Children who struggle to regulate their emotions at age seven are more likely to experience anxiety and depression throughout adolescence, even after accounting for pre-existing mental health difficulties, according to new research published in the Journal of Affective Disorders.

Anxiety and depression are among the leading health burdens facing young people worldwide. These conditions often emerge or worsen during the transition from childhood to adolescence—a developmentally sensitive period when the brain is rapidly changing and young people face increasing social and academic pressures. One strong candidate leaving adolescents vulnerable to these mental health conditions is emotion regulation: the ability to manage and respond to emotional experiences in a healthy and appropriate manner.

Previous research has linked poor emotion regulation—such as experiencing intense mood swings, acting without thinking, or becoming easily overwhelmed—to mental health difficulties in young people. However, most studies have been short-term or unable to distinguish a genuine causal relationship from the effects of other variables that affect both emotional development and mental health (such as poverty or a harsh home environment).

Led by Aja Murray of the Department of Psychology at the University of Edinburgh, researchers sought to investigate whether childhood emotion dysregulation genuinely causes internalising problems later in life, and whether addressing it early could serve as a meaningful prevention target.

The team used data from the UK Millennium Cohort Study, a large-scale nationally representative study tracking thousands of children born in Britain at the start of this century. The analysis included between 6,394 and 11,178 children, depending on the age and data source for each outcome.

Emotion dysregulation was assessed by parents when children were 7 years old. Mental health outcomes were then measured at ages 11, 14, and 17 using a widely used questionnaire that captured symptoms such as frequent worrying, unhappiness, nervousness in new situations, and unexplained physical complaints. Ratings were provided by parents, teachers, and the young people themselves at different time points.

Rather than using standard statistical techniques, which are vulnerable to confounding by background factors, Murray and her team employed a sophisticated method known as counterfactual analysis. This approach is designed to mimic, as closely as possible, the conditions of a randomised controlled trial. The algorithm mathematically grouped children who shared similar backgrounds and early life experiences—accounting for potential confounders including prior mental health, parenting style, socioeconomic disadvantage, sleep habits, and cognitive ability—but who differed in how well they regulated their emotions at age 7.

The results demonstrated a consistent, statistically significant relationship: children with greater emotional dysregulation at age 7 had higher levels of anxiety and depression at age 11 (as rated by parents), age 14 (as rated by parents), and age 17 (as rated by both parents and the young people themselves).

Teacher reports at age 11 did not reach significance, which the researchers attributed largely to a smaller available sample size rather than a true absence of effect.

“Emotion (dys-)regulation in childhood may be a causal factor in internalising problems in adolescence and therefore a promising intervention target,” the authors concluded. “Effects were present until age 17 suggesting a sustained benefit of better emotion regulation in childhood; however, they were modest in magnitude, highlighting that targeting emotion (dys-)regulation alone is unlikely to protect young people against the onset or escalation of internalising problems in adolescence.”

Murray and colleagues noted some limitations, including the inability to fully rule out unmeasured confounders—an inherent challenge in all observational research. The study also relied on broad questionnaire measures that could not distinguish between anxiety and depression separately. Finally, because the researchers heavily relied on parent reports to determine both the child’s emotional regulation and the resulting mental health outcomes, they warn that the data could be subject to “common rater bias,” which can artificially inflate the strength of the relationship.

The study, “Is emotion dysregulation in childhood a precursor to internalising problems in adolescence?“, was authored by Aja Murray, Helen Wright, Hannah Casey, Josiah King, Xinxin Zhu, Yi Yang, Zhuoni Xiao, and Xuefei Li.