The role of difficulties on emotion regulation in mediating the relationship between adverse childhood experiences and anxiety in emerging adulthood
DOI:
https://doi.org/10.26905/jpt.v21i2.17082Keywords:
Adverse childhood experiences, Anxiety, Difficulties on emotion regulation, Emotion regulation, Internalizing problemsAbstract
Emerging adulthood is a developmental phase during which individuals may be particularly vulnerable to internalizing problems, such as anxiety. One of the determinant factors of anxiety is Adverse Childhood Experiences (ACE). This study aims to examine the role of ACEs in internalizing problems, considering difficulties in emotion regulation (DER) as a mediating variable in emerging adulthood in Indonesia. The study used a quantitative approach with a cross-sectional design. A total of 305 participants were selected using purposive sampling with the criteria of being aged 18-25 years and not having received a mental health diagnosis before from a professional expert, including psychologist or psychiatrist. The instruments employed including the Adverse Childhood Experiences Questionnaire (ACE-Q), the Difficulties in Emotion Regulation Scale (DERS-18), and the Depression Anxiety Stress Scale (DASS-21). Data analysis was performed using the Structural Equal Model with a Partial Least Square (SEM-PLS) approach through the Smartpls4 application. The results showed that DER (clarity, goals, non-acceptance, strategies) acted as a partial mediator in the relationship between ACE and internalizing problems (anxiety). However, impulse, as one of the dimensions of DER, did not act as a mediator in this study. The findings highlight the importance of emotion regulation as a psychological mechanism in understanding the long-term impact of ACE on internalizing problems in emerging adulthood.
Downloads
References
Agnafors, S., Sydsjö, G., Svedin, C. G., & Bladh, M. (2023). Symptoms of depression and internalizing problems in early adulthood–associated factors from birth to adolescence. Nordic Journal of Psychiatry, 77(8), 799-810. https://doi.org/10.1080/08039488.2023.2254281
Aldao, A., Gee, D. G., De Los Reyes, A., & Seager, I. (2016). Emotion regulation as a transdiagnostic factor in the development of internalizing and externalizing psychopathology: Current and future directions. Development and Psychopathology, 28(4pt1), 927-946. https://doi.org/10.1017/s0954579416000638
American Psychological Association. (2018). Anxiety [Internet]. American Psychological Association. Retrieved from: https://www-apa-org.translate.goog/topics/anxiety?_x_tr_sl=en&_x_tr_tl=id&_x_tr_hl=id&_x_tr_pto=tc
Arnett, J. J. (2006). The psychology of emerging adulthood: What is known, and what remains to be known? In J. J. Arnett & J. L. Tanner (Eds.), Emerging adults in America: Coming of age in the 21st century (pp. 303–330). American Psychological Association. https://doi.org/10.1037/11381-013
Azwar, S. (2018). Psychological research methods (2nd Edition). Student library.
Azwar, S. (2022). Compilation of psychological scales (2nd Edition). Student Library.
Bakhtiar, B., Syakarofath, N. A., Karmiyati, D., & Widyasari, D. C. (2023). Peran adverse childhood experience terhadap internalizing problem dan externalizing problem pada remaja. Gadjah Mada Journal of Psychology (GamaJoP), 9(2), 277-292. https://doi.org/10.22146/gamajop.77578
Balistreri, K. S., & Alvira-Hammond, M. (2016). Adverse childhood experiences, family functioning and adolescent health and emotional well-being. Public Health, 132, 72-78. https://doi.org/10.1016/j.puhe.2015.10.034
Bandoli, G., Campbell-Sills, L., Kessler, R. C., Heeringa, S. G., Nock, M. K., Rosellini, A. J., Sampson, N. A., Schoenbaum, M., Ursano, R. J., & Stein, M. B. (2017). Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: A test of the stress sensitization hypothesis. Psychological Medicine, 47(13), 2379-2392. https://doi.org/10.1017/S0033291717001064
Bardeen, J. R., Fergus, T. A., & Orcutt, H. K. (2014). The moderating role of experiential avoidance in the prospective relationship between anxiety sensitivity and anxiety. Cognitive Therapy and Research, 38(4), 465-471. https://doi.org/10.1007/s10608-014-9614-z
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191. https://doi.org/10.1097/00007632-200012150-00014
Bie, F., Yan, X., Xing, J., Wang, L., Xu, Y., Wang, G., Wang, Q., Guo, J., Qiao, J., & Rao, Z. (2024). Rising global burden of anxiety disorders among adolescents and young adults: trends, risk factors, and the impact of socioeconomic disparities and COVID-19 from 1990 to 2021. Frontiers in Psychiatry, 15, 1489427. https://doi.org/10.3389/fpsyt.2024.1489427
Bobrowski, K. J., & Ostaszewski, K. (2022). Risk and protective factors associated with internalizing and externalizing mental health problems among 13-15-year-old youth. Psychiatria Polska, 56(5), 1033-1048. https://doi.org/10.12740/PP/139519
Brown, S., Fite, P. J., Stone, K., & Bortolato, M. (2016). Accounting for the associations between child maltreatment and internalizing problems: The role of alexithymia. Child Abuse & Neglect, 52, 20-28. https://doi.org/10.1016/j.chiabu.2015.12.008
Cicchetti, D. (2006). Development and psychopathology. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Theory and method (2nd ed., pp. 1–23). John Wiley & Sons, Inc.
