Adolescents with severe emotion dysregulation show clinical-level symptoms, study finds

Emotion dysregulation is a multidimensional construct associated with mental health disorders. Yet its distribution and clinical significance in the general adolescent population have remained underexplored. A new study published in Borderline Personality Disorder and Emotion Dysregulation set out to measure how common emotion dysregulation is among community adolescents and to compare those findings with a clinical sample of same-aged outpatients.

The researchers recruited 611 students with a mean age of 16.1 years and 63 clinical outpatients with a mean age of 17.5 years who had diagnoses of Borderline Personality Disorder, Depressive Disorder, or Anxiety Disorder. All participants completed the Difficulties in Emotion Regulation Scale (DERS), a self-report instrument, along with questionnaires assessing depression, anxiety, impulsivity, risk behaviors, emotion regulation skills, social problem-solving, and childhood trauma.

Using the percentile-based stratification, the student sample was divided into low, moderate, and high emotion dysregulation subgroups. Across these groups, the study observed a trend linking higher levels of emotion dysregulation with increased psychopathological symptoms, greater impulsivity, more reported childhood trauma, reduced adaptive emotion regulation strategies, and higher rates of risk behaviors, specifically binge eating, non-suicidal self-injury, and problematic internet use.

The most striking finding concerned the high-emotion-dysregulation students. Their clinical characteristics were comparable to those of the clinical outpatient sample, yet only 51 percent of them had ever sought mental health support. This gap between symptom burden and service use suggests that a substantial share of adolescents with severe emotion regulation difficulties in the community remain outside the mental health care system, a point the authors suggest could inform the development of preventive interventions.

The latent profile analysis added a finer-grained picture. It identified four distinct subgroups of students: a low-ED group comprising 31 percent of the sample, a mild-ED group at 31 percent, a moderate-ED group at 24 percent, and a high-ED group at 13 percent. These profiles differed in their patterns of DERS subscale scores and in their associations with clinical variables.

The authors conclude that emotion dysregulation among students appears to vary along a continuum of overall severity and is strongly associated with clinical variables. The latent profiles were primarily distinguished by overall severity, while also showing subtle differences in the relative prominence of specific emotion regulation domains. The study was conducted within the framework of a randomized clinical trial registered on ClinicalTrials.gov (NCT04349709), and the article was released as an open-access, peer-reviewed accepted manuscript ahead of the final version of record.

Subject of Research: Prevalence and clinical correlates of emotion dysregulation in community adolescents compared with a clinical outpatient sample

Article Title: Emotion dysregulation in adolescents: comparing community and clinical samples and their association with mental health and risk behaviors

Article References: Pedrini, L., Meloni, S., Lanfredi, M., Geviti, A., Bonfiglio, N. S., Cattaneo, A., & Rossi, R. (2026). Emotion dysregulation in adolescents: comparing community and clinical samples and their association with mental health and risk behaviors. Borderline Personality Disorder and Emotion Dysregulation. https://doi.org/10.1186/s40479-026-00371-1

Image Credits: AI Generated

DOI: 10.1186/s40479-026-00371-1

Keywords: emotion dysregulation, adolescence, DERS, latent profile analysis, mental health, risk behaviors, non-suicidal self-injury, binge eating, problematic internet use, childhood trauma, impulsivity, community sample