A Systematic Review of Associations Between Adverse Peer Experiences and Emotion Regulation in Adolescence

Abstract

Adolescence is a developmental period marked by changes in cognition, emotion, and social relations. For example, sensitivity to social feedback increases as peer relationships become more important yet less stable, leaving adolescents vulnerable to experiences of peer victimization and rejection. Given that prefrontal brain regions responsible for regulatory abilities continue to mature during adolescence, the brain is especially susceptible to environmental influences. As such, exposure to adverse peer experiences may undermine emotion regulation development. Thus, the present review sought to elucidate the association between adverse peer experiences and emotion regulation in adolescence (i.e. age 12–17 years). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature assessing adverse peer experiences (victimization and rejection) and emotion regulation (including neurobiological, behavioral, cognitive levels of analysis) was conducted (Narticles included = 27). Results demonstrate that adverse peer experiences are negatively associated with emotion regulation processes, behaviorally and neurally. Although variability in definitions and measurement of constructs make nuanced comparisons between studies difficult, the present systematic review organizes this body of literature and discusses how promising theoretical perspectives, including the cognitive control of emotion model and social information processing theory, may help to explain this association. Finally, recommendations for future work to expand our understanding of these processes, and for intervention and prevention efforts (e.g., school-based violence prevention and socio-emotional learning programs, parenting practices) that may serve to ameliorate outcomes for youths facing adverse peer experiences and emotion dysregulation, are discussed.

Full text

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Clinical Child and Family Psychology Review (2021) 24:141–163
https://doi.org/10.1007/s10567-020-00337-x
A Systematic Review ofAssociations Between Adverse Peer
Experiences andEmotion Regulation inAdolescence
ToriaHerd1 · JungmeenKim‑Spoon1
Accepted: 6 December 2020 / Published online: 11 January 2021
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021
Abstract
Adolescence is a developmental period marked by changes in cognition, emotion, and social relations. For example, sensitiv-
ity to social feedback increases as peer relationships become more important yet less stable, leaving adolescents vulnerable
to experiences of peer victimization and rejection. Given that prefrontal brain regions responsible for regulatory abilities
continue to mature during adolescence, the brain is especially susceptible to environmental influences. As such, exposure
to adverse peer experiences may undermine emotion regulation development. Thus, the present review sought to elucidate
the association between adverse peer experiences and emotion regulation in adolescence (i.e. age 12–17years). Following
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of
the literature assessing adverse peer experiences (victimization and rejection) and emotion regulation (including neurobio-
logical, behavioral, cognitive levels of analysis) was conducted (Narticles included = 27). Results demonstrate that adverse peer
experiences are negatively associated with emotion regulation processes, behaviorally and neurally. Although variability in
definitions and measurement of constructs make nuanced comparisons between studies difficult, the present systematic review
organizes this body of literature and discusses how promising theoretical perspectives, including the cognitive control of
emotion model and social information processing theory, may help to explain this association. Finally, recommendations for
future work to expand our understanding of these processes, and for intervention and prevention efforts (e.g., school-based
violence prevention and socio-emotional learning programs, parenting practices) that may serve to ameliorate outcomes for
youths facing adverse peer experiences and emotion dysregulation, are discussed.
Keywords Adolescence· Emotion regulation· Peer victimization· Peer rejection
Emotion regulation (ER) has long been recognized as a
trans-diagnostic predictor of psychopathology and malad-
justment outcomes across development (Cole etal. 2017).
It is therefore important for research to elucidate how ER
development unfolds, including the extent to which specific
environmental factors may impair or enhance it, as these
factors may be informative for prevention and interven-
tion work aimed at reducing negative outcomes associated
with emotion dysregulation. The developmental period of
adolescence, in particular, brings with it novel changes in
cognition, emotion, and social relations that leave adoles-
cents vulnerable to difficulties with ER. For example, pre-
vious research has suggested that susceptibility to adverse
peer experiences, including peer victimization and rejec-
tion, during adolescence heightens the risk of experiencing
difficulties with ER (Adrian etal. 2019; Herts etal. 2012;
McLaughlin etal. 2009). Thus, the current review sought to
evaluate the state of the literature linking adverse peer expe-
riences and ER, focusing on measurement and methodology
issues, the directionality of the association between adverse
peer experiences and ER, the role of risk and protective
factors, and their implications for preventive intervention
efforts that promote positive developmental outcomes for
adolescents.
Emotion Regulation
ER can be defined as the internal and external processes
involved in modifying the experience or expression
of an emotion (Thompson 1994). In contrast, emotion
* Toria Herd
tiherd@vt.edu
1 Department ofPsychology (MC 0436), Virginia Tech,
Blacksburg, 24061, Virginia, USA
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142 Clinical Child and Family Psychology Review (2021) 24:141–163
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dysregulation occurs when strategies employed to manage
emotions are unsuccessful in the long-term, or success-
ful in the short-term but with consequences for long-term
well-being (Cole etal. 2017). Adolescence is a particularly
important developmental period for examining ER because
of the introduction of novel social and emotional situations
that require advanced cognitive control abilities for more
adaptive ER, including increases in autonomy in navigating
certain contexts, sensation seeking and risk taking, reorgani-
zation of relationships, and identity formation (McRae etal.
2012; Steinberg 2005). Furthermore, adolescence is often
characterized by greater fluctuations in emotions relative
to earlier developmental periods, (Maciejewski etal. 2015)
and by the introduction of new and increased intensity in
emotions (i.e., romantic feelings, hopelessness; Morris etal.
2007). Finally, brain regions thought to be associated with
ER, particularly the prefrontal cortex, continue to mature
throughout adolescence, yielding potential for more refined
and adaptive regulatory strategies (McRae etal. 2012; Stein-
berg 2005).
Prior research has considered how ER may be linked to
the emergence of adjustment difficulties during adolescence.
That is, the inability to regulate emotions in an adaptive
way has been linked to a myriad of negative outcomes such
as internalizing and externalizing psychopathology (Aldao
etal. 2016; Morris etal. 2010; Silk etal. 2003), poorer aca-
demic outcomes (Gumora and Arsenio 2002), and worse
relationship quality (Farley and Kim-Spoon 2014). Thus,
determining factors related to the development of individual
differences in ER abilities is important given the relevance
of ER in explaining numerous adjustment difficulties.
Adverse Peer Experiences andEmotion
Regulation
Extant research has identified the social context as an
important contributing factor to the development of ER,
suggesting that adaptive and effective ER depends on posi-
tive social interactions (Fosco and Grych 2012; Morris
etal. 2007; Thompson 1994). Given that social agents often
serve as role models for ER abilities and are crucial sources
of external ER for youths, it is important to consider how
changes in social context may influence ER development.
One prominent social context to consider in adolescence is
the peer context (Smetana etal. 2006). In particular, adverse
peer experiences encompassing both peer rejection and peer
victimization appear to be critical for ER development dur-
ing adolescence. We focused on peer victimization and peer
rejection as these constructs share key factors involving an
intent to cause harm and an imbalance of power between
perpetrator and victim (Graham and Bellmore 2007), thus
differentiated from other forms of adverse peer experiences,
such as peer conflicts. Though related, peer victimization
focuses on an individuals’ exposure to negative behaviors
from peers (including overt and relational aggression; i.e.,
name calling, social exclusion, physical attacks), whereas
peer rejection refers to the group-level dislike of an indi-
vidual (Lopez and DuBois 2005). Moving from childhood
into adolescence, social exclusion becomes a more salient
tactic of peer victimization, and peer rejection may take
place within groups with a greater number of peers than
previously (Lopez and DuBois 2005). Regardless, exposure
to adverse peer experiences has extensive implications for
adjustment difficulties (Graham and Bellmore 2007), such
as anxiety and depression (Adrian etal. 2019), aggression
(Herts etal. 2012), post-traumatic symptoms (Crosby etal.
2010), and substance use (Topper etal. 2011). In sum, peer
contexts represent an important source of influence on ado-
lescents’ behaviors with broad implications for both posi-
tive and negative consequences of psychosocial development
(Poulan and Chan 2010).
Previous research indicates that adverse peer experiences
have important implications for emotional development.
Adolescents look to peers for a sense of inclusion and secu-
rity, which are essential for positive emotional development.
While increased sensitivity to peer evaluation and feedback
during adolescence is typical, often shaping social inter-
actions and adjustment—with peer acceptance predicting
higher levels of social competence and self-esteem—peer
rejection can serve as fodder for heightened negative emo-
tions that are difficult to regulate and can predict further
maladaptive outcomes (Guyer etal. 2014; Rubin etal. 2006).
For example, adolescents who report high levels of peer vic-
timization also report high levels of emotion dysregulation
(McLaughlin etal. 2009; Morelen etal. 2016), rumination,
and poor emotional awareness (Herts etal. 2012). There is
also evidence that peer rejection may influence neurobio-
logical systems related to emotional reactivity and regula-
tion (Jankowski, etal. 2018; Masten etal. 2013; Miller etal.
2018; Rudolph etal. 2016). Furthermore, adverse peer expe-
riences seem to be indirectly related to both internalizing
and externalizing symptomatology via emotion dysregula-
tion (Herts etal. 2012; McLaughlin etal. 2009; Schwartz
and Proctor 2000). Taken together, these studies identify ER
as a potential mechanism underlying the association between
adverse peer experiences and psychopathology, suggesting
that the ability to regulate emotions in response to interper-
sonal stressors is crucial for healthy development.
A number of theories have been proposed to explain how
adverse peer experiences may be related to ER. Broadly,
cognitive-behavioral models emphasize the interrelatedness
of cognitions, emotions, and behaviors, with individuals’
perceptions of, or spontaneous thoughts about situations
influencing their emotional and behavioral reactions. How-
ever, if individuals’ beliefs about themselves or others are
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143Clinical Child and Family Psychology Review (2021) 24:141–163
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distorted, which is especially likely to occur in distressing
situations, emotional and behavioral reactions can become
dysfunctional. Others’ responses to these dysfunctional
reactions can create a negative feedback loop in which the
distorted beliefs are confirmed and give rise to greater dys-
functional reactions, with implications for clinical outcomes
(Kalodner 2011). To understand the mechanisms involved
in the link between adverse peer experiences and emotion
dysregulation (cognitive, emotionally, and behaviorally),
methodological approaches that integrate biological, cogni-
tive, social, and emotional processes will allow for a more
nuanced understanding of the multiple, yet linked, pathways
through which this association may occur.
First, the cognitive control of emotion model (Ochsner
etal. 2012) describes both neural and behavioral methods of
capturing ER, suggesting that the demands placed on regu-
latory functions to dampen emotional responses are great.
As a result, sustained negative affect resulting from adverse
peer experiences may overwhelm and prohibit the ability to
engage in adaptive ER strategies involving re-interpretation
of emotion-eliciting situations in ways that limit emotional
responses (Ochsner and Gross 2005). Indeed, evidence from
functional neuroimaging studies describe brain activity fol-
lowing adverse peer experiences in regions that support ER,
including the striatum, prefrontal cortex, and orbitofrontal
cortex (Moor etal. 2010). Second, social information pro-
cessing models (Dodge and Crick 1990) suggest that biases
in processing (i.e., hypervigiliance to threat) may provoke
dysregulated emotions and behaviors (i.e., emotion dysregu-
lation, aggression) in response to any provocation interpreted
as hostile, resulting in increased risk for peer victimization.
