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. Author manuscript; available in PMC: 2023 Feb 1.
Published in final edited form as: Res Child Adolesc Psychopathol. 2022 Feb;50(2):211–224. doi: 10.1007/s10802-020-00686-9

Maternal Emotion Dysregulation Predicts Emotion Socialization Practices and Adolescent Emotion Lability: Conditional Effects of Youth ADHD Symptoms

Lauren E Oddo 1, Natalie V Miller 1, Julia W Felton 1,2, Jude Cassidy 1, Carl W Lejuez 1,3, Andrea Chronis-Tuscano 1
PMCID: PMC7874497  NIHMSID: NIHMS1619395  PMID: 32778993

Abstract

Maternal emotional functioning and emotion socialization practices can facilitate or hinder children’s emotional development, and youth with symptoms of attention-deficit/hyperactivity disorder (ADHD) are at increased risk for emotion lability. However, little is known about the independent and interactive effects of maternal emotion dysregulation and adolescent ADHD symptoms on maternal emotion socialization and adolescent emotion lability over time. Using secondary data analyses of a longitudinal community sample of youth and their mothers (Nbaseline = 247; 43.7% female), the current study examined direct and indirect effects of maternal emotion dysregulation on adolescent emotion lability via supportive and non-supportive emotion socialization practices as mediators, and the extent to which adolescent ADHD symptoms moderated these longitudinal pathways. Mothers reported on all study constructs. Results showed that non-supportive parenting responses to adolescents’ negative emotional expressions partially mediated the association between maternal emotion dysregulation and adolescent emotion lability, and the effect was stronger at higher levels of youth ADHD symptom severity. Results suggest that parent- and youth-level characteristics interact to confer risk for non-supportive emotion socialization practices and adolescent emotion lability. This research contributes uniquely to theory and research on ADHD and emotional functioning across adolescence. Future research should extend this work by utilizing multi-modal assessment.

Adolescence is characterized by biological, psychological, and social challenges wherein substantial changes in the lability and intensity of emotions are unlike any other developmental period (Hollenstein & Lanteigne, 2018). Relative to children and adults, adolescents display more intense responses to emotion-eliciting situations, oscillate between emotional states more rapidly, and experience an uptick in negative affectivity (Riediger & Klipker, 2014). Navigating adolescent development is challenging for youth and their families, yet this developmental period is critical to identity formation and autonomy, ultimately enabling adolescents to develop the necessary skills to assume adult roles and responsibilities.

One risk factor for adolescent social-emotional maladjustment is emotion lability, typified by frequent and intense maladaptive responses to emotion-eliciting situations and difficulty recovering from negative emotions (Dunsmore, Booker, & Ollendick, 2013; Rogers, Halberstadt, Castro, MacCormack, & Garrett-Peters, 2016). Empirical studies support emotion lability as a unique and additive correlate of youth adjustment (Kim-Spoon, Cicchetti, & Rogosch, 2013). Emotion lability has been linked to a variety of mental health outcomes and can be considered a trans-diagnostic risk factor for the emergence of psychopathology. Higher rates of emotion lability are associated with internalizing and externalizing symptoms (Carthy, Horesh, Apter, Edge, & Gross, 2010; Stringaris & Goodman, 2009), risky behaviors (Oshri, Sutton, Clay-Warner, & Miller, 2015), bullying and victimization (Garner & Hinton, 2010) and substance use (Wilcox, Pommy, & Adinoff, 2016). Efforts to identify mechanisms underlying risk for adolescent emotion lability are therefore of utmost clinical importance (Hollenstein & Lanteigne, 2018).

Direct and Indirect Effects on Adolescent Emotion Lability

Adolescence is characterized by a burgeoning desire for autonomy resulting in more time spent with peers, yet parents’ emotional functioning and parenting practices related to emotions remain well-documented correlates of adolescent emotional development (Brand & Klimes-Dougan, 2010). While many adolescents are already equipped with foundational skills, learning to recognize, label, and manage emotions is a dynamic process unfolding over development (Miller-Slough & Dunsmore, 2016; Zeman et al., 2012). Consequently, parents are routinely tasked with providing sufficient emotional support and structure in the context of ever-evolving social and environmental changes and stressors (Miller-Slough & Dunsmore, 2016; Riediger & Klipker, 2014; Thompson & Meyer, 2007). Indeed, a foundational theoretical model of the impact of the family on children’s emotion regulation and adjustment, originally proposed by Morris and colleagues (2007), highlights the idea that parents engage in emotion socialization parenting behaviors that shape an interactive emotional world wherein youth learn, both directly and indirectly, about emotions and how to respond to them.

In their theoretical model, Morris et al. (2007) propose that children’s emotional development is directly impacted by a parent’s own emotional functioning (Morris, Silk, Steinberg, Myers, & Robinson, 2007). Specifically, one hypothesized parent-level risk factor is maternal emotion dysregulation, defined as difficulties modulating internal processes to promote appropriate responses to situational demands (Cole, Michel, & Teti, 1994). In part, maternal emotion dysregulation is theorized to directly impact adolescent emotional development, as youth learn about emotions and how to respond to them by observing their parents’ own emotional functioning (Morris et al., 2007). In fact, the direct effect of maternal emotion dysregulation on adolescent emotion lability may be especially robust during the adolescent period (Sarıtaş, Grusec, & Gençöz, 2013), as adolescents’ desire for independence may make them less receptive to direct parental guidance and input (Brand & Klimes-Dougan, 2010; Katz & Hunter, 2007).

