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Cognitive Emotion Regulation as Determinants of Internalizing and Externalizing Problems of Adolescents.

Byline: Sidra Mumtaz, Aneela Maqsood and Ghazala Rehman

Cognitive emotion regulation has a pivotal role in determining the emotional and behavioral problems particularly in adolescence age group. The present study examined the role of cognitive coping in predicting the internalizing and externalizing problems among school going adolescents. A sample of 305 boys and girls with age range 12 to 18 years reported the use of cognitive coping strategies after having experienced negative events or situations. Cognitive coping styles; including 'Refocus on Planning', 'Catastrophizing', 'Rumination', 'Putting into Perspective' and 'Self-blame' came out as unique predictors of internalizing problems. 'Planning' and 'Putting into Perspective' turned out to be predictors of internalizing and externalizing problems.

Girls dominantly use 'Rumination' and 'Catastrophizing' with high tendencies for internalizing problems; whereas, boys use 'Acceptance, and 'Positive Reappraisal reported higher on externalizing problem. The study carries implications in context of adolescents' counseling in Pakistani cultural context.

Keywords. Adolescents, emotion regulation, cognitive coping, internalizing problems, externalizing problems.

Emotion regulation is a crucial factor in establishing healthiness (Cicchetti, Ackerman, and Izard, 1995) particularly during the adolescence age group. Adolescence is the stage characterized with marked cognitive functioning additive to regulate emotions (Hooper, Luciana, Conklin, and Yarger, 2004). Adolescent period is normally considered to reflect emotional disturbances, which however becomes serious if these start interfering with routine activities (Oltmans and Emery, 1995). Several theorists have supported that individuals who cannot cope well with stressful events are more prone to psychological distress (Mennin and Farach, 2007; Nolen-Hoeksema, Wisco, and Lyubomirsky, 2008). Many human dysfunctions and torments stem from problematic thought patterns leading to the notion that capability to think albeit improving human capacities can also be a major source of disturbance if not harnessed properly (Beck, 1976).

Adolescence period holds a significant importance in growth of cognitive coping skills (Aldwin, 1994) particularly the regulatory abilities to alter the kind and intensity of emotions (Diamond and Aspinwall, 2003; Gross, 1998). Taking cognitive emotion regulation as the cognitive way of handling the emotionally arousing information includes external and internal actions accountable for the examination, assessment and shaping of emotional responses (Thompson, 1991). Emotional regulation can best be understood in the context of psychopathological symptoms that include both emotional and behavioral problems or subsequently the term of internalizing and externalizing disorders (Achenbach and Edelbrock, 1978). Beck's cognitive theory supports the notion that emotion dysregulation relates to psychopathology and predicts internalizing and externalizing problems particularly during adolescence age (Beck and Fernandez, 1998).

A comparatively higher rate of co-occurrence or comorbidity of internalizing and externalizing problems in adolescence has been observed (McConaughy and Skiba, 1993). Internalizing problems include behaviors which are over controlled and manifest in form of anxiety, depression, somatic complains and social withdrawal (Baker, Grant, and Morlock, 2008; Merrell, 2001); while externalizing problems include those behaviors which are sort of under controlled as acting out tendencies e.g., aggression, disruptive, hyperactive and defiant behaviors (Merrell, 2003; Zahn-Waxler, Dougan, and Slattery, 2000). Strong relationships between negative thought pattern and internalizing problems have been shown in studies (Joiner and Wagner, 1995; Ronan and Kendall, 1997). In other studies, internalizing group has been found to report more mental distortions or disturbances than externalizing group (Epkins, 2000; Leung and Wong, 1998).

Because of marked association of coping strategies with adolescence age (Garnefski and Kraaij, 2006), some specific cognitive factors have been seen crucial in dealing with internalizing problems. Researches on coping have provided evidence that protective cognitive coping patterns e.g., positive refocusing, acceptance, refocus on planning, and positive reappraisal have negative associations with depression and anxiety (Carver, Scheier, and Weintraub, 1989; Janoff-Bulman, 1992). On the other hand, symptom promoting cognitive coping strategies e.g., rumination, self-blame, and catastrophizing have shown positive associations with internalizing problems such as depression and anxiety (Garnefski, Boon, and Kraaij, 2003).

