Extrinsic Dysregulation: A Cross-National Reconceptualisation of Emotion Dysregulation in Middle Childhood

Abstract

Youth mental health is an urgent global concern, with emotion dysregulation increasingly recognised as a key mechanism in the development and persistence of neurodevelopmental disorders, such as Attention-Deficit/Hyperactivity Disorder (ADHD). Middle childhood represents a critical developmental period for the emergence of emotion regulation capacities, yet it remains underexplored in existing research, which often adopts narrow, individual-focused models and pays limited attention to the contextual and relational factors that shape emotional development. This thesis addresses these gaps by reconceptualising emotion dysregulation, focusing specifically on ADHD and its interaction with parenting practices across middle childhood.

Study 1 involved conducting a scoping review, synthesising 11 studies on existing conceptualisations of emotion dysregulation in middle childhood. Two key themes emerged: (a) difficulties in processing emotions, including emotion generation and reactivity, and (b) challenges in adopting appropriate emotion regulation strategies, which hinder goal-directed behaviour. Importantly, existing models often neglect critical influences such as parenting, adverse childhood experiences, and coping mechanisms that are particularly relevant during middle childhood. To address these gaps, Study 1 proposes a revised, developmentally grounded conceptualisation of emotion dysregulation that emphasises its social, relational, and contextual nature in children aged 6-12.

Using longitudinal data from two cohort studies, the UK Millennium Cohort Study (MCS; ages 5, 7, and 11) and the Zurich Project on Social Development from Childhood to Adulthood (z-proso; ages 7, 9, and 11), Study 2 empirically investigated cross-sectional and longitudinal associations between ADHD symptoms, parenting practices (withdrawn/harsh in MCS; positive/negative in z-proso), emotion dysregulation symptoms (MCS)/anger (z-proso), and socio-emotional outcomes (peer relationship problems in MCS; conflict coping strategies in z-proso), employing both moderation and mediation analyses. In the MCS, cross-sectionally at age 7, ADHD symptoms significantly moderated the association between withdrawn parenting and emotion dysregulation, with a statistically significant negative interaction indicating that the positive relationship between withdrawn parenting and emotion dysregulation weakened, as ADHD symptom levels increased. Longitudinally, ADHD symptoms at age 7 strengthened the associations between age 5 withdrawn/harsh parenting and peer problems at age 11. In z-proso, ADHD symptoms did not moderate the effects of parenting on anger at age 9; however, anger significantly mediated the longitudinal influence of ADHD symptoms at age 7 on both aggressive and competent conflict coping by age 11, highlighting emotional reactivity as a key pathway in behavioural development.

Study 3 integrated findings from Studies 1 and 2 to introduce the novel construct of extrinsic dysregulation, defined as a child’s difficulty regulating the emotions of others, particularly parents. This construct challenges traditional, intrapersonal models by framing emotion regulation as a socially co-constructed and relational process, shaped by parenting practices, socio-economic conditions, and developmental stage.

This thesis makes three main contributions. It reconceptualises emotion dysregulation as a relational and developmentally specific construct relevant to the context of middle childhood. It provides cross-national, longitudinal evidence of how ADHD symptoms interact with parenting practices and emotional development. Finally, it introduces the original construct of extrinsic dysregulation, highlighting children’s difficulties in regulating their parents’ emotions and offering a new perspective on the relational nature of emotional development. These findings underscore emotion dysregulation as a central yet under-addressed factor in child development, with significant implications for educators and practice. For educators, understanding children’s emotion dysregulation may support the creation of emotionally responsive environments that foster positive peer interactions. For clinicians, the findings indicate that considering systemic and dyadic processes, such as family dynamics and co-regulation strategies, could help address children’s emotion dysregulation within the relational contexts in which it occurs.