These models emphasize that the way emotions are regulated
influence social interactions (Vranjes etal. 2018). That is,
as adolecents rapidly adjust to social evaluations, they use a
range of affective, cognitive, and social processes to update
their expectations and decide how to respond in each social
situation (Guyer etal. 2012). Third, social learning theory
posits that low levels of self-efficacy—personal judgements
regarding how well one can respond to challenges—sig-
nal increased emotion dysregulation in response to stress
(Bandura 1977). That is, adolescents with lower levels of
self-efficacy who are faced with adverse peer experiences
may experience greater stress and dysregulation. Finally,
ego depletion theories posit that self-regulatory skills draw
upon a limited amount of cognitive resources (Baumeister
2002; Inzlicht etal. 2006). Adverse peer experiences may
then increase emotional reactivity to the point that overuse
of regulatory resources leads to deficits in ER. Indeed, extant
research has indicated that adverse peer experiences elicit
negative affect that can deleteriously affect adolescents’ ER
capabilities, and each theory proposed emphasizes different
pieces of the individual and their context in shaping this
process. Yet, a systematic evaluation of literature on this
topic is needed to identify which theory (or a combination
thereof) may provide the most relevant explanation.
From methodological viewpoints, integrating results
across multiple levels of analysis may help to construct
pertinent connections between theoretical models rooted in
different bodies of literature (i.e. neural versus social sys-
tems). Furthermore, given novel contextual changes within
the developmental period of adolescence, applicable theories
may benefit from extensions that consider additional factors,
including individual characteristics (e.g. gender), develop-
ment, and context (e.g. school changes, home environment).
For instance, there is evidence that females are more sensi-
tive to social evaluation in adolescence than males which
may have implications for increases in adverse outcomes
related to victimization for female adolescents (Rose and
Rudolph 2006). Moreover, the heightened sensitivity to peer
evaluation unique to adolescence, combined with continued
maturity of regulatory and social information-processing
regions, emphasizes developmental differences in these
processes (Moor etal. 2010).
Limitations oftheCurrent State
oftheLiterature
Adolescence seems to be pertinent for disentangling devel-
opmental and contextual processes involved in shaping indi-
vidual differences in ER because this developmental period
is often characterized by increased sensitivity to social
influences (Blakemore and Mills 2014; Somerville 2013),
increased prevalence of adjustment difficulties (Silk etal.
2003), the introduction of new and increased intensity in
emotions (Morris etal. 2007), and continued maturation of
brain regions thought to be associated with ER (i.e., the pre-
frontal cortex; McRae etal. 2012; Steinberg 2005). Nonethe-
less, research examining associations between adverse peer
experiences and ER currently lacks a systematic appraisal of
the methodologies and conclusions of prior studies, making
it difficult to converge evidence from studies using differ-
ent measurements and across multiple levels of analyses;
disentangle the direction of effects between adverse peer
experiences and ER; and clarify the role of additional risk
and protective factors.
First, given that ER is inherently defined as a dynamic
process expressed at neurobiological, behavioral, and cogni-
tive levels, it is important to integrate results from studies
using diverse methodologies, including self-report, other
informants (e.g. parent, teacher, or peer), physiological/bio-
logical indicators, observational approaches, and behavioral
tasks (Adrian and Berk 2018; Beauchaine 2015) in order to
converge and summarize results. This will be beneficial for
determining how adverse peer experiences may negatively
affect the ER process across multiple levels. Additionally,
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144 Clinical Child and Family Psychology Review (2021) 24:141–163
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the literature is mixed when it comes to the measurement of
adverse peer experiences, capturing either peer victimization
or peer rejection, or both. Though peer victimization and
rejection are related, they differ conceptually and empiri-
cally in important ways (Lopez and DuBois 2005). Thus,
evaluating whether different subtypes of adverse peer experi-
ences may be differentially related to ER development will
facilitate a more nuanced understanding of the link between
adverse peer experiences and ER.
Second, while many prior studies have concluded that
adverse peer experiences may impair ER abilities, the asso-
ciation may in fact be bidirectional. Adolescents exhibiting
emotion dysregulation may be at a greater risk for adverse
peer experiences given behaviors (i.e. immaturity, lack of
self-control, or poor social skills) that often provoke peer
victimization (Blake etal. 2012). Since emotion dysregula-
tion may be both a precursor to, as well as an outcome of
adverse peer experiences, longitudinal studies are essential
to clarify the direction of effects (McDougall and Vaillan-
court 2015).
Third, given the negative consequences associated with
adverse peer experiences and emotion dysregulation (i.e.
psychopathology), identifying adolescents who are particu-
larly vulnerable to adverse peer experiences would help in
detecting adolescents who may benefit most from interven-
tion. Many studies have examined the link between adverse
peer experiences and ER in clinical samples and demon-
strated that youths with disabilities or clinical diagnoses (i.e.
Autism Spectrum Disorder, Attention Deficit Hyperactivity
Disorder, learning disabilities) are more likely to be victim-
ized by peers than their typically developing counterparts
(Blake etal. 2012). Such disabilities may be characterized or
accompanied by social and emotional deficits that may cause
them to be seen as “different” from their peers and therefore
targets of ridicule or rejection. Even further, adolescents
with disabilities may not be able to accurately interpret sub-
tle victimization as hostile or may not be able to defend
themselves against abuse, making them more likely to be the
subject of victimization. As such, intervention is critical to
mitigate the consequences of such increased exposure and
experience for these adolescents.
Lastly, with respect to identifying targets in intervention
work, identification of protective factors for at-risk adolescents
is needed. For example, previous research has documented the
importance of social support in buffering against deleterious
outcomes associated with adverse peer experiences among
adolescents. Specifically, parental support has been shown
to be beneficial for adolescent ER following the experience
of relational aggression (Kokkinos etal. 2019; Rudolph etal.
2020a, b). Adolescents who are well connected to support-
ive parents and feel a sense of acceptance and trust may be
able to use parents as a means of establishing healthy coping
mechanisms for managing negative emotions (Rudolph etal.
2020a, b). Further, positive peer relations, such as friend-
ship and peer acceptance, have been identified as protective
factors in the link between depressive symptoms (related to
emotion dysregulation) and later peer victimization (Kochel
etal. 2017). Friendships that provide intimacy and support
may not only afford emotional protection against aggressors,
but also become resources for advice and conflict management
for adolescents frequently targeted. Moreover, adolescents who
are highly accepted by peers are less likely to be victimized,
likely because aggressors fear the social retribution of their
attacks. As such, interventions that improve adolescent social
relationships, by facilitating close connections between par-
ents and adolescents and improving adolescent interpersonal
skills to help them establish and maintain mutual friendships,
are likely to be beneficial in mitigating risk for emotion dys-
regulation and related deleterious outcomes. Another study
hypothesized that adolescent religiousness and forgiveness
would buffer against the link between peer victimization and
both ER and internalizing symptomatology given that in adult
samples, these constructs are associated with letting go of
negative thoughts and emotions that ultimately would aid in
reducing psychopathology associated with emotional distress.
However, results indicated that religiousness did not serve as a
moderator between peer victimization and ER or internalizing
symptomatology. Instead, certain dimensions of forgiveness
(specifically, benevolence motivations) actually heightened the
association between adverse peer experiences and internaliz-
ing symptomatology (Walters and Kim-Spoon 2014). Thus, a
review of possible risk and protective factors that may either
exacerbate or alleviate the effects of adverse peer experiences
on ER will be beneficial for informing potential targets in
intervention efforts.
Aims oftheReview
By systematically reviewing available empirical research, we
aim to (1) clarify directionality in the association between
adverse peer experiences and ER, (2) evaluate how dif-
ferences in definition and measurement of ER may affect
results, and whether specific subtypes of adverse peer expe-
riences differentially impact ER, (3) clarify the role of mod-
erating processes in the association between adverse peer
experiences and ER, and (4) discuss both the implications
for prevention and interventions as well as directions for
future research.
Methods
Search Methods
We conducted a search of three electronic databases (Psy-
cINFO, Psychology and Behavioral Sciences Collection
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145Clinical Child and Family Psychology Review (2021) 24:141–163
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from EBSCOhost, and PubMed) in October of 2019. Search
terms were selected by reviewing keywords of relevant arti-
cles. To ensure pertinent words had not been overlooked, key
words were entered into the American Psychological Associ-
ation Thesaurus of Psychological Index Terms in addition to
being compared against Medical Subject Headings (MeSH
terms) in PubMed. Additional relevant terms noted from
these steps were added. Lastly, several expert researchers on
these topics weighed in before search terms were finalized.
Searches in PsychINFO and EBSCOhost were conducted
using the following text and filtered by title or abstract: [ado-
lescen* AND ("peer victimization" OR "peer rejection" OR
bully* OR “social exclusion” OR “overt aggress*” OR
“relational aggress*” OR reject*) AND ("emotion*regu-
lat*" OR "affect* regulat*" OR "emotion* dysregulat*”
OR “emotion* difficult*” OR “emotion* control*”)]. The
search string was altered slightly for the search in PubMed,
incorporating MeSH terms, in order to be read better by
the database: ((adolescen*[tiab] OR adolescent[mesh])
AND (peer victimization[tiab] OR peer rejection[tiab] OR
bully*[tiab] OR Bullying[mesh] OR social exclusion[tiab]
OR overt aggress*[tiab] OR relational aggress*[tiab]
OR reject*[tiab]) AND (emotion regulat*[tiab] OR emo-
tional regulat*[tiab] OR affect regulat*[tiab] OR affective
regulat*[tiab] OR emotion dysregulat*[tiab] OR emotional
dysregulat*[tiab] OR emotion difficult*[tiab] OR emo-
tional difficult* OR emotion control*[tiab] OR emotional
control*[tiab])). Two independent researchers screened
titles and abstracts of all search results using Covidence
Systematic Review Software (2018), and any discrepancies
were resolved through mediation (k = 0.79). After screening
was complete, we searched the reference lists of all included
studies for any additional papers.
Selection Criteria
Articles were included in the review if they met the follow-
ing criteria: (1) the study was quantitative in nature (2) the
mean age of the sample fell between 12 and 17years, (3) the
study tested an association between adverse peer experiences
and ER (regardless of the directionality of that association),
and (4) the article was empirical and published in Eng-
lish in a peer-reviewed journal. We followed the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines for determining study inclusion.
Variable Extraction andCoding
Two independent researchers extracted details of interest
from each study that met inclusion criteria. We coded sev-
eral variables describing sample characteristics: whether the
sample was community-based or clinical, age (mean, stand-
ard deviation, and range), percentage of male participants,
and race/ethnicity. Variables related to study design
included: location of data collection, cross-sectional versus
longitudinal design, definition and measurement of adverse
peer experiences, definition and measurement of ER, the
direction of the effect investigated (adverse peer experi-
ences predicting ER or vice versa), covariates included in
the analyses, whether the association between adverse peer
experiences and ER was mediated or moderated by addi-
tional variables, and if the association was linked to further
outcomes.
Results
Included Articles
Search methods yielded a total of 385 studies to be screened
(376 via database search and 9 via forward citation search-
ing). After 55 duplicates were removed, a total of 330 stud-
ies underwent a title and abstract screening. Seventy-four
full-texts were screened, 27 of which fulfilled all criteria
and were included in the final review. The study selection
process (see Fig.1), adhered to PRISMA guidelines (Moher,
Liberati, Tetzlaff, Altman, & Group 2009). Table1 presents
a summary of study characteristics.