In addition to direct effects, maternal emotion dysregulation may also impact the development of adolescent emotion lability indirectly, via the effect on emotion socialization parenting behaviors designed to help youth learn about, and respond to, their emotional world (Miller-Slough & Dunsmore, 2016; Morelen, Shaffer, & Suveg, 2016; Zeman et al., 2012). Consistent with the Morris et al. (2007) model, parents’ responses to the negative emotional expressions (i.e., anger, sadness) of their children are among several mechanisms through which maternal emotion dysregulation may indirectly shape adolescent emotion lability over time. Mothers who report being overwhelmed by their own emotions or view their emotions as unmanageable are at risk for using maladaptive coping strategies in stressful parenting situations, such as when their child expresses negative emotions; in turn, children of mothers with emotion regulation difficulties are thought to be at risk for poor emotional development (Gratz & Roemer, 2004; Morris et al., 2007). Despite theoretical support, much of the existing literature has evaluated these pathways in children, with far fewer studies on the longitudinal effect of parental responses to adolescents’ negative emotions on youth emotion lability (Buckholdt, Parra, & Jobe-Shields, 2014; Riediger & Klipker, 2014; Yap, Allen, & Ladouceur, 2008).

An emerging emotion socialization literature among adolescents supports the Morris et al. (2007) theoretical model. For example, research shows that mothers’ non-supportive reactions characterized by minimizing (e.g., “tell him/her not to make such a big deal out of it”) or punitive (e.g., “get angry at him/her for losing his/her temper”) responses to children’s negative emotions (Fabes & Eisenberg, 1998) are associated with higher levels of child emotion dysregulation. Briscoe, Stack, Dickson, and Serbin (2018) found that maternal self-reported punishing of preschoolers’ negative emotional displays predicted adolescent negative emotionality. Their follow-up cross-sectional mediation findings also supported an indirect effect, such that non-supportive parenting responses explained the concurrent effect of mothers’ negative emotionality on that of their adolescent offspring (Briscoe et al., 2018). Conversely, problem-solving and comforting emotion socialization practices are more likely to reduce maladaptive child coping responses. For example, Shortt, Stoolmiller, Smith‐Shine, Eddy, & Sheeber (2010) found that youth ages 10–13 whose mothers reported having supportive discussions about upsetting situations were less likely to concurrently experience difficulties coping with their anger. Taken together, these studies provide empirical evidence for aspects of the Morris et al. (2007) model. They also expose the importance of evaluating both supportive and non-supportive emotion socialization behaviors in models of risk pathways, as these are associated with differential child outcomes (Morris et al., 2008; Yap, Schwartz, Bryne, Simmons, & Allen, 2010). Yet, studies in adolescent samples are limited by smaller samples and cross-sectional designs. There is a need to expand upon this foundational work by explicitly testing key pathways of these theoretical models using longitudinal designs with diverse community samples (Morris et al., 2007).

Moderating Role of Adolescent ADHD Symptoms

For all adolescents, and perhaps especially for those with symptoms of attention-deficit/hyperactivity disorder (ADHD), maternal emotion dysregulation and emotion socialization practices are salient predictors of adolescent outcomes (Fabes et al., 2001; Johnston & Chronis-Tuscano, 2015; Sanders, Zeman, Poon, & Miller, 2015). ADHD symptoms are considered especially costly to adolescent functioning, as inattention interferes with sustained, goal-directed acts, and hyperactive/impulsive symptoms beget rash verbal and emotional behavior. Consequently, youth with ADHD and those with subthreshold, but elevated, ADHD symptoms are at risk for academic failure, grade retention, interpersonal problems with parents and peers, reduced quality of life, sleep disturbance, depression, suicide, and substance use (Bunford, Evans, Becker, & Langberg, 2015; Bussing, Mason, Bell, Porter, & Garvan, 2010; Chronis-Tuscano et al., 2010; Gau & Chiang, 2009; Mesman, 2015). Ultimately, adolescence represents a significant risk period for the emergence of co-occurring emotional problems in youth with ADHD symptoms.

Compounding these concerns in adolescence, or perhaps underlying them, are the affective difficulties associated with ADHD symptomatology. Youth with ADHD display more negative emotions, greater emotional reactivity, and lower levels of frustration tolerance than youth without ADHD (Seymour & Miller, 2017). Compared to their typically developing peers, children with ADHD engage in poorer problem solving when upset, are less likely to seek help from parents when frustrated, and focus on more negative components of tasks (Martel, 2009). Emotion lability/negativity is also an established mechanism linking ADHD to co-occurring internalizing problems (e.g., depression) in both clinical and community samples (Anastopoulos et al., 2011; Bunford et al., 2015; Seymour et al., 2012; Seymour, Chronis-Tuscano, Iwamoto, Kurdziel, & MacPherson, 2014). Recognizing the elevated risk among youth with ADHD symptoms, identifying mechanisms of risk for emotion lability during adolescence is critical to developing targeted prevention programs.

For many youth with ADHD symptoms and their families, adolescence is replete with frustration and failure experiences. Accordingly, adolescents with elevated symptoms of ADHD may require more parental support and scaffolding related to their negative emotions. Yet, parenting a child with ADHD symptoms is considered especially taxing, given that children with ADHD characteristically have difficulties with emotion lability (i.e., adaptively responding to emotion-eliciting situations and recovering from emotions) (Sobanski et al., 2010). Consistent with the Morris et al. (2007) model whereby youth- and parent-level vulnerabilities interact to shape child adjustment, mothers with more difficulties regulating their own emotions may be at-risk for harsh and less supportive responses to their children’s negative emotional displays. In turn, these responses may set the stage for worsening adolescent emotion lability. These pathways are likely the strongest in the context of higher levels of adolescent ADHD symptoms (Johnston & Chronis-Tuscano, 2015). In the one known study to evaluate the independent and interactive effects of youth ADHD symptoms and parenting responses on youth emotion lability, Breaux, McQuade, Harvey, and Zakarian (2018) found in a sample of 61 youth (average age = 10.67 years) that non-supportive parenting responses were associated with greater adult-reported emotion lability for children with high levels of ADHD symptoms. They also showed that supportive emotion socialization practices predicted better youth emotion regulation skills over a period of one year, regardless of ADHD symptomatology. In part, their results suggest that youth emotion lability is impacted by parent emotion socialization practices, particularly among youth with ADHD symptoms. Breaux and colleagues (2018) provided a critical first-step in examining hypothesized pathways, however the temporal unfolding of these constructs over a longer follow-up period, particularly among adolescents, remains largely unknown.