The progressions and disruptions in internalizing and externalizing problems are also explained by leading psychosocial factors such as gender, age variation and family characteristics (Harland, Reijneveld, Brugman, Verloove-Vanhorick, and Verhulst, 2002; Leadbeater, Blatt, and Quinlan, 1995; Thoits, 1995). Studies have shown that girls ruminate and catastrophize more than boys (Garnefski, Teerds, Kraaij, Legerstee, and Van den Kommer, 2004) and demonstrated high on internalizing problems; whereas boys displayed high tendencies for externalizing problems (Carter, Jaccard, Silverman, and Pina, 2009).

Throughout the world, wide range of studies is being conducted to investigate the frequency of internalizing and externalizing problems of adolescents and children (Barkmann and Markwort, 2005; Egger and Angold, 2006). However, realization regarding children mental health issues left disregarded in the developing states. In Pakistan, there is an insufficiency of empirical researches reporting the rate of internalizing and externalizing problems of adolescents and children (Javed, Kundi, and Khan, 1992; Syed, Hussain, and Mahmud, 2007) and the influential factors (Khan and Shahzad, 2015). In addition, the role of cultural and social background of the child in which he/she lives stands as an important contextual information partly because Westerners and East Asians exhibit differential emotional responding (Tsai, Levenson, and McCoy, 2006).

Studies of collectivistic cultures have shown somewhat high tendency for internalizing problems compared to externalizing problems (Abdel-Fattah et al., 2004; Emami, Ghazinour, Rezaeishiraz, and Richter, 2007). In traditional Asian collectivistic cultures, the overdependence of the child on the family is prolonged (Chao, 1994). Children living in conventional family systems are more under control as compared to Western children who gain autonomy at an early age. Therefore, child bonding with their parents is affected, thus a child feel rejected and this feeling might have an impact on the overall functioning of the child particularly the internalizing problems (Fotti, Katz, Afifi, and Cox, 2006).

In light of aforesaid literature, the present study aims to investigate the predictive role of cognitive coping strategies in explaining externalizing and internalizing problems among school adolescents. The study will provide a possible account of the sociocultural aspect of the adolescents' lives through assessing the possible influences of gender and family system.

Method

Participants

A sample of 305 adolescents including 163 (53.4%) girls and 142 (46.6%) boys age range 12-18 years with mean age of 15 years enrolled in secondary and higher secondary public schools of Rawalpindi region were approached in school settings. With respect to age range, 52.1% of sample was of 12-15 years and 47.9% falls under 16-18 years group.

72.1% were from nuclear family structure and 27.9% from joint family system and 93.4% of the sample living with both parents. Those who were not living with both parents (6.6%), reported reasons e.g., due to death of a parent, father living abroad, parental separation, and other reasons. 5.6% of the participants had 1-2 siblings, 39.2% had 3-4 siblings and 54.9% had 5 and more siblings. The income group of sample corresponds to lower and middle socio-economic status.

Assessment Measures

Cognitive Emotion Regulation Questionnaire (CERQ). CERQ developed by Garnefski, Kraaij, and Spinhoven (2002) is a widely used measure in clinical practice (Miklosi, Martos, Kocsis-Bogar, and Perczel, 2010) to assess cognitive coping styles. Cognitive coping strategies are defined as "strategies for cognitive emotion regulation", that is, regulating in a cognitive way the emotional responses to events causing the individual emotional aggravation" (Thompson, 1991). The measure includes nine subscales with four items each referring to what people think after having experienced negative or stressful situations. Each subscale ranges from 1 to 5 with minimum score of 4 and the maximum score 20. The higher the subscale score, the more the specific cognitive strategy is used.

Definition of the CERQ Scales. The meaning of subscales (Garnefski et al., 2002) are as follows: Self-blame, refers to thought pattern in which a person puts the blame of his bad experiences upon himself; Acceptance, referring to thoughts of resigning to what has happened; Rumination, referring to thinking all the time about feelings and thoughts associated with the negative experiences; Positive Refocusing, refers to thinking about joyful and pleasant matters instead of thinking about the actual event; Refocus on Planning, refers to thinking about what steps could be taken to handle the negative event; Positive Reappraisal, thoughts of attaching a positive meaning to events for personal growth; Putting into Perspective, refers to thought pattern of minimizing the severity of an event while comparing with other experiences; Catastrophizing, refers to explicitly emphasizing the terror of what he has experienced; Other-blame, thoughts of putting the blame of bad experiences on the environment or another person.

