Disruptive behavior disorder in middle childhood and early adolescence: What is the role of attachment and emotional regulation strategies?

Introduction: Children with Disruptive Behavior Disorder (DBD) show severe impairments in academic, peer and family contexts, involving high cost for the communities. Several studies suggest that difficulties in attachment and emotional regulation are linked with the development of child psychopathology, as DBD. However, few studies have investigated the role of these two variables during the middle childhood and early adolescence. Aims of the study: 1) to assess attachment and emotional regulation strategies in a group of children with diagnosis of DBD; 2) to examine the associations among attachment, emotional regulation and Externalizing Problems. Material and Methods: Participants were 84 children, aged from 9 to 15: 42 with DBD, and 42 children without psychiatric difficulties as control group. They were administered: Child Behavior Checklist 6-18 (CBCL 6-18), Child Attachment Interview (CAI) and Emotional Regulation Questionnaire for Children and Adolescents (ERQ-CA). Results: Data showed: 1) Lower levels of Emotional Openness, Resolution of Conflict, Coherence and higher levels of Dismissal to caregivers in DBD group than control group; no differences on Emotional Regulation strategies; 2) in DBD group, a negative correlation between Externalizing Problems and Security scale (correlations between -.39 and -.46, p = .000) and a positive correlation between Externalizing Problems and Dismissal to father (r = 3.17, p = .006). Conclusion: These results suggest that emotional and relational difficulties of DBD children during the middle childhood and early adolescence are primary caught by attachment representation rather than emotional regulation strategies. This might help clinicians to have directions for the evaluations and treatment processes in this age.