The Current Study

The current prospective longitudinal study sought to examine whether adolescent ADHD symptoms moderate the longitudinal association between maternal emotion dysregulation and adolescent emotion lability via two emotion socialization dimensions: 1) non-supportive and 2) supportive parenting reactions to adolescents’ negative emotional expressions. Paramount to elucidating theoretically-proposed moderators and mediators is using prospective longitudinal designs and data analyses while controlling for prior levels of emotion lability, parenting behaviors, and important psychological covariates. Including prior levels of key study constructs (i.e., emotion socialization and emotion lability) provides a rigorous evaluation of temporal unfolding – allowing conclusions about changes in functioning over time rather than cross-sectional associations.

The current study is further strengthened by including youth Oppositional Defiant Disorder (ODD) symptoms and biological sex as covariates. It is important to include ODD symptoms in models examining risk processes for emotion lability, even in a community sample unselected for psychopathology such as ours, because ODD is often characterized by negative emotionality/irritability (Cavanagh, Quinn, Dunca, Graham, & Balbuena, 2017) and ADHD and ODD symptoms commonly co-occur (Yoshimasu et al., 2012). Additionally, including adolescent sex as a covariate is consistent with prior research supporting sex-differentiated emotion socialization parenting behaviors (Cassano, Perry-Parrish, & Zeman, 2007) and sex differences in ADHD prevalence (Arnett, Pennington, Willcutt, DeFries, & Olson, 2015).

The current longitudinal study used a model building approach to systematically examine theory-driven pathways to adolescent emotion lability. First, we sought to test a dual simple mediation model wherein maternal emotion dysregulation predicts supportive and non-supportive parenting responses, in turn leading to youth emotion lability. Consistent with the Morris et al. (2007) model, we hypothesized that maternal emotion dysregulation would be positively associated with non-supportive emotion socialization practices and negatively associated with supportive emotion socialization practices. In turn, we predicted that emotion socialization practices would mediate the longitudinal association between maternal emotion dysregulation and youth emotion lability. We aimed to further extend this model by examining how the interaction between maternal emotion dysregulation and adolescent ADHD symptoms impacts the strength of these emotion socialization pathways. In line with theoretical and emerging empirical support in adolescent samples, we hypothesized that the strength of the effects of maternal emotion dysregulation on both emotion socialization and adolescent emotion lability would be strongest at higher levels of youth ADHD symptoms.

Methods

Participants and Procedures

Recognizing that mediation analyses assume a temporal relation between variables over time and that community-based samples capture a range of symptom severities, this study used secondary data from a larger, 10-year longitudinal community project on risk behaviors (see Collado, Felton, MacPherson, & Lejuez, 2014). All study procedures were approved by the University of Maryland, College Park (UMD) Institutional Review Board (IRB). Youth and their parent(s) were recruited from the Washington, D.C. metropolitan area. Eligible families for the original longitudinal project: 1) had a child between the ages of 9–13 years; 2) were proficient in English; and 3) indicated that they could participate in annual study assessments. Assessments were conducted once per year over 8 years in a laboratory setting, with children and parents receiving up to $40 for completing each assessment. During the annual assessments, children and their caregivers arrived at the laboratory at UMD, where research staff provided informed consent and assent. Assessments were completed in separate rooms, and children’s responses were not accessed by caregivers, per confidentiality guidelines and IRB approval. All measures were administered using standard instructions and prompts.

Because maternal emotion dysregulation measures were not collected until the third wave of the larger study, the current study’s baseline was at wave 3 of data collection for the larger study; each timepoint in this sub-sample is labeled T1–T3 for clarity. Of the original sample of 277 youth, 247 participated in T1 (M age = 13.06, SD age = 0.90), 233 participated in T2 (M age = 14.00, SD age = 0.89), and 213 participated in T3 (M age = 15.02, SD age = 0.95). The final sample for the present study reflects an important developmental period (i.e., approximating the early teenage years – on average, ages 13–15). Mothers were between the ages of 28–57 years at T1 (M age = 44.09, SD age = 6.07) and reported annual family income ranging from $0 to $325,000 (M income = $102,498, SD income = $56,350). Youth race/ethnicity was 52.5% White, 37.7% Black/African American, 1.6% Asian, and 8.2% “other race/ethnicity.”

Measures

Demographics.

Mothers reported their own educational attainment and child age, sex, and race/ethnicity at each time point. Race/ethnicity was dichotomized to represent (1) White and (0) non-White youth, given the low percentage of Asian, Latino, and “other” race/ethnicities in the sample. Maternal educational attainment was dichotomized to represent (1) received post-high school education and (0) received a high school education only.

Maternal Emotion Dysregulation.

Maternal emotion dysregulation was measured (as the baseline predictor) using the 36-item Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004). Mothers rated how often each item applied to them using a 5-point Likert-scale from 1 (almost never, 0–10%) to 5 (almost always, 91–100%). The DERS assesses six domains of emotion dysregulation: non-acceptance of negative emotions, difficulties engaging in goal-directed behaviors when distressed, inability to regulate impulsive behaviors when distressed, difficulties employing effective emotion regulation strategies, having problems identifying expressed emotions, and having a lack of overall emotional awareness. We calculated a DERS total score by summing items across subscales, with higher scores indicating more maternal emotion dysregulation (Gratz & Roemer, 2004). In this study, Cronbach alpha (α) =.80.

Parenting Responses to Adolescents’ Expressions of Negative Emotions.

