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Table of Contents
REVIEW ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 34-39

Emotion Regulation in Adolescence: Different Strategies and Associated Functional Connectivity of Brain Regions


Department of Biological Sciences, Sunandan Divatia School of Science, NMIMS (Deemed-to-be) University, Mumbai, Maharashtra, India

Date of Submission27-Nov-2020
Date of Decision15-Dec-2020
Date of Acceptance15-Dec-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Ms. Athulya Krishnan
V. L, Pherozeshah Mehta Road, Vile Parle, Mumbai - 400 056, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bmrj.bmrj_13_20

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  Abstract 


Adolescence is often characterized as a period of overwhelming sensitive emotions. Additional to the emotional instability, there are rapid changes in the development and the maturation of the brain regions because of the effects of sex hormones. Accordingly, the mismatch maturation rate of the amygdala and prefrontal cortex determines the disrupted functional connectivity between them leading to delayed cognitive responses. As a result of the increased emotional reactivity together with delayed cognitive responses, adolescence is more prone to maladaptive shifts in regulation skills. These shifts in the course of puberty lead to diminished emotion regulation in adolescents. Hence, the ability to execute successful regulatory skills becomes a vital aspect concerning mental well-being. Taken together, the current review evaluates the efficiency of the regulatory skills (strategies) and the associated connectivity of neural networks during emotional regulation in adolescence. Furthermore, the present review correlates the success of emotion regulation with psychiatric symptoms.

Keywords: Adolescence, amygdala-prefrontal cortex, cognitive development, emotion regulation, functional connectivity, psychopathology


How to cite this article:
Krishnan A. Emotion Regulation in Adolescence: Different Strategies and Associated Functional Connectivity of Brain Regions. Biomed Res J 2020;7:34-9

How to cite this URL:
Krishnan A. Emotion Regulation in Adolescence: Different Strategies and Associated Functional Connectivity of Brain Regions. Biomed Res J [serial online] 2020 [cited 2021 Apr 15];7:34-9. Available from: https://www.brjnmims.org/text.asp?2020/7/2/34/305768




  Introduction Top


Adolescence is characterized as a period of emotional instability. In addition to bio-physiological changes, increased emotional torment can influence healthy mental status, leading to immaturity in regulation abilities. This is the consequence of the mismatch maturation rate of different brain regions. Similar results were in line with the findings that the brain maturation happens in a bottom-up manner accompanied by a top-down regulation. Thereby, results in the disrupted interplay between the emotional processing and regulating regions of the brain.[1] Consistent with this view, different studies were conducted that deals with the aspect of successful emotional regulation skills and its associated connectivity of neural networks in adolescent individuals. Functional magnetic resonance imaging (fMRI) analysis is identified as one of the accurate methodologies performed. It provides evidence to interrelate the activation of different brain regions that correspond with the course of emotion regulation.[2]

fMRI studies reported a heightened activation of the amygdala during an intense negative emotion given that the amygdala is concerned with identifying the emotional stimuli and selecting responses. Regulation of the amygdala was observed to be performed by the prefrontal cortex (PFC), which implies the ability of cortical regions to introduce effective cognitive control. Furthermore, the activation of subgenual anterior cingulate cortex (sgACC) is identified to improve the self-relevance of one's emotional thought processing.[3] Therefore, efficient interplay between the above-mentioned regions results in the downregulation of the negative intense reactivity.

The onset of puberty causes rapid changes in the interplay between the said regions.[4] As a consequence, emotional sensitivity is at its peak during puberty and can impair conceptual thinking, leading to the selection of inefficient responses.[5] Previous studies have proved that the regulatory skills (strategies) that accompany efficient interplay of brain regions are said to be successful in the downregulation of intense negative affect.[6] Based on such prior studies, different strategies were categorized into adaptive and maladaptive. Adaptive strategies such as acceptance, reappraisal, and problem-solving were found to be more successful in down-regulating the emotional torment than the maladaptive strategies such as rumination, aggression.[7] Consistent with this view a maladaptive shift in adolescence manifested a negative correlation between the success of affect control and psychopathology.[5] Hence, studies were conducted to analyze the underlying functional connectivity associated with such strategies.[3]

Thus, the current review deals with the aspect of linking pubertal changes with brain development and maturation. Furthermore, to provide implications about the functional connectivity of the brain networks associated with different strategies amid emotion regulation and its correlation with mental health.


