregiver emotion coaching, caregiver‐adolescent closeness, and friendship quality were associated with adolescents’ emotion levels, emotion variability, and emotion network density. Further, we examined whether caregiver‐adolescent closeness moderated the associations between coaching and emotion dynamics. Participants were 150 adolescents (61% girls; Mage = 14.75) and one of their caregivers (95% female; Mage = 43.35) who completed a baseline survey and 21 daily surveys. Results showed that caregiver emotion coaching interacted with caregiver‐adolescent closeness in predicting emotion levels and variability. Specifically, when closeness was higher, emotion coaching was significantly associated with lower sadness and anger levels, higher happiness levels, and lower happiness variability. Caregiver emotion coaching, independent of closeness, was also associated with lower anxiety levels, lower sadness variability, and lower emotion network density. Friendship quality was significantly associated with lower levels of sadness, anxiety, and anger, higher levels of happiness, and lower variability in anxiety and anger. These findings suggest that caregivers and friends are central to everyday emotion levels and variability and a more flexible emotion system in adolescents.
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Adolescence is a dynamic period for the development of emotion regulation. For many individuals, emotion regulation skills improve dramatically during adolescence. However, for some youth adolescence marks the beginning or worsening of psychopathology characterized by difficulties with emotion regulation. In the present review, I describe evidence that caregiving experiences play an outsized role in shaping interindividual variability in emotion regulation during adolescence. After describing work demonstrating links between caregiving – with an emphasis on parental socialization practices – and emotion regulation outcomes, I characterize our current understanding of how behavioral and neurobiological indices of emotion regulation develop normatively across adolescence. Using cognitive reappraisal as an exemplar emotion regulation strategy, I outline ways that caregiving might impact interindividual variability in emotion regulation neurodevelopment. I conclude by identifying two key future directions for adolescent emotion regulation research.