Parenting was measured (as the mediator variable and statistical covariate) using the Coping with Children’s Negative Emotions Scale – Adolescent Version (CCNES-A; Fabes & Eisenberg, 1998). The CCNES-A is a parent-report measure with subscales designed to reflect typical parenting responses to adolescents’ negative emotions. Mothers were presented with 9 hypothetical scenarios in which their adolescent might express negative emotions and rated how likely they were to respond to the scenarios in each of six ways (e.g., “When my teenager gets angry because he/she can’t get something that he/she really wants, I usually…”). Mothers reported on a 7-point Likert-type scale from 1 (very unlikely) to 7 (very likely). We use two composite variables to categorize non-supportive (e.g., “get upset with him/her for being so angry”) and supportive (e.g., “help him/her think of other ways to go about getting what he/she wants”) parenting responses to adolescents’ negative emotional expressions using two composite variables (Ehrlich, Cassidy, Gorka, Lejuez, & Daughters, 2013; Mazursky-Horowitz et al., 2015). We computed a composite variable for non-supportive parenting responses by averaging z-scores of the punitive (M = 17.30, SD = 7.56) and minimizing (M = 28.59, SD = 11.82) responses subscales. The supportive responses composite variable was computed by averaging the z-scores of three subscales: problem-focused (M = 55.74, SD = 6.21), expressive encouragement (M = 52.66, SD = 8.02), and emotion-focused (M = 50.29, SD = 7.89) responses. Prior research using the CCNES-A in parents of adolescents shows adequate reliability of the non-supportive parenting summary score (0.73) and the supportive parental responses variable (0.87) (Ehrlich et al., 2013; Ehrlich, Cassidy, Lejuez, & Daughters, 2014). In this study, internal consistencies of non-supportive (α = 0.88) and supportive (α = 0.90) were very good.

Adolescent Emotion Lability.

Youth emotion lability was evaluated (as the main outcome variable and statistical covariate), via maternal report on the Emotion Regulation Checklist-Lability/Negativity subscale (ERC-L/N; Shields & Cicchetti, 1997). The ERC-L/N subscale was used because it most closely aligns with the broader affective difficulties present in youth with ADHD (Martel 2009; Seymour et al., 2012, 2014). Mothers reported the frequency with which youth display inappropriate regulation of negative emotions, emotional intensity, variability of mood and rigidity of emotion responding, and dysregulation of positive emotion. Responses were rated using a 4-point Likert scale (1 = rarely/never; 4 = almost always). The ERC-L/N consists of 15 items, including “is easily frustrated,” “can bounce back and recover quickly when upset or frustrated (e.g., doesn’t pout or stay sullen, anxious, or sad after emotionally distressing events),” and “transitions well from one activity to another; doesn’t become angry, anxious, distressed or overly excited when moving from one activity to another.” A total score was calculated from these 15 items. Higher scores indicate greater emotion lability. While the ERC-L/N was initially developed for youth up to 12 years old, it has been used among youth ages 12–17 (Daly, Haden, Hagins, Papouchis, & Ramirez, 2015; Houck, Hadley, Barker, Brown, Hancock, & Almy, 2016; Miller-Slough & Dunsmore, 2019; Seymour et al., 2012). In this study, internal consistency was good (α = 0.85).

Youth ADHD and ODD Symptoms.

Mothers completed the Disruptive Behavior Disorders checklist (DBD; Pelham, Gnagy, Greenslade, & Milich, 1992). From the DBD, two subscales were derived: ADHD (18 items) and ODD (8 items) symptoms (as the predictor variable and statistical covariate, respectively). Mothers rated their children’s behaviors on a 4-point scale (0 = not at all to 3 = very much). A total score was created for the ADHD and ODD subscales by summing all respective items, with higher scores indicating more symptomatology. Nine percent of the sample reported 6 or more inattentive or hyperactive/impulsive symptoms, in line with community prevalence estimates (e.g., Sayal, Prasad, Daley, Ford, & Coghill, 2018). The DBD has good internal consistency (ADHD α = .94; ODD α = .80) in the current sample.

Data Analytic Plan

Prior to conducting analyses, patterns of missingness were examined. First, correlations between demographic variables and missingness on both study variables at T1 and subsequent retention were examined. Second, for missing variables, Little’s (1988) missing completely at random (MCAR) test was performed using SPSS, with non-significant results supporting the presence of MCAR data. No demographic variables were associated with missingness on T3 adolescent emotion lability, or T2 parenting (non-supportive or supportive). Results from Little’s MCAR test supported the assumption that data were missing at random (χ2(68) = 58.74, p = .78).

Structural equation modeling (SEM) with lavaan in RStudio (version 1.0.136) was used to test the main study hypotheses (see Figure 1 for conceptual model). First, the direct effect of maternal emotion dysregulation on adolescent emotion lability was examined (see Figure 2a for conceptual model). Second, a dual mediation model with both T2 non-supportive and supportive parenting variables mediating the association between T1 maternal emotion dysregulation and T3 adolescent emotion lability was evaluated – controlling for prior levels of adolescent emotion lability and parenting (see Figure 2b). Next, T1 adolescent ADHD symptoms were tested as a moderator of all five pathways in the dual mediation model (see Figure 2c). Predictors were mean centered, with the interaction term derived from the product of the mean centered predictors. Statistically significant moderated paths were included in the main moderated mediation model to ensure the most parsimonious final model.

Figure 1.

Figure 1

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Path model of moderated mediation model with standardized coefficients.

Note. T1 = 13 year assessment; T2 = 14 year assessment; T3 = 15 year assessment. * p < .05, ** p < .01. Grey pathways were non-significant.

Figure 2a.

Figure 2a

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Conceptual model of the direct effect of maternal emotion dysregulation on adolescent emotion lability.

Figure 2b.

Figure 2b

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Conceptual model of the indirect effect of maternal emotion dysregulation on adolescent emotion lability via parenting responses mediators.

