A cognitive versus behavioral approach to emotion regulation training for externalizing behavior problems in adolescence: Study protocol of a randomized controlled trial

Abstract

BackgroundInterventions for adolescents with externalizing behavior problems are generally found to be only moderately effective, and treatment responsiveness is variable. Therefore, this study aims to increase intervention effectiveness by examining effective approaches to train emotion regulation, which is considered to be a crucial mechanism involved in the development of externalizing behavior problems. Specifically, we aim to disentangle a cognitive and behavioral approach to emotion regulation training.MethodsA randomized controlled parallel-group study with two arms will be used. Participants are adolescents between 12 and 16 years old, with elevated levels of externalizing behavior problems. Participants will be randomly assigned to either the control condition or the intervention condition. Participants in the intervention condition receive both a cognitive and behavioral emotion regulation module, but in different sequences. Primary outcome measures are emotion regulation skills, emotion regulation strategies, and externalizing behavior problems. Questionnaires will be completed at pre-test, in-between modules, and post-test. Moreover, intensive longitudinal data is collected, as adolescents will complete weekly and daily measures.DiscussionGaining insight into which approaches to emotion regulation training are more effective, and for whom, is important because it may lead to the adaptation of effective intervention programs for adolescents with externalizing behavior problems. Eventually, this could lead to individually tailored evidence-based interventions.Trial registrationThe trial is registered at the Central Committee on Research Involving Human Subjects (NL61104.041.17, September 20th, 2017) and the Dutch Trial Register (NTR7334, July 10th, 2018).

The structure of emotion regulation strategies in adolescence: Differential links to internalizing and externalizing problems

“…Specifically, a subsample of 67 participants (20% of the total sample; 73% boys) were selected based on teacher report of externalizing problems. These adolescents also participated in an experimental emotion regulation study (for more details see te Brinke et al, 2018).…”

Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study

“…intervention approaches [39][40][41][42], techniques / mechanisms [43][44][45] and modes of delivery [46][47][48]. In the following subsections, we summarise the results in terms of endorsed and discarded items organised by category.…”

“…Definitions were primarily sourced from the American Psychological Association’s Dictionary of Psychology [31] and the National Institute of Mental Health’s Research Domain Criteria (RDoC) Constructs Matrix [32], as well as from specialised literature on cognitive processes (i.e. targets) [33–38], intervention approaches [39–42], techniques / mechanisms [43–45] and modes of delivery [46–48]. In the following subsections, we summarise the results in terms of endorsed and discarded items organised by category.…”

Emotional Regulation in Adolescents: A narrative review

“…Third-wave psychotherapies such as dialectical behavior therapy, acceptance commitment therapy, and mindfulness-based cognitive therapy also reserved a specific focus for targeting emotional dysregulation through acceptance and give a pave way to the interpersonal effectiveness of children and adolescents [64] However, more studies are required to augment the evidence [67,68]. In line with the existing evidence, Brinke et al 2018 are in the process of conducting a randomized controlled trial with 186 the aim to assess the comparative effectiveness of cognitive (think cool) versus behavioral (act cool) approach of emotional regulation training in the management of externalizing behavior problems in adolescents [69].…”