Urdu version of CERQ reported in a recent study (Butt, Sanam, Gulzar, and Yahya, 2013) was used. Authors have reported adequate alpha coefficient i.e., [alpha] = .83. On present sample, Cronbach's alpha coefficient on total scores of CERQ was .72 and for the subscales it ranges from .66 to .50. Interpreting the alpha coefficient, Bowling (2002) suggested that studies in health issues with reported coefficients up to 0.50 or higher are considered acceptable. In addition, the reason of relatively moderate reliability could be because of the fact that the questionnaire itself is prone to induce variation in responses while asking to think about certain life events which they thought to be disturbing for them. For instance, any event or happening regarding relational stress, family, siblings, friends conflict or any other person from surrounding they don't like or any other stressor. The variation of responses may in turn attenuates the alpha coefficient.

Moreover, this might have introduced a certain bias, the study was not able to control for, as it cannot be determined how stressful the event was perceived (Garnefski et al., 2003) and also the level of maturity compatible to their age while interpreting the experiences.

School Children Problem Scale (SCPS). SCPS is an indigenous screening measure to assess the emotional and behavioral problems reported by school children of 12-18 years corresponding to Grade 7-10 (Saleem and Mahmood, 2011). It is a 44 item self-report measure scored on a four point scale (0-3). The higher the score the more severe the problem is interpreted. Authors reported that SCPS is a valid scale with acceptable psychometric properties (test-retest reliability = .79). The scale was found to have a significant positive correlation with the two broad band scales of Youth Self Report (Achenbach and Rescorla, 2001) namely internalizing and externalizing.

The four subscales of SCPS (Anxiousness, Social Withdrawal, Feeling of Rejection and Psychosomatic Complaints) were summed up and grouped together into 'internalizing problems' and subscale 'aggression' was termed as 'externalizing problem'. On present sample, alpha coefficients on scores of SCPS ranged from high to moderate (.85 to .56).

Ethical Conduct and Procedure

The study was approved by the Advanced Research and Study Board of the Fatima Jinnah Women University. Formal permission was secured from the Education District officer (EDO) of Rawalpindi to access higher secondary schools. Schools were selected using random procedure from the list provided by the EDO office. Students were approached during regular school hours. Confidentiality, autonomy and consent of respondents adheres to ethical guidelines of APA.

Results

Results present the Pearson Product-Moment Correlation also explaining the relationship between variables. Hierarchical regression analysis explains the role of cognitive emotion regulation strategies in predicting internalizing and externalizing problems. Mean differences were computed between the groups on different cognitive strategies using t-test analysis. For mean differences with respect to demographic variables, MANOVA was applied.

Table 1 Correlation on Subscales of CERQ and Internalizing and Externalizing Problem Groups (N = 305)

###1 2###3###4###5###6###7###8###9###10###11

CERQ

1. Self-blame###- .02###.29** -.00###.02###.08###.15**###.32**###.05###.28**###.05

2. Acceptance###-###.11###.14**###.04###.31**###.11*###.15**###.06###-.06###.07

3. Rumination###-###.08###-.05###.01###.24**###.55**###.25**###.39**###.03

4. Refocusing###-###.33**###.28**###.15** -.03###.08###-.07###-.07

5. Planning###-###.33** -.04###-.07###-.02###-.19**###-.16**

6. Reappraisal###-###.06###.07###.06###-.12*###-.01

7. Perspective###-###.20**###.10###.28**###.14**

8. Catastrophiz###-###.20**###.40**###.01

9. Other-blame###-###.16**###.04

10. Internalizing###-###.17*

11. Externalizing###-

Correlation (table 1) showed that protective coping strategy 'planning' is negatively associated with internalizing and externalizing problems. The style, positive reappraisal is negatively associated with internalizing problems only. Among negative coping strategies, 'self-blame', 'rumination', 'catastrophizing' 'perspective' and 'other-blame' showed positive association with internalizing problems.