General Characteristics
About half of the studies included in the review were con-
ducted in the United States (14; 52%; Adrian etal. 2019;
Bolling etal. 2011; Doyle and Sullivan 2017; Ettekal and
Ladd 2019; Herts etal. 2012; Huang etal. 2018; Jankowski
etal. 2018; Jarcho etal. 2015; King etal. 2018; Masten
etal. 2009, 2013; McLaughlin etal. 2009; Riley etal. 2019;
Walters and Kim-Spoon 2014). Studies conducted in another
country included two in Belgium (Vanhalst et al. 2018;
Vranjes etal. 2018), two in Australia (Chervonsky and Hunt
2019; Trompeter etal. 2018), one in Sweden (Dickson etal.
2019), one in Spain (Estévez etal. 2019), one in the Neth-
erlands (Larsen etal. 2012), and two with a hybrid sample
from the US and from Australia (Hemphill and Heerde 2014;
Hemphill etal. 2015). The remaining four studies did not
specify where the study was conducted (Bettencourt etal.
2013; Miller etal. 2018; Platt etal. 2015; Sebastian etal.
2011).
Regarding study design, 16 studies (59%; Adrian etal.
2019; Bettencourt etal. 2013; Chervonsky and Hunt 2019;
Dickson etal. 2019; Doyle and Sullivan 2017; Ettekal and
Ladd 2019; Hemphill and Heerde 2014; Hemphill etal.
2015; Herts etal. 2012; Huang etal. 2018; King etal. 2018;
Larsen etal. 2012; McLaughlin etal. 2009; Platt etal. 2015;
Riley etal. 2019; Vanhalst etal. 2018) were conducted lon-
gitudinally, whereas 11 (41%; Bolling etal. 2011; Estévez
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146 Clinical Child and Family Psychology Review (2021) 24:141–163
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etal. 2019; Jankowski etal. 2018; Jarcho etal. 2015; Mas-
ten etal. 2009, 2013; Miller etal. 2018; Sebastian etal.
2011; Trompeter etal. 2018; Vranjes etal. 2018; Walters and
Kim-Spoon 2014) studies were cross-sectional (see Table1);
however two of the studies that were conducted longitudi-
nally only had adolescent data at one time point (Ettekal
and Ladd 2019; Platt etal. 2015). For the purposes of this
review, the adolescent data/results from these two studies
were considered separately and treated cross-sectionally.
Turning to sample characteristics, 24 studies (89%;
Adrian etal. 2019; Bettencourt etal. 2013; Bolling etal.
2011; Chervonsky and Hunt 2019; Dickson etal., 2019;
Estévez, etal. 2019; Hemphill and Heerde 2014; Hemphill
etal. 2015; Herts etal. 2012; Huang etal. 2018; Jarcho
etal. 2015; King etal. 2018; Larsen etal. 2012; Masten
etal. 2009, 2013; McLaughlin etal. 2009; Miller etal.
2018; Ettekal and Ladd 2019; Riley etal. 2019; Sebastian
etal. 2011; Trompeter etal. 2018; Vanhalst etal. 2018;
Vranjes etal. 2018; Walters and Kim-Spoon 2014) were
conducted using community samples. Of those 24, one,
while recruited from the community, was interested in ado-
lescents that were overweight or obese (Jarcho etal. 2015).
Three studies compared clinical samples to healthy con-
trols, two using depressed adolescent samples (Jankowski
etal. 2018; Platt etal. 2015) and one using a sample of
adolescents with disabilities (Doyle and Sullivan 2017).
However, of these four studies that were interested in dif-
ferential patterns of the adverse peer experiences-ER link,
two ensured that the comparison sample was recruited
from the same population as the typically developing
Fig. 1 PRISMA flow diagram for determining study inclusion
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147Clinical Child and Family Psychology Review (2021) 24:141–163
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Table 1 Summary of studies testing the association between adverse peer experiences and emotion regulation
Grade level is reported when age in years was not available for mean age and age range
APE adverse peer experiences, ER emotion regulation
Study N Mean age Age range Study design Definition of
APE
Measurement
of APE
Definition of
ER
Measurement
of ER
Direction of
effect
Adrian etal.
(2019)
287 16.56 16–17 Longitudinal Victimization Self-report Abilities Self-report APE to ER
Bettencourt
etal. (2013)
477 11.30 6th–7th grade Longitudinal Victimization Self-report Abilities Self-report ER to APE
Bolling etal.
(2011)
40 13.05 7–17 Cross-sectional Rejection Cyberball Brain activa-
tion
fMRI APE to ER
Chervonsky
and Hunt
(2019)
232 11.97 7th–8th grade Longitudinal Victimization Self-report Strategy use Self-report Both
Dickson etal.
(2019)
1409 13.42 7th–9th grade Longitudinal Victimization Self-report Abilities Self-report Both
Doyle and Sul-
livan (2017
485 6th graders 6th grade Longitudinal Victimization Self-report Abilities Self-report APE to ER
Estévez etal.
(2019)
1318 13.80 11–18 Cross-sectional Victimization Self-report Abilities Self-report APE to ER
Ettekal and
Ladd (2019)
482 11th graders N/A Longitudinal Both Sociometrics Abilities Parent/Teacher
Report
ER to APE
Hemphill
and Heerde
(2014)
809 15.20 14–19 Longitudinal Victimization Self-report Abilities Self-report ER to APE
Hemphill etal.
(2015)
673 13.00 7th–9th grade Longitudinal Victimization Self-report Abilities Self-report ER to APE
Herts etal.
(2012)
1065 11–14 11–14 Longitudinal Victimization Self-report Abilities Self-report APE to ER
Huang etal.
(2018)
691 6th–8th graders 6th–8th grade Longitudinal Victimization Teacher-report Abilities Teacher-report APE to ER
Jankowski etal.
(2018)
126 14.75 11–17 Cross-sectional Rejection Cyberball Brain activa-
tion
fMRI APE to ER
Jarcho etal.
(2015)
22 15.80 13–17 Cross-sectional Rejection Chatroom Task Brain activa-
tion
fMRI APE to ER
King etal.
(2018)
273 16.50 16–17 Longitudinal Rejection Chatroom Task Abilities Emotional
Stroop
APE to ER
Larsen etal.
(2012)
1465 13.80 7th–8th grade Longitudinal Victimization Self-report Strategy use Self-report APE to ER
Masten etal.
(2009)
23 13.00 12–14 Cross-sectional Rejection Cyberball Brain activa-
tion
fMRI APE to ER
Masten etal.
(2013)
23 13.00 12–14 Cross-sectional Rejection Cyberball Brain activa-
tion
fMRI APE to ER
McLaughlin
etal. (2009)
1065 6th–8th graders 6th–8th grade Longitudinal Victimization Self-report Abilities Self-report APE to ER
Miller etal.
(2018)
33 12.47 9–16 Cross-sectional Rejection Social Evalu-
ation
Brain activa-
tion/task
fMRI APE to ER
Platt etal.
(2015)
30 15.40 15–17 Longitudinal Rejection Chatroom Task Brain activa-
tion/task
fMRI APE to ER
Riley etal.
(2019)
357 12.23 5th–8th grade Longitudinal Victimization Self-report Abilities Self/Parent
report
ER to APE
Sebastian etal.
(2011)
19 15.44 14–16 Cross-sectional Rejection Cyberball Brain activa-
tion
fMRI APE to ER
Trompeter
etal. (2018)
459 14.67 8th–10th grad-
ers
Cross-sectional Victimization Self-report Abilities Self-report APE to ER
Vanhalst etal.
(2018)
730 15.43 9th–12th grad-
ers
Longitudinal Rejection Vignette Strategy use Self-report APE to ER
Vranjes etal.
(2018)
1715 13.60 10–15 Cross-sectional Victimization Self-report Strategy use Self-report APE to ER
Walters and
Kim-Spoon
(2014)
127 15.28 12–18 Cross-sectional Victimization Self-report Abilities Self-report APE to ER
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148 Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
sample, whereas for the other two it was unclear how
recruitment was handled to limit bias.
Considering gender, three studies used an all-female sam-
ple (Jarcho etal. 2015; Miller etal. 2018; Sebastian etal.
2011), given that sex differences are often found in rates of
adverse peer experiences and ER (Sebastian etal. 2011). One
study did not indicate the gender of their sample (Bolling
etal. 2011). The remaining 23 studies included both males
and females and indicated the ratio of males to females in
the sample. Eleven studies examined gender as a moderating
factor in the association between adverse peer experiences
and ER (Chervonsky and Hunt 2019; Doyle and Sullivan
2017; Hemphill and Heerde 2014; Herts etal. 2012; Larsen
etal. 2012; McLaughlin etal. 2009; Miller etal. 2018; Riley
etal. 2019; Sebastian etal. 2011; Trompeter etal. 2018;
Vanhalst etal. 2018), with 10 studies indicating compara-
ble results between males and females. However, one study
did find differences in results based on gender. Specifically,
Vanhalst etal. (2018) identified differences by gender in
ER strategies used, such that girls were more likely to self-
blame, ruminate, and catastrophize than boys, following an
adverse peer experience. Five additional studies used gender
as a covariate in their analyses. Two studies did not include
estimates of gender on the association between adverse peer
experiences and ER (Adrian etal. 2019; King etal. 2018),
two studies investigated whether gender predicted class
membership (bullies, victims, or bully victims) rather than
examining differences in the association between adverse
peer experiences and ER (Bettencourt etal. 2013; Ettekal
and Ladd 2019), and one study determined that the model
was unaffected by gender (Huang, etal. 2018). Whether and
how gender may affect study results is discussed below.
Exclusion criteria dictated that the average age of the
sample had to be between 12 and 17, in order to restrict
the review to the developmental period of adolescence.
The average age of the sample for each study is recorded in
Table1 with the exception of four studies that simply indi-
cated the grade levels of their sample (including 6th graders,
6th–8th graders, and 11th graders; Doyle and Sullivan 2017;
Ettekal and Ladd 2019; Huang, etal. 2018; McLaughlin
etal. 2009) and one study that merely reported the age range
and did not provide a mean age (Herts etal. 2012).
Effects ofAdverse Peer Experiences onEmotion
Regulation
Twenty studies (74%) examined whether adverse peer expe-
riences predicted ER (see Table1)—the majority of which
(18) demonstrated a significant link between adverse peer
experiences and emotion dysregulation. For example, Huang
etal. (2018) found that victims of peer victimization (bul-
lying) demonstrate longitudinal increases in emotion dys-
regulation. Similarly, Vanhalst etal. (2018) measured ER
strategies used in response to peer rejection and investigated
whether these results varied longitudinally according to the
adolescent’s history of loneliness. Results demonstrated that
chronically lonely adolescents were more likely than ado-
lescents in any other loneliness trajectory to use maladap-
tive ER strategies, including catastrophizing, ruminating,
and self-blame, in response to social exclusion. Chronically
lonely adolescents were also less likely to use adaptive ER
strategies, such as putting things in perspective and focusing
on the positive aspects of the situation.
Additionally, several longitudinal studies identified ER
as a mediator in the association between adverse peer expe-
riences and psychopathology. For example, Adrian etal.
