Institutional members access full text with Ovid®

Share this article on:

Relationship Between Unsupervised Time and Participation in an Emotion Regulation Intervention and Risk Outcomes

Hadley, Wendy PhD; Barker, David PhD; Thamotharan, Sneha PhD; Houck, Christopher D. PhD

Journal of Developmental & Behavioral Pediatrics: November/December 2017 - Volume 38 - Issue 9 - p 714–722
doi: 10.1097/DBP.0000000000000498
Original Articles

Objective. This study is a secondary analysis of outcomes examining risk behavior in the context of the naturalistic occurrence of parental monitoring and participation in an emotion regulation intervention over a 12-month period.

Method: Early adolescents with mental health symptoms (N=420), ages 12–14 years, were recruited and randomized into either an Emotional Regulation (ER) or Health Promotion (HP) condition. Assessments included adolescent self-report of unsupervised time, substance use and sexual behavior at baseline, 6-months, and one year post-intervention. Analytic groups were formed by intervention condition (ER or HP) and baseline reports of unsupervised time (≤1× per week or >1× per week of unsupervised time with opposite sex peers) resulting in a total of four groups. Logistic regression and time-to-event analyses were used to test differences in substance use and delay of sexual initiation between the groups.

Results: Participation in the ER intervention in the presence of low unsupervised time was superior in reducing both substance use and sexual initiation than either factor alone; and either factor alone was more effective than the absence of both.

Conclusion: Findings suggest that interventions targeting health risk behaviors, including substance use and sexual risk behavior, among early adolescents with mental health symptoms may be more effective when targeting both internal (e.g., emotional regulation) and external (e.g., unsupervised time spent with peers) protective factors. Limiting unsupervised time spent with peers through parental monitoring may serve to scaffold and reinforce early adolescent acquisition of effective emotion regulation which can be employed during emotionally arousing risk situations.

Bradley Hasbro Children's Research Center, Department of Psychiatry and Human Behavior, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI.

Address for reprints: Wendy Hadley, PhD, Bradley/Hasbro Children's Research Center, One Hoppin St, Suite 204, Providence, RI 02903; e-mail:

Supported by NINR grant R01 NR 011906 to Rhode Island Hospital.

Disclosure: The authors declare no conflict of interest.

Received September , 2016

Accepted June , 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.