Table 2 Hierarchical Multiple Regression Predicting Internalizing and Externalizing problems by Cognitive Strategies (N=305)

###Internalizing problems###Externalizing problems

Predictors###R2###IRA2###[beta]###F###R2###IRA2###[beta]###F

Step1###.11###.11###13.06***###.12###.12###13.84***

Gender###.30***###.32***

Family structure###.12*###.07

Age###.05###.10*

Step 2###.33###.25###14.21***###.19###.07###5.81***

Self-blame###.18**###.04

Acceptance###-.04###-.00

Rumination###.14*###.08

Refocusing###-.04###-.09

Planning###-.13*###-.12*

Reappraisal###-.05###-.01

Perspective###.16**###.17**

Catastrophizing###.19**###-.04

Other-blame###.06###.04

Table 2 shows variance in internalizing and externalizing problems produced by cognitive coping after controlling for gender, age and family structure. Gender, age and family structure entered at step 1 explained 11.5% variance in internalizing problems. After entry of coping strategies at step 2, the total variance explained by the model as a whole increased up to 33.9%, F(12, 292) = 14.21, p < .001. The coping strategies explained an additional 25.4% variance in internalizing problems after controlling for gender, age and family structure together (R squared change = .25, F change (9,292) = 13.03, p < .001). Significant unique predictors of internalizing problems were refocus on planning, catastrophizing, rumination, putting into perspective and self-blame. Strong effects are found for gender and family structure. For externalizing problems, gender, age and family structure explained 12.1% variance in externalizing problems (step 1).

After entry of the cognitive strategies at step 2, the total variance was 19.3%, F(12, 292) = 5.81, p <.001. The cognitive strategies explained an additional 7.2% variance in externalizing problems after controlling for gender (R squared change =.72, F change (9,292) = 2.88, p < .001. Significant predictors of externalizing problems were 'planning' and 'putting into perspective'. Significant effects are found for gender and age.

Table 3 Mean Differences by Gender on CERQ (N=305)

###Boys###Girls###CI (95%)

###(n = 142)###(n = 163)

Variables###M###SD###M###SD###t###LL###UL###Cohen's d

Self-blame###11.06###2.85###11.06###3.11###0.00###-0.67###0.67###-.00

Acceptance###13.11###2.84###11.56###3.80###4.07**###-2.30###-0.80###-.47

Rumination###11.50###3.32###12.88###3.20###3.69**###0.64###2.11###.42

Refocusing###14.88###2.56###14.72###3.05###0.50###-0.80###0.47###-.05

Planning###15.11###2.83###15.06###2.79###0.14###-0.68###0.59###-.01

Reappraisal###14.33###2.75###13.46###3.17###2.55*###-1.55###-0.20###-.29

Perspective###11.40###2.98###12.09###3.55###1.82###-0.05###1.42###.61

Catastrophize###10.16###3.66###11.50###3.65###3.19**###0.51###2.16###.36

Other-blame###9.14###3.04###9.60###3.86###1.15###-0.32###1.23###.13

Table 3 demonstrated that girls reported more use of rumination and catastrophize coping styles; whereas, boys use 'acceptance' and 'reappraisal'. Multivariate Analysis of Variance (MANOVA) revealed age categories, family type and number of siblings as non-significant and gender as significant in explaining the association with internalizing and externalizing problems. Girls are higher on internalizing problems (M = 35.70) compared to boys (M = 27.63); whereas, boys are higher on externalizing problem (M = 9.08) compared to girls (M = 6.29) with significant (F = 48.6, p = .001). Analysis on other demographic factors revealed that fathers' income particularly the lower income group associates with externalizing problem. For reasons where parents are not living together, fathers' death and separation showed high mean scores for internalizing problems.

