Systematic review Executive dysfunction is commonly reported following stroke with most research in this area focused on frontal lobe lesions. A systematic review was carried out to evaluate the evidence of executive dysfunction following stroke as compared to control groups. It was found that executive functions are consistently impaired following stroke and is not limited to frontal lobe lesions. Processing speed, mental flexibility, attention and working memory impairments were found to be the most common executive functioning impairments following stroke. Given the impact executive dysfunction may have on successful rehabilitation, relationships, return to work and quality of life, a comprehensive assessment of such difficulties is important following stroke to aid in the development of appropriate and effective rehabilitation strategies. Future research should use larger samples and a wide range of measures to assess different aspects of executive functioning. Introduction Mood disorders and psychological distress are common following stroke, and depression and emotional lability have been studied extensively. There has, however, been little research into difficulties in emotion regulation following stroke and whether this is associated with emotional or cognitive difficulties. The current study investigated emotion regulation difficulties following stroke and their relationship with quality of life, executive functions, anxiety and depression. Method Fifty participants who had suffered a stroke and forty five age matched controls completed the Difficulties in Emotion Regulation Scale, the Hospital Anxiety and Depression Scale, the World Health Organization Quality of Life assessment – Brief version and the National Adult Reading Test. In addition individuals with stroke completed four measures of executive functioning – Color Trails Test, Verbal Fluency, Brixton Spatial Anticipation Test and the Hayling Sentence Completion Test. Results Individuals with stroke had significantly greater difficulties in emotion regulation compared to age matched controls and this was significantly associated with lower self reported quality of life and increased levels of both anxiety and depression. No significant associations were found between emotion regulation and executive functions or between executive dysfunction and lower self reported quality of life. Discussion The current study found evidence that individuals who have suffered a stroke have more difficulties in emotion regulation than an age matched control group. This is clinically important as emotion regulation difficulties are found in mood disorders and it may be that such difficulties precipitate and/or maintain depression following stroke. The absence of an association between difficulties in emotion regulation and executive functioning suggests that other factors may influence such difficulties, such as the trauma of having a stroke. Future research should explore emotion regulation difficulties further following stroke, particularly investigating whether the course of these difficulties changes over time and if they are linked to type of stroke or lesion location.

The main purpose of this study was to explore the relationships between age, temperament, emotional regulation, creative drama and preschoolers¡¦ creativity. The participants included 116 preschool children sampling from kindergartens in Taipei, Kaohsiung, and Hsinchu City. The employed instruments were The Childhood Temperament Inventory, The Checklist of Creative Drama Instruction, The Checklist of Emotional Regulation Strategy, and The Test of Creativity. The data were collected via observation, interviews, and questionnaires; and the applied analysis methods were Descriptives, One-way Multivariate Analysis of Variance, One-way Univariate Analysis of Variance, Canonical Correlation, and Discriminant Analysis. The main findings in this study were as follows¡G 1.While significant gender differences on temperament were found, no significant differences were found on the preschoolers¡¦ performances in emotional regulation and creativity. 2.The children in the big class outperformed those in the middle class on creativity. 3.Temperament had significant differences on the preschools¡¦ creativity; more specifically, those with positive temperament outperformed those with negative temperament on the overall creativity performance, and the temperament of ¡§persistence¡¨ had the highest correlation with the preschoolers¡¦ performances on ¡§novelty¡¨ and ¡§usefulness¡¨. 4.Emotional regulation had positive influences on the preschools¡¦ creativity; more specifically, the ¡§social strategy¡¨ of emotional regulation had the highest correlation with the preschoolers¡¦ performances on ¡§novelty¡¨ and ¡§usefulness¡¨. . 5.Creativity drama instruction had significant differences on the preschools¡¦ creativity performance as well as on ¡§novelty¡¨ and ¡§usefulness¡¨. 6.Age, temperament, emotional regulation, and creative drama could jointly predict the preschools¡¦ ability group of creativity. Finally, the researcher proposed some suggestions for educational instruction and future studies.

