|Year : 2017 | Volume
| Issue : 4 | Page : 312-318
Emotion regulation and psychological problems among Indian college youth
TP Lavanya, M Manjula
Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
|Date of Web Publication||17-Nov-2017|
T P Lavanya
Department of Clinical Psychology, Dr. M.V. Govindaswamy Building, NIMHANS, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Background: Study of emotion regulation strategies used by youth becomes necessary in the background of the high prevalence of emotional disorders in this population. This study examined emotion regulation and psychological problems among college youth as well as the relationship between the two. Methodology: Four hundred and nineteen students, who were divided into two groups (older adolescents, aged 16-17 years - group 1, n = 217; young adults aged 18-25 years - group 2, n = 202) participated in this exploratory study. Results: Predominantly positive emotion regulation strategies were used by group 1 (positive refocusing, refocus on planning, and positive reappraisal, respectively). The sample as a whole used more positive strategies (positive refocusing: 82% and 64% and refocus on planning: 93% and 87% in groups 1 and 2, respectively). Significant correlations between emotion regulation strategies (CERQ) and psychological problems (YSR/YASR) were found, thereby indicating that negative emotion regulation strategies were associated with psychological problems and vice versa. Females were found to have more of anxiety problems as opposed to males with more of conduct problems. However with increase in age, increase in the percentage of psychological problems and usage of negative emotion regulation strategies was observed. Conclusion: The findings of the present study contribute to understanding the patterns of emotion regulation in various emotional disorders. Findings could also contribute to developing an intervention program to help students having difficulty in regulation of their emotions.
Keywords: College students, emotion regulation, psychological problems
|How to cite this article:|
Lavanya T P, Manjula M. Emotion regulation and psychological problems among Indian college youth. Indian J Soc Psychiatry 2017;33:312-8
|How to cite this URL:|
Lavanya T P, Manjula M. Emotion regulation and psychological problems among Indian college youth. Indian J Soc Psychiatry [serial online] 2017 [cited 2018 Mar 22];33:312-8. Available from: http://www.indjsp.org/text.asp?2017/33/4/312/218601
| Introduction|| |
Emotions have been considered as a very integral part of human existence. “Emotion regulation processes are those mechanisms that serve to modulate, inhibit, and enhance emotional experiences and expressions, and may be both effortful and automatic.” Individuals tend to engage in usage of some kind of emotion regulation strategy as part of their waking life, therefore, management and control of emotions have important health implications. Gross  in his seminal research proposed the process model of emotion regulation, where he described five emotion regulation strategies, namely, situation selection, situation modification, attentional deployment, cognitive change, and response modulation. These strategies enable people to regulate their emotions; however, individual differences exist with respect to usage of a particular strategy, as well as the success with which, they apply the strategies. Cultural differences have been observed with respect to impact and usage of emotion regulation strategies. Despite studies in the area of emotion regulation being in its infancy, among East Asian Cultures  a rise in the same has however been observed.
Wealth of research has indicted that emotion regulation is one of the core features of various forms of psychopathology  and has been linked to outcomes in mental health. Deficits in emotion regulation have often been manifested as internalizing and externalizing disorders.,, Research has also differentiated between the adaptive and maladaptive emotion regulation strategies based on their relationship with symptoms. Acceptance, reappraisal, and problem solving have been considered as adaptive strategies since they have indicated negative associations with psychopathology. Conversely, avoidance, suppression, worry, and rumination have been considered as maladaptive strategies, due to their positive associations with psychopathology. Differentiation also exists with respect to strategies used by those with either internalizing or externalizing disorders. The emotion regulation strategies that have been linked with the internalizing spectrum consists of cognitive reappraisal, emotional suppression, ruminative reflecting, ruminative brooding, and avoidance., Depression has also been inversely related to positive emotion regulation strategies. With regard to externalizing disorders, studies on addictions and aggressive behavior have indicated the presence of high emotional arousal, self-blame, and impulsivity., Research among the eastern cultures has indicated that students who indulged in self-injurious behavior had higher levels of emotion regulation difficulties like nonacceptance of emotions, difficulty in goal directed behavior, impulse control, limited access to strategies, and lack of emotional clarity. Hence emotion dysregulation could be implicated as a transdiagnostic factor relevant across different types of psychopathology.