Discussion

Adolescents' internalizing and externalizing problems are well explained by certain styles of cognitive emotional strategies. The dysregulation of emotions has been associated with negative emotional affect (Hagekull and Bohlin, 2004). Studies have favored that certain forms of cognitive coping styles are not rated as appropriate ones such as catastrophizing, rumination and self-blame partly because they have shown strong relationships with internalizing problems such as depression or anxiety (Garnefski et al., 2003). Certain protective cognitive coping strategies including "refocus on planning", "positive refocusing", and "positive reappraisal" are assumed to have negative relationship with internalizing problems (Janoff-Bulman, 1992; Salkovskis, 1998).

The maladaptive thought pattern of putting the blame of distressing experiences on one's own self (Tennen and Affleck, 1990) and the thought pattern e.g., "putting into perspective" or social comparison has been observed to be as crucial factors in developing psychopathological symptoms (Allan and Gilbert, 1995; Janoff-Bulman, 1992).

Current study supported the findings that maladaptive cognitive emotion strategies including catastrophizing, rumination, putting into perspective, and self-blame are potentially linked to explain internalizing/ emotional problems. The assumption that maladaptive coping strategies strongly associates to internalize problems compared to externalize problems has received considerable support (Epkins, 2000; Leung and Wong, 1998). One of the reasons explaining why maladaptive coping strongly relates to internalizing problems is rooted in culturally driven suppression of expression and fear cultivated in children socialized in collectivistic culture. The culture where children roles are expected to be more compliant and obedient are usually expected to be more indulged in internalized problems compared to externalized ones. Studies of collectivistic culture have arrived for similar results (Abdel-Fattah et al., 2004; Emami et al., 2007).

The finding further supports the theoretical speculations that cognitive processes and negative thinking influence first our feelings and emotions that explains the internalizing component of behavior and later influences behavior- the externalizing component of the behavior (Beck, 1976).

The positive coping strategy 'refocus on planning' stands out as an important protective factor because of its negative association with both internalizing and externalizing problems. Planning as cognitive coping emphasizes the thinking about appropriate steps to take to deal with the event and thinking up a plan to change the situation. It is particularly important for Counselors and teachers to concentrate upon planning/ management skills of school children so that they better able to critically analyze the problematic situation helping to select the appropriate strategy to resolve it.

Findings suggest that 'putting into perspective' as maladaptive coping strategy is critical to explain the externalizing/ behavioral problem particularly aggression among adolescents. Because of the dominant thought pattern that plays down the seriousness of the event when compared to other events may apparently calms down and works well for regulating emotions. However, the coping itself becomes negative when individuals undermine negative consequences by comparing with other events partly because it may contribute to take corrective actions.

'Putting into perspective' showed negative association in predicting internalizing and externalizing problems. This further implies that a strong focus to live in present and sorting out the negative experience is much desirable compared to indulging oneself to underestimate the impeding influences of the negative experiences.

Literature identifies that internalizing and externalizing problems are not caused by a single etiology. Rather a number of causes are responsible for such behavioral problems. A number of leading factors may include age and gender of the child (Bilancia and Rescorla, 2010; Maikovich-Fong and Jaffee, 2010), family system and family size (Luoma et al., 1999), socioeconomic status (Slobodskaya and Akhmetova, 2010). The sociocultural aspects of adolescents' lives particularly reflected through one's gender, experiences with age variation and family structure are well supported by current findings. Generally, women stress more on their emotional experiences, are more cognizant of their emotions, discuss them more publically and ruminate more on distressing events than men do (Fivush and Buckner, 2000; Thoits, 1995). The current study revealed that girls are high on maladaptive cognitive coping than boys. Girls tend to catastrophize and ruminate more compared to boys.

The current study supported the assumption that girls are usually high on internalizing problems while boys are high on externalizing problems. Cultural based expectations and gender norms provide a logical explanation as why women and men behave differently in regulating their emotions (McRae, Ochsner, Mauss, Gabrieli, and Gross, 2008). In collectivistic culture, the expectation that women should conceal or internalize her emotions is generally considered as the acceptable one (Ali et al., 2011). Whereas, men are more prone to exhibit aggressive behavior including physical and verbal aggression which in turn could be attributed to differences in styles of coping employed by them (Burton, Hafetz, and Henninger, 2007). Different styles of cognitive coping employed by men and women might answer differences among gender in the impressions and preservation of emotional problems both in the times of adolescence and adulthood (Matud, 2004; Ptacek, Smith, and Dodge, 1994).

