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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

CiteScore 2018: 0.79

SCImago Journal Rank (SJR) 2018: 0.350
Source Normalized Impact per Paper (SNIP) 2018: 0.476

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The mediating role of difficulties in emotion regulation on attachment styles of adolescents with conduct disorders

Mojtaba Yaghoubipoor / Seyed Hamid Seyed Bagheri
  • Corresponding author
  • Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran, Phone: +98 09131998601, Fax: +98 34 34335600
  • Department of Pediatric Nursing, Nursing and Midwifery School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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/ Hadi Khoshab
Published Online: 2019-07-08 | DOI: https://doi.org/10.1515/ijamh-2018-0260


Adolescence is a period of achieving emotion regulation skills. One of the main responsibilities of adolescents is to learn adaptive emotion regulation and personal autonomy. The purpose of this study was to investigate the mediating role of difficulties in emotion regulation in the attachment styles of adolescents with conduct disorders. This was a cross-sectional and correlational study. The study consisted of 105 adolescent residing in detention centers in the southeast of Iran using multi-stage random sampling. Data were collected using various questionnaires such as the Inventory of Parents and Peer Attachment-Revised (IPPA-R), the Difficulties of Emotion Regulation Scale (DERS), and the Strength and Difficulties Questionnaire (SDQ). Information was analyzed using path analysis. The results show parental attachment and difficulties in emotion regulation significantly contribute to the prediction of conduct problems. A sense of alienation causes conduct disorders through disturbance in emotional regulation, but trust and communication with parents are only indirectly related to conduct disorders by disturbances in emotional regulation. As attachment is closely correlated with emotional regulation and difficulties in emotion regulation also lead to the conduct disorders, it is suggested to train emotion regulation in adolescents and their families with the aim of shaping relationships that will lead to the formation of a secure attachment style in the child.

Keywords: adolescents; attachment styles; conduct disorder; emotion regulation


  • [1]

    Avenevoli S, Steinberg L. The continuity of depression across the adolescent transition. Adv Child Dev Behav. 2002;28(C):139–73.CrossrefGoogle Scholar

  • [2]

    Andersen SL, Teicher MH. Stress, sensitive periods and maturational events in adolescent depression. Trends Neurosci. 2008;31(4):183–91.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [3]

    Kolp HM, Hershberger AR, Sanders J, Um M, Aalsma M, Cyders MA. Conduct disorder symptoms and illicit drug use in juvenile justice involved youth: the reciprocal relationship between positive illicit Drug-use attitudes and illicit drug use. Subst Use Misuse. 2017;53(8):1252–9.Web of SciencePubMedGoogle Scholar

  • [4]

    Steinberg L. Is Decision making the right framework for research on adolescent risk taking? Reducing adolescent risk: toward an integrated approach [Internet]. 2003;18–24. Available from: http://sk.sagepub.com/books/reducing-adolescent-risk/n3.xml.

  • [5]

    Moghadam HS, Bakhshipour A, Jamalpour Y, Nazari MA. Comparing executive function between adolescents with conduct disorder and the normal ones in Iranian population. Iranian J Psych Behav Sci. 2017;11(1):1–6.Google Scholar

  • [6]

    Baker K. Conduct disorders in children and adolescents. Paediatr Child Health (United Kingdom). 2016;26(12):534–9.CrossrefGoogle Scholar

  • [7]

    Salmanian M, Asadian-Koohestani F, Mohammadi MR. A systematic review on the prevalence of conduct disorder in the Middle East. Soc Psychiatry Psychiatr Epidemiol. 2017;52(11):1337–43.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [8]

    Bowen E. Conduct disorder symptoms in pre-school children exposed to intimate partner violence: gender differences in risk and resilience. J Child Adolesc Trauma. 2017;10(2):97–107.CrossrefGoogle Scholar

  • [9]

    Diamond LM, Hicks AM. Attachment style, current relationship security, and negative emotions: the mediating role of physiological regulation. J Soc Pers Relat. 2005;22(4):499–518.CrossrefGoogle Scholar

  • [10]

    Oshri A, Sutton TE, Clay-Warner J, Miller JD. Child maltreatment types and risk behaviors: associations with attachment style and emotion regulation dimensions. Pers Individ Dif. 2015;73:127–33.CrossrefGoogle Scholar

  • [11]

    Nielsen SK, Lønfeldt NN, Wolitzky-Taylor KB, Hageman I, Vangkilde S, Daniel SIF. Adult attachment style and anxiety – the mediating role of emotion regulation. J Affect Disord. 2017;218:253–9.Web of ScienceCrossrefPubMedGoogle Scholar

  • [12]