Age-related changes in specific emotion regulation strategies have been observed. According to Gross and John, age-related changes are expected because of contextual and experiential changes. Experience of emotions by younger and older adults differ, leading to a stable or an upward trend in positive emotions with age and a downward trend in experience of negative emotions. Gender differences have indicated that girls and older children use less of suppression as a strategy compared to boys and younger children. Self-blame, catastrophizing, rumination, and positive reappraisal emerged as few of the most valuable predictors of negative emotions among adolescents in a community sample. Strategies used by students to handle their emotions while they were about to face exams were distancing from the situation, suppression, and reappraisal. However, as stated by Thompson and Calkins, a priori assumptions about positives and negatives of an emotion regulation strategy cannot be made as usage of these strategies is often context specific. Hence, it becomes important to understand the emotion regulation strategies used by college youth (older adolescents and young adults) in the background of the high prevalence of emotional disorders in this population. This study also attempts to examine the relationship between emotion regulation and psychological problems which can aid in the development of intervention models to promote positive mental health among youth.
| Methodology|| |
The participants (n = 419) consisted of students in Bengaluru who were divided into two groups, those belonging to pre-university (group 1, n = 217) and graduation (group 2, n = 202) courses. A cross-sectional design with purposive sampling method was used. The inclusion criteria included students belonging to the age range of 16-25 years, knowledge of English to answer the questionnaires and belonging to Indian nationality. The tools used in this study are:
Sociodemographic data sheet: This consists of information about the participant's identification, viz., age, sex, education, socioeconomic status, residence, religion, marital status, type of family, birth order, siblings, whether family members stay together, presence of a chronic physical disability or a major psychiatric/drug dependence problems in the family.
Cognitive emotional regulation questionnaire: This is a 36-item questionnaire consisting of the following nine conceptually distinct subscales, each consisting of four items: self-blame, other blame, rumination, catastrophizing, putting into perspective, positive refocusing, positive reappraisal, acceptance, and planning. The items are measured on a 5-point Likert scale. Individual subscale scores are obtained by summing the scores belonging to the particular subscale (ranging from 4 to 20). Higher score on each subscale indicated greater usage of the particular emotional regulation strategy. Previous research on cognitive emotion regulation strategies has shown that all subscales have good internal consistencies ranging from 0.68 to 0.86. CERQ has good factorial validity and high reliabilities, with Cronbach's alpha ranging between 0.75 and 0.87. In addition, the cognitive emotion regulation strategies accounted for considerable amounts of variance in emotional problems.
Youth self-report: This is a 112-item questionnaire, scored on a 3-point Likert scale. This questionnaire is standardized for children and adolescents ages between 11 and 18 years. The YSR provides scores on 8 empirically derived syndrome scales and 6 Diagnostic Statistical Manual (DSM) oriented scales. The syndrome scales used for this study include, affective problems, anxiety problems, somatic problems, attention deficit hyperactivity disorder, oppositional defiant problems, and conduct problems.
It is a self-administered questionnaire and has been widely used cross-culturally. This questionnaire has been seen to have an excellent reliability (ranging from 0.63 to 0.94).
Young adult self-report: It is a 126-item self-report questionnaire which is meant for adults (ages 18-59). It is scored on a 3-point Likert scale. This scale assesses different aspects of a person's adaptive functioning and problems. The ASR provides scores on 8 empirically derived syndrome scales, 6 DSM oriented scales, and questions about substance use. The syndrome scale used for this study includes depressive problems, anxiety problems, somatic problems, avoidant personality problems, attention deficit/hyperactivity problems, and antisocial personality problems.
For both YSR and YASR T-score was obtained based on the total score for each of the subscales using the ASEBA software programme. T-scores were used to categorize the subjects into either of the three groups: clinical, normal, and borderline.
Procedure: The sample was selected from five colleges chosen in the city of Bengaluru according to the inclusion and exclusion criteria. The data collection was carried out between August 2013 and January 2014. The study protocol was reviewed and approved in the protocol committee of the Department of Clinical Psychology. The administration was conducted in groups consisting of a whole class of students (30-100 per class). The questionnaires were administered on 500 college students, out of which 79 forms were invalid. Hence, the final sample comprised of 419 students.
Analysis of data: Descriptive statistics like frequency and percentage were calculated for the sociodemographic variables of the two groups. Group 1 consisted of pre-university students and group 2 consisted of graduation students. Normal distribution was checked before using parametric tests. Mean and standard deviation were computed for subscales of cognitive emotion regulation questionnaire and the subscales of the youth self report and young adult self-report. Correlation was conducted to study the relationship between emotion regulation and psychological problems, t-test was conducted to study the age and gender differences in the above mentioned variables.
| Results|| |
The mean age of group 1 was 16.4 years (SD ± 0.5) and that of group 2 was 19 years (SD ± 1.9). Majority of the participants were females in both groups. In group 1, majority of students (93.5%) were from the science stream, whereas in group 2, majority of them belonged to the arts stream (59.4%). Majority of students in both the groups belonged to nuclear families in an urban habitat. Only a minority of the students reported the presence of family history of psychiatric illness [Table 1].