Figure 2c.

Figure 2c

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Conceptual model of the moderation analyses of each pathway.

Full Information Maximum Likelihood procedures were used to simulate the missing parameters (Enders, 2001). Full Information Maximum Likelihood is optimal for inferring probable values of the missing parameters because it utilizes all observed data in the simulations, thereby reducing biased parameter estimates for data that meets the assumption of missing at random. Robust standard errors were also used to account for any non-normality bias in the standard errors, producing model fit indices that more accurately reflect the appropriate amount of misfit in the model compared to standard indices (Satorra & Bentler, 2010).

To examine mediation pathways, the delta method was used to test the significance of the product of standard errors for the a and b paths (Sobel, 1982). In addition to the delta method, a conservative estimate of mediation, Monte Carlo confidence intervals (CIs) (Tofighi & MacKinnon, 2016) were used to test the indirect effect using an interactive online tool with 20,000 repetitions (Preacher, Rucker, & Hayes, 2007; Preacher & Selig, 2012). Monte Carlo CIs were chosen over bootstrapped CIs to retain robust standard errors used for parameter estimates. Finally, indirect effects were assessed at one standard deviation above/below the mean of youth ADHD symptoms using the delta method and Monte Carlo CIs.

To assess model fit, the comparative fix index (CFI) and the root mean square error of approximation (RMSEA) were used. The fit between the hypothesized model and the observed data is evident in the CFI values, of which a .95 or higher is considered acceptable (Klein, 2016). In terms of RMSEA values, results under .05 support a good model fit, values between .05 and .08 indicate an adequate fit, and values greater than .10 indicate a poor fit (Browne & Cudeck, 1993). The chi-square statistic was also observed, although this index is sensitive to sample size and large chi-square values are often observed in large sample sizes (Bentler, 1990).

Demographic (i.e., race, maternal education) and control variables were included as predictors when they were significantly correlated with the outcome variables. Emotion lability and non-supportive and supportive parenting responses were modeled as control variables on their respective outcome variables. Covariate pathways among predictor, demographic, and control variables were free to covary when significantly correlated; otherwise these pathways were constrained to zero. Given sex differences in ADHD symptom prevalence and emotion socialization parenting (e.g., Theule, Wiener, Tannock, & Jenkins, 2013), we used multiple group modeling to examine the moderating role of youth sex on each pathway. Chi-square values were compared in analyses with regression coefficients constrained to be equal across sex vs. analyses with regression coefficients free to vary. Chi-square difference testing determined if pathways were moderated by sex; significant difference tests provide evidence of moderation.

Results

Descriptive statistics and bivariate associations

Descriptive statistics and bivariate associations for the key variables are shown in Table 1. Relative to non-White youth, mothers of White youth reported using lower levels of non-supportive, t(194) = 2.61, p = .01, d = .46 and supportive emotion socialization, t(194) = 2.35, p = .02, d = .25; mothers with a high school education reported lower levels of supportive emotion socialization compared to mothers with higher levels of education, t(206) = −2.46, p = .01, d = .35. ODD symptoms (T1) were positively associated with later non-supportive emotion socialization and youth emotion lability. Chi-square difference testing indicated that youth sex did not moderate regression coefficient strength in any of the models (see Table 2). However, there was an effect of adolescent sex in analytic models after controlling for other variables; thus, sex was retained as a covariate.

Table 1.

Descriptive statistics and bivariate associations for key and demographic variables

1. Maternal ED (T1) 2. Youth ADHD Symptoms (T1) 3. Non-Supportive Responses (T2) 4. Supportive Responses (T2) 5. Youth Emotion Lability (T3)
1. Maternal ED (T1)
2. Youth ADHD Symptoms (T1) .21**
3. Non-Supportive (T2) 42** .17*
4. Supportive (T2) −.22** −.12+ −.20**
5. Youth Emotion Lability (T3) .26** .52** .31** −.15*
Youth Sex (Male) .03 −.11 −.03 −.08 .04
Youth ODD Symptoms (T1) .15* .59** .19** −.07 .33**
Youth Race (White) .11 .11 .18** −.17* .11
Mother Education (T1) .04 −.06 .07 .17* .10
N 230 212 220 220 197
M(SD) 64.28 (16.48) 2.17 (3.53) −.001 (.60) .003 (.57) 23.61 (6.30)
Min 36.00 .00 −.91 −2.13 15.00
Max 112.00 17.00 2.03 .84 44.00
Skew .73 2.08 .80 −.78 .94
Kurtosis .03 4.17 .19 .44 .69
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Note. ED = emotion dysregulation; ADHD = attention-deficit/hyperactivity disorder; T1 = time point 1 (Mage adolescent = 13.06 years); T2 = time point 2 (Mage adolescent = 14.00 years); T3 = time point 3 (Mage adolescent = 15.02 years).

+

p ≤ .10,

*

p < .05,

**

p < .

Table 2.