  Maladaptive Shift in Adolescence Top


Volatile emotions are predominant during adolescence and can alter brain functionality in controlling negative affect.[4] Hence, the characteristic attribute of the adolescent period is their immaturity in processing vivid affect and generating efficient responses. Since the completion of brain development and maturation takes place within two and a half decades, the still-developing PFC in addition to heightened sensitivity of emotions can diminish cognitive thinking and often results in a maladaptive shift in the selection of efficient responses toward emotions.[1]

Considering the poor emotion regulation as a result of the incomplete neural network, adolescents are more vulnerable to various psychopathologies. Intending to understand the heightened risk of mental disorders during puberty, the maladaptive shift model concluded the existence of a nonlinear relation of maladaptive response selection, which was later stabled over age.[5],[8] Therefore, inferring that successful handling of emotions matures with age. Furthermore, the cognitive maturation model explains similar results to infer that bottom-up maturation paired with the top-down regulation of brain regions leads to disrupted functional connectivity between them.[1] Hence, diminishes the ability to cognitively respond to negative emotions. As a result, individuals are more inclined toward maladaptive regulation strategies.[9]

Although the above-discussed models suggested the role of age in varied differences of response selection, however, the accurate understanding of the differential maturation time of the brain regions is required to explain the underlying lack of their connectivity. This understanding is attained by studying the associated sex effects on brain development and maturation. Together underscore its relation to efficient cognitive development and maturation.


  Sex Effects on Cognitive Development and Maturation Top


Consistent studies regarding the role of age for efficient response selection are also coupled with the underlying sex effects. The pubertal bio-physiological changes in the body lead to differential brain development and maturation.[1]

One such study is in line with the findings that “despite the close proximity of the sub-cortical structures explored, there were clear differences in their structural development during adolescence.”[4] Thereby implicates that the brain structures have not proved to show any similar growth pattern at the same time. Each structure matures at a different time. Limited concentrations of sex hormones can cross the blood–brain barrier and get bound to their respective receptors on the brain structures.[4] Depending upon the concentration level of pubertal hormone accumulated on the brain surface, its early development is determined. Varying levels of the pubertal hormone receptors explain the varied hormonal concentration levels on the brain structures. Sex hormones receptors are found in large quantities in the sub-cortical regions, infers that the sub-cortical regions like the amygdala matures and stabilizes faster than cortical regions such as the PFC during teen years. Stable PFC volume is attained during mid-twenties.[1],[3] This underscores the developmental mismatch and the differential maturation pattern. Furthermore, previous studies have shown the function of amygdala to modulate the memory of emotional stimuli with the levels of stress hormones released during the said event [Figure 1].[10] Consistent with this view, hemisphere laterization was also found during memory consolidation in both sexes, i.e., dominance of the right hemisphere in males and left in females.[11]
Figure 1: Role of amygdala in emotional memory pathway

Click here to view


Since the amygdala and PFC is more concerned with affect processing and cognitive control, respectively, the efficient interplay between them is necessary for the successful downregulation of the intense negative emotions. Given the early maturation peak of amygdala volume together with delayed in prefrontal cortical regions can undermine efficient cognitive abilities across adolescence.[1] Hence, clear understanding of the functional connectivity between them provides evidence for its potentiality to respond to emotions effectively. However, successful respond selections are coupled with the use of various strategies, the associated functional connectivity of adaptive and maladaptive strategies provides insight about the successful down-regulation of affect


  Influence of Adaptive and Maladaptive Strategies on Functional Connectivity of the Brain Regions during Emotion Regulation Top