Emotion regulation strategies: Refocus on planning, positive reappraisal, and positive refocus are the predominantly used positive strategies by both groups. However, group 1 used significantly more of the above said regulation strategies than group 2. The negative emotion regulation strategies used are self-blame, rumination, and acceptance (acceptance used more than moderate levels is considered to be a negative strategy). There is no significant difference between the two groups with respect to negative emotion regulation strategies. There was also no significant gender differences among the emotion regulation strategies used [Table 2].
Psychological problems: On the YSR and the YASR, a comparison of the two groups on psychological problems have indicated that students belonging to group 2 have significantly more psychological problems (on all domains, except avoidant personality and oppositional defiant disorder and Attention Deficit Hyperactivity Disorder (ADHD) since these domains have just been represented, however not compared, since they cannot be combined) compared to students in group 1 [Table 3].
Emotion regulation and psychological problems: Self-blame, acceptance, rumination, catastrophizing, and other blame are negative emotion regulation strategies which have a significant positive correlation with depressive/affective, anxiety problems, and avoidant personality/ADHD problems. Self-blame positively correlates with ODD. Catastrophizing also positively correlates with somatic problems, attention deficit hyperactivity problems/ODD, and antisocial personality/conduct problems. Except for attention deficit hyperactivity problems/ODD, other blame as a strategy correlates with somatic problems and antisocial personality/conduct problems. Similarly positive emotion regulation strategies such as positive refocusing, refocus on planning, and positive reappraisal have a significant negative correlation with the above mentioned psychological problems [Table 4].
|Table 4: Correlation between cognitive emotion regulation strategies and psychological problems|
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Gender differences among psychological problems
More number of females in this study were observed to qualify for the clinical range of anxiety problems compared to males (t = 2.88; P = 0.006) and males to have more of conduct/antisocial and oppositional defiant problems compared to female students (t = 5.49; P = 0.001 and t = 2.461; P = 0.015) [Table 5].
| Discussion|| |
The emotional regulation strategies used by the sample indicate that majority of the students use positive coping strategies (refocus on planning and positive reappraisal) to deal with demands of life situations. These findings suggest a sign of psychological well-being similarly like other studies. Reappraisal and refocusing as emotion regulation strategies have been considered as commonly used strategies to reduce externalizing problems., A comparison of the emotion regulation strategies used by both the two groups indicate that students in group 1 have healthier and more positive ways of handling situations compared young adults belonging to group 2. Academic courses chosen by both groups; science by group 1 and commerce and arts by group 2 might also explain the disparity in the usage of emotion regulation strategies. This finding however might be specific to the Indian context and cannot be generalized, because the academic pressure with respect to those who have chosen the science stream has been observed to be higher in the Indian context, in comparison with commerce and arts. The pressure of scoring good grades in group 1 could have led to a greater usage of problem focused coping strategies, thereby serving them the purpose of handling stress adequately on a regular basis. It can also be explained that, with age, young adults begin to use more negative strategies, which is in sync with the literature. One of the reasons may be that graduation (after Pre-university College (PUC)/plus 12) could be seen as a phase of life, wherein students would have entered adulthood, along with added stressors due to a plethora of reasons such as romantic relationships, staying away from parents, peer influences, course demands, decisions regarding their career, etc. These factors might have increased their demands on their decision-making process causing emotional reactions to be triggered off more often.
Comparison of the groups on psychological problems indicates that students belonging to group 2 have more psychological problems compared to students in group 1. Similar results are reported in a study by Rousoss et al., where young adults have been observed to display more of delinquent behavior, on domains of aggression, delinquency and other externalizing scales. The reason could be that, during late adolescent period, the symptoms of various psychological problems might be in their prodromal phases, becoming more pronounced during adulthood. After the age of 18, a more confident diagnosis could be made, along with a complete formation of personality occurring during this age group. Another reason may be an increase in exposure to life events, which have been considered as one of the main triggering factors for the development of psychological disorders. Studies have not indicated whether, conduct/antisocial problems are more in adolescents or young adults, however they have indicated that young adults' psychological problems might become more prominent than adolescents' due to lack of stringent regulations for adolescents.