Summary of results from analytic models

Total effect Dual simple mediation Moderated mediation
b (SE) B b (SE) B b (SE) B
Effects on youth emotion lability (T3)
 Maternal ED (T1) 0.02 (0.02) 0.06 .01 (0.02) 0.03 0.01 (0.02) 0.03
 Non-supportive parenting (T2) 1.01* (0.50) 0.10 1.01* (0.50) 0.10
 Supportive parenting (T2) 0.002 (0.002) 0.06 0.002 (0.002) 0.06
 Youth ADHD symptoms (T1) 0.32* (0.13) 0.18 0.33* (0.13) 0.19 0.33** (0.13) 0.19
 Youth emotion lability (T1) 0.80** (0.08) 0.75 0.77** (0.08) 0.73 0.77** (0.08) 0.73
 Youth ODD symptoms (T1) −1.06** (0.31) −0.24 −1.05** (0.30) −0.24 −1.05** (0.30) −0.24
 Youth Gender (Male) −1.41* (0.59) −0.11 −1.53* (0.61) −0.12 −1.53* (0.61) −0.12
Effects on non-supportive parenting (T2)
 Maternal ED (T1) 0.008** (0.002) 0.22 0.008** (0.002) 0.21
 Youth ADHD symptoms (T1) 0.001 (0.01) 0.008 −0.001 (0.009) −0.01
 Maternal ED × youth ADHD symptoms 0.001** (0.00) 0.10
 Non-supportive parenting (T1) 0.73** (0.05) 0.69 0.74** (0.05) 0.71
 Youth ODD symptoms (T1) −0.003 (0.03) −0.01 −0.006 (0.03) −0.01
 Youth Caucasian −0.06 (0.05) −0.05 −0.07 (0.05) −0.06
 Youth Gender (Male) −0.02 (0.05) −0.02 −0.01 (0.05) −0.01
Effects on supportive parenting (T2)
 Maternal ED (T1) 0.002 (0.002) 0.06 0.002 (0.002) 0.06
 Youth ADHD symptoms (T1) −0.005 (0.009) −0.03 −0.005 (0.009) −0.03
 Supportive parenting (T1) 0.77** (0.06) 0.75 0.77** (0.06) 0.75
 Mother high-school only (T1) 0.26** (0.09) 0.14 0.26** (0.09) 0.14
 Youth Caucasian −0.09 (0.06) −0.07 −0.08 (0.06) −0.07
 Youth Gender (Male) 0.09 (0.05) 0.07 0.09 (0.05) 0.07
Model fit
 χ2 χ2(4) = 4.15, p = .39 χ2(33) = 42.21, p = .13 χ2(38) = 45.78, p = .18
 CFI 1.00 .99 .99
 RMSEA .01 .03 .03
 R2 emotion lability .59 .59 .59
 R2 non-supportive parenting .63 .64
 R2 supportive parenting .58 .58
Gender differences None None None
 χ2 χ2(4) = 8.15, p = .09 χ2(16) = 23.22, p = .11 χ2(17) = 18.58, p = .35
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Note. ED = emotion dysregulation, ADHD = attention-deficit/hyperactivity disorder, ODD = oppositional defiant disorder. T1 = time 1 (Myouth age = 13.06 years), T2 = time 2 (Myouth age = 14.00 years), T3 = time 3 (Myouth age = 15.02 years).

*

p <. 05,

**

p <. 0

Total, direct, and indirect effects

Results and model fit from the analytic models are presented in Figure 1 and Tables 2–4. Overall, model fit was excellent across the models (CFI ≥ .98, RMSEA ≤ .03). We found no direct effect of maternal emotion dysregulation (T1) on youth emotion lability (T3). Results from the dual mediation model showed a significant indirect effect of maternal emotion dysregulation on youth lability via non-supportive emotion socialization (T2) using Monte Carlo CIs (b = 0.008, SE = 0.004, p = .06, 95% CI [0.0004, 0.017]). However, the indirect effect of maternal emotion dysregulation on youth lability via supportive emotion socialization was non-significant (b = 0.00, SE = 0.001, p = .97,95% CI [−0.003, 0.004]).

Table 4.

Summary of moderation models

Youth ADHD symptoms × non-supportive parenting predicting youth emotion lability Youth ADHD symptoms × supportive parenting predicting youth emotion lability
b (SE) B b (SE) B
Effects on youth emotion lability (T3)
 Non-supportive parenting (T2) 1.13* (0.48) 0.11
 Supportive parenting (T2) −0.20 (0.53) −0.02
 Youth ADHD symptoms (T1) 0.28* (0.11) 0.16 0.36** (0.13) 0.20
 Non-supportive parenting × youth ADHD symptoms 0.21 (0.19) 0.06
 Supportive parenting × youth ADHD symptoms 0.18 (0.21) 0.06
 Youth emotion lability (T1) 0.79** (0.08) 0.74 0.80** (0.08) 0.76
 Youth ODD symptoms (T1) −1.07** (0.30) −0.24 −1.09** (0.32) −0.24
 Youth Sex (Male) −1.53** (0.58) −0.12 −1.42* (0.60) −0.11
Model fit
 χ2 χ2(5) = 3.45, p = .63 χ2(7) = 8.50, p = .29
 CFI 1.00 .99
 RMSEA .00 .03
 R2 emotion lability .60 .58
 R2 non-supportive parenting
 R2 supportive parenting
Sex differences None None
 χ2 χ2(5) = 5.53, p = .36 χ2(5) = 10.57, p = .06
Open in a new tab

Note. ED = emotion dysregulation, ADHD = attention-deficit/hyperactivity disorder, ODD = oppositional defiant disorder. T1 = time 1 (Myouth age = 13.06 years), T2 = time 2 (Myouth age = 14.00 years), T3 = time 3 (Myouth age = 15.02 years).

Moderating role of ADHD symptoms on total, direct, and indirect effects

We examined the moderating effect of youth ADHD symptoms on each of the five pathways of the dual mediation model (see Tables 3 and 4 for these results). Youth ADHD symptoms only moderated the effect of maternal emotion dysregulation on non-supportive emotion socialization (b = 0.001, SE = 0.00, p = .005, B = 0.10). Simple slope analyses revealed that maternal emotion dysregulation was related to non-supportive emotion socialization at higher (+1SD; b = 0.01, SE = 0.002, p < .001, B = 0.31) and average levels (b = 0.008, SE = 0.002, p < .001, B = 0.21) of youth ADHD symptoms, but not lower levels (−1SD; b = 0.004, SE = 0.002, p = .12, B = 0.11).

Table 3.