(2019) demonstrated significant indirect effects from high
peer victimization to increases in depression through low
behavioral ER and from high peer victimization to increases
in anxiety through low cognitive ER. In addition, Doyle and
Sullivan (2017) reported significant indirect effects of high
peer victimization on increases in anxiety and depression via
poor sadness regulation (though not poor anger regulation)
and McLaughlin etal. (2009) reported a significant indirect
effect of high peer victimization on increases in internalizing
symptoms via increases in emotion dysregulation (conceptu-
alized as poor emotional awareness, dysregulated expression
of anger and sadness, and rumination). Finally, Herts etal.
(2012) found that high peer victimization predicted increases
in emotion dysregulation which in turn predicted increases
in aggression.
It is interesting to note that prior studies focusing on
cyber victimization have demonstrated similar results. For
example, Estévez etal. (2019) demonstrated that high rates
of both traditional and cyber victimization were associated
with poor ER. Results by Trompeter etal. (2018) demon-
strated a significant path model in which cyber victimiza-
tion predicted lower levels of coping self-efficacy which in
turn predicted high emotion dysregulation which then pre-
dicted high levels of internalizing symptomatology. Finally,
Vranjes etal. (2018) demonstrated that cyber victimized
adolescents were more likely to use maladaptive ER strat-
egies (i.e., suppression) relative to non-victimized adoles-
cents and that non-victimized adolescents were more likely
to use adaptive ER strategies (i.e. cognitive reappraisal) than
their victimized counterparts. However, these studies should
be interpreted in light of the limitation related to the use of
cross-sectional design.
Focusing on the only available study that used a purely
behavioral performance measure of ER, results suggest a
slightly more complicated association between peer rejec-
tion and ER (King etal. 2018). Briefly exposing partici-
pants to unknown peers, who subsequently either accepted
or rejected them, had implications for adolescents’ regula-
tory abilities. For example, mere exposure to peers (regard-
less of acceptance versus rejection) predicted more adverse
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149Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
ER. Results suggest that given the salience of peers during
adolescence, their mere presence may impede the ability to
disengage from emotional distractors (i.e. emotional faces)
to perform the task. Furthermore, peer rejection specifically
predicted impaired distress tolerance, which is defined by the
willingness to persist in the face of frustration, and may be
associated with ER. Increases in the negative affect associ-
ated with peer rejection coupled with distress intolerance,
may produce frustration that is difficult to regulate, lead-
ing to giving up on the task. While this study suggests a
more complicated perspective, it is important to recognize
the complexity of the study design relative to other stud-
ies included in the review. King etal. (2018) included peer
acceptance and peer rejection in their manipulation and
included a control group with a neutral condition to explore
how the nature of peer interactions might influence regula-
tion. Moreover, ER was measured via the emotional Stroop
task which has been criticized as a measurement of ER in
the past (Buhle etal. 2010).
Turning to neuroimaging studies (which are difficult to
compare with the previous studies given the stark differ-
ences in methodology), several studies suggest that patterns
in brain activation—in areas previously linked to ER—fol-
lowing experimental manipulation of peer rejection indicate
less adaptive ER. For example, altered brain activation was
found in similar regions across these studies including: the
dorsal anterior cingulate cortex, bilateral insula, hippocam-
pus, middle temporal gyrus, dorsal lateral prefrontal cortex,
and posterior cingulate cortex (Bolling etal. 2011); insula,
right ventral prefrontal cortex, ventral striatum and anterior
cingulate cortex (Masten etal. 2009, 2013); left dorsal lat-
eral prefrontal cortex and medial prefrontal cortex (Sebas-
tian etal. 2011); ventromedial prefrontal cortex (Jarcho etal.
2015); medial prefrontal cortex/perigenual anterior cingulate
cortex, left and right inferior frontal gyri, right precentral
gyrus, right superior temporal gyrus/medial temporal gyrus
and bilateral occipital cortex (Jankowski etal. 2018); and
ventral lateral prefrontal cortex, anterior cingulate cortex,
and insula (Miller etal. 2018). Further, Jankowski etal.
(2018) demonstrated differences between depressed par-
ticipants and healthy controls, such that healthy adoles-
cents recruited greater left medial temporal gyrus activity
than depressed adolescents during social exclusion relative
to social inclusion, while depressed adolescents recruited
similar activity during exclusion and inclusion. These results
suggest that healthy adolescents selectively engage in ER
related to adverse peer experiences, while depressed ado-
lescents do not. However, Platt etal. (2015) demonstrated
functional connectivity differences between depressed and
non-depressed adolescents, such that when instructed to
use cognitive reappraisal as an ER strategy following peer
rejection, increased connectivity between the right frontal
pole and the left superior frontal gyrus, and between the
hippocampus and amygdala plus the right inferior parietal
lobule, was observed in depressed adolescents, compared to
non-depressed adolescents. Thus, the results indicate that
adolescents with depression are able to use cognitive reap-
praisal to regulate emotions following peer rejection when
instructed, suggesting not an impairment in abilities neces-
sarily, but rather a struggle with engaging an adaptive ER
strategy. As a whole, selective neural patterns of ER during
adverse peer experiences may reflect difficulties with ER,
though whether and how these patterns look different in
depressed adolescents is still unclear.
While the evidence seems to suggest that adverse peer
experiences predict emotion dysregulation, it is important
to weigh“longitudinal change” studies that can demonstrate
changes in emotion dysregulation as a result of adverse peer
experiences most heavily, “longitudinal level” studies that
did not control for previous levels of emotion dysregulation
less heavily, and “cross-sectional” studies even less heav-
ily, considering their inability to comment on directional
inferences (see Study Designs in Table1). Finally, not all
studies showed a significant link between adverse peer
experiences and ER. For instance, Walters and Kim-Spoon
(2014) reported a non-significant association between peer
victimization and ER, even when accounting for potential
moderators, such as religiousness and forgiveness. Likewise,
Larsen etal. (2012) examined whether peer victimization
mediated the association between depressive symptoms and
use of suppression as an ER strategy, but results indicated
that depressive symptoms did not predict peer victimization
nor did peer victimization predict suppression use. As such,
any conclusions drawn need to be considered in light of dis-
crepant or potentially study (or sample) specific findings.
Furthermore, we should be mindful of the possibility of the
reverse pathway (emotion dysregulation predicting adverse
peer experiences) and/or dynamic bi-directional associations
between these constructs.
Effects ofEmotion Regulation onAdverse Peer
Experiences
Five studies (19%) examined the impact of ER on exposure
to adverse peer experiences (see Table1), with four demon-
strating significant associations. Riley, etal. (2019) found
that higher levels of emotional awareness predicted better
ER and anger regulation longitudinally, which in turn pre-
dicted lower frequencies of victimization experiences. While
this was a longitudinal study, it is important to note that the
association between ER and adverse peer experiences was
tested cross-sectionally. Studies by Hemphill etal. provide
evidence consistent with these findings by demonstrating
that emotion dysregulation is a predictor of cyber victimi-
zation as well (Hemphill and Heerde 2014; Hemphill etal.
2015).
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150 Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
Two further studies used latent class analysis to identify
subgroups of adolescents characterized by both their use
and experience of victimization (Bettencourt etal. 2013;
Ettekal and Ladd 2019). Latent class analysis is a person-
centered analysis technique that attempts to group individu-
als into membership classes based on several different fac-
tors. As such, these studies aimed to answer a related yet
somewhat different question than that of the present review.
Latent class analysis allowed these studies to ask how the
individuals in their sample could be grouped into different
victimization classes based on several key variables, includ-
ing emotion dysregulation, rather than whether or not ER
predicts adverse peer experiences. Results by Bettencourt
etal. (2013) demonstrated cross-sectional associations
between ER and victimization class membership, such that
adolescents with high levels of emotion dysregulation were
more likely to be aggressive-victims (experience and engage
in victimization) and aggressors (merely engage in victimi-
zation) than well-adjusted youths. Although the study by
Ettekal and Ladd (2019) was conducted longitudinally, only
the final time point of data involving ER and peer victimiza-
tion were collected during adolescence and was thus consid-
ered separately for the purposes of the current review. At this
time point, emotion dysregulation was not associated with
latent class membership based on engagement in and experi-
ence of victimization. While these results appear discrepant,
it is important to note that the class indicators used in each
study to determine victimization group membership differed,
making comparisons difficult even though the analyses were
similar.
Bidirectional Effects ofAdverse Peer Experiences
andEmotion Regulation
To date, there have been only two studies that investigated
bi-directional effects between adverse peer experiences and
ER. Though constructs between the two studies were some-
what different, results appear conflicting. First, Chervonsky
and Hunt (2019) examined whether ER strategy use pre-
dicted peer victimization or vice versa, but did not dem-
onstrate any significant findings between these constructs.
Second, Dickson etal. (2019) demonstrated a longitudinal
mediation model in which the association between derisive
parenting (characterized by belittlement and criticism) and
adolescent experience of peer victimization was mediated
by anger dysregulation. Results showed that derisive par-
enting impaired adolescent ER over one year, which in turn
predicted increases in the likelihood of both engaging in
and experiencing peer victimization in the following year.
Authors also tested whether derisive parenting was related
to ER through peer victimization but found non-significant
indirect effects. Perhaps in cases where changes in adverse
peer experiences follow changes in emotion dysregulation,
negative social interactions elsewhere (e.g. parent–child
relationship) may play a role.
Definition andMeasurement ofAdverse Peer
Experiences
Considering our definition of adverse peer experiences, we
coded whether the studies reviewed included peer victimiza-
tion, peer rejection, or both in their analyses (see Table1).
Twelve studies (44%) defined adverse peer experiences
consistent with the definition of peer victimization, includ-
ing victimization, bullying, overt, and relational aggression
(Adrian etal. 2019; Bettencourt etal. 2013; Chervonsky
and Hunt 2019; Dickson etal. 2019; Doyle and Sullivan
2017; Estévez etal. 2019; Herts etal. 2012; Huang etal.
2018; Larsen etal. 2012; McLaughlin etal. 2009; Riley etal.
2019; Walters and Kim-Spoon 2014). Four additional stud-
ies (15%) were also classified as peer victimization though
they included a particular cyber bullying component which
they defined as unique from traditional bullying, given that
cyber bullying is often public, anonymous, and can hap-
pen anytime (Hemphill and Heerde 2014; Hemphill etal.
2015; Trompeter etal. 2018; Vranjes etal. 2018). Of these
16 studies, all used self-report to assess victimization, except
for one which used teacher report (Huang etal. 2018; see
Table1).
Eight studies (30%) defined adverse peer experiences
consistent with the definition of peer rejection, including
social exclusion (Bolling etal. 2011; Jankowski etal. 2018;
Jarcho etal. 2015; Masten etal. 2009, 2013; Miller etal.
2018; Sebastian etal. 2011; Vanhalst etal. 2018). Two
studies (7%) used social evaluation to capture the differ-
ence between peer acceptance and peer rejection (King
etal. 2018; Platt etal. 2015). Of these 10 studies, all used
experimental tasks to confer a sense of peer rejection. Five
studies used the Cyberball task to induce feelings of peer
rejection (Bolling etal. 2011; Jankowski etal. 2018; Mas-
ten etal. 2009, 2013; Sebastian etal. 2011). The Cyberball
task involves a simulated ball toss game with two virtual
peers. In the inclusion trials, all players had an equal chance
of receiving the ball. In the exclusion trials, participants
were excluded while the two virtual players passed the ball
between them. Another three studies used the Chatroom task
to create a sense of peer rejection (Jarcho etal. 2015; King
etal. 2018; Platt etal. 2015). The Chatroom task involves
multiple phases with the goal of inducing feelings of rejec-
tion based on peer feedback. One study used vignettes to
describe hypothetical situations of social exclusion to which
adolescents were asked to respond (Vanhalst etal. 2018).