In the current study, negative emotion regulation strategies such as self-blame, acceptance, rumination, catastrophizing, and other blame have been positively correlated with psychological problems like depressive/affective, anxiety problems, and avoidant personality and ADHD problems. Positive emotion regulation strategies such as positive refocusing, refocus on planning, and positive reappraisal have a significant negative correlation with the above-mentioned psychological problems. Depression as a psychological problem has been seen as a manifestation of using rumination and self-blame as a way to handle emotions.,, It has been observed that, in conditions like generalized anxiety disorder, individuals resort to usage of perseverative strategies like rumination, worry, and self-criticism as a compensatory mechanism due to their inability to manage their distressing emotions. This is indicative of the role of emotion regulation in the onset, maintenance and treatment of generalized anxiety disorder. An important finding has also been the association between catastrophizing and other blame with conduct/antisocial problems. This finding is contrary to the previous studies about the correlation between internalizing problems and the use of catastophizing as an emotion regulation strategy. These phenomena, could be understood by the fact that, catastrophizing and other blame could make the person believe that, he/she has been subject to distress more than anyone else and that others are to be blamed for it, leading to beliefs that his/her needs and rights have been violated and they need not consider abiding by the societal norms or the rights of others. Violating other's rights and causing them distress could be considered as the only means through which, they could claim justice. The world view for those with conduct/antisocial problems is different from the rest. Conduct/antisocial problems might either not get highlighted at a younger age or despite being highlighted, it might be difficult to state the developmental trajectories or the significant causal factors for these problems. The universal tendency of trying to treat children less leniently for their crimes compared to adults, could also be one of the reasons for the growing rates of conduct problems.
Comparison of males and females on psychological problems indicate that, females qualified more for anxiety problems and males for conduct/antisocial and oppositional defiant problems. Female's level of anxiety sensitivity, menstrual cycles, lower sense of personal control over their life, heightened sensitivity to social cues and tendency to ruminate, etc. might have contributed to the results. Women have been observed to have a greater prevalence of anxiety disorders compared to men, mainly because they tend to internalize their emotions. In this study, male students have been observed to have more oppositional defiant tendencies and conduct/antisocial problems compared to women. This finding could be explained by factors like, high risk behaviors and aggression as well as externalization of their emotions in males. Female's level of conduct/antisocial behaviors was not too less either. This might be presumed since, with age, conduct problems in females could transform into the internalizing spectrum, thereby depicted as anxiety or affective problems. Antisocial problems having emerged as major psychological problem in the current sample could be attributed to an increase in exposure to violence and crime in the developmental period either through media or though electronic sources, lack of adequate parenting, less stringent laws, a divide between the haves and have not's, exposure to the idea of being able to get away with antisocial acts, etc.
Strengths and limitations
The strengths of the study include large sample size, comprehensive evaluation of the variables, good reliability and validity of tools, and a contribution to the growing field of emotion regulation, especially in the Eastern Culture. Few of the limitations of the study include social desirability of responses due to usage of self-report questionnaires and bias in sampling due to restriction of the sample to Bengaluru city only. This might have resulted in a nonrepresentative sample for this age group. The tools used, despite having good reliability and validity, do not have Indian norms. This study could be further replicated cross-culturally, longitudinally, and could also be used to develop of an intervention model focusing on enhancing skills to handle/regulate one's emotions.
| Conclusion|| |
In the overall sample, positive emotion regulation strategies were used more. However, greater usage of these strategies was seen in group 1. Significant differences were seen between the two groups in all the six categories of psychological problems, with group 2 having more psychological problems, compared to group 1. Anxiety problems in females and conduct/antisocial problems in males have been predominant. The findings of the present study contribute to understand the role of emotion regulation in the development of psychological problems.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Gross JJ. Antecedent-and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. J Pers Soc Psychol 1998;74:224.
Zawadzki MJ. Rumination is independently associated with poor psychological health: comparing emotion regulation strategies. Psychol Health 2015;30:1146-63.
Opitz PC, Gross JJ, Urry HL. Selection, optimization, and compensation in the domain of emotion regulation: applications to adolescence, older age, and major depressive disorder. Soc Personal Psychol Compass 2012;6:142-55.
Tull MT, Aldao A. New directions in the science of emotion regulation. Curr OpinPsychol 2015;3:1-122.
Koole SL. The psychology of emotion regulation: an integrative review. Cognition Emotion 2009;23:4-41.
Bariola E, Gullone E, Hughes E. Child and adolescent emotion regulation: the role of parental emotion regulation and expression. Clin Child Fam Psychol Rev 2011;14:198-212.
Kober H, Ochsner KN. Regulation of emotion in major depressive disorder. Biol Psychiatry 2011;70:910.
