Background: The management of emergency presentations at child and adolescent psychiatric outpatient clinics, by children and adolescents with self-injurious thoughts and behaviors, represents very responsible tasks but also offers the opportunity for immediate interventions. The stability and degree of emotional reactivity (ER) is a significant psychopathological symptom for development and maintenance of self-injurious behavior, differentiating between those who have continued to injure themselves and those who have not. In general, the relationship between ER and self-injurious behavior has been shown to be bidirectional. However, the stability of ER over time, as well as important predictors for ER itself have not been investigated so far. Therefore, this present study aimed at investigating the stability of ER over time and the relationship between non-suicidal self-injury (NSSI) and ER. Reinforcement functions and several variables of psychological functioning were considered as possible influencing factors.

Methods: As part of a longitudinal study, 97 adolescents aged 11–18 years who presented due to self-injurious thoughts or behaviors underwent standardized emergency management. This included a specified detailed psychiatric assessment at baseline (including the Emotion Reactivity Scale, ERS, and the Self-Injurious Thoughts and Behaviors Interview, SITBI) and treatment recommendations. These were followed by a catamnestic examination with two follow-up appointments. Changes over time in ER, NSSI, reinforcement functions of NSSI and general indicators of psychological functioning (General Severity Index, GSI) were examined and significant correlations were followed up by a linear-mixed effect model predicting the ERS score over time.

Results: Data analysis revealed a statistically significant decrease in ERS scores and GSI over time. However, reinforcement functions for and the symptomatology of NSSI did not change. Furthermore, no predictive relationship from ER to NSSI could be identified. A linear-mixed effect model predicting the ERS identified the GSI, automatic positive reinforcement (as a reinforcement function for NSSI) and age as the only significant predictors.

Conclusion: Results demonstrate the importance of NSSI reinforcement functions for heightened emotional reactivity and emphasize their role as a point for therapeutic intervention by providing alternatives to NSSI and thereby possibly reducing emotional reactivity.

The development of emotion regulation (ER) is associated with children’s and adolescents’ psychosocial adjustment and well-being. In this regard, previous studies have examined the role of different ER strategies, which can be characterized as being functional (e.g., reappraisal, problem solving) or dysfunctional (e.g., suppression, rumination). Based on the process model of emotion regulation, the strategies can also be classified according to their temporal position within the emotion generative process, with five families of ER strategies being proposed: situation selection, situation modification, attentional deployment, cognitive change, and response modulation. This study aimed to examine the role of ER for adolescents’ psychosocial adjustment (internalizing and externalizing problems, prosocial behavior) and well-being. First, associations were investigated on a more general level by distinguishing between functional and dysfunctional ER. Second, relations were examined on a more specific level by additionally distinguishing between the five families of ER strategies as suggested in the process model of ER. Questionnaire self-reports of N = 1,727 German children and adolescents (55% girls) aged 9–18 years (M = 13.03, SD = 1.75) collected in schools were analyzed. Path analyses showed that more functional and less dysfunctional ER in general is associated with fewer internalizing and externalizing symptoms, and higher well-being. Prosocial behavior was only positively related to functional but not dysfunctional ER. Analyses of associations on the level of specific categories of ER strategies generally showed a similar pattern, but in part indicated differential associations with the dependent variables: Internalizing problems were particularly associated with functional situation selection, dysfunctional cognitive change, and dysfunctional response modulation. Externalizing problems were associated with functional situation selection and response modulation, as well as numerous dysfunctional strategies, none of which were particularly salient. Similarly, numerous rather than single specific associations emerged between prosocial behavior and the five categories of functional ER strategies. Well-being was particularly associated with functional situation selection and dysfunctional cognitive change. Overall, a more precise assessment of ER, as implemented in this study, could not only advance research in this field, but can also be helpful in planning and evaluating prevention and intervention programs.