Finally, one study used a social evaluation task to measure
peer rejection (Miller etal. 2018). In this social evaluation
task, participants were informed that while they were per-
forming the task in the scanner, they would be watched by
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151Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
an unfamiliar peer who they had previously indicated that
they would like to meet and talk to. Later in the scan, par-
ticipants were informed that after the new peer began watch-
ing them andafter learning more about them, they were
no longer interested in interacting with the participant, thus
creating a targeted feeling of peer rejection. In all of these
experimental manipulations, a situation or feedback was cre-
ated intentionally to make the participant feel excluded, left
out, or rejected. However, it is worth noting that they were
virtual or non-face-to-face interactions with unknown peers
or hypothetical scenarios which likely contributed to less
ecological validity.
Finally, one study assessed both peer victimization and
peer rejection (Ettekal and Ladd 2019) using sociomet-
rics which involved peer ratings (Ettekal and Ladd 2019).
Sociometric data is arguably the most objective and rigor-
ous method for elucidating peer relations, including peer
acceptance and peer rejection. However, it is more difficult
to conduct sociometrics in adolescence than it is in child-
hood, given a number of logistical issues associated with
this developmental period (e.g. larger class sizes, switching
classrooms; Prinstein 2007)—ultimately likely contributing
to the absence of sociometric studies included in the current
review.
While the majority of studies captured peer victimiza-
tion, this was primarily assessed via self-report; studies that
attempted to capture peer rejection were more likely to use
an experimental manipulation. As such, the adverse peer
experience constructs defined seem to be conflated with
methodology.
Definition andMeasurement ofEmotion Regulation
Across the studies, ER was defined in a variety of ways. For
the purposes of this review, we have simplified definitions
into three categories: abilities/difficulties, strategy use, and
brain activation (see Table1). First, fifteen studies (56%)
considered ER more generally in terms of regulatory abili-
ties or dysregulation difficulties. Definitions in this category
included cognitive and behavioral regulation in addition to
emotional reactivity (Adrian etal. 2019), anger dysregula-
tion (Bettencourt etal. 2013; Dickson etal. 2019; Riley etal.
2019), anger and sadness dysregulation (Doyle and Sulli-
van 2017), emotional control (Hemphill and Heerde 2014;
Hemphill etal. 2015), emotion dysregulation (Ettekal and
Ladd 2019; Huang etal. 2018; Trompeter etal. 2018), poor
emotional understanding, dysregulated emotional expres-
sion, and rumination (Herts etal. 2012; McLaughlin etal.
2009), emotional attention, clarity, and regulation (Estévez
etal. 2019), hot cognitive control (King etal. 2018), and
abilities and empathy (Walters and Kim-Spoon 2014). Sec-
ond, four studies (15%) defined ER as strategy use, including
suppression (Larsen etal. 2012), suppression and reappraisal
(Chervonsky and Hunt 2019), concealing and adjusting
(Vranjes etal. 2018), and acceptance, focusing on posi-
tive things, focus on planning, positive reappraisal, putting
into perspective, rumination, catastrophizing, self-blaming,
and other-blaming (Vanhalst etal. 2018). Third, six stud-
ies (22%) focused on brain regions previously implicated
in ER (Bolling etal. 2011; Jankowski etal. 2018; Jarcho
etal. 2015; Masten etal. 2009, 2013; Sebastian etal. 2011).
Finally, two studies (7%) defined ER as both the strategy
use (i.e., a cognitive reappraisal task) and brain activation
(Miller etal. 2018; Platt etal. 2015). In these studies, both
behavioral and neural ER was assessed, which strengthens
their conclusions.
Across all studies, 18 (67%) studies measured ER via
informant reports on questionnaires. Of the 18, 15 studies
used self-report by adolescents (Adrian, etal. 2019; Betten-
court etal. 2013; Chervonsky and Hunt 2019; Dickson etal.
2019; Doyle and Sullivan 2017; Estévez etal. 2019; Hemp-
hill and Heerde 2014; Hemphill etal. 2015; Herts et al.
2012; Larsen etal. 2012; McLaughlin etal. 2009; Trom-
peter etal. 2018; Vanhalst etal. 2018; Vranjes etal. 2018;
Walters and Kim-Spoon 2014). In one study, both parent
and teacher reports were used (Ettekal and Ladd 2019), in
another study, only teacher reports were used (Huang etal.
2018), and finally another study used both adolescent and
parent report (Riley etal. 2019). One study (3%) examined
ER behaviorally using the emotional Stroop task (King
etal. 2018). Finally, considering neurobiology, eight studies
(30%) assessed brain activation during ER using fMRI (Bol-
ling etal. 2011; Jankowski etal. 2018; Jarcho etal. 2015;
Masten etal. 2009, 2013; Miller etal. 2018; Platt etal. 2015;
Sebastian etal. 2011).
Unlike the adverse peer experiences construct, there was
not a clear association between how ER was defined and
how it was assessed; though both definition and measure-
ment of ER was also much more diverse than the definition
and measurement of adverse peer experiences. However, like
adverse peer experiences, the majority of data were collected
via self-report, which may be more likely to be affected by
subjective biases.
Risk andProtective Factors
The current review also sought to identify possible factors
that may either exacerbate or ameliorate cascading risk
from adverse peer experiences and emotion dysregulation.
Risk factors examined included gender, disability status,
loneliness, depression, and loss of control eating. We note
that most previous studies did not examine the interactive
effects involving moderators (i.e., the association between
adverse peer experiences and ER vary depending on the lev-
els of moderator) but rather examined the additive effects of
risk and protective factors that are related to adverse peer
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152 Clinical Child and Family Psychology Review (2021) 24:141–163
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experiences and ER. Eleven studies examined gender as a
moderating factor in the association between adverse peer
experiences and ER (Chervonsky and Hunt 2019; Doyle
and Sullivan 2017; Hemphill and Heerde 2014; Herts etal.
2012; Larsen etal. 2012; McLaughlin etal. 2009; Miller
etal. 2018; Riley etal. 2019; Sebastian etal. 2011; Trom-
peter etal. 2018; Vanhalst etal. 2018), with 10 studies dem-
onstrating comparable results between males and females,
indicating that gender is not a salient moderating factor for
the association between adverse peer experiences and ER.
However, Vanhalst etal. (2018) identified gender differences
in use of ER strategies, such that girls were more likely to
self-blame, ruminate, and catastrophize than boys, following
an adverse peer experience. While ER may not be more or
less affected by adverse peer experiences based on gender,
there are likely differences in how ER strategies are social-
ized by gender, which plays a role in the strategies chosen
by girls and boys in response to an adverse peer experience.
As such, it may be beneficial to explore differences in how
ER strategies may be socialized by gender.
Turning to other risk and protective factors, results sug-
gest that youths with particular symptoms or clinical diag-
noses may be more vulnerable to adverse peer experiences
and emotion dysregulation. For example, both Jankowski
etal. (2018) and Platt etal. (2015) identified differences in
ER in depressed adolescents as compared to healthy con-
trols. More specifically, the study by Jankowski etal. (2018)
indicated that depressed adolescents exhibit difficulties in
ER based on patterns of brain activation. However, Platt
etal. (2015) found that although depressed adolescents may
struggle to initiate adaptive ER strategies in response to
adverse peer experiences, they have the ability to engage in
cognitive reappraisal once instructed to. Further, results by
Jarcho etal. (2015) indicate that overweight or obese ado-
lescent girls demonstrate reduced ventro-medial prefrontal
cortex engagement in response to peer rejection, possibly
indicating a failure to engage prefrontal regions implicated
in ER to regulate negative emotions related to social distress.
Finally, Vanhalst etal. (2018) investigated whether levels
of adolescents’ loneliness are related to ER in response to
peer rejection. Results demonstrated that chronically lonely
adolescents were more likely to use maladaptive ER strate-
gies (e.g., catastrophizing, ruminating, self-blame) and less
likely to use adaptive ER strategies (e.g., putting things in
perspective, focusing on the positive aspects of the situation)
in response to adverse peer experiences, compared to their
counterparts who were not chronically lonely. Overall, these
findings imply that clinical populations, particularly those
with disabilities or depression, or with additional socio-emo-
tional struggles (i.e., loneliness) may find ER in response to
adverse peer experiences especially challenging.
Regarding possible protective factors, religiousness
and forgiveness (Walters and Kim-Spoon 2014) as well
as teacher-student relationships (Huang etal. 2018) were
hypothesized to ameliorate negative effects associated with
adverse peer experiences and emotion dysregulation, but no
evidence was found to suggest that this is the case.
Risk ofBias Assessment
The extent to which the present review can draw conclu-
sions about the adverse peer experiences-ER link depends
on whether the data and results from the included studies are
valid. The Newcastle–Ottawa Scale (NOS) is a risk of bias
assessment tool used for both case–control and longitudi-
nal studies (Margulis etal. 2014). The NOS evaluates three
quality parameters (selection, comparability, and outcome)
divided across eight specific items. Each item on the scale is
scored with one point, except for comparability, which can
be adapted to the specific topic of interest to score up to two
points. Thus, the maximum for each study is 9, with studies
having less than 5 points being identified as representing
at high risk of bias. For the “demonstration that outcome
of interest was not present at the start of the study” item,
we opted to consider this true for studies that controlled
previous levels of the outcome in their analyses. A sum-
mary of the results can be viewed in Fig.2. The two largest
areas of concern were in assessment of the constructs—with
many studies using self-report as opposed to a more objec-
tive measure—and adequate time before a follow-up assess-
ment—with several studies being cross-sectional. Results
should be interpreted in light of these limitations.
Discussion
The current systematic review was designed to clarify direc-
tionality of the association between adverse peer experiences
and ER, elucidate how differences in definition and measure-
ment of ER may affect results, and describe the role of addi-
tional risk and protective factors involved in this association.
While previous reviews have examined the impact of adverse
peer experiences on psychopathology (e.g., Arseneault etal.
2010), to our knowledge, this is the first review to consider
the impact of adverse peer experiences specifically on ER,
and to emphasize the effect of this association during ado-
lescence, a period in which there is unique sensitivity to and
salience of both adverse peer experiences and ER develop-
ment (Troop-Gordon 2017). As such, we discuss important
implications for adolescents’ development and adjustment.
Directionality oftheAssociation betweenAdverse
Peer Experiences andEmotion Regulation
Though variability in definition and measurement of both
adverse peer experiences and ER across studies makes it
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153Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
difficult to directly compare findings, the present systematic
review broadly demonstrates that adverse peer experiences
are negatively associated with ER, as evidenced by more
emotion dysregulation, greater use of maladaptive ER strat-
egies, and less use of adaptive ER strategies. Furthermore,
neuroimaging studies indicate altered patterns of recruitment
of specific brain regions involved in ER, including the ante-
rior cingulate cortex, insula, prefrontal cortices, and ventral
striatum, suggesting more effortful regulation following
adverse peer experiences.
