Changing the neural mechanism of emotion regulation in children with behavior problems steven woLtering anD marc D. Lewis
Externalizing behavior problems are characterized by high levels of aggression and delinquency. These problems entail serious costs for the person, the immediate social environment, as well as social institutions and society as a whole, and they are thought to be persistent across the lifespan if left untreated (Caspi, Moffit, Newman, and Silva, 1996). Attempts to change the trajectory of externalizing problems through intervention programs that start in childhood seem promising but, unfortunately, they show a lot of variability in their outcomes. Studies generally reveal that about 40 percent of aggressive children do not show any significant improvement when treatment has ended. In order to improve treatment efficacy, many researchers call for a better understanding of what makes some children, and not others, respond to treatment. Cognitive mechanisms that children use to regulate emotions may play an important role in determining treatment outcomes. Emotion regulation allows individuals to control their emotional impulses, appraisals, and expressions. An effective strategy of emotion regulation, therefore, helps individuals display emotional responses with appropriate intensity and form, at the correct time and place, and modulate or inhibit inappropriate responses. Externalizing problem behaviors may be due to a lack of effective emotion regulation with respect to anger, and that is why they are characterized by excessive and disproportionate aggressive responses. Not surprisingly, the development of effective emotion regulation is thought to be crucial for adaptive socialization. Ineffective emotion regulation, on the other hand, can lead to the development of externalizing pathologies when aggressive responses become habitual and uncontrolled. These behavioral patterns are often highly resilient and may interfere with successful treatment outcomes once these pathologies have emerged. Recently, with the discovery of neural mechanisms and neural markers of psychological processes, clinical-developmental psychology has increasingly been informed by neuroscientific research. The current chapter will discuss what we have learned in our lab about changes in the neural mechanisms of emotion regulation with treatment aimed at reducing children’s aggressive behavior. We
will first ask what networks in the brain are associated with emotion regulation. Second, we will ask if successful treatment aimed at improving emotion regulation yields changes in those hypothesized neural systems. Finally, we will speculate on how these results may improve clinical-development theory and stimulate future research, by postulating a hypothesis that underlying internalizing problems play a key role in the development of externalizing behavior problems.