This Thesis follows the portfolio format and a brief overview is given here. Chapter one is a systematic review of the literature on the relationship between emotion regulation, anxiety and depression in older adults. Chapter two is a research journal which explores the relationship between fear of falling and emotion regulation in community dwelling older adults. The systematic review is written up for publication in the Journal of Affective Disorders. The research article is written up for publication in Aging and Mental Health. Their respective style guidelines were followed. Purpose The aim of the thesis was to explore the relationship between emotion regulation and psychological distress in older adults. The aim of the systematic review was to explore the relationship between self-reported emotion regulation, anxiety and depression in older adults. The empirical study aimed to look at the relationship between fear of falling, a common type of psychological distress in older adults, and emotion regulation. It also aimed to look at the relationship between fear of falling related avoidance behaviour and emotion regulation. Methods The literature was systematically searched for research which has explored the relationship between emotion regulation, anxiety and depression in older adults. The papers which met the inclusion criteria were rated according to predetermined quality criteria. An overview of the results and implications were discussed. The empirical research used a cross-sectional design to examine the research hypothesis. Older adults completed self-report measures of emotion regulation, fear of falling, fear-related avoidance behaviour, anxiety and depression. Correlational analysis explored the relationship between the study variables. A linear regression model examined the unique contribution of emotion regulation to fear of falling after controlling for age, falls history, anxiety and depression. Results 12 studies met the inclusion criteria for the systematic review. The most prevalent relationship explored was that between rumination and depression with consistent evidence that higher levels of rumination were related to higher levels of depressive symptoms. Common methodological limitations were the lack of valid and reliable emotion regulation measures for older adults, non-random sampling, and failure to control for important confounding factors. Within the empirical research, a significant relationship between emotion regulation and fear of falling was found. There was also a significant relationship between emotion regulation and fear of falling avoidance behaviour. After controlling for age, number of falls, depression and anxiety, emotion regulation was no longer significantly associated with fear of falling. Depression was the only modifiable variable that retained a significant association to fear of falling.

Background: Around 33-50% who attend treatment for substance use disorder (SUD) and alcohol use disorder (AUD) have a history of trauma. Experiencing trauma can lead to psychological disorders, difficulties with emotional regulation and dissociation. SUD and AUD can be chronic, relapsing disorders and understanding what individual factors affect addiction has important implications for treatment. Objective: The systematic review was interested in whether alexithymia affects abstinence after relapse prevention treatment (both psychological and pharmacological). The review was also interested in whether alexithymia is a stable trait after relapse prevention treatment (both psychological and pharmacological) as measured by the Toronto Alexithymia Scale. The research study investigates the relationships between trauma, dissociation, alexithymia, emotional regulation and SUD, AUD and polysubstance use. There has been little research looking at the relationships between these variables and how they compare in different types of substance use. It was hypothesised that patients with poly-substance addiction will have higher incidents of trauma, dissociation, alexithymia and poorer emotional regulation when compared to alcohol and drug dependence alone. Methods: A systematic search of articles published between January 1989 - January 2017 was carried out following the Cochrane (2008) guidelines. PSYCHInfo, Medline and Cinahl were the key databases searched. Papers were quality assessed to identify strengths and weaknesses. The research study is a qualitative, cross-sectional design that involved ninety-one AUD, SUD and poly-substance use participants who were attending outpatient NHS addiction services. They were asked to complete questionnaires assessing trauma, dissociation, alexithymia and emotional regulation. Results: The systematic review found twelve articles that related to the review questions. The systematic review found alexithymia did not impact on abstinence and there was no difference between abstinence after treatment between low and high alexithymic groups. There were mixed results for whether alexithymia score changes after relapse prevention treatment. Overall, the results suggest that alexithymia is relatively stable across SUD and AUD after relapse prevention treatment. The empirical study found that there is no difference between type of addiction and trauma, alexithymia and emotional regulation. People with polysubstance misuse reported significantly higher levels of dissociation than the other two groups. Multiple regression was conducted on the full data set and it was found that emotional regulation, alexithymia and dissociation were able to predict trauma in alcohol, drug and polysubstance users. Conclusions: The systematic review found that despite the assumption that people with alexithymia have higher rates of relapse and attrition this is not the case. Alexithymia has no impact on treatment outcome. The review also found that CBT was identified as an effective relapse prevention treatment for people with alexithymia. The research paper highlighted that the type of substance used by people who have experienced trauma may not be as important as previously thought. Also, understanding that poor emotional regulation, alexithymia and dissociation commonly co-occur with trauma so it may be important to screen for this when treating people with trauma who have co-morbid addictions.

