A meta-analysis examining emotional regulation skills in youth with depression.

Introduction: The resources and skills a person has available to manage their emotional experiences – their emotional regulation skills – are related to their mental wellbeing. These skills can be classified as adaptive (helpful, e.g., acceptance) or maladaptive (unhelpful, e.g., avoidance). This meta-analytic review assessed the association between the use of adaptive and maladaptive emotional regulation skills, and symptoms of depression in adolescents. Unlike previous meta-analyses, we included studies spanning the full adolescent range from 10 to 25 years, and explored whether any associations were moderated by phase of adolescence (early, middle, or late). Methods: This meta-analytic review was pre-registered on PROSPERO (CRD42023460510). Three electronic databases were searched and systemically reviewed using pre-outlined inclusion/exclusion criteria e.g. adolescents aged between 10-25 years, and valid self-report measures of depression and six emotion regulation strategies, three adaptive (acceptance, reappraisal, problem-solving) and three maladaptive (rumination, suppression, avoidance).Results: Random effects meta-analyses were conducted. 44 studies (92 effect sizes) met the inclusion criteria for analysis. Effects were quantified for the full adolescent age range (10-25 years), and separately for early (10-14), mid (15-18) and late adolescence (19-25). There was a significant relationship between four emotion regulation strategies, one adaptive (reappraisal) and three maladaptive (suppression, rumination, and avoidance), and depression. These effects were not moderated by stage of adolescence (early, middle, or late). Conclusion: The use of maladaptive emotion relation strategies was linked to elevated symptoms of depression, with weaker evidence for an association between the use of adaptive strategies and reduced depressive symptoms. These results suggest adolescents using maladaptive strategies are likely to be at increased risk for mental health problems. We interpret these results in terms of the potential for teaching adaptive strategies to adolescents who frequently use maladaptive strategies to reduce symptoms of depression.