Reappraisal

“Reappraisal is often seen as an adaptive strategy”[7] to regulate emotions that aims at the reinterpretation of the negative emotional stimuli. The diverse interaction of brain regions during cognitive reappraisal comprehends its ability to regulate emotions. Studies using cognitive reappraisal strategy found a negative coupling between the amygdala and PFC.[9] Lesser activation of the amygdala by the PFC infers greater down-regulation of affect.[12] Furthermore, a mediating pathway involving the connections among the ventromedial PFC (vmPFC) and amygdala concludes the influence of the former on successful amygdala modulation by ventrolateral PFC (vlPFC) during cognitive reappraisal.[13] Thus, connectivity between vmPFC-amygdala evaluates the effective cognitive control exhibited by the vlPFC on the amygdala. Prior studies were also consistent with the relation between efficient amygdala-PFC connectivity and the strength of interplay between the regions of the PFC

Interregion connectivity of PFC and amygdala with other cortical regions was enhanced in individuals with greater cognitive reappraisal skills. One such feedback functional connectivity was between inferior frontal gyrus (IFG) and dorsolateral PFC, which implicates a successful response selection to down-regulate emotions.[3] As prior studies have shown, increased coupling between IFG and vmPFC during cognitively demanded up-regulation of emotions, implications were derived that vmPFC is related to conceptually regulated affect.[13]

Furthermore, neuroimaging studies showed a co-activation of sgACC and positive connectivity with the amygdala. Therefore, the up-regulation of emotions with enhanced connectivity between sgACC and the amygdala represents the success of cognitive reappraisal and implies a heightened ability to keep track of one's emotional thoughts through efficient processing of self-relevance.[3] Such connections are often lost in highly ruminating individuals.

Rumination

Rumination is a maladaptive strategy in which negative thought is repeatedly replayed in the mind. Un-fluctuating results were found about rumination and were associated with increased impaired behaviors in adolescence. This infers that rumination strategy is at its peak during adolescence due to intense negative emotions and poorer cognitive development.[5] fMRI analysis conducted to evaluate stress reactive rumination concluded the disrupted functional connectivity between the amygdala and the PFC.[14] Hence, this leads to enhanced reactivation of the amygdala and a reduction in its ability to down-regulate the emotions. Such inefficient interplay was predominately seen in children with major depressive disorders (MDD) backgrounds who were asked to cognitively reappraise a negative stimulus.

In children with MDD background, greater efforts were taken to cognitively reappraise the affect. This implicates that the interaction between brain regions was influenced by the prevalent use of rumination. Cognitive reappraisal was successful in down-regulating the affect in healthy controls, which indicates that they were independent of any interference by rumination in brain connectivity. Henceforth concludes a link between rumination and inefficient emotion regulation during reappraisal tasks in children with MDD background.[15] Similar neuroimaging studies supported the results regarding the up-regulation of emotions.

The up-regulation of emotions involves the connection between regions concerned with the self-relevance of one's feelings (sgACC) and amygdala. Therefore, increased coupling between them results in cognitive reappraisal success.[3] However, such association was interrupted by rumination leading to the suppression of self-relevance on one's emotional thought. Henceforth children with highly ruminating characteristics resulted in a declined ability to monitor internal emotions due to poor self-relevance during the upregulation of emotional state. This implies that rumination leads to a declination of cognitive reappraisal success due to the decreased coupling between sgACC and amygdala.[15] Although rumination ceases to down-regulate emotions, it is often used to treat people with aggressive behaviors.[16]

Aggression

Aggression is a form of maladaptive strategy in which individuals release their frustration on others. Maladaptive emotion regulation studies have shown increased activation of the amygdala and decreased activation of the PFC. Taken together, this result underscores an inefficient regulatory response to elicited affect. Although the efficient interaction between the amygdala and PFC postemotional task was decreased in violent offenders, however, notable connectivity between them before anger provocation provides implications about the over-regulation of emotions in instances where it is not necessary. These speculations comprehend that greater than the normal efforts were required to regulate emotions in them than the nonviolent offenders.[16] As a result, out of control behavior like violence becomes a necessity to overcome the intensified anger arousal. This conclusion was in lines with insula-superior temporal gyrus connectivity.

Prior studies have shown enhanced activation of the posterior insula following an angry stimulus, and it is also found to be coupled with bilateral superior temporal gyrus.[17] Indeed, superior temporal gyrus was speculated to involve in processing involuntary attention to stimuli; hence, its interaction with the insula implicates a heightened interrelation between the both in grasping anger and modulating violent behavior associated with it. Hence, violent offenders are necessarily treated to control emotions by using rumination as a strategy.


