Emotion regulation, attention and mindfulness in adolescents with social, emotional and ...

194 Pages·2015·2.57 MB·English

by  Pip Day

Emotion regulation, attention and mindfulness in adolescents with social,
emotional and behavioural difficulties.

Philippa Bullemor-Day
June 2015

Research submitted in partial fulfilment of the requirements for the degree of Doctor
in Clinical Psychology (DClinPsy), Royal Holloway, University of London.

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Acknowledgments

I would like to say a massive thank you to both my supervisors, Catherine Sebastian
and Tamsin Owen, for their invaluable support and guidance throughout this whole
process. I would also like to thank my research assistant, Tyler Saunders, for all his
help collecting the data, and cutting the time it would have taken me in half, and John
Rogers at Delosis for the time and effort he put into creating the computerised battery,
and his support and patience with me trying to use it! Also, to all the schools, teachers
and students that took part, I am extremely grateful for your time and perseverance
with the study tasks. Finally, I would like to thank the family and friends that have
listened to me moan for the last few months but continued to encourage and support
me as always.

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Abstract
Social, emotional, and behavioural difficulties (SEBD) impact significantly on the
life, education, and psychological wellbeing of adolescents. A central factor in the
development and maintenance of SEBD is emotion regulation (the ability to regulate
emotional responses). Emotion regulation has been linked to attention and
mindfulness, where studies have showed positive correlations between these
constructs. Mindfulness-based interventions are beginning to be widely used, however
have been studied very little in adolescents with SEBD, despite this population being
recognised as having distinct difficulties with emotion regulation and attention, and a
group in need of helpful interventions. Furthermore, there is little research exploring
the mechanisms underlying mindfulness, particularly in adolescents. The present
study aimed to investigate the relationships between emotion regulation, attention and
mindfulness in adolescents with SEBD and controls. In particular, the study explored
the mediating role of attention in the relationship between mindfulness and emotion
regulation, and looked specifically at the effect of varying levels of callous-
unemotional traits on these relationships. Adolescents aged 11-16 with identified
SEBD and controls participated in the study which used self-reported and teacher-
rated questionnaires as well as cognitive tasks to measure levels of SEBD, emotion
regulation, attention and trait mindfulness. The results showed there were significant
positive correlations between emotion regulation, attention and mindfulness in
adolescents with SEBD and in controls, when using particular measures of these
variables. Attention was found to significantly mediate the relationship between
mindfulness and emotion regulation. The results, however, showed little support for
any differences between the relationships between these constructs in those with
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varying levels of callous-unemotional traits. The results are helpful in adding to
theories surrounding emotion regulation, attention and mindfulness in adolescents,
particularly in adolescents with SEBD, where research is more limited, and have
important implications for developing and tailoring interventions in both clinical and
educational settings.

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List of Tables

Table 1: Breakdown of participant demographics by group…...................................81
Table 2: Means, SDs and ranges for self-reported questionnaire scores….…………82
Table 3: Means, SDs and ranges for teacher-rated questionnaire scores……………87
Table 4: Means, SDs and ranges for the emotional n-back task......…………………90
Table 5: Means, SDs and ranges for the flanker task………..………………………93
Table 6: Correlations between emotion regulation, attention and mindfulness
variables………………………………………………………………………………98
Table 7: Correlations between emotion regulation, attention and mindfulness
variables for those with high and low levels of callous-unemotional
traits…………………………………………………………………………………107

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List of Figures

Figure 1: Process model of emotion regulation reproduced from Gross and Thompson
(2007, p. 10)………………………………………………………………………….20
Figure 2: The components of attention based on Posner & Petersen
(1990)………………………………………………………………………………...33
Figure 3: Attention as a mediator in the relationship between mindfulness and
emotion regulation…..………………………………………………………………..56
Figure 4: Emotional n-back stimuli showing the fixation cross and numbers flanked
by emotional faces………………...…………………………………………….........66
Figure 5a: Flanker task trial sequence for congruent cue and congruent target
condition.…..................................................................................................................68
Figure 5b: Flanker task trial sequence for incongruent cue and congruent target
condition.…..................................................................................................................68
Figure 5c: Flanker task trial sequence for congruent cue and incongruent target
condition.…..................................................................................................................69
Figure 5d: Flanker task trial sequence for incongruent cue and incongruent target
condition.…..................................................................................................................69
Figure 6: Mean accuracy scores on the two n-back conditions for SEBD and control
groups………………………………………………………………………………...90
Figure 7a: Flanker task mean accuracy scores for each condition across
groups…..…………………………………………………………………………….95
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Figure 7b: Flanker task mean reaction times for each condition across
groups…..…………………………………………………………………………….95
Figure 8: Mediating effect of attention on the relationship between mindfulness and
emotion……………………………………………………………………………...105

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Table of Contents
Title Page………………………………………………………………………………1
Acknowledgements……………………………………………………………………2
Abstract………………………………………………………………………………..3
List of Tables…………………………………………………………………………..5
List of Figures………………………………………………………………………....6
Chapter 1:
Introduction…………….…………………………………………………………...14
1.1 Overview…………………………………………………………………14
1.2 Social, emotional, and behavioural difficulties…………………………..16
Conduct problems and callous-unemotional traits in SEBD…………17
1.3 Emotion regulation……………………………………………………….18
Definition……………………………………………………………..18
Emotion regulation strategies………………………………………...19
Development of emotion regulation strategies……………………….21
Emotion regulation and mental health………………………………..21
Emotion regulation and SEBD……………………………………….23
Emotion regulation and conduct problems…………………………...26
Measuring emotion regulation………………………………………..28
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1.4 Attention………………………………………………………………….32
Definition……………………………………………………………..32
Attention and emotion regulation…………………………………….33
Attention as an emotion regulation strategy………………….33
Training attention to improve emotion regulation…………...35
1.5 Mindfulness………………………………………………………………38
Definition……………………………………………………………..38
State versus trait mindfulness………………………………………...38
Measuring mindfulness………………………………………………40
Mindfulness-based interventions……………………………………..42
Research in adults…………………………………………….43
Research in adolescents………………………………………44
Theories of mindfulness……………………………………………...50
Mechanisms underlying mindfulness………………………………...51
Attention as an underlying mechanism of mindfulness……...52
Emotion regulation as an underlying mechanism of
mindfulness…………………………………………………..53
Attention as a mediator between mindfulness and emotion
regulation……………………………………………………..55
1.6 Rationale for the present study…………………………………………...56
1.7 The present study…………………………………………………………58
Hypotheses…………………………………………………………...59
Chapter 2: Method……..…………………………………………………………...61
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2.1 Participants……………………………………………………………….61
Sample………………………………………………………………..61
Inclusion criteria……………………………………………………...61
Exclusion criteria……………………………………………………..61
Power analysis………………………………………………………..62
Ethical approval………………………………………………………62
2.2 Measures………………………………………………………………….63
Design………………………………………………………………...63
Experimental tasks…………………………………………………...63
Questionnaire measures………………………………………………69
Psychometric measures………………………………………………75
2.3 Procedure…………………………………………………………………75
Chapter 3: Results…………………………………………………………………..78
3.1 Data screening……………………………………………………………78
3.2 Participant demographics………………………………………………...79
Gender, age and ethnicity…………………………………………….79
Socio-economic status………………………………………………..79
IQ……………………………………………………………………..80
3.3 Questionnaire data………………………………………………………..82
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