Stigma is one factor posited to play a role in the negative physical and mental health sequelae of sexual victimization (e.g., Finkelhor & Browne, 1985). Stigma has been shown to be associated with negative health outcomes across various marginalized populations, including LGBT individuals (e.g., Hatzenbuehler et al., 2014), and difficulties with emotion regulation (DERS) have been shown to be one mechanism through which stigma leads to psychological outcomes (Hatzenbuehler et al., 2009). This study sought to examine if DERS (Gratz & Roemer, 2004) mediated the relation between sexual victimization stigma (Gibson & Leitenberg, 2001) and physical health outcomes of general self-rated health and somatic symptoms (SSS-8; Gierk et al., 2014) in a sample of college students (N=194, 79% female, 81% white) in rural Appalachia with an experience of sexual victimization. Emotion regulation difficulties significantly mediated the relation between stigma and both health outcomes [self-rated health: R2 = .07, F(2,179) = 7.20, p < .01, indirect effect t(179) = -2.64, p < .01, CI = -.011, - .001; somatic symptoms: R2 = .23, F(2,180) = 27.50, p < .000, indirect effect t(180) = 5.41, p < .000, CI = .05, .02]. Results highlight the importance of considering the role of stigma for survivors of sexual violence, as well as suggest a treatment target in increasing emotion regulation skills.

The purpose of this study is to examine how respiratory sinus arrhythmia (RSA) is affected across paced breathing, attention, inhibition, and emotion-eliciting tasks and how those relationships may be mediated by emotion regulation strategies in children with different levels of externalizing and internalizing behaviors between the ages of 8 and 12 years. The first aim was to determine whether externalizing and internalizing symptoms during a paced breathing or natural breathing task better predicted RSA levels. The hypothesis was that internalizing and externalizing behaviors would be more predictive of RSA baseline levels when utilizing a paced-breathing method of measuring RSA. The second aim was to determine how RSA levels across an attention, inhibition, sad, and anger task are predicted by internalizing and externalizing symptoms after controlling for baseline RSA levels. There were four hypotheses: (1) as levels of externalizing behaviors increase, levels of baseline RSA would decrease, (2) as levels of internalizing behaviors increase, levels of baseline RSA will decrease, (3) there will be significantly smaller changes in RSA reactivity) as the level of externalizing behaviors increases, and (4) as levels of internalizing symptoms increase, there will be significantly larger changes in RSA levels relative to RSA baseline levels (RSA reactivity).The results showed that externalizing and internalizing behaviors did not predict RSA levels during a paced or natural breathing task. Additionally, there was very little difference in the outcomes when used either a natural or paced breathing method of RSA as a control variable except when predicting RSA levels during a sad emotion-eliciting task. Although RSA levels during three experimental tasks (attention, inhibition, and sad) were not significant, there were moderate effect sizes for externalizing and/or internalizing symptoms predicting various RSA reactivity (i.e., RSA levels after controlling for baseline) across these conditions. One model was significant in predicting the level of variance of RSA reactivity during an anger emotion-eliciting task, with internalizing and hyperactivity/inattention symptoms contributing the most variation in the model. Findings point towards understanding how internalizing and externalizing symptoms may impact an individual's physiological response during a task.

