The Development of Emotion Regulation and Dysregulation: A Clinical Perspective

Author(s): Pamela M. Cole, Margaret K. Michel and Laureen O'Donnell Teti

Reviewed work(s):
Source: Monographs of the Society for Research in Child Development, Vol. 59, No. 2/3, The
Development of Emotion Regulation: Biological and Behavioral Considerations (1994), pp. 73-
100
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 THEDEVELOPMENTOF EMOTION
AND DYSREGULATION:
REGULATION
PERSPECTIVE
A CLINICAL

PamelaM. Cole,MargaretK. Michel,

and LaureenO'DonnellTeti

Anger is a short madness.-Horace

The movements of expression in the face ... are in themselves

of much importance for our welfare.-Charles Darwin

The ancient Greek philosophers conceptualized the emotions as irratio-

nal, animistic, visceral phenomena that interfered with the higher-order
processes of thought and reason. From that early conceptualization, emo-
tion has had a long history of being construed as a psychological under-
ground that disturbs or disrupts rational thought and behavior (Mora,
1980). The emphasis in Freudian theory on unconscious affective processes
shaping personality and psychopathology reinforced the image of the dis-
ruptive influence of emotion (e.g., Freud, 1915/1957). Impulses were
viewed as primitive emotions that dominated early life and were subjugated
to reason and internalized social control after age 7.
The Darwinian perspective offered a different vantage point, one that
is represented in modern theories of emotion and its development (e.g.,
Arnold, 1960; Campos, Barrett, Lamb, Goldsmith, & Stenberg, 1983;
Frijda, 1986; Izard, 1977; Mandler, 1982; Plutchik, 1980; Tomkins, 1963).
These theories argue that emotion organizes human functioning and that
each emotion serves specific functions, coordinating organismic needs with

We wish to thank Rheta DeVries, Claire Kopp, Doug Teti, Ross Thompson, and
Carolyn Zahn-Waxlerfor their thought-provokingcomments on earlier drafts of this
essay. Address correspondenceto PamelaM. Cole, Departmentof Psychology,Pennsylva-
nia State University,UniversityPark PA 16802.

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NATHANA. FOX,ED.

environmental demands. For example, anger serves progress toward goals

in the face of obstacles. Sadness serves the relinquishing of desired objects
and goals, preventing wasted effort and eliciting nurturance from others.
Thus, emotion has a regulatory influence on other processes, such as focus-
ing attention and communicating with others. Emotion is also regulated in
that the experience and expression of emotion can be modulated to meet
situational demands. For example, one may attenuate intense anger in ex-
pression to avoid damaging a relationship.
Views of emotion as poorly controlled or disorganizing are still central
in popular conceptualizations of psychological immaturity and deviance and
in clinical conceptualizations of maladaptive behavior and psychopathology.
Clinical models of psychopathology and therapeutic change focus on the
problematic aspects of emotion, implicitly or explicitly, and assume that
awareness and flexible control of emotion states are indices of adjustment
and treatment success (Bradley, 1990; Greenberg & Safran, 1987; Hart,
1983; Luborsky, 1984; Safran & Greenberg, 1991). That is not to say that
emotion is deemed the sole cause or most important variable in clinical
conceptualizations but rather that emotion and emotion-related events are
critical factors in the etiology of maladjustment and in therapeutic change.
Can these two different emphases be integrated? If emotions are inher-
ently adaptive and organizing, how do we define and understand the poorly
modulated and disorganizing emotions observed in clinical work? In this
essay, we take the position that emotion is inherently regulatory and regu-
lated, two processes that are subsumed under the term emotionregulation.
Emotion regulation is an ongoing process of the individual's emotion pat-
terns in relation to moment-by-moment contextual demands. These de-
mands, and the individual's resources for regulating the related emotions,
vary. Individual differences in patterns of emotion regulation become char-
acteristics of personality. Under certain conditions, patterns of emotion reg-
ulation jeopardize or impair functioning, and such patterns may support
or become symptoms of psychopathology. That is, basic emotion patterns
can develop into patterns that interfere with functioning. This interference
may involve the disruption of other processes, such as attention or social
relations, or a failure to regulate emotion experience and expression flexi-
bly. When emotion regulation patterns become linked with such problems,
we use the term emotiondysregulation.
An important agenda for research on the etiology and prevention of
child mental health problems involves understanding individual differences
in emotionality that distinguish psychopathology from more adaptive func-
tioning and identifying the processes by which adaptive emotionality be-
comes associated with risk, maladjustment, and psychopathology. Every
emotion researcher knows that individual differences in emotionality are
the norm; the issue is how to differentiate normative variability from varia-

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 THEDEVELOPMENT
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tions that are indicative or predictive of maladjustment. Also, we need to

identify the developmental trajectories that link individual differences in
emotion regulation at one point in time with later clinical problems. How
does the emotionality that serves the elicitation of caregiving, the communi-
cation of needs, the defining of the world of objects and persons, and the
selection of behavioral plans relate to the emotionality that disturbs relation-
ships with caregivers, confuses others about the need of the moment, dis-
torts perception and understanding, and interferes with the execution of
plans? This essay attempts to integrate modern emotion theory and clinical
perspectives on emotion regulation and dysregulation, describe dimensions
of emotionality that might serve to differentiate normative and maladaptive
patterns, and outline how adaptive emotion patterns might acquire dysregu-
latory qualities over the course of development.
Developmental psychopathology provides a framework for under-
standing atypical development in the context of typical development (Cic-
chetti, 1989b, 1990; Rutter & Garmezy, 1983; Sroufe, 1990). This frame-
work suggests ways to integrate the study of basic developmental processes
with the study of individual differences that have implications for the evolu-
tion of mental health problems (see also Calkins, in this volume). The devel-
opment of emotion regulation is an important and central theme of devel-
opmental psychopathology. Studies that trace the development of emotion
characteristics and their regulatory aspects in samples of typical, at-risk,
and atypical populations provide much-needed information on normative
aspects of emotional development, conditions that create deviations from
these norms, and the nature of the deviations that become symptomatic and
develop into disorders. There is an acute need for identifying the develop-
ment of mental health problems in early childhood, and clinical researchers
and epidemiologists look to developmentalists for guidance in conceptual-
ization and assessment (National Institute of Mental Health, 1992).
In discussing the development of emotion dysregulation, we turn to
several conceptual frameworks: emotion theory, developmental research
on emotion regulation, and clinical research and practice. Contemporary
emotion theories and developmental research provide a means of conceptu-
alizing and studying emotion as both regulatory and regulated. Clinical
research and practice offer perspective on the range of variation in emotion-
ality that is associated with psychopathology and suggest directions for de-
velopmental psychopathology research. We use these literatures to define
emotion regulation and emotion dysregulation, to suggest dimensions of emotion
regulation that may distinguish adaptive and maladaptive qualities, and to
discuss how adaptive emotion patterns evolve into patterns of dysregulation
and become part of a psychopathological condition. Throughout the essay,
there is an emphasis on identifying clinically relevant emotion patterns in
young children, on the implications of individual differences in emotion

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NATHANA. FOX,ED.

regulation patterns for risk for emotion dysfunction in later years, and on
the importance of social context in emotion dysregulation and the develop-
ment of psychopathology.