  Emotion Regulation Success of the Above Strategies Top


Studies conducted to analyze the correlation between various regulation strategies and its associated functional connectivity also regressed to give evidence for the success of strategies to down-regulate sensitive emotions. These findings were in line with the positive correlation between emotion regulation success and functional connectivity of amygdala with the PFC and sgACC throughout reappraisal tasks [Figure 2].[18]
Figure 2: Activation pattern of amygdala in response to cognitive reappraisal of negative emotions[3],[9],[13]

Click here to view


Predominant rumination in people showed impaired connectivity of the amygdala-sgACC in addition to the PFC. Since the interaction between these regions was ideally up-regulated during reappraisal tasks, the above observations hinted the failure to focus on internal emotions. Consistent with this aspect, rumination leads to a declination of cognitive reappraisal success by decreasing the coupling between sgACC and amygdala.[3] Although the success of rumination as a strategy proved to be in vain during emotional regulation, however, this was much used to treat people characterized by out of controlled emotions like aggression.[16]

In addition to the disrupted connectivity between the amygdala and PFC, a positive connection between the insula and superior temporal gyrus speculate to triggers violent behaviors with regards to anger provocation.[17] Thereby, further indicating that the anger grasping in response to negative stimuli decreases the ability to down-regulate emotions. Hence proves the failure of aggression to reduce affect. Individuals with the inclined usage of such maladaptive strategies are proved to be unsuccessful in down-regulating emotions. Furthermore, they are at higher risk to show psychiatric symptoms.[6]


  Correlation between Disrupted Functional Connectivity of Brain Regions and Psychopathologies Top


Mental well-being is characterized by the ability to achieve the goal of successful affect control.[9] Adolescents when overwhelmed by various emotions leads to a decrease in their ability to cognitively respond to negative emotions. Consistent with this view studying the brain functional connectivity of maladaptive strategies (rumination and aggression) infers their psychopathological interactions.

The inability to let go of negative thoughts is highly reduced in people with habitual rumination. Family environment plays a role in the habitual rumination in adolescents. Correlational studies between parents and children's metacognitive beliefs found that “a high level of parental negativity was associated with a high level of positive metacognitive beliefs about rumination in adolescents.”[19] To avoid negative responses from parents, children tend to internalize such beliefs and become more likely to select the maladaptive strategies (rumination) to regulate negative emotions.[19] Consistent with this view, similar studies have shown a relation between greater autobiographical memory, rumination and depression. Adolescents with greater autobiographical memory about emotional events interact with rumination and the extension of such episodes can result in depression.[20]

Although rumination decreases violent behavior, it is often characterized as an inefficient regulatory method to control elicited affect due to the disrupted interaction of emotions monitoring regions of the brain.[14] These findings simplify the relationship between the impaired interplay of PFC and limbic regions and its correlation with depressive symptoms.[15] Correlation between functional connectivity and psychiatric symptoms can also be explained in a way that since PFC ceases to decrease the amygdala reactivity; the associated negative emotions are more prevalent. Since emotions are not properly driven by cognitive thoughts and conceptual analysis in adolescence, chances of onset of psychopathologies are enhanced during this period. As a consequence, adolescents are at higher risk of deviating from a healthy mental status. Hence, careful regulation of emotions in the form of successful methods such as cognitive reappraisal has to be strengthened to lessen the onset of psychiatric disorders.


  Conclusions Top


The current review provides first-hand knowledge about the adolescent emotion regulations and its underlying functional connections of neural networks. Maturation mismatch of emotion processing and regulating brain regions interpret to be the cause of impaired functional connectivity between them. As a result, the ability to execute successful adaptive strategies diminishes during adolescence. Given that unsuccessful emotion regulation is related to psychopathologies, therefore, maladaptive strategies seed a heightened risk of psychological disorders in adolescents. Conclusion about the brain lateralization during memory consolidation can henceforth be extrapolated in future studies to understand the gender differences in brain development and mature handling of emotions. In addition to the gender difference, future studies should work on the relationship between emotion regulation and other factors such as the effect of parental care in adolescence. Hence, contributions of the sort provide insight concerned with the vital role of efficient emotion regulation in mental well-being.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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