An Emotion Regulation Intervention for Early Adolescent Risk Prevention

Difficulties in Emotion Regulation Scale- The Difficulties in Emotion Regulation Scale (36 items) uses 6 subscales (all α > .80) to assess perceptions of skill in ER, awareness, and impulse control based on Linehan's theoretical work.

The six subscales are:

• Nonacceptance of emotional response (6 items)
• Difficulties engaging in goal directed behavior [goals] (5 items)
• Impulse control difficulties [impulse] (6 items)
• Lack of emotion awareness [awareness] (6 items)
• Limited access to emotion regulation strategies [strategies] (8 items)
• Lack of emotional clarity [clarity]. (5 items)

Participants rate their responses on a 5-point Likert scale ranging from 1 (almost never)- 5 (almost always). The total score is calculated from the sum of all the items, with higher scores indicating greater problems with emotion regulation. (Total possible range: 36-180)

Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2) is a computer-based measure that asks participants to identify the emotion of facial expressions displayed in a series of 24 photographs and in 24 oral presentations of a neutral sentence, with higher scores indicating higher accuracy of emotion recognition. Total possible range = 0-48.

The Emotion Regulation Checklist contains 24 items on a 4-point Likert scale (1=never through 4= almost always; Total Range: 15-360). Parents rate 24 behavioral descriptions, yielding 2 subscales: 1) Lability/Negativity (α= .95), and 2) Emotion Regulation (α=.84). The Emotion Regulation subscale contains 8 items, while the Lability/Negativity scale contains 15 items. Higher scores on the Lability/Negativity scale indicate higher inflexibility, emotional reactivity, and dysregulated negative affect; higher scores on the emotion regulation subscale indicate greater situationally appropriate affective displays, empathy, and emotional self-awareness (Shields & Cicchetti, 1997). Alphas for the subscales are good (L/N α = .96; ER α = .83). One single measurement of emotion regulation is generated from the overall scores in both sub-scales (α = .89; Shields & Cicchetti, 1997).

The Regulation of Emotions Questionnaire* (21 items) assesses frequency of use of both functional and dysfunctional emotion regulation strategies (α= >.66). Participants rate their responses on a 5-point Likert scale from 1- "never" through 5- "always". (Total Range: 21-110). Higher scores indicate higher frequency of use of emotion regulation strategies.

The Emotional Self-efficacy subscale of the Self-Efficacy Questionnaire for Children (8 items) assesses perception of one's ability to cope with negative emotions (α= .83). It has been shown to be valid, reliable, and related to risk behaviors among US adolescents. Subjects rate their responses on a 5-point Likert scale from 1 "not at all" through 5 "very well". (Range: 8-40, with lower scores indicating low perception of ability to cope with negative emotions).

The Emotion Regulation Behaviors Scale (8 items) measures use of the specific emotion regulation strategies taught in Project TRAC (α= .73). Participants respond on a scale of 1 (never) to 5 (all the time) across 8 items, with higher scores indicating more regulatory behaviors (range: 8-40).

The Affect Dysregulation Scale contains 6 items used to assess frequency of difficulty with affect regulation on 4-point Likert scale from 1=not at all to 4=often (α= .72), with higher scores indicating more difficulty managing feelings. affect (range: 6-36).

7 items taken from the Center for Disease Control's Youth Risk Behavior Surveillance System will be used to assess adolescents' engagement in substance use, violence, and other risk behaviors. Participants will be asked risk behavior questions similar to the following item: "During the past 30 days, on how many days did you smoke cigarettes?" with answer choices ranging from 0, 1-2, 3-5, 6-9, 10-19, 20-29, 30.

Behavioral Indicator of Resiliency to Distress (BIRD) and Mirror Tracing Persistence Task (MTPT) are 5-minute computerized distress tolerance tasks that generate a score of time spent persisting on a dysregulating task that provides negative feedback (aversive noise) when users do not succeed at very challenging tasks, with more time spent on the tasks indicating greater distress tolerance. Possible range = 0-300 seconds.