Aim: The aim of the study is to explore the relationships between an adolescent’s weight and parenting style, emotional eating, and emotional regulation and lifestyle behaviours to further develop the understanding of the factors that contribute to the current epidemic of childhood obesity. Design: A cross sectional survey design was used. Method: 112 adolescents, aged between 16 and 18 from three secondary schools in Scotland completed a self-report questionnaire on their mother and father’s parenting style, their own emotional regulation strategies, emotional eating and lifestyle behaviours. Their height and weight was measured by the researcher and used to calculate the adolescents’ BMI. Results: Overall, this study did not find that adolescent’s healthy food habits, exercise and emotional eating predicted BMI. There were no significant relationships found between BMI and parenting style, emotional eating and emotional regulation. Conclusion: These findings suggest that parenting style, emotional eating, emotional regulation and lifestyle behaviours are not related to adolescent weight.

Research has linked emotional regulation to the adaptive functioning of adolescents. Further research suggests that family processes, which include implicit rules, impact children's emotional regulation. The current study examined the impact of implicit rules that are facilitative of family connectedness on development of adolescents' emotional regulation. Data came from the Flourishing Families Project (FFP), a seven-year longitudinal study measuring family processes that impact adolescent development. The sample was collected in the northwestern United States and consisted of 500 families with a target child between the ages of 10 and 14 years. Participants filled out self-report measures on implicit family rules and emotional regulation. Data was organized in a cohort sequential design and analyzed using latent variable growth curve modeling. Results indicated that there was no statistically significant growth in emotional regulation across the adolescent years. Results further indicated that initial status of facilitative rules did not have a statistically significant effect on growth in emotional regulation. Finally, growth in facilitative rules was found to have a statistically significant impact on growth in emotional regulation. Clinical implications for work with adolescents and families are discussed.

The aim of this study was to investigate emotions and emotion regulation of a downsizing in an industrial company. The sample consisted of persons who had experienced a downsizing but have kept the employment, within a same position or being transferred to another one. Data consisted of two focus group interviews, analysed by an inductive thematic analysis. The results have indicated that emotional reactions changed over time as well the emotional regulation did during the different phases. The groups differed in emotional reaction related to the time of decision regarding the retention of employment. One conclusion is that fast and accurate information during the different phases of a downsizing process may lead to more positive emotional reactions, which in consequence may result in a positive experience of the reduction process as a whole. The confidence in management increased across the time, due to its decisiveness during the process of downsizing. / Syftet med studien var att undersöka individers emotionella upplevelser och emotionsreglering i samband med nedskärningsprocess på ett industriföretag. Urvalet bestod av individer som varit med om en nedskärningsprocess och fått behålla sin anställning, antingen på samma tjänst eller blivit omflyttade till annan tjänst. Data samlades in genom fokusgruppsintervjuer och analyserades med induktiv tematisk analys. Resultatet indikerar att de emotionella upplevelserna av nedskärningsprocessen förändrades över tid liksom emotionsregleringen vid de olika faserna i processen. Resultaten från de olika grupperna vad gäller emotionell reaktion skiljer sig åt framförallt vid tidpunkten för beslut om behållande av anställning. En slutsats är att snabb och tydlig information i samband med nedskärningsprocessens olika faser leder till mer positiva emotionella upplevelser, vilket bidrog till att nedskärningsprocessen som helhet upplevdes som positiv. Företagsledningens agerande, som visade på handlingskraft, ledde till ett ökat förtroende för företagsledningen.