EMOTIONREGULATION

As noted by Thompson (in this volume), the term emotionregulation

has no single definition; nonetheless, common threads that bind varying
definitions can be discerned. These definitions generally emphasize one of
two aspects of emotion regulation. Some focus on the regulatory functions
of emotions in organizing internal processes (e.g., attention, memory, action
readiness) and social communication, which permit the individual to react
quickly to situational demands. Others emphasize the ways in which emotion
is regulated (e.g., cognitive control, internalization of social expectations)
that allow the individual to monitor, delay, and adjust those preparatory
reactions and adapt them to the complexities and subtleties of those situa-
tional demands (Frijda, 1986; Izard, 1977; Plutchik, 1980). A few authors
emphasize both aspects (Barrett & Campos, 1987; Campos, Campos, & Bar-
rett, 1989). In fact, emotionregulationmight be defined as the ability to
respond to the ongoing demands of experience with the range of emotions
in a manner that is socially tolerable and sufficiently flexible to permit spon-
taneous reactions as well as the ability to delay spontaneous reactions as
needed.
In the first 7 years of life, the child has many emotion-based develop-
mental tasks to accomplish: frustration tolerance, engaging and enjoying
others, recognizing danger and coping with fear and anxiety, defense of
self and property within the bounds of acceptable behavior, tolerating being
alone for reasonable periods, interest and motivation in learning, and devel-
opment of friendships. All these developmental tasks involve the regulation
of emotion.
Emotion regulation as a developmental process has been discussed and
defined articulately in several books and articles (e.g., Barrett & Campos,
1987; Campos & Barrett, 1984; Eisenberg & Fabes, 1992a; Garber & Dodge,
1991; Kopp, 1989; Sroufe, 1979; Thompson, 1990). The regulatory aspects
of emotion are especially emphasized in infancy research that demonstrates
that emotion organizes the development of social relations (e.g., Sroufe,
Schork, Motti, Lawroski, & LaFreniere, 1984) and physical experience
(Klinnert, Campos, Sorce, Emde, & Svejda, 1983) and influences such inter-
nal processes as attention (Rothbart & Posner, 1985). Beyond infancy, devel-
opmental research has emphasized the development of the child's ability to
regulate her own emotions. Most developmentalists regard the acquisition
of the ability to regulate emotions and related behaviors as a major develop-

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 THEDEVELOPMENT
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mental task (Cicchetti, Ganiban, & Barnett, 1991; Dodge, 1989; Eisenberg
& Fabes, 1992a; Kopp, 1989).
Psychopathology is associated with a range of emotion symptoms that
interfere with various developmental tasks. This argues for an examination
of how children come to feel and express all emotions adaptively and how
typical adaptive patterns may evolve into patterns of emotion dysregulation.
Unfortunately, individual differences research in child development has not
been well integrated with clinical conceptualizations of emotion dysregula-
tion. We now turn to a discussion of emotion dysregulation and the role of
emotion from a clinical perspective.

EMOTIONDYSREGULATION

Emotion dysregulation is a common dimension of most categories of

psychopathology and a defining feature of many. One quick illustration of
the prevalence of emotional difficulties in the conceptualization and differ-
entiation of mental health problems is given by a review of diagnostic crite-
ria in the DSM-III-R classification system (American PsychiatricAssociation,
1987). Table 1 provides a list of emotion-related symptoms of the major
diagnostic categories of children and adults. Inappropriateness of affect,
chronic worry or tension, blunting or avoidance of emotions, constriction
of affect, unpredictable fluctuation between emotionlessness and rage, ela-
tion, or dejection, the predominance of one emotion and the relative ab-
sence of another, and sustained negative emotions are common examples
of emotion characteristics associated with clinical disorders.
In addition, clinical research has been interested in the dysregulatory
potential of emotion. For example, clinical studies have provided evidence
"ofthe role of emotion in the incidence of relapse of clinical problems (e.g.,
Koenigsberg & Handley, 1986) and of the negative influences that emotion
can have on cognitive processes (Bower, 1981; Isen, 1984). These data pro-
vide empirical support for the position that emotion can dysregulate social
and cognitive processes and does so in clinical conditions.
Definitions of emotiondysregulationtend to be relatively few and rather
diverse, despite its importance to clinical conceptualization. Typically, they
include reference to interference in the processing of information and
events (e.g., Dodge, 1991a; Plutchik, 1980), difficulties with the flexible
integration of emotion with other processes (Cicchetti et al., 1991; Katz &
Gottman, 1991), and poor control over affective experience and expression
(Izard, 1977; Kopp, 1989; Lazarus, 1966; Thoits, 1985). More broadly,
emotion dysregulation has been described as failures to meet the develop-
mental tasks of emotional development (Cicchetti et al., 1991; Dodge &
Garber, 1991).

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 TABLE 1
CRITERIA
ANDASSOCIATED
EMOTION-RELATED
SYMPTOMS
IN COMMON DSM-III-R DIAGNOSES

Disordersof childhoodand
adolescence
Autistic disorder ............... Lack of awareness of feelings of others; little or
no facial expressivity for communication; dis-
tress over trivial changes in environment; ab-
normal comfort seeking under distress
Disruptive behavior disorder .... Lack of concern for feelings of others; lack of
guilt or remorse; readily blaming others for
own misdeeds; low self-esteem; irritability, re-
sentfulness; temper outbursts; low frustration
tolerance; argumentative; deliberately
annoying; easily annoyed; spitefulness, vindic-
tiveness; comorbid anxiety and depres-
sion
Anxiety-related disorders ....... Unrealistic, persistent worries and fears; lack of
self-confidence, timidity; marked feelings of ten-
sion, inability to relax
Adult disorders
Affective disorders ............. Elevated, expansive mood; depressed, irritable
mood; diminished interest, pleasure; excessive,
inappropriate guilt; low self-esteem; comorbid
anxiety, worry, panic
Anxiety disorders .............. Intense, sudden apprehension, fear, or terror;
persistent, recurring fears and worries; comor-
bid depression
Posttraumatic stress disorder and
related disorders ............. Intense distress in response to reminders, recollec-
tions, and dreams; detachment from feelings,
numbness; restricted affect; irritability, anger
outbursts; depression, anxiety, painful guilt
Schizophrenia ................. Flat or grossly inappropriate expression of affect;
lack of subjective emotion intensity; emotional
detachment from others
Eating disorders ............... Intense fear of gaining weight, lack of worry
about symptoms; depressed mood, anxiety
about adequacy of self
Substance disorders ............ Mood disturbance, lability; anxiety, irritability; de-
pression, anhedonia; suspiciousness, paranoia
Personality disorders ........... Irritability, rage, or absence of hostility; easily
hurt or highly critical; inappropriate, con-
stricted, or exaggerated affect; chronic empti-
ness, boredom; preoccupation with envy, suspi-
cion, or fear; lacking in remorse, inappropriate
anger; affective instability, rapidly shifting and
shallow emotions

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 THEDEVELOPMENT
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Although clinical theory has not defined emotiondysregulationexplicitly,

emotion regulation is an implied goal of most treatment models. Under-
standing emotion patterns and their historical roots, learning to recognize
emotions and to express them appropriately, and experiencing problematic
emotion patterns in order to modify them are major goals of many thera-
pies. It has been suggested that all psychotherapies, including pharmaco-
therapy, are aimed at influencing emotion regulation (Bradley, 1990) and
that the emotion patterns must be experienced in treatment in order to be
better regulated and to modify their regulatory influences on thought and
behavior (Greenberg & Safran, 1987).
For example, traditional psychoanalytic theory outlines a develop-
mental process in which individual differences in emotion regulation shape
personality and psychopathology. Early childhood emotions such as anxiety,
despair, and disappointment are regulated by the individual; if these regula-
tory attempts are not flexible or do not change over time, they constrain
personality and produce symptoms. Defense mechanisms are postulated
to be emotion regulators; they are cognitive and behavioral strategies for
avoiding, minimizing, or converting emotions that are too difficult to toler-
ate because of their powerful latent meanings. The concepts of catharsis
and abreaction emerged from Freud's contention that hysterical symptoms
resulted from the "strangulation"of strong emotion. The goal of treatment
was to gain insight into these emotions and their roots and thereby cope
with them in a more mature manner.
In modern variants of psychodynamic therapy, emotion signifies mean-
ing about interpersonal relationships, and emotions as symptoms lead the
therapist an understanding of the patient's impaired adult relationships
to
(Luborsky, 1984; Strupp & Binder, 1984). The therapist first helps clients
recognize emotions that they have not been acknowledging and then facili-
tates the integration of these emotions into conscious experience and ex-
pression. This perspective is also articulated in attachment theory (Bowlby,
1973). Emotion organizes the security or insecurity of the mother-infant
relationship, which is then internalized as a working model and carried into
subsequent relationships (Bretherton, 1985; Sroufe & Fleeson, 1986). This
conceptualization is reflected in interventions with mothers meant to help
them resolve emotional themes from their families of origin in order to be
more interpersonally attuned and responsive to their own children (e.g.,
Fraiberg, 1980; Lieberman, Weston, & Pawl, 1991).
The cognitive-behavioral clinical perspective emphasizes the role that
patterns of action and thought play in regulating emotion. Learned behav-
iors, attributional styles, belief systems, and self-statements contribute to the
development and maintenance of maladaptive emotion symptoms. Treat-
ment emphasizes the reduction of negative emotion states: anger control

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NATHANA. FOX,ED.