In comparison, current study suggests that boys are high on 'reappraisal' and 'acceptance' coping strategies. Acceptance refers to thoughts where you resign yourself to what has happened and accept it as something unchangeable. Though the strategy itself is good in certain situations but an overemphasis reflects in one's ability to influence the situations one is facing that in turn inherits negative feelings in it. Same way, a low emphasis is not desirable in situations that are uncountable. Moreover, associating positive meaning to an event is an important coping strategy unless a low emphasis warrants problems in one's personal growth. Restructuring and cognitive balance in regulating emotions while responding to stressful life events is what Counselors and health practioners need to struggle with. The varying levels of emphasis on each coping strategy provides a meaningful realization of desirable emotional regulation.

Conclusion. Given that faulty thought patterns and maladaptive cognitive strategies employed by a person can cause emotional deregulation and as a result influences the emotional and behavioral problems. Certain types of cognitive coping strategies such as catastrophizing, rumination, putting into perspective and self-blame may be more maladaptive and are responsible for internalizing distortions. A strong emphasis on planning as a way to cope with negative experiences helps control internalizing and externalizing problems.

Implications. The possible implications drawn for study findings are helpful for counseling adolescents particularly to help them challenging their maladaptive thought pattern such as self-blaming, catastrophization and rumination, instead focusing more on adaptive strategies e.g., refocus on planning. The cognitive maturity being associated with age and socioeconomic factors e.g., family structure and living status are important findings to be considered.

References

Abdel-Fattah, M., Asal, A., Al-Asmary, S., Al-Helali, N., Al-Jabban, T., and Arafa, M. (2004). Emotional and behavioral problems among male Saudi school children and adolescents' prevalence and risk factors. German Journal of Psychiatry, 7(1), 1-9.

Achenbach, T., and Edelbrock, C. (1978). The classification of child psychopathology: A review and analysis of empirical efforts. Psychological Bulletin, 85(6), 1275-1301.

Achenbach, T., and Rescorla, L. (2001). Manual for the ASEBA School-Age forma and profile. Vermont University, Department of Psychiatry.

Aldwin, C. (1994). Stress, coping and development. New York: The Guilford Press.

Ali, T., Krantz, G., Gul, R., Asad, N., Johansson, E. and Mogren, I. (2011). Gender roles and their influence on life prospects for women in urban Karachi, Pakistan: A qualitative study. Global Health Action, 4(1), 1-9. doi: 10.3402/gha.v4i0.7448

Allan, S., and Gilbert, P. (1995). A social comparison scale: psychometric properties and relationship to psychopathology. Journal of Personality and Individual Differences, 19(3), 293-299.

Baker, J., Grant, S., and Morlock, L. (2008). The teacher-student relationship as a developmental context for children with internalizing or externalizing behavior problems. School Psychology Quarterly, 23(1), 3-15.

Barkmann, C., and Schulte-Markwort. M. (2005). Emotional and behavioral problems of children and adolescents in Germany. An epidemiological screening. Social Psychiatry and Psychiatric Epidemiology, 40(5), 357-366.

Beck, A. (1976). Cognitive Therapy and the emotional disorders. New York: International Universities Press.

Beck, R., and Fernandez, E. (1998). Cognitive-behavioral therapy in the treatment of anger: A meta-analysis. Cognitive Therapy and Research, 22(1), 63-74.

Bilancia, S., and Rescorla, L. (2010). Stability of behavioral and emotional problems over 6 years in children ages 4 to 5 or 6 to 7 at time 1. Journal of Emotional and Behavioral Disorders, 18(3), 149-161.

Bowling, A. (2002). Research Methods in Health. In Investigating Health and Health Services. (2nd edition). Buckingham, Open University Press.

Burton, L., Hafetz, J., and Henninger, D. (2007). Gender differences in relational and physical aggression. Social Behavior and Personality, 35(1), 41-50.

Butt, M., Sanam, F., Gulzar, S., and Yahya, F. (2013). Cognitive emotional regulation and forgiveness. Interdisciplinary Journal of Contemporary Research in Business, 4(12), 769-792.