Cicchetti, D., & Toth, S. L. (2016). Child maltreatment and developmental psychopathology: A multilevel perspective. In D. Cicchetti (Ed.), Developmental psychopathology: Maladaptation and psychopathology (3rd ed., pp. 457–512). John Wiley & Sons, Inc. https://doi.org/10.1002/9781119125556.devpsy311
Cloitre, M., Khan, C., Mackintosh, M.-A., Garvert, D. W., Henn-Haase, C. M., Falvey, E. C., & Saito, J. (2019). Emotion regulation mediates the relationship between ACES and physical and mental health. Psychological Trauma: Theory, Research, Practice, and Policy, 11(1), 82–89. https://doi.org/10.1037/tra0000374
Cole, E., & Diaz, A. (2024). Specific emotion regulation deficits differentiate and mediate the relationship between adverse childhood experiences and internalizing psychopathology. Journal of Affective Disorders Reports, 16, 100722. https://doi.org/10.1016/j.jadr.2024.100722
Condinata, F., Satiadarma, M. P., & Suyasa, P. T. Y. (2021, December). Psychological distress among emerging adults: A descriptive study. In 1st Tarumanagara International Conference on Medicine and Health (TICMIH 2021) (pp. 195-198). Atlantis Press. https://doi.org/10.2991/ahsr.k.211130.033
Dagnino, P., Cordeu, C., Franco-Chalco, E., Gloger, S., Duisallant, M., Mizon, J., & Romero, L. (2025). The impact of different adverse childhood experiences on the dimensions of emotional dysregulation in adults with major depression. Frontiers in Psychology, 16, 1587042. https://doi.org/10.3389/fpsyg.2025.1587042
Dragan, M. (2020). Adverse experiences, emotional regulation difficulties and psychopathology in a sample of young women: Model of associations and results of cluster and discriminant function analysis. European Journal of Trauma & Dissociation, 4(1), 2468-7499. https://doi.org/10.1016/j.ejtd.2018.12.001
Eysenck, M. W., & Holmes, A. (2020). Anxiety, depression and cognitive dysfunction. In P. J. Corr & G. Matthews (Eds.), The Cambridge handbook of personality psychology (2nd ed., pp. 364–374). Cambridge University Press. https://doi.org/10.1017/9781108264822.033
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/s0749-3797(98)00017-8
Flechsenhar, A., Levine, S., & Bertsch, K. (2022). Threat induction biases processing of emotional expressions. Frontiers in Psychology, 13, 967800. https://doi.org/10.3389/fpsyg.2022.967800
Ford, K., Bellis, M. A., Hughes, K., Barton, E. R., & Newbury, A. (2020). Adverse childhood experiences: A retrospective study to understand their associations with lifetime mental health diagnosis, self-harm or suicide attempt, and current low mental wellbeing in a male Welsh prison population. Health & Justice, 8(1), 13. https://doi.org/10.1186/s40352-020-00115-5
Fox, B. H., Perez, N., Cass, E., Baglivio, M. T., & Epps, N. (2015). Trauma changes everything: Examining the relationship between adverse childhood experiences and serious, violent and chronic juvenile offenders. Child Abuse & Neglect, 46, 163-173. https://doi.org/10.1016/j.chiabu.2015.01.011
Gomis‐Pomares, A., & Villanueva, L. (2023). Adverse childhood experiences: Pathways to internalising and externalising problems in young adulthood. Child Abuse Review, 32(4), e2802. https://doi.org/10.1002/car.2802
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271
Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M. (2017). A primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). Sage College Publishing.