(Novaco, 1975; Williams & Williams, 1993), modification of depressive be-

liefs or self-control patterns that sustain sadness, hopelessness, and despair
(Beck, 1976; Rehm, 1977), and anxiety management (Suinn, 1990). An
underlying assumption of these cognitive-behavioral perspectives is that the
individual has either learned a set of beliefs and coping strategies that sus-
tain a negative emotion or failed to learn the skills necessary to regulate
those emotions.
Cognitive-behavioral anxiety-reduction techniques involve exposure,
symbolically or actually, to situations that arouse anxiety in order to acquire
alternative strategies for regulating the emotion experience. Emotion-
focused and expressive therapies are designed to elicit negative emotions
(Greenberg & Safran, 1987; Hart, 1983; Luborsky, 1984).

THERELATIONBETWEENREGULATION
AND DYSREGULATION

If emotions are fundamentally adaptive reactions that are regulated

and regulating by their very nature, then what is emotion dysregulation?
There are assumptions that we believe to be integral to a perspective that
respects the fundamental regulatory qualities of emotion as well as the po-
tential for dysregulatory qualities and risk for psychopathology.

DysregulationversusAbsence of Regulation

First, dysregulateddoes not mean unregulated.When individuals' emo-

tion-related behavior is extreme and deviant, they may appear to be unregu-
lated, but we would argue that emotion regulation is still present. The term
dysregulatedis preferable to unregulatedbecause it connotes that a normal
regulatory process is operating in a dysfunctional manner. That is, the pat-
tern of emotion regulation involves a cost reflected in an impairment or
restriction of functioning.
There are many facets of dysregulation, and it may be an oversimplifi-
cation even to attempt to limit dysregulation to two forms-over- and un-
derregulation. For example, an individual may appear underregulated in
the intensity or amount of expressed emotion but may also be overregulat-
ing a particular emotion state, as in the case of the disruptive child who
behaves in a silly, giddy manner but steadfastly avoids allowing himself
to experience personal distress. Dysregulation may also take the form of
overregulation, as in the case of blunted emotion expression or experience
(Thoits, 1985). However, in some cases, the overregulated expression of
emotion may be masking high levels of internal distress. Overregulation of
distress is inferred in insecurely attached-avoidant infants who fail to show

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distress on the departure of their primary caregivers (Main, 1981). The

interpretation is that an infant can learn to avoid the rebuffing of the parent
and develop a pattern of emotion expression that avoids revealing anxiety
to others.
Emotion dysregulation serves some regulatory function but in a man-
ner that has serious implications for adjustment. That is, even the most
dysregulated emotion serves some adaptive purpose in the present, even as
it interferes with optimal adjustment or development. A critical component
of effective psychotherapy, in fact, is the clinician's detection of the adaptive
function that a symptom serves. We provide two detailed examples from
clinical work that illustrate both the immediate functional value of and the
immediate or long-term dysfunction of emotion symptoms.
The first example is based on a case of a psychiatrically hospitalized
adolescent boy with severe oppositional defiant disorder. On the unit, he
frequently provoked other residents through hostile, aggressive behavior.
Traditional insight-oriented treatment was not yielding change, so a behav-
ior-modification program was instituted. After many weeks, he earned the
privilege of a weekend home visit. He eagerly awaited his mother (who
was believed to have borderline personality disorder), but she never came.
Eventually he called her, and she lightheartedly said that she was busy and
was not coming. He hung up the phone, showing no emotional reaction. A
few minutes later he was observed poking another youth with a sharp pencil.
Staff initiated the behavioral program; the boy was reminded that fail-
ure to stop would involve a demerit. He rudely claimed indifference, and
standard procedures for handling a youth who appears to be losing control
were begun. Each time he was reminded what to do to regain control, he
escalated. His affect transitioned from arrogant sarcasm to belligerent yell-
ing to shouting a stream of expletives and then screaming and flailing his
arms and legs as staff moved to restrain him. As he was carried to a time-out
room, he was foaming at the mouth, unable to articulate even curses. In
essence, language and action were subjugated to raw rage. Isolated, his rage
subsided, and he collapsed, whimpering, on the padded floor. This is about
as close to unregulated as dysregulated emotions become. Most dysregu-
lated emotion is under some form of regulation, however, although this is
not always obvious.
This event indicates the complex relation between regulation and dys-
regulation. First, despite his hostile and aggressive problem behavior, this
youth never expressed or reflected on his anger directly. He had no history
of such emotional outbursts. He did have episodes of violent behavior that
were not accompanied by expressed anger. (Once he threw a 20-pound
barbell at a staffperson with no accompanying expression of emotion.) His
rage reaction communicated the dangerousness of his anger and made us
aware of the regulation underlying his albeit inappropriate hostility and

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acts of aggression. He had been regulating angry impulses that might have
led to violence toward his mother.
Borderline personality disorder often elicits intense anger in others. In
the safety of the hospital setting with its physical and social protections, the
boy finally revealed to himself and to the staff the depth of his pain and
frustration. This event permitted the staff and this youth to realize his anger
and the reasons for it and to develop alternative ways to express and regu-
late it. Anger functions adaptively to promote the overcoming of obstacles.
One interpretation is that this oppositional youth was still striving to achieve
some action that would correct the problems in his life. To have relin-
quished his protest and efforts to change the relationship with his mother
may have led to depression and suicidality. In fact, this event marked a
turning point in individual therapy; feelings of grief and despair emerged,
and he was helped to cope with the reality of the loss of hope that his
mother would be sensitive to his needs.
The regulatory and dysregulatory aspects of emotion are seen in the
functioning of many father-daughter incest survivors. As adults, many of
these women do not recollect either a part or all of their abusive experi-
ences; they report feeling "numb" or having periods of time lost to them.
The origins of this emotional "cutting off" are hypothesized by many clini-
cians to be protective mechanisms that served to protect the young victim-
ized child from the overwhelming emotional distress typically associated
with incest. In fact, denial and dissociation appear to be part of the norma-
tive repertoire of early childhood (Cramer, 1991; Dunn, 1988; Gardner &
Olness, 1981), and they characterize the predominant coping style of adult
survivors (Putnam, 1985). Most young victims are unable to use alternative
solutions that might apply to more ordinary social problems. Help-seeking,
instrumental, and avoidant behaviors are not as viable when one's father is
sexually abusive. To survive the intense emotions and generalized distress
that they experience, many children seem to cut off from the sensations,
blunt the experience, and absent the sensations and emotions from con-
sciousness (Cole & Putnam, 1992).
At the time of the incest, and later in adulthood, this emotion style
protects the individual from the overwhelming, disorganizing emotion asso-
ciated with the memories. However, it is a profound truncation of emotion-
ality that has serious long-term consequences for adult functioning. This
represents dysregulation in that valuable emotions are inaccessible when
needed, memory processes are restricted, and relationships are strained.
In sum, we argue that notions of emotion as regulatory and dysregula-
tory are mutually consistent because emotions serve protective and commu-
nicative functions even when they are creating risk to or interfering with
adaptive development. Most symptomatic behavior involves regulation of
emotion that is over- and/or underregulated in some dimensions and that

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is difficult for the individual to modify because of the adaptive functions

being served.

Regulationversus Control

There is an important distinction between regulation and control. Emo-

tion regulation involves the ability to respond emotionally and to attune
one's emotion experience and expression to the ebb and flow of life's
moment-to-moment situations. The term regulation is preferable to the
term controlbecause the former implies a dynamic ordering and adjusting
of the emotion to the environment whereas the latter connotes restraint.
Emotion regulation is not simply a matter of stopping distress. It in-
volves many kinds of adjustments that organize human functioning and
promote the adaptation of the individual to life circumstances, both momen-
tary and ongoing. Emotion regulation is not solely the reduction of the
intensity or frequency of states (e.g., frequency of negative thoughts, inten-
sity of anxiety). It includes the capacity to generate and sustain emotions
in order to carry out activity and to communicate and influence others,
particularly in coordination with the emotion of others.
The well-adjusted individual is usually emotionally well regulated, at-
tentuating and curtailing the intensity and duration of emotions as needed,
and amplifying and extending emotion states when necessary. The speed
and immediacy of emotional reactions constitute one of their values, permit-
ting an individual to bypass more prolonged, planful processes. A model
of emotion regulation that focuses only on restraint overlooks the fact that
deficiencies in the capacity for spontaneity and immediacy can be as dys-
functional as deficiencies in the ability to attenuate strong emotion. Imagine
an intense negative reaction in which an adult becomes very angry and
loud, screaming at a child, perhaps even handling the child roughly. If she
is doing this to prevent her child from walking into the street in front of
an oncoming car, it is adaptive. She is bypassing internal controls of the
display of anger and fear in order to initiate a rapid, critical response and
thereby protect her child. A mother who is too inhibited to do so would be
responding maladaptively.