Carter, R., Jaccard, J., Silverman, W., and Pina, A. (2009). Pubertal timing and its link to behavioral and emotional problems among at-risk African American adolescent girls. Journal of Adolescence, 32(3), 467-481.

Carver, C., Scheier, M., and Weintraub, J. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283.

Chao, R. (1994). Beyond parental control and authoritarian parenting style, understanding Chinese parenting through the cultural notion of training. Child Development, 65(4), 1111-1119.

Cicchetti, D., Ackerman, B., and Izard, C. (1995). Emotions and emotion regulation in developmental psychopathology. Development and Psychopathology, 7(1), 1-10.

Diamond, L., and Aspinwall, L. (2003). Emotion regulation across the life span: An integrative perspective emphasizing self-regulation, positive affect, and dyadic processes. Motivation and Emotion, 27(2), 125-156.

Egger, H., and Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47(3-4), 313-337.

Emami, H., Ghazinour, M., Rezaeishiraz, H., and Richter, J. (2007). Mental health of adolescents in Tehran, Iran. Journal of Adolescent Health, 41(6), 571-576.

Epkins, C. (2000). Cognitive specificity in Internalizing and Externalizing problems in community and clinic-referred children. Journal of Clinical Child psychology, 29(2), 199-208.

Fivush, R., and Buckner, J. (2000). Gender, sadness, and depression: The development of emotional focus through gendered discourse. In A. H. Fischer (Ed.), Gender and Emotion: Social Psychological Perspectives (pp. 232-253). Paris: Cambridge University Press and Editions.

Fotti, S. A., Katz, L. Y., Afifi, T. O., and Cox, B. J. (2006). The associations between peer and parental relationships and suicidal behaviours in early adolescents. Canadian Journal of Psychiatry, 51(11), 698-703.

Garnefski, N., and Kraaij, V. (2006). Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual differences, 40(8), 1659-1669.

Garnefski, N., Boon, S., and Kraaij, V. (2003). Relationships between cognitive strategies of adolescents and depressive symptomatology across different types of life events. Journal of Youth and Adolescence, 32(6), 401-408.

Garnefski, N., Kraaij, V., and Spinhoven, P. (2002). CERQ: Manual for the use of the Cognitive Emotion Regulation Questionnaire. Leiderdrop: The Netherlands.

Garnefski, N., Teerds, J., Kraaij, V., Legerstee, J., and Van den Kommer, T. (2004). Cognitive emotion regulation strategies and depressive symptoms: Differences between males and females. Personality and Individual Differences, 36(2), 267-276.

Gross, J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271-299.

Hagekull, B., and Bohlin, G. (2004). Predictors of middle childhood psychosomatic problems: An emotion regulation approach. Infant and Child Development, 13(5), 389-405.

Harland, P., Reijneveld, S., Brugman, E., Verloove-Vanhorick, S., and Verhulst, F. (2002). Family factors and life events as risk factors for behavioural and emotional problems in children. European Child and Adolescent Psychiatry, 11(4), 176-184.

Hooper, C., Luciana, M., Conklin, H, and Yarger, R. (2004). Adolescents' performance on the Iowa Gambling Task: Implications for the development of decision making and ventromedial prefrontal cortex. Developmental Psychology, 40(6), 1148-1158.

Janoff-Bulman, R. (1992). Shattered Assumptions: towards a new psychology of trauma. New York: Free Press.

Javed, M., Kundi, M., and Khan, P. (1992). Emotional and behavioral problems among school children in Pakistan. Journal of Pakistan Medical Association, 42(2), 181-183.

Joiner, T., and Wagner, K. (1995). Attributional style and depression in children and adolescents: A meta-analytic review. Clinical Psychology Review, 15(8), 777-798.

Khan, A., and Shahzad, S. (2015). Cognitive correlates of depression in adolescents. Journal of Pakistan Psychiatric Society, 12(1), 53-53.

Leadbeater, B., Blatt, S., and Quinlan, D. (1995). Gender-linked vulnerabilities to depressive symptoms, stress, and problem behaviors in adolescents. Journal of Research on Adolescence, 5(1), 1-29.

Leung, P., and Wong, M. (1998). Can cognitive distortions differentiate between internalizing and externalizing problems? Journal of Child Psychology and Psychiatry, 39(2), 263-269.