Hakim, M. A., & Aristawati, N. V. (2023). Measuring depression, anxiety, and stres in early adults in Indonesia: Construct validity and reliability test of DASS-21. Jurnal Psikologi Ulayat, 10(2), 232-250. https://doi.org/10.24854/jpu553
Hansen, L. K., & Jordan, S. S. (2017). Internalizing behaviors. In V. Zeigler-Hill & T. K. Shackelford (Eds.), Encyclopedia of Personality and Individual Differences (1–5). Springer International Publishing. https://doi.org/10.1007/978-3-319-24612-3_907
Hanson, J. L., van den Bos, W., Roeber, B. J., Rudolph, K. D., Davidson, R. J., & Pollak, S. D. (2017). Early adversity and learning: Implications for typical and atypical behavioral development. Journal of Child Psychology and Psychiatry, 58(7), 770-778. https://doi.org/10.1111/jcpp.12694
Heleniak, C., Jenness, J. L., Vander Stoep, A., McCauley, E., & McLaughlin, K. A. (2016). Childhood maltreatment exposure and disruptions in emotion regulation: A transdiagnostic pathway to adolescent internalizing and externalizing psychopathology. Cognitive Therapy and Research, 40(3), 394-415. https://doi.org/10.1007/s10608-015-9735-z
Herzog, J. I., & Schmahl, C. (2018). Adverse childhood experiences and the consequences on neurobiological, psychosocial, and somatic conditions across the lifespan. Frontiers in Psychiatry, 9, 420. https://doi.org/10.3389/fpsyt.2018.00420
Hicks, M. R., Kernsmith, P., & Smith-Darden, J. (2021). The effects of adverse childhood experiences on internalizing and externalizing behaviors among black children and youth. Journal of Child & Adolescent Trauma, 14(1), 115-122. https://doi.org/10.1007/s40653-020-00316-y
Kaligis, F., Ismail, R. I., Wiguna, T., Prasetyo, S., Indriatmi, W., Gunardi, H., Pandia, V., Magdalena, C. C. (2021). Mental health problems and needs among transitional-age youth in Indonesia. International Journal of Environmental Research and Public Health, 18(8), 4046. https://doi.org/10.3390/ijerph18084046
Kim, J., & Cicchetti, D. (2010). Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. Journal of Child Psychology and Psychiatry, 51(6), 706–716. https://doi.org/10.1111/j.1469-7610.2009.02202.x
Liu, D. Y., & Thompson, R. J. (2017). Selection and implementation of emotion regulation strategies in major depressive disorder: An integrative review. Clinical Psychology Review, 57, 183-194. https://doi.org/10.1016/j.cpr.2017.07.004
Liu, J., Chen, X., & Lewis, G. (2011). Childhood internalizing behaviour: Analysis and implications. Journal of Psychiatric and Mental Health Nursing, 18(10), 884–894. https://doi.org/10.1111/j.1365-2850.2011.01743.x
Lovibond, S. H., & Lovibond, P. F. (1995). Depression Anxiety Stress Scales (DASS--21, DASS--42) [Database record]. APA PsycTests. https://doi.org/10.1037/t01004-000
McGovern, R., Bogowicz, P., Meader, N., Kaner, E., Alderson, H., Craig, D., Geijer-Simpson, E., Jackson, K., Muir, C., Salonen, D., Smart, D., & Newham, J. J. (2023). The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: A systematic review and meta‐analysis. Addiction, 118(5), 804-818. https://doi.org/10.1111/add.16127
McLaughlin, K. A., Weissman, D., & Bitrán, D. (2019). Childhood adversity and neural development: A systematic review. Annual Review of Developmental Psychology, 1(1), 277-312. https://doi.org/10.1146/annurev-devpsych-121318-084950
Mirman, A., Bick, A. S., Kalla, C., Canetti, L., Segman, R., Dan, R., Yehuda, A. B., Levin, N., & Bonne, O. (2021). The imprint of childhood adversity on emotional processing in high functioning young adults. Human Brain Mapping, 42(3), 615-625. https://doi.org/10.1002/hbm.25246
Muniz, C. N., Fox, B., Miley, L. N., Delisi, M., Cigarran, G. P. II, & Birnbaum, A. (2019). The effects of adverse childhood experiences on internalizing versus externalizing outcomes. Criminal Justice and Behavior, 46(4), 568–589. https://doi.org/10.1177/0093854819826213
Paulus, F. W., Ohmann, S., Möhler, E., Plener, P., & Popow, C. (2021). Emotional dysregulation in children and adolescents with psychiatric disorders. A narrative review. Frontiers in Psychiatry, 12, 628252. https://doi.org/10.3389/fpsyt.2021.628252