Peer victimization and rejection represent developmen-
tally salient stressors for adolescents. Adolescents experi-
encing chronic adverse peer experiences may fail to benefit
from healthy, supportive relationships that can serve to miti-
gate negative emotions via important interpersonal coping
skills (Rudolph etal. 2020a, b). According to the model
of the cognitive control of emotion (Ochsner etal. 2012),
decreasing emotional responses places greater demands
on regulatory functions during ER following adverse peer
experiences—evidenced by both less regulated behavior and
greater activation in ER-associated brain regions. Cognitive
neuroscience research has demonstrated that when attending
to a stressor, behavioral and neural responses either facili-
tate or inhibit emotions (Ochsner and Gross 2005). With
regards to inhibition, successful ER involves diminishing
or eradicating negative emotions in response to adverse
peer experiences. Behaviorally, ER may appear as suppres-
sion of expressive behavior, which often does not serve to
lessen the unpleasant emotions. Cognitively, ER may be
reflected by attending to or interpreting emotion-eliciting
situations in ways that limit emotional responses (Ochsner
and Gross 2005). Depending on context, adolescents decide
which strategies to use, when to do so, and how to express
them. Neurologically, while variability regarding the pre-
cise prefrontal and appraisal systems recruited in ER has
been observed across studies, in general, emotions can be
regulated by activation in the prefrontal cortex and cingulate
cortex control systems (Ochsner and Gross 2005; Ochsner
etal. 2012). Overtime, with sustained or heightened inten-
sity in negative affect, chronic attempts at regulation associ-
ated with adverse peer experiences may deplete regulatory
resources, interfering with problem solving abilities and
making attempts at ER ineffective (Ochsner etal. 2012).
Indeed, results of the present review consistently demon-
strated that adverse peer experiences are negatively associ-
ated with ER. Thus, the salience of adverse peer experi-
ences (Somerville 2013) seems to intersect with protracted
development of prefrontal brain regions during adolescence
(Lewis and Stieben 2004), with important implications for
the manifestation of ER and further adjustment outcomes.
Turning to evidence for the notion that emotionally dys-
regulated adolescents are more likely to experience peer vic-
timization, results indicate that high emotion dysregulation
predicts an increased likelihood of being an aggressor or
aggressive-victim and of being victimized. Social informa-
tion processing theory (Dodge and Crick 1990) may pro-
vide an initial theoretical explanation for how youths process
and interpret cues in social situations, though Lemerise and
Fig. 2 Risk of bias assessment summary
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154 Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
Arsenio (2000) have since expanded this model to incorpo-
rate the specific role of emotion in youths’ social information
processing and decision making. Youths enter social inter-
actions with past experiences and biologically determined
capabilities, including individual differences in emotional
reactivity and ER abilities, that influence navigation of the
social situation. Importantly, social information processing
theory emphasizes youths’ability to effectively encode and
interpret emotional cues during these interactions. Indeed,
Riley etal. (2019) demonstrated that adolescents’ poor emo-
tional awareness was associated with emotion dysregulation,
which in turn increased the likelihood of experiencing peer
victimization. Thus, adolescents who have difficulty identi-
fying and interpreting emotional cues may exhibit deficits in
social information processing, which leaves them vulnerable
to victimization in social interactions.
One common social information processing bias is hyper-
vigilance to threat—characterized by over-attending to and
perceiving social cues as hostile. Such hypervigilance may
provoke dysregulated emotions and behaviors (i.e. aggres-
sion), in response to perceived hostility, that lead adoles-
cents to become victimized or rejected by their peers. For
example, Dickson etal. (2019) demonstrated that derisive
parenting (characterized by rejection, sarcasm, and belit-
tling) impaired adolescent ER, which in turn predicted a
greater likelihood of both engaging in and experiencing peer
victimization. Results suggest that negative interactions with
parents may adversely impact adolescents’ social informa-
tion processing, resulting in consequences for negative peer
relationships.
Two possibilities for how this process may unfold exist.
First, adolescents who experience harsh parenting (i.e.,
derisive parenting) may develop a hypervigilance to threat
that manifests as a victim mindset. These adolescents likely
default to a passive role in social interactions (i.e., less able
or willing to assert or defend themselves in response to
aggressive peers), making them easy targets of peer victimi-
zation. For ER to precede peer victimization in adolescence,
emotion dysregulation maystem from biases in social infor-
mation processing that have been previously socialized (e.g.,
via harsh or abusive parenting). Indeed, previous research
has emphasized a “cycle of victimization” in which victims
of maltreatment are likely to be revictimized later in life
(Widom 2014). A recent study indicated that a history of
victimization predicted less effective ER behaviorally and
neurally in adolescent girls with high (but not low) rejec-
tion sensitivity (Rudolph etal. 2020a, b). Whether this
association exists as a result of social information process-
ing biases resulting in ER difficulties that can create prob-
lems with peers (Dodge and Crick 1990; Kim and Cicchetti
2010), or submissive or withdrawn tendencies that make
these children easy targets for victimization by their peers
(Juvonen and Graham 2014), earlier victimization seems
to be a strong predictor of peer victimization later on (see
Lereya etal. 2013 for a meta-analysis). Second, adolescents
who are hypervigilant to threat may be especially reactive
to even the smallest of provocations, exhibiting emotion-
ally dysregulated behavior that increases the likelihood of
engagement in aggression as a form of retaliation, as sug-
gested by Bettencourt etal. (2013). Therefore, adolescents
who experience and engage in peer victimization may have
social information processing biases that provoke dysregu-
lated, even aggressive, responses to social interactions. This
process may readily extend to cyber victimization. Results
by Hemphill and Heerde (2014) and Hemphill etal. (2015)
suggest that adolescents with poor ER face increased risk
for experiences of cyber victimization. Perhaps aspects of
cyber victimization that are unique (i.e. high speed at which
information is exchanged, miscommunications and misun-
derstandings via text) increase risk for hypervigilant ado-
lescents to quickly respond with aggression that perpetuates
victimization. Thus, the association between peer victimi-
zation and emotion dysregulation may be cyclic, such that
a persistent display of dysregulation provokes aggression
which then perpetuates experiences of victimization.
Though the studies reviewed here provide evidence for
the impact of adverse peer experiences on ER and for the
reverse direction, we currently do not have sufficient evi-
dence to determine whether associations are reciprocal
overtime. Nevertheless, we hypothesized that the associa-
tion between adverse peer experiences and ER would be
bidirectional, such that adverse peer experiences would
impair ER, which in turn would increase the likelihood of
exposure to adverse peer experiences, and so on, resulting in
cascading risk for maladjustment. Indeed, social information
processing models (Lemerise and Arsenio 2000) suggest that
initial processing biases may become canalized with con-
sistent experiences of victimization. However, few studies
have attempted to systematically conclude the directionality
of the effect, with little indication of bidirectional effects
(Chervonsky and Hunt 2019; Dickson etal. 2019). Moreo-
ver, these studies tested models for each direction separately
instead of testing reciprocal pathways simultaneously, leav-
ing a gap in our understanding of how these constructs are
dynamically related overtime.
Furthermore, given the number of cross-sectional studies
included in the current review, as well as the nature of cor-
relational data, caution must be taken in drawing conclusions
about directionality. Moreover, many of the neuroimaging
studies included assessed brain activation during a peer
rejection task, not during an ER task. While brain regions
related to peer rejection have also been implicated in ER
processes in extant literature, we must be careful not to make
reverse inferences (Poldrack 2011), or assume brain activa-
tion is an indication of ER when ER was not specifically
measured. In sum, future research will benefit from further
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155Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
longitudinal work that will add to the limited literature con-
sidering whether adverse peer experiences predict change in
ER (or vice versa), controlling for previous levels, and that
can simultaneously estimate reciprocal effects. Nonetheless,
we argue that the current review provides promising initial
evidence for impairments in ER predicting and predictive
of adverse peer experiences. However, differential results
according to definition and measurement of constructs are
discussed in detail below.
Definition andMeasurement ofAdverse Peer
Experiences
Adverse peer experiences were considered along two main
dimensions: peer victimization and peer rejection. Extant
literature has suggested that while related and co-occuring,
they are conceptually and empirically distinct. Indeed, previ-
ous research has demonstrated that peer victimization and
peer rejection each have unique predictive value of adjust-
ment outcomes, including emotional and academic problems
(Lopez and DuBois 2005). However, the current review is
unable to make claims regarding differential impacts of peer
victimization and peer rejection on ER, primarily because of
heterogeneity in measurement that does not allow for direct
comparisons. Specifically, most studies that assessed peer
victimization used self-report of prevalence rates, whereas
most studies examining peer rejection experimentally
manipulated feelings of rejection with tasks that exclude
participants or provide negative social feedback. Neverthe-
less, in general, both peer victimization and rejection have
important implications for ER. For example, self-reported
peer victimization was overwhelmingly associated with
emotion dysregulation. Interestingly, studies that examined
outcomes associated with cyber victimization found more
consistent associations between cyber victimization and
ER than traditional victimization and ER. This was true in
predicting both directions of this association (Hemphill and
Heerde 2014; Hemphill etal. 2015; Trompeter etal. 2018;
Vranjes etal. 2018). This may be because cyber victimi-
zation is often pervasive across contexts and can easily be
made public and anonymous (Hemphill and Heerde 2014).
A fruitful extension of this work may be within-person com-
parisons to examine whether the impact of victimization on
ER is worse if it occurs online rather than in person. Social
information processing biases combined with online activity
that can be public, fast paced, and anonymous, may stimu-
late emotional reactivity among adolescents with particular
implications for victimization perpetuation.
The two studies that did not find a significant associa-
tion between adverse peer experiences and ER (Larsen etal.
2012; Walters and Kim-Spoon 2014) emphasize the role
of the parent-adolescent relationship in this association.
For example, Larsen etal. (2012) demonstrated that low
parental support was associated with ER strategy use (i.e.
suppression), whereas peer victimization was not. Perhaps,
for adolescents who are experiencing low parental support,
social information processing biases develop overtime with
implications for ER in response to threat. For example, ado-
lescents may suppress their emotions to manage relationship
difficulties with parents but be unable to sustain long-term
suppression in response to peers (a context where emotional
reactivity might be “safer” given the lack of power imbal-
ance). Thus, excessive demand for cognitive resources in
response to peer victimization coupled with a social infor-
mation processing bias reinforced by parenting may result
not in masking emotions, but rather in greater emotional
reactivity to peers. On the other hand, Walters and Kim-
Spoon (2014) suggest that the presence of supportive parents
may be one explanation as to why a significant association
between peer victimization and ER was not demonstrated.
Future studies considering how parenting behaviors may
interact with negative peer experiences to predict adjust-
ment will be a valuable addition to this field.
Turning to peer rejection more specifically, all studies
that defined adverse peer experiences as peer rejection dem-
onstrated an association between experimentally manipu-
lated peer rejection and ER. Though peer rejection tasks
involved negative experiences with peers, they were stran-
gers to participants, demonstrating that consistent neural and
behavioral effects on ER were observed in real time, despite
limitations in ecological validity. In contrast, more diverse
definitions of peer victimization (e.g. physical, verbal, rela-
tional), as compared to peer rejection, may have resulted in
less consistency in results. For example, evidence suggests
that relational and reputational victimization may exhibit
a different pathway to adjustment outcomes than overt
victimization (McLaughlin etal. 2009). That is, emotion
dysregulation mediated the association between relational
and reputational victimization and internalizing symptoma-
tology, but did not mediate the association between overt
victimization and internalizing symptomatology. Authors
note that increased hypervigilance to threat in adolescents
who experience more frequent overt victimization (as
opposed to relational or reputational victimization) may
require an examination of dysregulated fear as an underly-
ing mechanism (McLaughlin etal. 2009). Thus, differential
effects on ER seem to exist depending on the type of peer
victimization.