Positive versus Negative Emotion

The perspective that all emotions are adaptive offers the opportunity
to reexamine the tendency to equate positive affect with adaptation and
negative affect with maladaptation. Clearly, an overall affectively positive
demeanor is associated with social competence in young children (Denham,
McKinley, Couchoud, & Holt, 1990; Shantz & Shantz, 1985; Sroufe et al.,

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1984) and adults (Tellegen, 1982; Watson & Clark, 1984). From the per-
spective of organizational, functional models of emotion, however, negative
emotions have their adaptive place and are not inherently dysfunctional.
For example, negative emotions are often essential in marking salient issues
in communication, as shown in the mother's ability to prevent her child
from running out into the street. Toddlers respond to the emotional quality
of their mothers' prohibitions more than to the semantic content. Mothers
often begin a prohibitive episode in "motherese" prosody but then shift to
a more firm, angry tone to convince the child that the prohibition is serious.
Alternatively, positive emotion can be dysregulatory and dysregulated.
Such inappropriate responses as smiling when describing problems in one's
current or past experience or laughing at another's misfortune represent
two different examples of dysregulated positive affect. In the first example,
the positive emotion indicates a potential problem with the person's reality
testing or insight. In the second, the expression of positive affect is not
modulated so as to take account of the other's distress. While most positive
emotion in social situations is regulatory in that it engages and sustains
interaction, silly, giddy behavior in the classroom or in peer interaction
disrupts the achievement of goals. In fact, children with attention deficit
disorder often experience peer rejection because of their poorly timed,
poorly regulated positive affect (Barkley, 1990; Sroufe et al., 1984).

EmotionRegulationand Dysregulationas ContextBound

Finally, it is important to consider that no single aspect of emotion

provides an absolute measure of emotion regulation or dysregulation with-
out a consideration of context (Campos et al., 1989; Izard, 1977). Emotion
regulation is embedded in experiences and plans that are further embedded
in their relation to contextual demands. Emotions are linked to the promo-
tion of goals (e.g., sustaining a relationship, overcoming an obstacle, relin-
quishing an unattainable goal, escaping danger). Emotion dysregulation
occurs when a pattern of emotion regulation jeopardizes or impairs pro-
ductive and appropriate functioning (e.g., to preserve relationships, to think
clearly, to venture into unfamiliar situations, to solve problems with a spouse
or child, to get out of bed, to hold one's job, to inhibit destructive impulses).
The key component is the functional relation between the emotion and the
immediate events (of the outside world or their internal representations) in
light of the larger life context of achieving developmental goals (Cicchetti
et al., 1991).
From our view, emotions are regulatory and regulated. Context pro-
vides the frame of reference from which dysregulation is determined.
Spe-
cifically, dysregulation implies that emotion regulation patterns are interfer-

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ing with current functioning or jeopardizing development. The ability to

regulate positive and negative emotions along a number of dimensions and
in ways that support cognitive, behavioral, and social functioning is emotion
regulation. In the next section, we describe dimensions of emotion regula-
tion and dysregulation that are used in clinical judgments.

DIMENSIONSOF EMOTIONREGULATION
AND DYSREGULATION

Emotion dysregulation involves difficulty modulating emotion experi-

ence and expression in response to contextual demands and controlling the
influence of emotional arousal on the organization and quality of thoughts,
actions, and interactions. In this section, we present dimensions that under-
lie clinicaljudgments of emotion dysregulation. Although emotion dysregu-
lation may occur only as an occasional event in the emotion regulation
process of most people, clinicians work with individuals who have developed
stable, problematic emotion styles that have become attributes of their psy-
chopathology (Malatesta & Wilson, 1988). Later, we discuss the develop-
mental links between instances of emotion dysregulation and the emotion
symptoms of psychopathology. The list of dimensions is offered to suggest
ways that patterns of emotionality that are relevant to both typical and
atypical development can be assessed. Individual differences in emotion
regulation will be more valuable to developmental psychopathology if mea-
surement moves beyond aggregated totals of positive and negative emotion.

Access to the Full Range of Emotions

If emotions are basically adaptive in quality, preparing individuals to

engage quickly in actions that support social and individual survival, then
it follows that access to the full range of emotions is a characteristic of
emotion regulation. Joy, anger, sadness, and social emotions such as guilt
and pride are all necessary for optimal functioning. The individual who
experiences fear when threatened, sadness when a loved one is lost, and
anger when goals are blocked has access to the emotions that appear to be
designed for coping in such situations (Barrett & Campos, 1987; Frijda,
1986; Izard, 1977).
When an emotion that is held as typical and appropriate to a particular
situation is inaccessible, it is a signal that some basic, adaptive function is
blocked. A pattern of inability to access a typical emotion in a pertinent
situation is emotion dysregulation. A stable pattern of such blockage inter-
feres with such adaptive functions as affective communication in close rela-
tionships and successful problem resolution. Access to the range of emotions

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is therefore taken to be a goal of psychotherapeutic treatment (for a review,

see Greenberg & Safran, 1987).
Access to the range of emotions is an aspect of personality assessment
(Greenspan, 1981; for theoretical discussion, see Malatesta & Wilson, 1988).
When a person's emotion style is disproportionately dominated by a particu-
lar affect (e.g., anger or sadness), it may be that the person has difficulty
perceiving, experiencing, and/or expressing other emotions. The inability
to access certain emotions may be as critical in defining the dysregulation
as the dominant emotion. For example, we often regard depression in terms
of excessive sadness, but the inability to generate positive affect is an equally
critical component. Anger is seen as dominant in conduct problems, and a
bias toward perceiving the world as hostile has been shown in highly aggres-
sive children (Dodge, Murphy, & Buchsbaum, 1984). However, diminished
anxiety and guilt, particularly in relation to wrongdoing and harming oth-
ers, are critical features of antisocial individuals. Their hostile, aggressive
presentations are often interpreted as covering over feelings of loss, sadness,
and low self-esteem that cannot be tolerated (Winnicott, 1958/1975). There-
fore, we think that the emotion dysregulation associated with psychopathol-
ogy does not necessarily involve a single emotion but that the dominance
or absence of a single emotion reflects a state of dysregulation in the overall
emotion system.
One implication of this dimension for research is the need for assess-
ment in multiple contexts to assess the range of emotions. Such research
would require carefully conceived hypotheses that a particular emotion that
would be present in most individuals in a certain context is not evinced by
an individual with a particular risk factor or with associated symptoms.

Modulationof Intensityand Durationof Emotion

The classic Yerkes-Dodson principle holds that there is an inverted

U function relation between the intensity of felt anxiety and its effect on
performance of a task. That is, some increase in anxiety optimizes perfor-
mance, but, once a certain level of arousal has been reached, any further
increase in anxiety interferes with performance. This suggests that the in-
tensity and duration of an emotion are as important as its mere presence
in judging the degree to which the emotion supports the individual's reac-
tion to situational demands.
Typically, developmental and clinical research associates emotion regu-
lation with the reduction of intensity and duration of negative emotion. As
stated earlier, adaptation requires the flexibility to generate and sustain
negative emotion and the ability to modulate positive emotion, as befits the
circumstance. At times, the generation of intense, strong emotion is desir-

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able, and even necessary, for a quick and effective response to a situation.
In fact, the elicitation of strong emotion is encouraged in many psychother-
apies. Assertiveness training, for example, teaches the individual to gen-
erate all the emotions appropriate to various situations rather than to be
paralyzed by anxiety (Wolpe, 1982), and cognitive-behavioral perfor-
mance-enhancement strategies often include psyching up or anxiety arousal
(Suinn, 1990).
In the same way that amplification and sustenance of negative emotions
may be a focus of treatment, positive emotions may require some minimiza-
tion or reduction. In emotionally conflicted situations, disruptive children
may deal with conflict by laughing or acting silly or giddy and thus failing
to demonstrate the seriousness of another's concern. Their positive affect
interferes with adult and peer relationships and the ability to solve problems
effectively. Troubled children and adolescents become disorderly and dis-
tracted when difficult emotional themes are stirred. The inappropriate
laughing and happy interpersonal exchanges allow them to avoid difficult
problems. Research is needed to understand how these quantitative aspects
of emotion support or interfere with behavior in specific contexts.

