Deliberate Emotion Regulation (ER), the effortful regulation of emotions, is strongly linked to psychopathology. In adults, deliberate ER is often experienced as a self-narrative, such as reappraising a negatively perceived scenario. However, researchers have yet to study how young children articulate deliberate ER strategies, whether these strategies relate to real-time ER neurophysiological processes, and how they are associated with psychopathology. Thus, from an existing sample of 59 children, I aimed to examine preschool-aged children’s verbally articulated ER strategies prior to a frustration challenge, and related these strategies to subsequent neural and physiological responses to frustration and psychopathology. I categorized children’s responses into two groups: those who articulated any emotion regulation strategy (i.e., “strategy”) and those who did not articulate a strategy (i.e., “no strategy”). We found that about 70% of children in this age range were able to articulate an emotion regulation strategy. Children who articulated a strategy had lower psychophysiological stress during a frustration task and fewer parent-reported ADHD inattention symptoms than children who did not articulate a strategy. There were no observed differences between groups for Prefrontal Cortex (PFC) activation, parent-reported externalizing symptoms, or parent-reported irritability symptoms. To our knowledge, this study is the first to provide evidence that emotion regulation strategy articulation is an emerging skill, and that children who are able to articulate emotion regulation strategies are also able to change their physiological stress in response to a negative emotion challenge and have fewer symptoms of psychopathology.