Very preterm birth is an important developmental and public health concern, with clear evidence to suggest that very preterm children may be at long term risk of neurodevelopmental impairment and educational difficulties. Although a great deal is known about the neurodevelopmental outcomes associated with very preterm birth,comparatively little is known about the social competence of children born very preterm during the important early childhood period. Therefore, as part of a prospective, longitudinal study, this research examined the social competence of 105 children born very preterm (birth weight <1,500 g and/or gestational age ≤33 weeks) and 108 full term comparison children (gestational age 37-40 weeks) at age 4 years (corrected for extent of prematurity at birth). The aims of this study were 1) to examine the social competence of a regional cohort of children born very preterm and full term comparison children at age four years, 2) to identify infant clinical factors and socio-familial characteristics associated with poor social competence amongst children born very preterm, and 3) to examine the predictive validity of social competence problems amongst both very preterm and full term preschoolers in relation to school academic functioning and behavioural adjustment at age 6 years. At age 4, children were assessed using a range of parent and/or teacher completed questionnaires, spanning emotional regulation, behavioural adjustment and interpersonal social behaviour. Measures included the Emotion Regulation Checklist, the Infant-Toddler Symptoms Checklist, the Strengths and Difficulties Questionnaire, the Behaviour Rating Inventory of Executive Functioning “ Preschool version and the Penn Interactive Peer Play Scale. In addition, as part of a structured research assessment, children completed a battery of false belief tasks and a short form version of the Weschler Preschool and Primary Scales of Intelligence. Two years later at age 6, school teachers qualitatively rated children's behavioural adjustment and academic achievement in math, reading, spelling and language comprehension compared to their classroom peers. Results showed that relative to their full term peers, some children born very preterm tended to score less well across several areas of social competence. Specifically, parent report showed that children born very preterm were more likely to be characterised by higher levels of emotional dysregulation (p=.002) as well as a range of behavioural adjustment problems, spanning inhibitory control problems (p=.03), hyperactivity/inattention (p=.01), conduct problems (p=.01) and emotional symptoms (p=.008). While elevated rates of behavioural adjustment difficulties were also evident amongst very preterm children within the preschool environment, group differences were not statistically significant. However, a statistical trend towards elevated risk of inhibitory control problems amongst very preterm children in the preschool environment was noted (p=.09). Further, children born very preterm were at around a four-fold risk of emotional regulation difficulties of clinical significance,as well as being around 1.5 times more likely to exhibit clinically significant externalising and internalising behavioural difficulties and interpersonal social problems at age 4 years. In contrast, the interpersonal social behaviours and the extent of social cognitive understanding were largely similar across both groups. This pattern of findings remained largely unchanged following statistical control for the selection effects of family socio-economic status. Amongst children born very preterm, significant infant clinical and sociofamilial predictors of both emotional dysregulation and externalizing behaviour were male gender (p=.008/p=.006), neonatal indomethacin (p=.002/p=.005) and elevated maternal anxiety (p=.009/p=.002). Emotional dysregulation was also predicted by low socio-economic status (p=.002). In contrast, internalising behaviour was predicted only by low birth weight (p=.03). Finally, across both groups significant associations were found between overall social competence problems at age 4 years and later school adjustment with those very preterm and full term preschoolers characterised by poor social competence being at elevated risk of a range of behavioural adjustment difficulties and poor academic functioning in reading, spelling and math at age 6 years (corrected). Links between poor social competence and later behavioural adjustment remained across both groups following statistical control for child IQ, while associations with academic functioning were largely attenuated. By age 4 years a number of very preterm children are beginning to display elevated levels of emotional dysregulation, hyperactivity/inattention, conduct problems and emotional symptoms. Further, a substantial proportion of very preterm children may be at risk of developing clinically significant difficulties with these most pronounced in terms of emotional regulation abilities. Children's abilities to regulate their emotions and behaviour represent important building blocks for their later social and emotional functioning. Further, these abilities will likely influence the extent to which children are able to successfully transition to school. Therefore,alongside other important aspects of development, these findings highlight the importance of monitoring the social abilities of preschoolers who were born very preterm across a range of developmental domains and contexts. Preschoolers characterised by emotional, behavioural and/or interpersonal difficulties could then receive targeted intervention aimed at facilitating their social competence prior to school entry.