Fluid,Smooth Shifts

Fluid, smooth shifts or transitions from one emotion state to another

are one more aspect of flexible, coherent functioning. Typically, an individ-
ual appears to be in a relatively calm, neutral state, and the onset and offset
of emotions are experienced and expressed relatively gradually. Certain
circumstances, such as surprise, are associated with a discrete, sudden
change in emotion. In general, however, change in emotion is more gradual
and bracketed by what the observer perceives as neutral periods. Abrupt,
unexpected, frequent, or dramatic changes in emotion and mood suggest
emotional difficulty, particularly when those changes are inexplicable to
the observer. The term lability,borrowed from the biological and physical
sciences, is used to convey the instability and potential disorganization that
is assumed to underlie a high degree of emotional reactivity or change in
emotion. Emotional lability is identified as a symptom of emotional distur-
bance, particularly of such serious diagnoses as personality disorders.
This aspect of emotion has received some empirical attention in the
infancy literature (Hirshberg & Svejda, 1990; Malatesta & Haviland, 1982;
Thompson, Cicchetti, Lamb, & Malkin, 1985; Wolff, 1987). Emotional labil-
ity appears to diminish with age. Younger infants and children engage in
more rapid and more frequent changes of emotion than older children.
One common scenario is the adult distracting the distressed baby or toddler
with a toy and the child's affect changing from angry tears to delighted

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surprise. Most parents discover that this technique becomes less effective as
children gain more control over the transitions in their own emotional reac-
tions and can sustain the emotion on the basis of internal cues.
Even in infancy, however, there is a pattern to the emotional communi-
cation between mother and infant that appears to be smooth and expectable,
related predictably to changing physical and social events (Emde, Gaens-
bauer, & Harmon, 1976; Fogel, 1982b; Tronick, 1989; Wolff, 1987). When
clinicians observe labile, unpredictable emotion in adolescents or adults,
serious psychopathology such as personality disorder is considered.
Paradigms that are sensitive to the problematic features of rapid
changes in emotion (e.g., the interference in communication in a peer inter-
action) and those that are sensitive to the need to change quickly (e.g., the
ability to respond quickly when a threatening situation arises) would be a
valuable aspect of developmental research.

Conformitywith CulturalDisplayRules

The well-regulated person expresses emotions within the boundaries of

cultural display rules (Saarni, 1990). This individual can coordinate emotion
expression with the social standards of display behavior in the cultural
group (Ekman, 1977). Inappropriate affect is associated with either the
presence of an emotion (e.g., laughing at another's misfortune) or the ab-
sence of an emotion (e.g., being affectively flat while discussing a highly
emotional event). Clinical work often focuses on some adjustment of the
personal display rules that have been acquired in the socialization process.
Some individuals can flexibly coordinate their emotion expression with situ-
ational variation, while others appear to be rigid and unable to modulate
expression regardless of context (Malatesta & Wilson, 1988).
Over the course of development, for example, people develop rules
about the appropriate contexts and forms for the expression of anger, and,
in a culture as diverse as that in the United States, there is wide variation
in the manner and amount of anger that individuals express in their rela-
tionships. We know from adult cases that, owing to internalized family dis-
play rules, many people limit their anger displays even though they may be
experiencing acute frustration and anger. There are also children who seem
to fail to learn subcultural rules for the display of anger and who appear
rude and unruly. Research is needed to distinguish children who are more
emotionally reactive (e.g., get more angry when frustrated) from children
who are simply failing to control their expressions of emotion (e.g., failing
to conform to rules about displaying anger to authority figures). Paradigms
that show individual differences in one social context but not in another
(e.g., peer vs. adult, other vs. alone) will be useful in this regard.

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Integrationof Mixed Emotions

A basic premise of adult ego development is that the mature individual

is capable of integrating emotions-for example, feeling anger and sadness,
or even happiness and sadness, simultaneously. This capacity is fundamen-
tal to being able to experience self-worth in conjunction with a disappoint-
ment or an embarrassment, to realize one's fondness for a person even
when angered by that person, or to resolve ambivalence. An inability to
integrate multiple emotions is indicative of emotion dysregulation.
For individuals who have very basic difficulties in integrating the mixed
emotions that are an inevitable aspect of life, clinicians often use a concept
referred to as splitting (Blanck & Blanck, 1976). The concept is derived
from object relations theory and describes the adult's difficulty perceiving
or experiencing the mixed affective valence of many human circumstances,
particularly in their most important relationships. For example, some clients
will present an overly positive portrayal even while describing serious physi-
cal and emotional abuse. In adult clinical work, this phenomenon is associ-
ated with personality disorder (Hamilton, 1988; Mendelsohn, 1987). The
concept of splitting has been applied in the coding of the Adult Attachment
Interview (George, Kaplan, & Main, 1985). Most developmental research,
however, has focused on children's knowledge of mixed emotions (e.g.,
Gnepp & Hess, 1986; Harter, 1990). Observational research that examines
expressive aspects of the integration of emotion in naturalistic or quasi-
naturalistic situations is also needed.

VerbalRegulationof EmotionProcesses

The ability to think and talk about emotion is one important dimension
of self-regulation (Bruner, 1983; Luria, 1961; Vygotsky, 1987). This is not
to say that, a la 1960s pop psychology, everyone should be urged to express
every feeling. Language is a communicative system by means of which expe-
rience is internalized. It is adaptive to be able to label, describe, conceptual-
ize, and understand one's feelings. Insight into one's emotional reactions is
a goal of many therapies. Many outpatients' work is focused on learning to
think and talk about emotional reactions and memories against which they
have defended. In a technique called emotionrestructuring,for example, a
problematic emotion is evoked and the client helped to construct a new,
more mature cognitive reorganization of the emotion experience (Green-
berg & Safran, 1987). The ability to conceptualize emotion experience
facilitates the self-reflective process (e.g., Malatesta & Wilson, 1988) and
enhances self-regulation (e.g., Cicchetti et al., 1991).
In terms of its communicative aspects, the verbal expression of feelings
is assumed to be associated with more control or better regulation of nonver-

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bal expression. Young children are encouraged to "use their words" when
distressed rather than to act out aggressively or to collapse in tears. This
communicative value must be balanced against the frequent clinical concern
for individuals who talk about difficult events without any sign of emotion.
Clinicians use discrepancies between the content of the spoken word and
its affective quality to identify clinical issues, to assist clients in recognizing
their feelings, to recognize that a certain physiological state is anxiety or
anger, and to help them use the language of emotion to access and to
regulate their emotion states. A well-balanced relation between talking
about emotion-related issues and conveying the content of speech with mod-
ulated emotionality supports effective communication and enhances oppor-
tunities for the social regulation of affective experience.

