Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology
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Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and "at-risk" remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology.
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ED may mediate the relationship between environmental stressors-such as trauma, neglect, or peer victimization-and later psychiatric outcomes.
“From a mechanistic perspective, ED may mediate the relationship between environmental stressors-such as trauma, neglect, or peer victimization-and later psychiatric outcomes.”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [34]
The Discussion (page not provided) reports that emotion dysregulation partially mediated the association between lifetime cumulative adversity and depressive symptoms in early and middle adulthood. The paper also discusses evidence for mediation in the broader stress–psychopathology relationship, but its own finding does not establish mediation for peer victimization specifically or for later psychiatric outcomes generally. (LLM, conf=0.82)
Experimental — accuracy not yet measuredED has been consistently associated with impaired academic performance, interpersonal difficulties, and a higher risk of psychiatric comorbidities.
“It has been consistently associated with impaired academic performance, interpersonal difficulties, and a higher risk of psychiatric comorbidities [34-36].”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [34]
The paper’s discussion of emotion regulation and psychiatric symptoms (section labeled Abstract; page unavailable) supports an association with psychiatric difficulties, and its study links emotion dysregulation with depressive symptoms. Our copy does not support the attributed associations with impaired academic performance or interpersonal difficulties; those outcomes are not reported in the cited passages or targeted searches. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEarly adversity disrupts normative emotion regulation development, increasing vulnerability to depression, anxiety, and behavioral problems.
“Several studies suggest that early adversity disrupts normative emotion regulation development, increasing vulnerability to depression, anxiety, and behavioral problems [34,35].”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [34]
The Abstract links repeated stressful events to disrupted emotion regulation and vulnerability to depression, and the Discussion describes emotion dysregulation as a risk factor for diverse psychopathologies. But the paper examines lifetime cumulative adversity, not disruption of normative emotion-regulation development specifically after early adversity; the cited passages also do not establish the claimed anxiety and behavioral outcomes. The indexed copy provides section labels but no page numbers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe degree of emotion dysregulation correlates positively with the severity of depressive and anxiety symptoms.
“the experience of emotion dysregulation is also positively associated with depressive and anxiety symptom severity.31–33”
From A meta-analysis of emotional regulation outcomes in psychological interventions for youth with depression and anxiety (2021) · cites this paper as [31]
Emotion dysregulation mediates the link between cumulative adversity in lifetime and depressive symptoms.
“and also the link between cumulative adversity in lifetime and depressive symptoms (Abravanel and Sinha, 2015).”
From Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies (2017) · cites this paper as Abravanel and Sinha, 2015
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- Authors
- Abravanel, B. T., & Sinha, R.
- Affiliations
- Yale University (US)
- Corresponding author
- Sinha, Rajita
- ORCID
- Sinha, Rajita
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 61
- Pages
- 89-96
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC4308421
- OpenAlex
- W1994490855
- Cited by
- 109
- References
- 83
- Citations by year
- 2026: 11 · 2025: 10 · 2024: 12 · 2023: 14 · 2022: 8 · 2021: 18 · 2020: 13 · 2019: 6 · 2018: 5 · 2017: 8 · 2016: 2 · 2015: 2
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (DK099039)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- cumulative adversity, emotional dysregulation, depressive symptoms, depression risk, life events, mediation, emotion regulation, stress reduction intervention, depression prevention
- MeSH terms
- Adaptation, Psychological, Adult, Depression, Emotions, Female, Humans, Interpersonal Relations, Life Change Events, Male, Personality Inventory, Risk Factors, Social Perception, Young Adult
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