Pizzie, R. G., McDermott, C. L., Salem, T. G., & Kraemer, D. J. (2020). Neural evidence for cognitive reappraisal as a strategy to alleviate the effects of math anxiety. Social Cognitive and Affective Neuroscience, 15(12), 1271-1287. https://doi.org/10.1093/scan/nsaa161
Quiñones-Camacho, L. E., & Davis, E. L. (2019). Emotion regulation strategy knowledge moderates the link between cumulative stress and anxiety symptoms in childhood. International Journal of Behavioral Development, 43(4), 369–374. https://doi.org/10.1177/0165025419833821
Rudenstine, S., Espinosa, A., McGee, A. B., & Routhier, E. (2019). Adverse childhood events, adult distress, and the role of emotion regulation. Traumatology, 25(2), 124–132. https://doi.org/10.1037/trm0000176
Schweitzer, C., DiGiovanni, A., Burynski, R., Kassim, A., Sabry, A., Russell, M., & Sandelich, S. (2025). The impact of adverse childhood experiences on emotional regulation in adult ED patients. Journal of Affective Disorders, 120419. https://doi.org/10.1016/j.jad.2025.120419
Sheridan, M. A., & McLaughlin, K. A. (2014). Dimensions of early experience and neural development: Deprivation and threat. Trends in Cognitive Sciences, 18(11), 580-585. https://doi.org/10.1016/j.tics.2014.09.001
Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical psychology review, 57, 141-163. https://doi.org/10.1016/j.cpr.2017.09.002
Soenke, M., Hahn, K. S., Tull, M. T., & Gratz, K. L. (2010). Exploring the relationship between childhood abuse and analogue generalized anxiety disorder: The mediating role of emotion dysregulation. Cognitive Therapy and Research, 34(5), 401–412. https://doi.org/10.1007/s10608-009-9264-8
Sugiyono. (2017). Quantitative, qualitative, and R&D research methods. Alphabet.
Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders: A review. Jama, 328(24), 2431-2445. https://doi.org/10.1001/jama.2022.22744
Thompson, R. A. (2019). Emotion dysregulation: A theme in search of definition. Development and Psychopathology, 31(3), 805-815. https://doi.org/10.1017/s0954579419000282
Trivedi, R. G., Kumar, A., Soundappan, K., Trivedi, G. Y., Ramani, H., & Kumar, S. (2024). Association between adverse childhood experiences and internalizing symptoms in adults at a wellness centre in India. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 50(3), 472. https://doi.org/10.4103/ijcm.ijcm_419_23
Tull, M. T., & Aldao, A. (2015). Editorial overview: New directions in the science of emotion regulation. Current Opinion in Psychology, 3, iv-x. https://doi.org/10.1016/j.copsyc.2015.03.009
Villanueva, L., Adrián, J. E., & Gomis-Pomares, A. (2024). The effect of childhood adversity on mental health in young adults: A longitudinal study. Current Psychology, 43(7), 6418-6429. https://doi.org/10.1007/s12144-023-04831-7
Victor, S. E., & Klonsky, E. D. (2016). Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-18) in five samples. Journal of Psychopathology and Behavioral Assessment, 38(4), 582–589. https://doi.org/10.1007/s10862-016-9547-9
Xie, C., Hagenaars, M. A., & Boelen, P. A. (2025). Adaptive and maladaptive regulation of positive and negative affect: Specific associations with anxiety, depression, and posttraumatic stress. Psychological Reports, 00332941251352441. https://doi.org/10.1177/00332941251352441
Yildirim, D., Vives, J., & Ballespí, S. (2023). Anxiety and depression: The moderating effects of attention to emotion and emotional clarity. Psychological Reports, 126(3), 1221-1234. https://doi.org/10.1177/00332941211070764
Zhou, Q., Chew, P., Oei, A., Chu, C. M., Ong, M., & Hoo, E. (2025). Longitudinal effects of cumulative adverse childhood experiences on internalizing and externalizing problems in adolescents in out-of-home care: Emotion dysregulation as a mediator. Adversity and Resilience Science, 6(4), 413-429. https://doi.org/10.1007/s42844-024-00161-0
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