Luoma, I., Puura, K., Tamminen, T., Kaukonen, P., Piha, J., Rasanen, E., and Almqvist, E. (1999). Emotional and behvaioural symptoms in 8-9 yearold children in relation to family structure. European Child and Adolescent Psychiatry, 8(4), 29-40.

Maikovich-Fong, A., and Jaffee, S. (2010). Sex differences in childhood sexual abuse characteristics and victims' emotional and behavioral problems: Findings from a national sample of youth. Child Abuse and Neglect, 34(6), 429-437.

Matud, M. (2004). Gender differences in stress and coping styles. Personality and Individual Differences, 37(7), 1401-1415.

McConaughy, S., and Skiba, R. (1993). Comorbidity of Externalizing and Internalizing problems. School Psychology Review, 22(3), 421-436.

McRae, K., Ochsner, K., Mauss, I., Gabrieli, J., and Gross, J. (2008). Gender differences in emotion regulation: An FMRI study of cognitive reappraisal. Group Processes and Intergroup Relations, 11(2), 143-162.

Mennin, D., and Farach, F. (2007). Emotion and evolving treatments for adult psychopathology. Clinical Psychology: Science and Practice, 14(4), 329-335.

Merrell, K. (2001). Helping students overcome depression and anxiety. New York: The Guilford Press.

Merrell, K. (2003). Behavioral, social, and emotional assessment of children and adolescents. London: Lawrence Erlbaum Associates, Publishers.

Miklosi, M., Martos, T., Kocsis-Bogar, K., and Perczel, F. (2010). Psychometric properties of the Hungarian version of the Cognitive Emotion Regulation Questionnaire. Psychiatria Hungarica: A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata, 26(2), 102-111.

Nolen-Hoeksema, S., Wisco, B., and Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3(5), 400-424.

Oltmans, T., and Emery, R. (1995). Abnormal psychology. Englewood Cliffs, NJ: Prentice-Hall.

Ptacek, J., Smith, R., Espe, K., and Dodge, K. (1994). Gender differences in coping with stress: when stressor and appraisals do not differ. Personality and Social Psychology Bulletin, 20(4), 421-430.

Ronan, K., and Kendall, P. (1997). Self-talk in distressed youth: states of mind and content specificity. Journal of Clinical Child Psychology, 26(4), 330-337.

Saleem, S., and Mahmood, Z. (2011). Development of a scale for assessing emotional and behavioral problems of school children. Pakistan Journal of Social and Clinical Psychology, 9(2), 73-78.

Salkovskis, P. (1998). Psychological approaches to the understanding of obsessional problems. In R. Swinson (Ed.), Obsessive- Compulsive Disorder: Theory, research and treatment (pp. 33-50). New York: Guilford Press.

Slobodskaya, H., and Akhmetova, O. (2010). Personality development and problem behavior in Russian children and adolescents. International Journal of Behavioral Development, 34(5), 441-451.

Syed, E., Hussain, S., and Mahmud, S. (2007). Screening for emotional and behavioural problems amongst 5-11 year old school children in Karachi, Pakistan. Social Psychiatry and Psychiatric Epidemiology, 42(5), 421-427.

Tennen, H., and Affleck, G. (1990). Blaming others for threatening events. Psychological Bulletin, 108(2), 209-232.

Thoits, P. (1995). Stress, coping, and social support processes: where are we? What next? Journal of Health and Social Behavior 53-79. Retrieved from: http://www.jstor.org/stable/2626957.

Thompson, R. (1991). Emotional regulation and emotional development. Educational Psychology Review, 3(4), 269-307.

Tsai, J., Levenson, R., and McCoy, K. (2006). Cultural and temperamental variation in emotional response. Emotion, 6(3), 484-497.

Zahn-Waxler, C., Dougan, B., and Slattery, M. (2000). Internalizing problems of childhood and adolescence: Prospects, pitfalls, and progress in understanding the development of anxiety and depression. Development and Psychopathology, 12(3), 443-466.
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Publication:Journal of Behavioural Sciences
Geographic Code:9PAKI
Date:Dec 31, 2017
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