Summary of moderation models

Maternal ED × youth ADHD symptoms predicting non-supportive parenting Maternal ED × youth ADHD symptoms predicting supportive parenting Maternal ED × youth ADHD symptoms predicting youth emotion lability
b (SE) B b (SE) B b (SE) B
Effects on youth emotion lability (T3)
 Maternal ED (T1) 0.03 (0.02) 0.06
 Youth ADHD symptoms (T1) 0.32* (0.13) 0.18
 Maternal ED × youth ADHD symptoms −0.001 (0.006) −0.01
 Youth emotion lability (T1) 0.79** (0.08) 0.75
 Youth ODD symptoms (T1) −1.05** (0.31) −0.23
 Youth Sex (Male) −1.42* (0.59) −0.11
Effects on non-supportive parenting (T2)
 Maternal ED (T1) 0.008** (0.002) 0.21
 Youth ADHD symptoms (T1) −0.003 (0.009) −0.02
 Maternal ED × youth ADHD symptoms 0.001** (0.00) 0.10
 Non-supportive parenting (T1) 0.74** (0.05) 0.70
 Youth ODD symptoms (T1) −0.004 (0.03) −0.009
 Youth White −0.07 (0.05) −0.06
 Youth Sex (Male) −0.01 (0.05) −0.01
Effects on supportive parenting (T2)
 Maternal ED (T1) 0.002 (0.002) 0.06
 Youth ADHD symptoms (T1) −0.005 (0.009) −0.03
 Maternal ED × youth ADHD symptoms 0.00 (0.001) −0.04
 Supportive parenting (T1) 0.77** (0.06) 0.76
 Mother high-school only (T1) 0.26** (0.09) 0.13
 Youth White −0.08 (0.06) −0.07
 Youth Sex (Male) 0.08 (0.05) 0.07
Model fit
 χ2 χ2(10) = 12.15, p = .28 χ2(15) = 17.60, p = .28 χ2(5) = 4.87, p = .43
 CFI .99 .98 1.00
 RMSEA .03 .03 .00
 R2 emotion lability .57
 R2 non-supportive parenting .64
 R2 supportive parenting .58
Sex differences None None None
 χ2 χ2(6) = 5.55, p = .48 χ2(6) = 7.48, p = .28 χ2(5) = 7.82, p = .17
Open in a new tab

Note. ED = emotion dysregulation, ADHD = attention-deficit/hyperactivity disorder, ODD = oppositional defiant disorder. T1 = time 1 (Myouth age = 13.06 years), T2 = time 2 (Myouth age = 14.00 years), T3 = time 3 (Myouth age = 15.02 years).

Given these results, we modeled the moderating effect of adolescent ADHD symptoms on the relation between maternal emotion dysregulation and non-supportive emotion socialization (i.e., the a path to non-supportive emotion socialization) within the dual mediation model. We found a significant indirect effect at higher (+ 1SD; b = 0.01, SE = 0.006, p = .04, 95% CI [0.0004, 0.022]) and average levels of ADHD symptoms (b = 0.008, SE = 0.004, p = .06, 95% CI [0.0004, 0.017]), but not at lower levels of ADHD symptoms (−1SD; b = 0.004, SE = 0.003, p = .20, 95% CI [−0.0009, 0.012]) (Figure 1). Further examination of the effect sizes suggest that the strength of the pathway significantly increased with increasing ADHD symptom severity.1

Discussion

Maternal emotional functioning and responses to children’s negative emotional expressions can facilitate or hinder children’s emotional development. These processes are likely salient predictors of youth outcomes, particularly among adolescents with ADHD symptoms who have been shown to display emotion lability (Sobanski et al., 2010), evidence poor adolescent outcomes (Bussing et al., 2010), and require increased parental support and scaffolding to regulate their behavior and emotions (Johnston & Chronis-Tuscano, 2015). Despite compelling support, we are unaware of any research that has examined the independent and interactive effects of maternal emotion dysregulation and adolescent ADHD symptoms on emotion socialization practices and adolescent emotion lability over time. Addressing these gaps, this study examined emotion socialization pathways through which mothers’ emotion dysregulation contributed to worsening adolescent emotion lability, and the extent to which youth ADHD symptom severity modified longitudinal risk pathways. Building upon prior theory and research, this study is strengthened by a large representative community sample followed over a period of three years, while controlling for prior levels of parent emotion socialization practices and youth emotion lability.

Findings from the dual mediation showed an indirect effect of maternal emotion dysregulation on adolescent emotion lability via non-supportive parenting responses. T2 non-supportive (but not supportive) parenting mediated the longitudinal relation between T1 maternal emotion dysregulation and T3 youth emotion lability, controlling for prior levels. Indeed, these results are consistent with the Morris et al. (2007) theoretical model, our hypotheses, and an emerging research base on the impact of maternal emotion dysregulation on parenting responses and adolescent emotion dysregulation, more broadly. For example, in an unselected sample of high school youth, Sarıtaş et. al., (2013) found that maternal emotion dysregulation was associated with non-supportive parenting responses (indexed by hostility and rejection), and non-supportive parenting responses explained much of the variance in youth emotion dysregulation.

Expanding upon the simple mediation model, the current study also tested whether adolescent (i.e., ADHD symptoms) and parental (i.e., maternal emotion dysregulation) characteristics influenced emotion socialization pathways involved in adolescent emotion lability. Findings from the dual moderated mediation model showed that the pathway from maternal emotion dysregulation to non-supportive emotion socialization practices and adolescent emotion lability was increasingly stronger among youth with more ADHD symptoms. Even in the current community sample, unselected for psychopathology, results showed that adolescent ADHD symptoms modified effects: the strength of the effect of maternal emotion dysregulation on non-supportive emotion socialization, and in turn, adolescent emotion lability, increased systematically as youth ADHD symptoms increased (the a path increased in strength). These findings support the idea that both parents and children bring personal vulnerabilities that contribute to caregiver responses (Bell & Calkins, 2000). Indeed, prior research shows that ADHD symptoms evoke negative responses from caregivers, but it remained unclear how the interaction of maternal emotion dysregulation (a parent-level risk factor) and adolescent ADHD symptoms (a youth-level risk factor) shape emotion socialization practices and adolescent emotional development over time (Johnston & Chronis-Tuscano, 2015). The current study extends upon these findings by exposing the temporal unfolding of these constructs. In so doing, these study findings highlight the “upstream effects” of youth ADHD symptoms on non-supportive parenting and emotion lability. Results expose mothers’ own emotion-related vulnerability as one factor that sets the stage for non-supportive parenting resulting in worsening youth emotion lability in adolescence, and youth ADHD symptoms strengthen these effects.