    Prosen S, Vitulić HS. Emotion regulation and coping strategies in pedagogical students with different attachment styles. Jpn Psychol Res. 2016;58(4):355–66.Web of ScienceCrossrefGoogle Scholar

  • [13]

    Ghiasi H, Mohammadi A, Zarrinfar P. An investigation into the roles of theory of mind, emotion regulation, and attachment styles in predicting the traits of borderline personality disorder. Iran J Psychiatry. 2016;11(4):206–13.PubMedGoogle Scholar

  • [14]

    Meredith P, Ownsworth T. A review of the evidence linking adult attachment theory and chronic pain: presenting a conceptual model. Clini Psychol Rev. 2008;28(3):407–29.CrossrefGoogle Scholar

  • [15]

    Bost KK, Wiley AR, Fiese B, Hammons A, McBride B, Harrison K, et al. Associations between adult attachment style, emotion regulation, and preschool children’s food consumption. J Dev Behav Pediatr. 2014;35(1):50–61.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [16]

    Denham SA. Emotional development in young children. Guildford: Guilford Press, 1998. 260 pp.Google Scholar

  • [17]

    Passamonti L, Fairchild G, Fornito A, Goodyer IM, Nimmo-Smith I, Hagan CC, et al. Abnormal anatomical connectivity between the amygdala and orbitofrontal cortex in conduct disorder. PLoS One. 2012;7(11):e48789.PubMedWeb of ScienceGoogle Scholar

  • [18]

    Raine A. An amygdala structural abnormality common to two subtypes of conduct disorder: a neurodevelopmental conundrum. Am J Psychiatry. 2011;168(6):569–71.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [19]

    van der Meer LB, van Duijn E, Giltay EJ, Tibben A. Do attachment style and emotion regulation strategies indicate distress in predictive testing? J Genet Couns. 2015;24(5):862–71.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [20]

    Spinrad TL, Eisenberg N, Cumberland A, Fabes RA, Valiente C, Shepard SA, et al. Relation of emotion-related regulation to children’s social competence: a longitudinal study. Emotion. 2006;6(3):498–510.PubMedCrossrefGoogle Scholar

  • [21]

    Cole PM, Zahn-Waxler C, Smith KD. Expressive control during a disappointment: variations related to preschoolers’ behavior problems. Dev Psychol. 1994;30(6):835–46.CrossrefGoogle Scholar

  • [22]

    Bohnert AM, Crnic KA, Lim KG. Emotional competence and aggressive behavior in school-age children. J Abnorm Child Psychol. 2003;31(1):79–91.PubMedCrossrefGoogle Scholar

  • [23]

    Dearing KF, Hubbard JA, Ramsden SR, Parker EH, Relyea N, Smithmyer CM, et al. Children’s self-reports about anger regulation: direct and indirect links to social preference and aggression. Merrill-Palmer Q (1982-). 2002;308–36.Google Scholar

  • [24]

    Armsden GC, Greenberg MT. The inventory of parent and peer attachment : individual differences and their relationship to psychological well-being in adolescence. J Youth Adolesc. 1987;16(5):427–54.PubMedCrossrefGoogle Scholar

  • [25]

    Gullone E, Robinson K. The Inventory of Parent and Peer Attachment – Revised (IPPA-R) for children: a psychometric investigation. Clin Psychol Psychother. 2005;12(1):67–79.CrossrefGoogle Scholar

  • [26]

    Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004;26(1):41–54.CrossrefWeb of ScienceGoogle Scholar

  • [27]

    Azizi A, Mirzaei A, Shams J. Correlation between distress tolerance and emotional regulation with students smoking dependence. Hakim Research Journal [Internet]. 2010;13(1):11–8. Available from: http://hakim.hbi.ir/browse.php?a_code=A-10-5-427&slc_lang=fa&sid=1 [in persian].

  • [28]

    Goodman R, Meltzer H, Bailey V. The strengths and difficulties questionnaire: a pilot study on the validity of the self-report version. Int Rev Pssychiatry. 2003;15(1):173–7.CrossrefGoogle Scholar

  • [29]

    Becker A, Hagenberg N, Roessner V, Woerner W, Rothenberger A. Evaluation of the self-reported SDQ in a clinical setting: do self-reports tell us more than ratings by adult informants? Euro Child Adolesc Psychiatry. 2004;13(Suppl 2):17–24.Google Scholar

  • [30]

    Mashhadi A, Mohamadi M. Comparison of attachment styles in normal and delinquent adolescents. Educational studies and psychology. 2010;10(3):27–40.Google Scholar

  • [31]

    Tehrani Doust M, Shahrivar Z. Validity of farsi version of strengths and difficulties questionnaire (SDQ). Adv Cogn Sci. 2007;8(4):33–9.Google Scholar