Carthy T, Horesh N, Apter A, Edge MD, Gross JJ. Emotional reactivity and cognitive regulation in anxious children. Behav Res Ther 2010;48:384-93.
Aldao A. The future of emotion regulation research capturing context. Perspect Psychol Sci 2013;8:155-72.
Arditte K, Joormann J. Emotion regulation in depression: reflection predicts recovery from a major depressive episode. Cognit Ther Res 2011;35:536-43.
Werner KH, Goldin PR, Ball TM, Heimberg RG, Gross JJ. Assessing emotion regulation in social anxiety disorder: the emotion regulation interview. J Psychopathol Behav Assess 2011;33:346-54.
Garnefski N, Teerds J, Kraaij V, Legerstee J, van den Kommer T. Cognitive emotion regulation strategies and depressive symptoms: differences between males and females. Person Ind Diff 2004;36:267-76.
Pierrehumbert B, Bader M, Miljkovitch R, Mazet P, Amar M, Halfon O. Strategies of emotion regulation in adolescents and young adults with substance dependence or eating disorders. Clin Psychol Psychother 2002;9:384-94.
Martin RC, Dahlen ER. Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Person Ind Diff 2005;39:1249-60.
Kharsati N, Bhola P. Patterns of non-suicidal self-injurious behaviours among college students in India. Int J Soc Psychiatry 2014;61:39-49.
Zimmerman P, Iwanski A. Emotion regulation from early adolescence to emerging adulthood and middle adulthood: Age differences, gender differences, and emotion-specific developmental variations. Int J Beh Dev 2014;38:182-94.
Yeung DY, Wong CK, Lok DP. Emotion regulation mediates age differences in emotions. Aging Ment Health 2011;15:414-8.
Gullone E, Hughes EK, King NJ, Tonge B. The normative development of emotion regulation strategy use in children and adolescents: a 2-year follow up study. J Child Psychol Psychiatry 2010;51:567-74.
Schmidt S, Tinti C, Levine LJ, Testa S. Appraisals, emotions and emotion regulation: an integrative approach. Motiv Emotion 2010;34:63-72.
Thompson RA, Calkins SD. he double-edged sword: emotional regulation for children at risk. Dev Psychopathol 1996;8:163-82.
Garnefski N, Kraaij V, Spinhoven P. Manual for the use of the cognitive emotion regulation questionnaire. Leiderdorp, The Netherlands: DATEC 2002.
Garnefski N, Legerstee J, Kraaij V, van den Kommer T, Teerds JA. Cognitive coping strategies and symptoms of depression and anxiety: a comparison between adolescents and adults. J Adolesc 2002;25:603-11.
Achenbach TM, Checklist AD. Youth self report (YSR). Burlington, VT: University of Vermont. 2001.
Achenbach TM, Rescorla L. ASEBA Adult Forms & Profiles: For Ages 18–59: Adult Self-Report and Adult Behavior Checklist. ASEBA, Burlington, VT, 2003.
Karreman A, Vingerhoets AJ. Attachment and well-being: the mediating role of emotion regulation and resilience. Person Ind Diff 2012;53:821-6.
Garnefski N, Kraaij V, van Etten M. Specificity of relations between adolescents' cognitive emotion regulation strategies and internalizing and externalizing psychopathology. J Adolesc 2005;28:619-31.
Roussos A, Francis K, Zoubou V, Kiprianos S, Prokopiou A, Richardson C. The standardization of Achenbach's Youth Self-Report in Greece in a national sample of high school students. Eur Child Adoles Psychiatry 2001;10:47-53.
Hill J, Maughan B. Conduct disorders in childhood and adolescence. Cambridge University Press 2001.
Liverant GI, Kamholz BW, Sloan DM, Brown TA. Rumination in clinical depression: a type of emotional suppression. Cognit Ther Res 2011;35:253-65.
Mennin DS, Fresco DM, Ritter M, Heimberg RG. An open trial of emotion regulation therapy for generalized anxiety disorder and cooccurring depression. Depress Anxiety 2015;32:614-23.
Burke JD, Loeber R, Birmaher B. Oppositional defiant disorder and conduct disorder: a review of the past 10 years, part II. J Am Acad Child Adolesc Psychiatry 2002;41:1275-93.
Pigott TA. Anxiety disorders in women. Psychiatric Clin North Am 2003;26:621-72.
Eaton NR, Keyes KM, Krueger RF, Balsis S, Skodol AE, Markon KE, et al.
An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. J Abnorm Psychol 2012;121:282.gender differences in mental disorder prevalence: evidence from a national sample. J Abnorm Psychol 2012;121:282.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]