In consideration of how emotion dysregulation may
increase risk for adverse peer experiences, results seem
to be consistent with social information processing mod-
els, such that emotion dysregulation (including anger and
emotional reactivity) functions as a precursor to multiple
forms of aggression. For example, results using latent class
analyses provide valuable information on the importance of
ER in characterizing profiles of adolescents who not only
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156 Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
experience but also engage in peer victimization (Betten-
court etal. 2013). In contrast, a longitudinal study, including
data collected during first, fifth, eighth, and eleventh grade,
demonstrated that among children with higher levels of emo-
tion dysregulation across childhood, there appeared to be a
persistent pattern of aggressive behavior, though this pat-
tern was not replicated at the adolescent time point (Ettekal
and Ladd 2019). Given that ER typically increases during
adolescence (Hardy etal. 2020), and aggressive behaviors
decline (Ettekal and Ladd 2019), future work may benefit
from unpacking developmental effects within the adverse
peer experiences-ER link. Nonetheless, past results dem-
onstrate that latent class and latent transition analyses yield
informative results for identifying adolescents who may
be most at risk (i.e. aggressive-victims) for maladjustment
outcomes.
In sum, adverse peer experiences, including both peer
victimization and peer rejection, are negatively associated
with ER. However, stark differences in methodology cap-
turing these two processes makes it challenging to directly
compare results. It is recommended for future research to
employ multiple levels of analysis for measuring these con-
structs in a comprehensive manner while reducing possible
biases related to method variance. For instance, assessing
peer rejection by self-report in addition to experimental
manipulations would help us to understand if outcomes asso-
ciated with subjective reports of rejection are consistent with
those associated with experimentally manipulated rejection.
Furthermore, multiplicity and chronicity of adverse peer
experiences may be an important qualifier of the association
between adverse peer experiences and ER. Consistent with a
cumulative risk perspective (Rutter 2001), it is plausible to
expect a dosage effect whereby a greater number of adverse
peer experiences (e.g. in person and online, victimization
and rejection) predicts more severe consequences for ER.
According to the cognitive control of emotion model, exces-
sive need—due to experiencing multiple types of adverse
peer experiences—for down regulation of negative affect
would produce deficits in regulation abilities (Ochsner etal.
2012). Over time, the effort required to manage negative
affect associated with peer victimization may deplete ado-
lescents’ ER resources, leaving them vulnerable to further
adverse maladjustment outcomes.
Definition andMeasurement ofEmotion Regulation
Extant research on ER has called for consensus in the defini-
tion and measurement of ER. Indeed, studies reviewed here
demonstrate such variability in the definition and measure-
ment of ER used in the field; the majority of studies used
informant reports of ER, followed by brain activation meas-
ures using fMRI, and finally, behavioral performance meas-
ures. Notable results are discussed in detail below to clarify
the roles of definition and measurement of ER in evaluating
the impact of adverse peer experiences on ER.
Although studies measuring ER abilities versus strategies
appear to be relatively consistent—demonstrating a nega-
tive association—it is worth pointing out that competency
in ER may not necessarily equate to use of what are typically
considered adaptive ER strategies. First, capacity for adap-
tive ER may not align with socialized adaptive strategies,
and second, strategies that are often considered maladap-
tive (i.e., suppression) may be beneficial in the short-term
during adverse peer experiences to reduce the likelihood
of repeated attacks. A non-significant association between
peer victimization and suppression found by Larsen etal.
(2012) suggests that adolescents do not necessarily use sup-
pression in response to adverse peer experiences. However,
Vranjes etal. (2018) demonstrated a cross-sectional associa-
tion between peer victimization and suppression use. Such
conflicting results may not necessarily indicate an increase
in emotion dysregulation (via greater suppression use–typi-
cally regarded as in ineffective ER strategy), but rather may
reveal a more complicated picture of how and when adoles-
cents employ certain ER strategies. That is, when compar-
ing results of studies examining adverse peer experiences
and ER abilities versus strategies, it is important to consider
that suppression use may not necessarily be maladaptive.
Indeed, reluctance to express emotions is positively corre-
lated with ER (Riley etal. 2019). As such, in adolescence,
social information processing biases may dictate when to
express or mask certain emotions, with many strategies con-
sidered to be both adaptive and maladaptive depending on
the situation. Certainly, adolescents with particular social
information processing biases (i.e. hypervigilance to threat)
may default to a victim mindset and use suppression as an
adaptive strategy during adverse peer experiences. In con-
trast, some adolescents may be more sensitive to adverse
peer experiences and may retaliate with a reactive, even
aggressive, response. Still others may choose to employ
other strategies. For example, Vanhalst etal. (2018) dem-
onstrated that lonely adolescents were unable to put things
in perspective, focus on the positive, and were also more
likely to ruminate, catastrophize, and self-blame. The latter
strategies, in theory, increase negative emotions, which do
not require as many cognitive resources as suppression (or
down regulation) might.
While results of studies in the current review were mostly
consistent regardless of how ER was defined, the field can
significantly benefit from studies that assess ER at multi-
ple levels of analysis. Given that ER is inherently defined
as a dynamic process expressed at neural, cognitive, and
behavioral levels, studies that assess ER using diverse
methodologies are crucial to our understanding of ER as a
process, developing within context (Adrian and Berk 2018;
Beauchaine 2015). One available study by Adrian etal.
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157Clinical Child and Family Psychology Review (2021) 24:141–163
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(2019) measured ER with a variety of self-report meas-
ures and behavioral tasks and then conducted confirma-
tory factor analyses to determine the structure of ER that
best fit the data. In the end, a three-factor structure was the
best-fitting model, including emotion reactivity, cognitive
regulation, and behavioral regulation, as separate latent fac-
tors. Observed variables were all measured using various
self-report scales. None of the behavioral tasks ended up
being meaningful indicators of ER. Such results contrast
with other studies that have used a one factor structure
composed of self-reported poor emotional awareness, dys-
regulated expression of anger and sadness, and rumination
(Doyle and Sullivan 2017; McLaughlin etal. 2009). Though
a myriad of self-report measures have been used, they tap
into similar themes of cognitive and behavioral regulation of
emotions, including emotional awareness (Doyle & Sullivan,
2017; Estévez etal. 2019; McLaughlin etal. 2009; Walters
and Kim-Spoon 2014), dysregulation of sadness and anger
as distinct emotions (Bettencourt etal. 2013; Dickson etal.
2019; Doyle and Sullivan 2017), and maladaptive cogni-
tive ER strategies (Chervonsky and Hunt 2019; Larsen etal.
2012; Vanhalst etal. 2018; Vranjes etal. 2018).
Further, while several neuroimaging studies were
included in the current review, results by several studies
may reflect a reverse inference and should be interpreted
with caution. That is, ER was often not directly assessed,
but rather inferred given the assumption that negative affect
increases and needs to be regulated following peer rejec-
tion and that activation in brain regions that have previously
been implicated in ER indicate attempts at ER. Results may
reflect brain regions recruited in social affective process-
ing rather than ER per se. Nonetheless, two studies exam-
ined the impact of peer rejection on ER at both behavio-
ral and neural levels (Miller etal. 2018; Platt etal. 2015).
Following an experimental manipulation of peer rejection,
Miller etal. (2018) asked adolescents to perform a cognitive
reappraisal task during an fMRI. Neural results, as well as
self-reported strength of emotional reaction following each
stimulus, yielded important information for understanding
reactivity and regulation following a salient stressor for ado-
lescents. Similarly, Platt etal. (2015) asked participants to
use cognitive reappraisal to regulate emotions while viewing
negative (rejecting) feedback from peers. Results replicated
those by Ochsner etal. (2012), highlighting the role of the
ventral and dorsomedial prefrontal cortex in ER, in response
to negative affect, and providing support for the theory of
cognitive control of emotion. In sum, protocols that meas-
ure brain activation while engaging in ER would provide a
more rigorous approach to elucidating the impact of adverse
peer experiences on neural correlates of ER than relying on
reverse inferences.
Taken together, these studies suggest three important
conclusions. First, ER can be expressed across multiple,
similar dimensions. However, components of ER may
also become more differentiated during adolescence, such
that ER abilities are shown by distinct (i.e., not necessar-
ily inter-correlated) behaviors across different adolescents
(Zimmermann and Iwanski 2014). Moreover, there is evi-
dence that such divergence may be related to emotion spe-
cific regulation (Zimmermann and Iwanski 2014). As such,
single indicators of ER that are not emotion specific, may
not be the best means of capturing this construct. Second,
the impact of adverse peer experiences on ER seems to be
most consistent and obvious in studies assessing ER with
self-report. Therefore, self-report seems to be an appropriate
and efficient means of testing this association. However, it
is important to acknowledge that this may be due to shared
method variance, as both adverse peer experiences and ER
were often reported by the same reporter using the same
method (questionnaires). Furthermore, results are difficult
to compare across methodologies, considering the limited
number of behavioral studies and the difficulty in drawing
inferences regarding how ER may be impacted at neural lev-
els as a result of adverse peer experiences. Third and finally,
this field of research will benefit from measurement of ER at
multiple levels that are most appropriate and comprehensive
for the given study’s definition of ER. Such measurement
will allow for more rigorous testing and robust conclu-
sions regarding the link between adverse peer experiences
and ER, surpassing possible biases due to methodological
approaches.
Risk andProtective Factors
Few studies have identified factors that may attenuate or
exacerbate the association between adverse peer experiences
and ER. Gender was one factor that was considered in sev-
eral studies. However, comparable results between males
and females in the majority of studies might seem to suggest
that gender is not a particularly salient moderating factor for
this association. Yet, research has demonstrated main effects
of gender (i.e., differences in the levels between genders)
in both adverse peer experiences and in ER with implica-
tions for their association (Rose and Rudolph 2006; Sanchis-
Sanchis etal. 2020). For example, adolescent girls exhibit
elevated reactivity to social stressors and increasing neural
sensitivity (Guyer etal. 2012; Rudolph 2009). A review by
Rose and Rudolph (2006) suggested gender differences in
the type of adverse peer experience, such that boys tend to
experience more overt and physical victimization, whereas
girls experience more relational victimization or friendship
stress. As such, although results of the present review sug-
gest that gender difference is not noteworthy with respect
to the adverse peer experiences and ER association, it is
plausible to assume dissimilar explanatory pathways. For
example, avoidance responses which are more common in
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158 Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
boys may be similarly disruptive to effective ER as rumina-
tion responses which are more common in girls (Rudolph
etal. 2020a, b). Certainly, there is more work to be done in
elucidating the role of gender in this association. Research
involving clinical samples offers initial evidence suggest-
ing that adolescents with particular symptoms (i.e. depres-
sion, loss of control eating, loneliness) may be more likely
to experience adverse peer interactions than their typically
developing counterparts. It is unclear whether this may be a
result of more negative treatment by peers given their “dif-
ferentness”, or related to initial impairments in ER associ-
ated with their symptoms which in turn made them more
vulnerable to negative peer interactions. Longitudinal bidi-
rectional modeling controlling for initial levels of ER will
greatly enhance our understanding of how and why these
adolescents may ultimately experience emotion dysregu-
lation. Nonetheless, results suggest that these adolescents
may benefit from intervention efforts to prevent cascading
risk associated with adverse peer experiences and emotion
dysregulation.