TheManagementof Emotionsabout Emotions

Part of the metacognitive process, known to many clinicians as the ob-

serving ego, is the ability to monitor and react to one's emotion state. This
ability means that one can evaluate one's emotional responses and have
emotional reactions to an emotional reaction. If a person becomes very
angry at someone, she can witness her own anger and understand why she
behaved so. She may also forgive or take pride in herself.
Negative emotions about an emotional reaction are regarded as patho-
genic. Defense mechanisms (e.g., isolation and displacement) are regarded
as strategies that the individual uses to cope with anxiety generated by
feeling sadness or anger (Freud, 1966). Tomkins (1963) describes the "neu-
rotic paradox" in which individuals become distressed by their own emo-
tional responses. Tomkins also describes the "multiple suffering bind" in
which negative affect is organized in such an overly generalized manner
that stimulation of a particular affect system tends to activate the other
negative affect systems.
Empirical support for the interrelationship of emotions remains to be
developed. Depression research offers some corroborative support. A char-
acteristic of depression appears to be that a negative emotional reaction to
an event is followed by negative emotions about the prior negative reaction.
Cognitive behaviorists in particular have documented this depressive cycle
in terms of critical self-talk (Beck, 1972; Rehm, 1977). Depressed persons
experience distress that is followed by distress about the distress, such as
feelings of self-criticism or guilt about being unhappy (for a review, see
Alloy & Abramson, 1988).
Each of these dimensions of emotionality has been associated with psy-
chopathological functioning. We hope that such clinically conceptualized
emotion dimensions will be reflected in research projects designed to study

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the emotional concomitants of the presence and risk of psychopathology.

Next, we attempt to integrate these dimensions into our understanding of
the links between emotion regulation, emotion dysregulation, and the emo-
tion symptoms of clinical disorders.

EMOTION AND THEDEVELOPMENT

DYSREGULATION
OF PSYCHOPATHOLOGY

Evidence that emotion is regulatory and regulated appears early in life,

and both aspects of emotion develop over the life span. Various reviews
provide perspectives on the normative aspects of the development of emo-
tion regulation (Kopp, 1989; Sroufe, 1979). In this section, we summarize
briefly some findings on typical and atypical emotional development. We use
these to suggest how, in the course of the development, adaptive emotion
regulation comes to have dysregulating qualities and how such patterns
become symptoms of developing disorders.
Cognitive development and social development contribute to the evolu-
tion of emotion regulation. Cognitive development influences the manner
in which emotional events and emotions themselves can be perceived and
understood (Kopp, 1989; Lewis & Michalson, 1983; Malatesta & Wilson,
1988). Self-conscious emotions like guilt or worthlessness require a certain
level of self-evaluative thought. Social influences such as modeling, sex-role
socialization, and cultural display rules teach children emotion-context rela-
tions (Campos et al., 1983) and communicate parameters of emotionally
expressive behavior (Saarni & Crowley, 1990).
Relatively little is known about the socialization and acquisition of the
self-regulation of emotion. It is generally believed that positive attributes in
parents are correlated with positive attributes in children, but the dynamic
exchange by which children's emotional lives are co-constructed with those
of their parents (and other important people) is not charted. One general
underlying assumption of many developmental and clinical models is that
children internalize the strategies of their caregivers. Parents under stress
and with psychopathology will themselves have dimensions of emotion dys-
regulation that promote those patterns in their children. Children in treat-
ment for anxiety disorders, for example, have a greater likelihood of having
a parent with anxiety disorder than children with other clinical problems
(Bradley, 1990; Reeves, Werry, Elkind, & Zametkin, 1987). Many empirical
data are needed to examine the interactional influences involved in the
regulation of emotion.
Our discussion of emotion dysregulation and the development of psy-
chopathology is organized around three periods of childhood-infancy and
toddlerhood, the preschool years, and later childhood. We begin with the

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premise that the child's capacity to self-regulate emotion starts to develop

in infancy but that infancy is a period of relative dependence on adult
regulation. Episodes of emotion dysregulation during this period are typi-
cally managed by caregivers. When this does not occur, development is
severely compromised.
The preschool years are marked by the emergence of periods of sus-
tained self-regulation and periods of child and adult co-regulation. During
this time, the scope and nature of emotion regulation increases and diversi-
fies (Kopp, 1989). This period of time may be important in that the child
is selecting emotion regulation patterns that may become characteristic.
During the preschool years, children try to cope autonomously with the
emotional demands of their lives and receive social feedback on their emo-
tional reactivity and expressivity. By middle childhood, emotion regulation
processes may be more internalized, less accessible to influence, and may
become more stylized and characteristic (Malatesta & Wilson, 1988). While
the balance tips toward self-reliance in emotion regulation during middle
childhood, social regulation still plays a large and critical role, as it does in
adult relationships (e.g., Coyne & Downey, 1991).

InfancythroughToddlerhood

In the first year of life, infants are largely dependent on adults to

regulate their environments and their experience, including their emotions,
in ways that promote well-being and minimize stress and danger. Infants,
however, have some mechanisms for self-regulating their arousal level
(Demos, 1986; Rothbart, 1989). They initiate tactile stimulation and gaze
aversion to generate a positive state or to minimize negative states. These
strategies are of course limited, and the infant relies on adults much of the
time. This reliance reveals the regulatory aspects of infant emotion. Infant
emotions communicate information about infant states and needs, signaling
and directing the caregiver's behavior (Bridges & Connell, 1991; Campos
et al., 1983; Trevarthen, 1984; Tronick, 1989). For example, crying signals
distress that infants cannot regulate on their own and cooing enjoyment in
activities that they wish to sustain.
Although the exact nature of the acquisition of the range of emotions
is not known, it does appear that within the first two years most children
express the basic emotions of anger, joy, sadness, fear, disgust, and surprise
as well as the rudiments of some "social" or "moral" emotions like guilt
and pride (Sroufe, 1979; Zahn-Waxler & Kochanska, 1990). Although it is
unlikely that infants are cognizant of emotion states and experience them
in a self-conscious manner (Lewis & Michalson, 1983), they do appear to
experience the range of basic emotions in a sensate way that organizes their
experience (e.g., Emde, Biringen, Clyman, & Oppenheim, 1991).

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The infant-caregiver relationship provides the context for the socializa-

tion of emotion regulation. Very young infants appear to follow the emo-
tional lead of the mother in face-to-face interaction, but by age 6 months
they take autonomous turns in the affective exchange (Kaye & Fogel, 1980).
Gender-related socialization appears in mothers' face-to-face contingent re-
sponses to infant emotion expressions (Malatesta & Haviland, 1982). In
addition to face-to-face interaction, parents respond to distress in young
children with state-change strategies such as picking up, cuddling, feeding,
and distracting (Wolff, 1987), strategies that parallel infant self-regulatory
strategies of self-stimulation and gaze aversion. It would be interesting to
know how parenting techniques like distraction relate to developmental
changes in emotional dimensions such as lability or emotion state changes.
Emotion dysregulation in these first years occurs in the context of a
poor fit between the infant's resources for emotion regulation and situa-
tional demands. One profound example is autism, in which the infant's
ability to coordinate emotional exchanges with the caregiver and to derive
meaning via emotion cues is impaired (Rutter, 1983). Emotion dysregula-
tion in infancy and toddlerhood also emerges in the context of dysfunctional
parenting. For example, depression interferes with a mother's synchrony
with and responsivity to her infant. When the infant's emotion is not success-
ful at eliciting corrective action on the mother's part, the infant's emotion
patterns begin to change (Tronick, 1989). The changes reflect increased
irritability, listlessness, and disinterest in communicating with adults (Field,
1984a; Tronick, 1989). For some infants, inadequate responsiveness to their
emotional communications can have serious mental health consequences,
such as functional depression (Cole & Kaslow, 1988; Spitz, 1965), nonor-
ganic failure to thrive, rumination disorder, and reactive attachment disor-
ders of infancy (Mayes, 1992). In such cases, the infant's range of emotion
experience becomes restricted and flat in intensity. Thus, a breakdown in
the dyadic co-regulation of emotion in early childhood results in emotion
dysregulation in the infant, whether the cause is found in the child or in
the caregiver (see also Calkins, in this volume).
During the typical first year, there is an increase in the vitality of infant
emotion (Thompson, 1990) as well as some learning about control of emo-
tional arousal (Demos, 1986; Rothbart, 1989; Stern, 1985). Between 6 and
12 months, infant emotion episodes increase in intensity and duration and
decrease in response latency, yielding a more animated, responsive child
(Thompson, 1990, in this volume). Episodes of dysregulation in the form
of problematic modulation of emotion intensity and duration and mood
changes are seen at this time. For example, temperamentally difficult chil-
dren appear to have a lower threshold for negative emotional reactions
and/or a tendency not to regulate negative affect via gaze aversion and
self-soothing (Calkins, in this volume; Fox, in this volume). Such negative

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emotionality creates stress in the parent-child relationship (Belsky & Von-

dra, 1989; Mangelsdorf, Gunnar, Kestenbaum, Lang, & Andreas, 1990)
and risk for the development of later psychopathology (Bates & Bayles,
1988; Bates, Bayles, Bennett, Ridge, & Brown, 1991; Bates, Maslin, & Fran-
kel, 1985).
Temperament appears to have strong biological underpinnings, but its
relation to symptomatology and mental disorders is probably dependent on
environmental factors (Egeland, Kalkoske, Gottesman, & Erickson, 1990).
We assume that the fit between parent and young child is important. For
example, both parent and infant characteristics influence the quality of the
attachment relationship, the important affective bond between infant and
caregiver that varies in terms of differences in the regulation of affect
(Sroufe et al., 1984). The infancy and toddlerhood period is dependent
on adequate, responsive social interactions for the promotion of adaptive
emotion regulation patterns. Failures in this process can have life-threaten-
ing or long-term deleterious effects on the child.