There are several possible explanations for our findings, each warranting substantial empirical attention. Perhaps mothers who report more emotion dysregulation experience difficulties coping with adolescents’ displays of negative emotions, having less “reserve” to facilitate adaptive parenting responses, relative to mothers with a greater capacity to regulate their emotions (Crandall, Deater-Deckard, Riley, 2015; Gratz & Roemer, 2004). This possibility is consistent with the social-cognitive literature on emotion regulation as a depleted resource, such that the ability to self-regulate across domains (i.e., emotions) is impaired after acts of effortful control. Additionally, mental fatigue after cognitively demanding tasks has been shown to result in impaired emotion regulation (Grillon, Quispe-Escudero, Mathur, & Ernst, 2015). Parenting an adolescent with ADHD symptoms can be stressful and perhaps require more frequent acts of maternal self-regulation (Podolski & Nigg, 2001).

Contrary to predictions, we did not find that fewer supportive parenting responses to adolescents’ negative emotions mediated the longitudinal association between maternal emotion dysregulation and adolescent emotion lability – regardless of youth ADHD symptomatology. Instead, the effect of maternal emotion dysregulation appeared to be unique to non-supportive emotion socialization practices, consistent with the widely-held idea that non-supportive and supportive parenting behaviors are not merely opposite ends of the same dimension (Dallaire et al., 2006). Supportive emotion socialization practices were negatively correlated with maternal emotion dysregulation and youth emotion lability, yet when non-supportive parenting was accounted for in the models, these effects were reduced. This suggests that the active ingredient for the transmission of maternal emotion dysregulation to youth emotion lability is increasingly non-supportive emotion socialization practices, rather than reductions in supportive emotion socialization practices, over time. Future research should continue to investigate the impact of supportive parenting on adolescent social-emotional functioning using longitudinal designs.

Limitations

Although this study contributes uniquely to the literature on processes shaping adolescent emotion lability, and was strengthened by a well-characterized community sample and a prospective longitudinal design, these findings should be interpreted in the context of limitations. A main limitation is the sole use of maternal report of all constructs. It is possible that the measure of emotion socialization behaviors could be impacted by social desirability and/or limited insight. Moreover, we cannot preclude the possibility that shared method variance impacted the present findings. However, the degree that shared method variance impacted the findings is reduced because we controlled for prior levels of both maternal emotion socialization practices and youth emotion lability. We also found differential effects of non-supportive, but not supportive, emotion socialization behaviors. Still, this is the very first study to prospectively examine key pathways of the Morris et al. (2007) model in relation to adolescent ADHD symptoms. Thus, despite this methodological shortcoming, the present study is a critical first step in understanding risk pathways during adolescence and should be replicated using multi-method assessment.

We also did not include a measure of fathers’ emotion dysregulation and emotion socialization practices, and more work is needed to evaluate the relative contributions of paternal vs. maternal emotion dysregulation on parenting responses and adolescent emotion lability over time (Brand & Klimes-Dougan, 2010). Also, a multi-informant, comprehensive assessment approach (i.e., including teacher reports and diagnostic interviews assessing impairment) is the gold standard for ADHD assessment (Pelham, Jr., Fabiano, & Massetti, 2005), as teachers see youth in different settings and often have a better metric for understanding developmentally normative behaviors. Therefore, these findings cannot necessarily be generalized to clinical populations of youth with ADHD. It is also critical to examine other variables potentially related to emotion lability, especially in youth with ADHD, as it is unlikely that mothers’ self-reported functioning exclusively shapes adolescent emotional outcomes. Other factors such as peer relationship quality, school climate, co-parent involvement, parental and child trauma history, and shared genetic or biological vulnerabilities, may shape adolescent emotion lability over time.

Conclusion and Implications

Emotion lability is a trans-diagnostic risk factor for psychopathology. Elucidating mechanisms and moderators of the developmental course of emotion lability during adolescence can lead to meaningful targets for intervention, particularly in the early teenage years when rates of negative emotionality and risk for psychopathology markedly increase. This study advances emotion socialization theory by examining differential effects of maternal emotion dysregulation on emotion socialization practices and youth emotional functioning in relation to youth ADHD symptoms. Study findings suggest that increasingly non-supportive emotion socialization may be the active ingredient for the transmission of maternal emotion dysregulation to youth emotion and pathways become stronger at higher levels of youth ADHD symptoms. By systematically evaluating emotion socialization mechanisms and their up-stream effects, these empirical findings help to clarify theoretical models of risk and illuminate possible intervention targets.

Acknowledgments

This project funded by a grant from NIH 2R01 DA18647 awarded to Carl Lejuez and by NIDA R21 DA25550 to Jude Cassidy.

Footnotes

Publisher's Disclaimer: This Author Accepted Manuscript is a PDF file of a an unedited peer-reviewed manuscript that has been accepted for publication but has not been copyedited or corrected. The official version of record that is published in the journal is kept up to date and so may therefore differ from this version.

Conflict of Interest The authors declare that they have no conflicts of interest.

1

We re-ran the main analyses using the subsample of participants with complete data for the mediation pathways (n = 171). Results were consistent with the results from the original analyses and are available from authors on request.

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