Department of Psychology, York University, Toronto, Ontario, Canada.
Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Child Care Health Dev. 2021 Sep;47(5):608-617. doi: 10.1111/cch.12868. Epub 2021 Apr 28.
Many youth with neurodevelopmental disorders (NDDs) experience mental health problems such as anxiety, depression or anger, and these are often associated with impairments of cognition and emotion regulation. The mechanisms that may be linking cognitive difficulties, emotion regulation and mental health are not known.
The current study examined whether adaptive and maladaptive (dysregulated) emotion regulation mediated the link between different cognitive control processes (working memory, inhibition and shifting) and internalizing/externalizing symptoms in children with NDDs.
Participants included 48 children (8-13 years of age) with one or more diagnoses of autism, attention deficit hyperactivity disorder, cerebral palsy and learning disability, who were enrolled in a larger study of cognitive behaviour therapy targeting emotion regulation. Multiple mediation analyses were implemented using the PROCESS macro. The mediation effects of adaptive and maladaptive emotion regulation were examined on the relationships between (1) working memory and internalizing/externalizing symptoms, (2) inhibition and internalizing/externalizing symptoms and (3) shifting and internalizing/externalizing symptoms. All data were collected prior to intervention, at baseline.
Shifting, inhibitory control and working memory predicted increased emotion dysregulation, which functioned as a full mediator to both internalizing and externalizing problems in children with NDDs.
In the presence of emotionally triggering situations, children with greater cognitive challenges experience greater maladaptive emotion regulation, which results in both internalizing and externalizing problems. For youth with NDDs, therapeutic plans that include strengthening of working memory, inhibition and shifting abilities in addition to emotion regulation skills training may be helpful in alleviating externalizing and internalizing behaviour.
许多患有神经发育障碍 (NDD) 的年轻人会经历心理健康问题，如焦虑、抑郁或愤怒，而这些问题通常与认知和情绪调节受损有关。目前尚不清楚可能将认知困难、情绪调节和心理健康联系起来的机制。
本研究旨在检验适应性和适应性不良（失调）情绪调节是否在 NDD 儿童的不同认知控制过程（工作记忆、抑制和转换）与内化/外化症状之间起中介作用。
参与者包括 48 名（8-13 岁）患有自闭症、注意缺陷多动障碍、脑瘫和学习障碍的儿童，他们参加了一项针对情绪调节的认知行为治疗的更大规模研究。使用 PROCESS 宏执行了多重中介分析。在（1）工作记忆与内化/外化症状、（2）抑制与内化/外化症状和（3）转换与内化/外化症状之间，考察了适应性和适应性不良情绪调节的中介作用。所有数据均在干预前、基线时收集。
转换、抑制控制和工作记忆预测情绪失调增加，这在 NDD 儿童中是内化和外化问题的完全中介。
在情绪触发的情况下，认知挑战较大的儿童经历更多的适应性不良情绪调节，这会导致内化和外化问题。对于患有 NDD 的年轻人，包括工作记忆、抑制和转换能力以及情绪调节技能训练在内的治疗计划可能有助于减轻外化和内化行为。