  • [32]

    Pourmohseni Koluri F, Irani Kolur SA, Tehranizade M. The role of attachment styles and emotion regulation strategies in prediction of Emotional-behavioral problems in foster care and non-foster care adolescents. J 491 Fam Res. 2016;11(4):491–512.Google Scholar

  • [33]

    Borna MR, Hamid N, Hayati D. The predictive role of personality traits, cognitive strategiesof emotion regulation, attachment styles, and brain-behavioral systems in active and non-active addiction and impulsiveness potential. Quarter J Res Addict. 2016;10(37):174–51.Google Scholar

  • [34]

    Shabani H, Mirzaian B, Sangani AR. Structural equation modeling of schemas and attachment styles with additional potential through the mediation of stress coping strategies, cignitive emotion regulation, and loneliness among the addicts under treatment. Q J Res Addict. 2017;11(43).Google Scholar

  • [35]

    Grisham JR, Martyn C, Kerin F, Baldwin PA, Norberg MM. Interpersonal functioning in Hoarding Disorder: an examination of attachment styles and emotion regulation in response to interpersonal stress. J Obsess Compuls Relat Disord. 2018;16:43–49.CrossrefWeb of ScienceGoogle Scholar

  • [36]

    van der Meer L, van Duijn E, Giltay EJ, Tibben A. Do attachment style and emotion regulation strategies indicate distress in predictive testing ? J Genet Counsel. 2015;24:862–71.CrossrefGoogle Scholar

  • [37]

    Forslund T, Brocki KC, Bohlin G, Granqvist P, Eninger L. The heterogeneity of attention-deficit / hyperactivity disorder symptoms and conduct problems : cognitive inhibition, emotion regulation, emotionality, and disorganized attachment. Br J Dev Psychol. 2016;34:1–17.Web of ScienceGoogle Scholar

  • [38]

    Poursina Z. Mediating role of emotional security in relationship between family functioning and child’s behavioral problems. Fam Psychol. 2015;1(2):69–78.Google Scholar

  • [39]

    Sigfusdottir ID, Bjork B, Hildigunnur A, Hall A, Sigurdsson JF, Young S, et al. An epidemiological study of ADHD and conduct disorder : does family conflict moderate the association ? Soc Psychiatry Psychiatr Epidemiol. 2017;52(4):457–64.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [40]

    Zarei E, Heydari H. The role of attachment styles in predicting of conduct disorder among students. Q J Child Psychol Dev. 2015;1(1).Google Scholar

  • [41]

    Besharat MA, Farahman H. The mediating role of difficulties in emotion regulation on the relationship between attachment pathologies and symptoms of depression and anxiety. J Thought Behav Clin Psychol. 2017;11(44).Google Scholar

  • [42]

    Sepehrian Azar F, Asadi Majreh S. The relationship between attachment and coping styles with emotion dysregulationin adolescence. J Urmia Univ Med Sci. 2014;25(10):922–30.Google Scholar

  • [43]

    Rolon B, David A, Rosanna HA, Elizabeth PB. Reciprocal relations between parenting behaviors and conduct disorder symptoms in preschool children. Child Psychiatry Hum Dev. 2018;49(5):786–99.Web of SciencePubMedCrossrefGoogle Scholar

  • [44]

    Taheri M. Comparison of executive functions and cognitive-emotional adjustment skills in adolescents with behavioral disorder and normal. J N Adv Behav Sci. 2017;2(9).Google Scholar

  • [45]

    Oakley C, Harris S, Fahy T, Murphy D, Picchioni M. Childhood adversity and conduct disorder : a developmental pathway to violence in schizophrenia. Schizophr Res. 2016;172:1–6.Web of ScienceGoogle Scholar

  • [46]

    Prosen S, Smrtnik Vitulic H. Emotion regulation and coping strategies in pedagogical students with different attachment styles. 1–3.Google Scholar

  • [47]

    Ghasempour A, Ramzani V. The comparison of emotion cognitive regulation strategies and impulsivity in normal adolescents and with attention deficit/hyperactivity disorder. Razi J Med Sci. 2015;22(137):9–18.Google Scholar

  • [48]

    Rezaeian H, Mohsseni N, Mohammadi M. Evaluation of casual model of family variables and self-understanding with conduct disoders. Hakim Res J. 2006;9(3):32–8.Google Scholar

About the article

Received: 2018-11-17

Accepted: 2018-12-03

Published Online: 2019-07-08

Funding: This research received no specific grant from any funding agency in the public, commercial, or not for-profit sectors.

Declaration of interest: The authors declare that they have no competing interests.

Citation Information: International Journal of Adolescent Medicine and Health, 20180260, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2018-0260.

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