Threeto Six Years

After about age 3-4 years, episodes of negative affect, such as tan-
trums, intense crying, and distress, appear to diminish (e.g., Fabes & Eisen-
berg, 1991; Goodenough, 1931; Kagan, 1976; Kopp, 1989, 1992). Research-
ers have tended not to focus on changes in positive affect, but it is possible
that these patterns also change. Preschoolers' ability to self-regulate can be
seen in their generation of emotion expressions in play and their modula-
tion of expressions in actual circumstances. By age 3 years, young children
mimic emotions in play (Dunn, 1988) and mask or minimize expressions
of negative feelings under certain conditions (Cole, 1986; Fabes & Eisen-
berg, 1991).
Individual differences in emotional reactivity and emotion regulation
differentiate problem preschoolers from nonproblem children. Behavior-
problem preschoolers show intense and prolonged distress and protest dur-
ing separations, unlike their nonproblem peers (Speltz, Greenberg, &
DeKlyen, 1990). It has been suggested that insecurely attached infants regu-
late emotion differently, in ways that organize the affective behavior of their
relationships throughout their lives (Hofer, 1980b; Sroufe & Fleeson, 1986).
For example, insecure children age 3-7 appear angry, hostile, sad, fearful,
or overly bright in their relationships (Cassidy, 1990; Crittenden, 1992).
In situations calling for the masking of disappointment, behavior-problem
preschoolers show negative emotions more quickly and for longer periods
than nonproblem children (Cole & Smith, 1993).
Not all clinically relevant variations, however, involve the underregula-

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tion of emotion expression. Children exposed to concentration camps, one

form of sustained trauma, appear to have difficulty sustaining feeling (Wil-
son, 1985). In fact, a major component of clinical lore is that dysfunctional
environments, such as abusive and alcoholic homes, contribute to the child's
muting emotionality in some situations (e.g., in the presence of dysfunc-
tional parents) while appearing poorly modulated in others (e.g., at school).
The preschool period marks important social changes as children's net-
works expand to include new siblings, classroom and neighborhood peers,
and teachers. These social influences provide new and different information
about emotion, its regulatory influences, and its social acceptability. For
example, research has found that displays of anger, disgust, and contempt
are associated with achieving one's goals in peer negotiations (Camras, 1982;
von Salisch, 1992) and that sad, submissive expressions are associated with
capitulation (Zivin, 1982). Frequent and intense displays of dominant emo-
tions like anger, however, are related to lower levels of social competence
(Cummings, 1987; Fabes & Eisenberg, 1991). The development of the abil-
ity to attune the intensity and duration of the emotion to best support the
situational demands of accomplishing goals and preserving relationships is
an important accomplishment, probably occurring within the preschool
years and continuing through childhood.
These years are also a period of cognitive and linguistic growth, which
influences emotion regulation. Recently, interest has been shown in the role
of the development of the frontal lobes and executive function with regard
to emotion regulation and psychopathology (Bradley, 1990; Fox, in this
volume). Individuals who suffer brain damage in the frontal area tend to
be emotionally impulsive, labile, and intense (Stuss & Benson, 1986), charac-
teristics that are associated with dysinhibitory psychopathology (Gorenstein
& Newman, 1980). Although there is evidence that some children with
conduct disorder may show deficits in executive function task performance
(Moffitt, 1990), there is a need for work that relates this aspect of develop-
ment to emotion regulation. The preschool years may mark important tran-
sitions in the protracted development of executive functions (Pennington,
1991); during this period, children with difficulties modulating attention
and impulses distinguish themselves from their peers in terms of the la-
tency, intensity, duration, and quality of shifts in emotion states, including
joy and excitement.
Emotions may also come under greater verbal control during the pre-
school years, but little is known about the complex relation between emo-
tional and language development in this period (Kopp, 1989, 1992). It is
commonly believed that around ages 5 and 6 children more often verbalize
their feelings instead of acting on them. By the third year, children have
fairly developed language repertoires and are able to think and talk about
emotions (for a review, see Bretherton, Fritz, Zahn-Waxler, & Ridgeway,

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1986). Their emotion knowledge can be promoted by their caregivers; com-

munication about affective states in the interactions of mothers and their
young children enhances the child's developing social understanding
(Dunn, 1988; Harris, 1989) and self-regulatory skill (Cicchetti et al., 1991;
Hesse & Cicchetti, 1982).
Children who are exposed to atypical levels of distress are at risk for
developing difficulties in the regulation of emotion experience and expres-
sion. For example, abused children are less likely to verbalize about internal
states like emotions, and insecurely attached children are less elaborated
and complex in their descriptions of feeling states (Bretherton & Beeghly,
1982; Cicchetti, 1989b; Cicchetti & Beeghly, 1987). An important aspect of
the development of dysregulated patterns of emotion may be deviations in
the social interactional process by which children acquire and use language
to talk about their own and others' emotions.
During the preschool years there is an increase in strategies for self-
regulating. Novel emotion experiences typically elicit a search for adult
intervention and support. When situations tax the child's developing pat-
terns of coping emotionally, the child is likely to resort to more immature
coping, such as denial, dissociation, or misbehavior. The fatigued preschooler
may become upset more easily than usual and have a tantrum in which the
developing abilities to use anticipation and reasoning, and even adult reason-
ing, are preempted. This is an instance of emotion dysregulation.
Of clinical concern, however, are circumstances that tax the child's emo-
tion regulation strategies repeatedly or traumaticallyand that lack adequate
adult intervention. One client, aged 9 years, was unable to handle the stress
of confrontation by peers. Under provocation, he would turn away and
begin to "hallucinate," that is, turn to an imaginary world in which the
present stress could be ignored. He was self-regulating fear and perhaps
anger but resorting to a strategy that was psychotic-like. The child was
taught assertive skills and eventually had the courage to reveal that he was
being sexually abused by his father. He had learned to retreat into his
imaginary world as a means of coping with overwhelming, emotion-laden
circumstances from the age of 4.
In sum, during infancy and early childhood, relationships and life ex-
periences provide opportunities to experience emotions, observe how they
function, learn the consequences of emotion states, talk about emotions, and
acquire initial strategies for modulating emotion experience and utilizing
emotion successfully. Conditions like exposure to interpersonal anger, dis-
cord between parents, a parent's psychopathology, and abusive parenting
quickly strain and overwhelm the developing emotion regulation patterns
of infants. Child characteristics that make it difficult for parents to decipher
how to read and soothe infant distress interfere with the infant's ability to
experience and learn from parents' emotion regulation strategies. On the

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other hand, a life in which stress is preempted and opportunities to learn

to communicate about and cope with thwarted goals, threatening or novel
experiences, and the relinquishing of goals are infrequent fails to afford
opportunities for development. Probably the optimal life circumstance for
the development of early patterns of emotion regulation is exposure to
manageable distress embedded in a responsive, approachable world (see
also Demos, 1986).

