Five Emotion Regulation Profiles in Adolescents Linked to Mental Health Patterns

Swedish adolescents who rarely report using any emotion regulation strategies showed mental health nearly as favourable as those who leaned heavily on positive thinking, according to a survey study of 759 community-dwelling adolescents with a mean age of 13.9 years. The finding challenges the assumption that using more coping strategies is inherently better, and suggests that the mental health correlates of any single strategy depend on the wider constellation of strategies in which it is embedded. The research, published in Child and Adolescent Psychiatry and Mental Health, used a person-centred statistical approach to sort teenagers into distinct emotion regulation profiles rather than averaging strategy use across the whole sample.

The questionnaire measured six emotion regulation strategies drawn from an adolescent-specific instrument: rumination or negative thinking, positive reorientation, social support seeking, aggressive outlet, creative expression, and distraction. Alongside these, the researchers assessed life satisfaction, anxiety, depression, and non-suicidal self-injury. Latent profile analysis, a statistical technique that groups individuals according to similar response patterns, was then applied to identify naturally occurring combinations of strategies.

Five profiles emerged. The Positive Reorientation–Focused profile, the largest at 39 percent of the sample, combined high use of positive reorientation and distraction with notably low rumination. The Minimal Strategy profile, 16.5 percent of adolescents and predominantly boys at 77 percent, showed generally low engagement across all six strategies, with most scores falling more than half a standard deviation below the sample mean. The Multiple Strategy profile, 12.8 percent, used strategies broadly, with particularly high creative expression alongside above-average positive reorientation, social support, and distraction. The Rumination–Focused profile, a quarter of the sample, showed rumination roughly one standard deviation above the mean plus elevated aggressive outlet and low positive reorientation. The smallest group, the Creative Rumination-Aggression profile at 6.7 percent and 87.8 percent girls, combined markedly elevated rumination, aggressive outlet, and creative expression with below-average distraction and positive reorientation.

The profiles differed significantly on every mental health outcome measured, with large effect sizes. Analyses using the BCH procedure, which accounts for the uncertainty inherent in assigning individuals to profiles probabilistically, confirmed these overall differences. Because the profiles also differed in gender composition, the researchers repeated the analyses adjusting for gender; the profile differences remained significant for life satisfaction, anxiety, depression, and continuous non-suicidal self-injury scores, although gender itself was independently associated with each outcome.

The Positive Reorientation–Focused and Minimal Strategy profiles showed the most favourable mental health, with life satisfaction roughly one standard deviation above the sample mean and anxiety and depression around half to one standard deviation below it. Only 2.7 percent of the Positive Reorientation–Focused group and 5.8 percent of the Minimal Strategy group scored in the clinical range for depression, compared with 10.5 percent of the total sample. The Multiple Strategy profile scored close to the sample mean, reflecting intermediate outcomes. At the other end, the Rumination–Focused and Creative Rumination-Aggression profiles showed life satisfaction approximately 1.5 to 2 standard deviations below the mean and anxiety and depression roughly 1 to 2 standard deviations above it.

The Creative Rumination-Aggression profile stood out as the most severely affected group. Nearly half of its members, 48.9 percent, scored within the clinical range for anxiety, 34.7 percent for depression, and 75.5 percent reported repetitive non-suicidal self-injury. In the Rumination–Focused profile, 19.8 percent scored in the clinical range for depression and 24.1 percent for anxiety. The authors stress that these are concurrent associations in a cross-sectional survey: the data cannot show whether this combination of strategies contributes to psychological difficulties, emerges in response to them, or reflects reciprocal processes, and the emotion-regulatory function of self-injury was not directly assessed.

Correlational results reinforced the profile picture. Rumination and negative thinking showed the strongest links to problems, correlating positively with anxiety, depression, and self-injury at roughly 0.37 to 0.65 and negatively with life satisfaction. Positive reorientation correlated positively with life satisfaction and negatively with internalizing symptoms. Aggressive outlet was consistently associated with difficulties. Creative expression was more ambiguous, appearing weakly to moderately related to anxiety, depression, and self-injury, particularly among boys. Notably, creative expression appeared in both a favourable profile, the Multiple Strategy group, and the poorest-outcome profile, suggesting its meaning depends on context: paired with rumination and aggression it accompanied severe difficulties, while paired with positive reorientation, distraction, and social support it did not.

The Minimal Strategy result is perhaps the most provocative. Previous person-centred studies have linked low-engagement profiles to both better and worse adjustment, and the authors propose several explanations that remain speculative. Adolescents reporting minimal strategy use may experience lower emotional intensity or fewer stressors, reducing the need for active regulation, or their regulation may be relatively automatic and not fully captured by self-report. Because baseline emotional intensity was not measured, the study cannot distinguish regulatory tendencies from differences in exposure to emotionally challenging situations. The authors explicitly call for longitudinal research to determine whether minimal strategy use reflects an adaptive pattern or a vulnerability that emerges over time.

A six-profile solution was also tested. Although it showed lower information criteria, the LMR test was not significant, and classification quality was comparable, so the more parsimonious five-profile solution was retained. The six-profile version mainly split the Creative Rumination-Aggression group into one configuration retaining elevated creative expression and another, labelled Aggressive Outlet–Focused, characterized by elevated aggression without high creative expression or rumination. Both solutions showed good classification quality, with entropies of 0.81 and 0.80 respectively, and the authors regard the six-profile alternative as potentially meaningful but requiring replication.

The authors emphasize several limitations. The cross-sectional design precludes conclusions about directionality or developmental change, causal relationships cannot be inferred, and latent profiles represent the most likely patterns in this sample rather than fixed categories. Regulatory flexibility was not measured, so broad strategy use should not be read as evidence of adaptability, and emotional awareness was not assessed, which may affect the precision of self-reported strategy use. The profiles are not definitive and may differ in other samples, age groups, or with other measures. The findings should not be interpreted as clinical risk profiles, though if replicated in longitudinal and clinical samples they could inform school-based prevention targeting rumination and strengthening adaptive strategies. Replication in independent samples and cultural contexts, along with intervention studies tracking whether changes in strategies accompany changes in psychological functioning, are the stated next steps.

Subject of Research: Person-centred identification of emotion regulation strategy profiles among Swedish adolescents and their concurrent associations with mental health outcomes

Article Title: Mapping emotion regulation profiles in adolescence and examining their associations with mental health outcomes

Article References: Nilsson, M., Segercrantz Walther, E., Willkomm, L., Bjärehed, J., & Daukantaitė, D. (2026). Mapping emotion regulation profiles in adolescence and examining their associations with mental health outcomes. Child and Adolescent Psychiatry and Mental Health, 20(1), Article 134. https://doi.org/10.1186/s13034-026-01180-8

Image Credits: AI Generated

DOI: 10.1186/s13034-026-01180-8

Keywords: emotion regulation, adolescence, latent profile analysis, mental health, rumination, non-suicidal self-injury, anxiety, depression, life satisfaction, creative expression, cross-sectional study, Sweden