Regarding protective factors, there is evidence demon-
strating parent support as a promising factor that may ame-
liorate detrimental effects of adverse peer experiences on
ER (Kokkinos etal. 2019). Given that parents continue to
be influential support figures in adolescence, understand-
ing how parent factors intersect with peer factors to predict
adolescent adjustment will be important. Additional models
have considered coping skills and self-efficacy (Trompeter
etal. 2018). Likewise, attributions related to confidence and
abilities in managing emotions play an important role in ER.
Given the dearth of research in this area, the identification of
moderating factors that may attenuate effects is an important
direction for future research.
Limitations andFuture Directions
By systematically reviewing this body of literature, a num-
ber of limitations in our understanding of the association
between adverse peer experiences and ER have come to light
and point to directions for future research. First, while the
present review highlights promising theoretical perspec-
tives that may begin to explain associations between adverse
peer experiences and ER, it is important to consider specific
developmental and contextual factors that are influential dur-
ing adolescence. For example, we speculated about the root
of social information biases (i.e. derisive parenting) in ado-
lescents that may contribute to dysregulated and aggressive
responses to peer victimization. Further, we articulated the
continued importance of the parent-adolescent relationship
and noted that future work may benefit from considering
how parent and peer effects transect to predict ER. Ado-
lescence is characterized by unique changes to context that
may be important to consider in our theoretical models of
how this process unfolds. Additionally, given the significant
indirect effects of overt peer victimization on both anxiety
and depression via sadness regulation, but not anger regula-
tion (Doyle and Sullivan 2017), future research may benefit
from examining regulation of specific emotions and whether
or not they are differentially connected to adverse peer expe-
riences and adjustment outcomes. Furthermore, different
emotions may be evoked by different experiences which
may be more or less salient during adolescence. Finally, the
small number of studies included in the present review did
not allow for nuanced discussion around several factors of
interest (e.g. developmental differences, method or inform-
ant effects; objective versus subjective victimization), which
would be aided by a greater number of studies examining the
adverse peer experiences-ER link in adolescence.
Next, regarding study design, experimental tasks that
manipulated feelings of rejection were unable to measure
ongoing adverse peer experiences. As such, we recommend
that future research consider whether the nature of chronicity
in adverse peer experiences impacts results. Furthermore,
longitudinal examination of bidirectional effects between
adverse peer experiences and ER is needed to determine
directionality in this association. Particularly, longitudinal
studies that allow for growth curve analyses may yield excit-
ing results of interrelations between systematic change in
these constructs across adolescence. Lastly, we recommend
a concerted effort in identifying both risk and protective
factors that may exacerbate or ameliorate negative outcomes
associated with adverse peer experiences and emotion dys-
regulation. Future studies that examine the adverse peer
experience to ER link in additional clinical samples (e.g.
Autism Spectrum Disorders, Attention Deficit Hyperactiv-
ity Disorder) will increase our ability to generalize findings
across clinical populations. Regarding protective factors,
individual (i.e. social competence, self-efficacy), parenting
(i.e. support, monitoring), and school factors (i.e. program-
ming) may be promising options to explore.
Finally, a number of methodological limitations are
noted. First, methods used to assess peer victimization and
peer rejection differed, making it difficult to compare results
directly. Future research may consider creatively captur-
ing both constructs in similar ways to allow evaluation of
whether each type of adverse peer experience contributes
differently to ER and related adjustment outcomes. One pos-
sibility is experience sampling methodology, or daily dia-
ries. Prior research has used daily diary reports successfully
to capture peer victimization across multiple reporters (Pou-
wels etal. 2016) as well as ER (Lennarz etal. 2019). Addi-
tionally, in experimental studies that manipulated feelings
of peer rejection, it may be informative to include a control
sample that did not experience rejection. Such a distinction
would strengthen causal inferences regarding the impact of
adverse peer experiences on ER. Further, the current review
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159Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
demonstrated an over reliance on self-report and question-
naires to assess constructs. For instance, of the 18 studies
that utilized self-report, 15 of them relied on self-report
for both adverse peer experiences and ER, while one of
them used teacher-report for both adverse peer experiences
and ER. Although self-reports on questionnaires may be a
simple and effective means of capturing these constructs,
shared method variance and reporter effects may have intro-
duced bias into the results. Utilizing multiple informants
and multiple methods (Geiser etal. 2010) could be ben-
eficial to improve construct validity in measuring adverse
peer experiences. Moreover, employing multiple methods
across multiple levels of analysis would deepen our under-
standing of the nature of the negative peer experiences and
ER link. For example, given that many of the neuroimaging
studies included made reverse inferences concerning ER,
we are limited in our ability to draw conclusions regard-
ing the effects of adverse peer experiences on ER at neural
levels. Further, the conclusions drawn are restricted by the
absence of sociometric peer status data to capture adverse
peer experiences, limiting the validity of the adverse peer
experiences construct. Although the present review demon-
strates that self-report is effective in capturing adverse peer
experiences and predicting emotion dysregulation, future
studies would benefit from including multiple measures of
constructs for greater validity. Overall, future research using
multiple levels of analyses will enhance our understanding
of the role of contextual factors including personality factors
(i.e., self-efficacy), physiological factors (i.e. emotional reac-
tivity), social factors (i.e. parent socialization of ER), and
neural factors (i.e. brain activation), for example, intersect
to predict adjustment.
Implications andConclusions
Adolescence is a developmental period marked by changes
in cognition, emotion, and social relations. During adoles-
cence, sensitivity to social feedback increases (Somerville
2013) as peer relationships become more important and
less stable (Hardy etal. 2002), leaving adolescents vulner-
able to experiences of victimization and rejection by peers.
Exposure to adverse peer experiences has deleterious effects
on adolescent development. Moreover, as prefrontal brain
regions responsible for regulatory abilities continue to
mature during adolescence (Lewis and Stieben 2004), the
brain is susceptible to environmental influences. As such,
chronic exposure to adverse peer experiences may under-
mine ER processes. Given that ER has important implica-
tions for several domains of development linked to ado-
lescent adjustment (Aldao etal. 2016), it is important to
recognize how difficulties with ER may cascade into further
adjustment problems (e.g. psychopathology). Indeed, sev-
eral studies included in the current review extended their
findings to adjustment outcomes, including anxiety, depres-
sion, aggression, and disordered eating (Adrian etal. 2019;
Doyle and Sullivan 2017; Herts etal. 2012; Jarcho etal.
2015). That is, difficulties with ER may prolong negative
affect and reduce effective coping and problem-solving skills
that can then extend into psychopathology. Indeed, emo-
tions and emotion dysregulation play a significant role in
the onset, expression, and course of anxiety disorders (Han-
nesdóttir and Ollendick 2017). Furthermore, as adolescents’
transition into young adulthood, difficulties with ER may
confer risk for engaging in risk taking (Holmes etal. 2019)
and substance use (Siegel 2015), as maladaptive forms of
coping with negative affect.
Therefore, the current review highlights ER as an impor-
tant target of intervention efforts aimed at reducing malad-
justment associated with adverse peer experiences. Consid-
ering preliminary support for the notion that the association
between adverse peer experiences and ER may be bidirec-
tional, intervention is imperative to prevent cascading risk.
Certainly, intervention techniques from existing protocols
(e.g. cognitive behavioral therapy; dialectical behavioral
therapy; mindfulness) that include ER components could be
incorporated into current interventions targeting victimized
adolescents. By working to intentionally develop ER skills
(e.g. cognitive reappraisal; Miller etal. 2018; Platt etal.
2015), adolescents will be better equipped to navigate social
contexts. Treatment programs developed with the intention
of focusing on emotions and building ER skills, have seen
some success. For example, a program called the Unified
Protocol for the Treatment of Emotional Disorders in Youth
addresses emotional problems faced by adolescents and has
demonstrated a reduction in overall emotion dysregulation,
anxiety, and depressive symptoms in youths (Trosper etal.
2009). Additionally, our findings suggest that adolescents
may use ER skills and abilities selectively. Thus, further
research that can identify how adolescents’ social relation-
ships and contexts affect the utilization of ER skills may
bolster intervention efforts by targeting not just individual
skills but also the larger social context.
Regarding prevention and intervention opportunities,
proximal contexts to adolescents (e.g., home and school
system) are designed to protect students against the nega-
tive effects of adverse peer experiences and emotion dys-
regulation. First, school-based youth violence preven-
tion programs that focus on enhancing school climate
(e.g. Olweus and Limber 2010) may serve to reduce the
number of incidents and impact of peer victimization,
as school staff can not only work to prevent recurrent
instances of peer victimization but also address signs of
increased dysregulation and psychopathology in victims.
Second, school-based socio-emotional learning programs
(Durlak etal. 2011), with a particular focus on ER skills,
can contribute to the development of students’ social
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160 Clinical Child and Family Psychology Review (2021) 24:141–163
1 3
skills, emotional competence, and conflict resolution
skills, thereby reducing negative outcomes in adolescents
exposed to peer victimization, stimulating psychosocial
adjustment, and ideally preventing future incidents of vic-
timization. Finally, educating parents in how to provide
appropriate monitoring and support to their adolescents
may serve to prevent exposure to adverse peer experi-
ences (Khurana etal. 2015), and strengthen ER abilities,
limiting negative outcomes. To illustrate, extant literature
has demonstrated that parental monitoring and autonomy-
supportive parenting (characterized by clear limits, a warm
and responsive climate, and autonomy support) guides and
reinforces the acquisition of adaptive ER abilities (Bren-
ning etal. 2015; Farley and Kim-Spoon 2017).
Taken together, results from the present review demon-
strate an association between adverse peer experiences and
ER. Consistent with the cognitive control of emotion model
(Ochsner etal. 2012), the salience of the peer context dur-
ing adolescence combined with the stress of experiencing
adverse peer experiences may undermine ER abilities and
their neural correlates. On the other hand, social information
processing theory (Dodge and Crick 1990) sheds light on
how adolescents with ER difficulties may be vulnerable to
experiences of peer victimization or rejection. Results also
indicate that there is considerable variability in definitions
and measurement of both adverse peer experiences and ER
that make nuanced comparisons between studies difficult.
Nonetheless, the present review takes a systematic approach
to organizing this body of literature and identifies promising
theoretical perspectives that help to explain this association.
Finally, we have offered recommendations for future work to
expand our understanding of these processes as well as for
prevention and intervention efforts that may serve to ame-
liorate outcomes for youths facing difficulties with adverse
peer experiences and emotion dysregulation.
Acknowledgments We are grateful to Erin Goetzke for her help with
article screening and coding.
Authors’ Contributions TH conceived the idea, performed the literature
search and analysis, and drafted the manuscript. JKS critically revised
the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by grant awarded to Jungmeen Kim-
Spoon from the National Institute on Drug Abuse (DA036017).
Compliance with Ethical Standards
Conflict of interest The authors report no conflict of interests.
Ethics Approval Not Applicable.
Consent to Participate Not Applicable.
Consent for Publication Not Applicable.
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