Childhood
The elementary school years mark new accomplishments in emotion
regulation development. Changes in cognitive and social development cre-
ate the context for greater reliance on the self-regulation of emotion and
for patterns of emotion dysregulation to become more stable and less acces-
sible to outside influence. During these years, the manner in which children
have internalized their experiences with emotion and its regulation may
become more stylized.
Perhaps the most interesting aspect is the development of abilities to
reflect on, conceptualize, and verbalize ideas about emotion more abstractly.
The development of emotion display rules provides an example. The social-
ization of emotion displays begins in early infancy (Malatesta & Haviland,
1982); thus, cultural display rules are being acquired at the same time as
other rules of conduct. The explicit understanding of display rules, how-
ever, emerges during the elementary school years (Gnepp & Hess, 1986;
Saarni, 1979, 1984).
Cognitive factors appear to play an important role in the transition
toward greater self-regulation. Visuospatial skills support the perception of
emotion in others, which in turn influences knowledge about emotion-
situation contexts and cultural display rules. Verbal abilities link images to
memory and provide alternative ways to communicate inner states. Children
with visuospatial and language delays are more likely to have emotional
disturbances (Cantwell, Baker, & Mattison, 1979; Rourke, 1989). Children
with behavioral problems show difficulties in processing information; peer-
rejected and aggressive children appear to misread interpersonal situations,
and this leads to frustration and disappointment (Dodge et al., 1984; Putal-
laz & Sheppard, 1992).
Cognitive development also supports the child's ability to self-reflect
on her behavior, thoughts, and emotions. This ability is seen in children's
conscious awareness of the possibility of experiencing simultaneous, mixed
emotions. A model example of the integration of clinical issues and basic
developmental psychopathology research is reflected in an interesting case
study reported by Harter (1977) of a 6-year-old client who felt "all bad"
some days and could not be reassured and "all good" other days and had

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no interest in discussing the "bad" days. By offering the child a concrete

physical representation of the emotional "parts" of a person, Harter was
able to assist the child in integrating her strongly opposed feelings.
Harter's empirical work focused on children's conceptual understand-
ing mixed emotions, using a Piagetian perspective on social cognition. In
of
this work, it appears that the integration process is a slowly evolving one.
Young children seem relatively less able to entertain simultaneous opposite
emotions and eventually come to conceptualize them as temporally contigu-
ous ("First I was bad, but now I'm good"). Only in middle childhood do
children seem to understand the simultaneity of opposite emotions. More-
over, Harter has shown that the increasingly complex and diversified aspects
of self and their integration over time is a continuing process still under
way during adolescence (Harter, 1990; Harter & Monsour, 1992).
Early childhood trauma is one condition that is thought to influence
the integration of aspects of self, including the integration of multiple emo-
tions (Cole & Putnam, 1992; Kluft, 1985). Symptoms such as splitting, a
kind of affective oversimplification of events or self as all good or all bad,
are associated with severe psychopathology, notably personality disorders.
When early childhood trauma occurs during periods of normative transition
in the ability to conceptualize emotion experience as being integrated, it
may interfere with this development in such a way as to create dissociations
that then continue through later development. In fact, many symptoms
associated with personality disorders seem to reflect dysfunctions in the
integrated achievement of the tasks of middle childhood.
As children become consciously aware of and able to judge their own
inner life, it becomes possible to have emotional reactions about emotional
reactions. The development of this emotion cycle capability has not been
studied. It is known that, prior to the development of self-reflective skills,
young children show emotional reactions to their own violations of behav-
ioral standards (Cole, Barrett, & Zahn-Waxler, 1992; Kagan, 1981) and that
preschoolers cope better with a stressful event if they were experiencing
positive rather than negative feelings in the preceding moments (Barden,
Garber, Duncan, & Masters, 1981; Carlson & Masters, 1986). As children
become able to reflect on their own internal states and to think about the
implications of those states, the reflections are not "cold" cognitions but
rather value judgments that carry emotional valence. Middle childhood may
be an important period for examining the emergence of problems in emo-
tions about emotions.
Social influences, such as the reactions of others to one's emotions, also
contribute to the internalization of emotions about emotions. One interest-
ing developmental approach might be to study the emotional flow in a
conflictual parent-child interaction. For example, it would be interesting to
examine how the self-regulation of emotion by the adult relates to emotional

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communications made to the child about his or her emotionality (for an

interesting discussion, see Dix, 1991). If a parent feels guilt, sadness, or
anxiety about an angry exchange with the child, the parent may model an
emotion/emotion cycle. In addition, such a cycle could also develop if a
child is scorned for or chastised about an emotional reaction, such as feeling
angry at the parent. One is reminded of Hoffman's (1982) statement that,
when trying to promote moral development, parents should focus their
reprimands on the inappropriate behavior rather than the felt emotion.
In sum, there are many examples of developmental research that can
be integrated into a developmental psychopathology perspective and many
aspects of emotionality that are relevant to clinical work and that remain to
be studied in both typical and atypical samples. Emotional development is
a complex transactional evolution in which child characteristics, caregiver
characteristics, and experience converge and transform. Circumstances that
stress children beyond their capacity to self-regulate, particularly when
there is a lack of adequate alternative sources for regulation in the child's
social world, create an opportunity for stable patterns of emotion dysregula-
tion to develop.
Emotion dysregulation begins as emotionally regulatory events that oc-
cur in a context. Over the course of development, these events influence the
development of stylized patterns of emotion regulation, and dysregulatory
qualities can become part of this style. Emotion dysregulation then becomes
an attribute of a person. Such dysregulatory patterns may accompany a
developing disorder or be causal factors in the etiology of other disorders.
They will probably not characterize the individual in all situations but rather
be specific to particular types of contexts. A 4-year-old's temper tantrum is
an instance of emotion dysregulation but is not necessarily a symptom of
or predictive of psychopathology. Yet all forms of psychopathology have
concomitant symptoms of emotion dysregulation.

SUMMARY

Clinical conceptualizations of emotion that stress its disruptive influ-

ences and functional models of emotion that emphasize its adaptive aspects
can be integrated into a developmental psychopathology framework. Under
certain conditions, emotion regulation may develop dysregulatory aspects
that can become a characteristic of an individual's coping style. This style
may then jeopardize or impair functioning and become associated with
symptomatic, disordered functioning. Emotional development provides a
critical vantage point from which to study the development of symptomatol-
ogy and psychopathology, particularly given the prevalence of emotional
symptoms in various forms of psychopathology. Dimensions of emotionality

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that can be used to characterize dysregulation include access to the range

of emotions, flexible modulation of intensity, duration, and transitions be-
tween emotions, acquisition and use of cultural display rules, and the ability
to reflect on the complexity and value of one's own emotions in a self-
supporting manner. Developmental psychopathology provides a framework
within which to examine how emotions are regulatory, how their regulation
changes over time, and under what conditions an adaptive emotion process
can develop into a pattern of dysregulation that then becomes, or sustains,
some symptoms of mental disorders.
Such research requires samples that include children with and without
risk or presence of particular mental health problems, paradigms that allow
the examination of dimensions of emotionality in context and provide multi-
ple assessments that include observations of children's reactions beyond
what they themselves can report, and analyses that extend beyond simple
global aggregates such as positive and negative emotion. We believe that it
is particularly important to study children and their families in situations
that challenge their emotional adaptation.
The developmental tasks of emotional life evolve in exchanges between
the child and the world of events and relationships. The emotional condi-
tions of early childhood appear to be very important in optimizing or in-
terfering with how the child's emotionality regulates his or her interpersonal
and intrapsychic functioning and how the child learns to regulate emotion.
The experiences that accrue around emotional events influence the stable
aspects of the developing personality and become trait-like aspects of the
person (Malatesta& Wilson, 1988). Dysregulation occurs when an emotional
reaction loses breadth and flexibility. If a dysregulatory pattern becomes
stabilized and part of the emotional repertoire, it is likely that this pattern
is a symptom and supports other symptoms. When development and adap-
tation are compromised, the dysregulation has evolved into a form of psy-
chopathology.
The line between normative variations and clinical conditions is not
clearly drawn. There is as yet no standard by which to state that an emotion-
ally dysregulated style is not of clinical concern. Persons with dysregulated
styles may never seek treatment or be diagnosed. They may live relatively
ordinary, functional lives, and their friends and family might be startled to
learn of their emotional difficulties, as is often the case in marital and family
therapy. Individuals may be so accustomed to patterns of emotion regu-
lation that have been part of their repertoire since early childhood that the
thought that this style may be problematic may never occur. We contend
that an emotion style that has dysregulated features is a vulnerability. The
advantage of a developmental psychopathology approach is that it makes it
possible to identify variations in emotion regulation and how they correlate
with other variables in normative, at-risk, and clinical samples.

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