Psychological Bulletin © 2017 American Psychological Association 2017, Vol. 143, No. 9, 939–991 0033-2909/17/$12.00 http://dx.doi.org/10.1037/bul0000110 Coping, Emotion Regulation, and Psychopathology in Childhood and Adolescence: A Meta-Analysis and Narrative Review Bruce E. Compas, Sarah S. Jaser, Alexandra H. Bettis, Kelly H. Watson, Meredith A. Gruhn, Jennifer P. Dunbar, Ellen Williams, and Jennifer C. Thigpen Vanderbilt University In this meta-analytic and narrative review, we examine several overarching issues related to the study of coping, emotion regulation, and internalizing and externalizing symptoms of psychopathology in child- hood and adolescence, including the conceptualization and measurement of these constructs. We report a quantitative meta-analysis of 212 studies (N ϭ 80,850 participants) that measured the associations between coping and emotion regulation with symptoms of internalizing and externalizing psychopathol- ogy. Within the meta-analysis we address the association of broad domains of coping and emotion regulation (e.g., total coping, emotion regulation), intermediate factors of coping and emotion regulation (e.g., primary control coping, secondary control coping), and specific coping and emotion regulation strategies (e.g., emotional expression, cognitive reappraisal) with internalizing and externalizing symp- toms. For cross-sectional studies, which made up the majority of studies included, we examine 3 potential moderators: age, measure quality, and single versus multiple informants. Finally, we separately consider findings from longitudinal studies as these provide stronger tests of the effects. After accounting for publication bias, findings indicate that the broad domain of emotion regulation and adaptive coping and the factors of primary control coping and secondary control coping are related to lower levels of symptoms of psychopathology. Further, the domain of maladaptive coping, the factor of disengagement coping, and the strategies of emotional suppression, avoidance, and denial are related to higher levels of symptoms of psychopathology. Finally, we offer a critique of the current state of the field and outline an agenda for future research. Keywords: adolescents, children, coping, emotion regulation, psychopathology The identification of processes of risk and resilience is crucial and adolescents adversely affected while others are resilient? The for understanding the etiology of internalizing and externalizing ability to cope with stressful events and circumstances and regu- symptoms and disorders in childhood and adolescence and for the late emotions across situations may play a primary role in the development of interventions for the prevention and treatment of development of resilience and reducing the risk for psychopathol- these symptoms and disorders (e.g., Cicchetti & Curtis, 2007; ogy during childhood and adolescence (Compas, Gruhn, & Bettis, Kraemer, Lowe, & Kupfer, 2005; Luthar, 2006; Masten, 2001, 2017; McRae & Mauss, 2016; Zimmer-Gembeck & Skinner, 2014; Troy & Mauss, 2011). Exposure to acute and chronic stress- 2016). Given the potential to inform our understanding of pro- ful events and adversity is one of the most potent risk factors for cesses of risk, resilience, and intervention, research on coping and psychopathology during childhood and adolescence (e.g., Evans, emotion regulation in children and adolescents is of considerable Li, & Whipple, 2013; Grant et al., 2003; Kushner, 2015). Yet not importance for the field of developmental psychopathology and all who experience stress and adversity go on to develop symptoms prevention science. However, despite a large and growing body of of psychopathology, raising the question, why are some children research, there has been no quantitative meta-analysis of the as- sociation of coping and emotion regulation with symptoms of This document is copyrighted by the American Psychological Association or one of its allied publishers. internalizing and externalizing psychopathology in children and This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. adolescents. Therefore, an integrative, quantitative review of this This article was published Online First June 15, 2017. Bruce E. Compas, Department of Psychology and Human Development, research is a high priority. Vanderbilt University; Sarah S. Jaser, Department of Pediatrics, Vanderbilt Although there are many commonalities between these con- University; Alexandra H. Bettis, Kelly H. Watson, Meredith A. Gruhn, structs, research on coping and emotion regulation has remained Jennifer P. Dunbar, Ellen Williams, and Jennifer C. Thigpen, Department relatively separate (e.g., Compas, Jaser, & Benson, 2009; Compas of Psychology and Human Development, Vanderbilt University. et al., 2014a; Kopp, 1989; Zalewski, Lengua, Wilson, Trancik, & This research was supported by Grants R01 MH100258 and T32 Bazinet, 2011; Zimmer-Gembeck et al., 2014). For example, Com- MH018921 from the National Institute of Mental Health, R01 CA118332 pas et al. (2014a) found that although both coping and emotion from the National Cancer Institute, and DP3 DK097678 from the National regulation are active areas of research, only 208 of 20,804 publi- Institute of Diabetes and Digestive and Kidney Diseases. Correspondence concerning this article should be addressed to Bruce E. cations (1%) between 2003 and 2012 identified in a PsycINFO Compas, Department of Psychology and Human Development, Peabody search included both of these concepts as key terms. There has 552, 230 Appleton Place, Vanderbilt University, Nashville, TN 37203. been little integration of the conceptualization and measurement of E-mail: [email protected] these two processes. Further, confusion in defining and conceptu- 939 940 COMPAS ET AL. alizing coping and emotion regulation in youth, as well as identi- Coping and Emotion Regulation: Definitions and fying clear dimensions or subtypes of these processes, has inhib- Conceptualization ited the synthesis and integration of findings (Skinner, Edge, Altman, & Sherwood, 2003). In addition, the measurement of Previous reviews have noted a lack of consensus in the defini- coping and emotion regulation is characterized by a large and tion and conceptualization of coping and emotion regulation in ever-expanding number of measures, many of which are of un- children and adolescents (e.g., Adrian, Zeman, & Veits, 2011; known psychometric quality. Finally, it has been 16 years since the Compas et al., 2001; Eisenberg et al., 2010; Skinner et al., 2003). last comprehensive review of coping and internalizing and exter- Clear consensus on the definitions of coping and emotion regula- nalizing psychopathology in children and adolescents (Compas, tion is needed to identify the boundaries of what is and is not Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001) and 7 included within each of these constructs, shape the identification of years since the last review of emotion regulation and these broad the structure and subtypes of coping and emotion regulation, and domains of psychopathology in young people (Eisenberg, Spinrad, guide the selection of measures for research on the association of & Eggum, 2010). Notably, neither of these reviews provided coping and emotion regulation with psychopathology. It is encour- quantitative meta-analyses. aging, therefore, that since earlier reviews of coping and emotion To address these gaps in the field, we begin by examining regulation were published there have been some signs of conver- several overarching issues related to the study of coping, emotion gence on the central features of these constructs. regulation, and psychopathology in children and adolescents. First, we consider several broad issues in this field including definitions Definitions of Coping and Emotion Regulation and conceptualizations of coping and emotion regulation in child- hood and adolescence, the status of the measurement of coping and The challenge of establishing consensus regarding definitions of emotion regulation, the role of exposure to acute and chronic coping and emotion regulation is reflected in the 212 studies stressors and the experience of emotions in the development of included in the meta-analysis reported below. The most widely psychopathology, and previous reviews on the associations of used definitions of coping and emotion regulation in childhood and coping and emotion regulation with symptoms of psychopathol- adolescence are presented in Table 1. Both the Lazarus and Folk- ogy. In the primary section of this review, we report on a quanti- man (1984) and Compas et al. (2001) definitions of coping high- tative meta-analysis of the associations between coping and emo- light the role of coping as a process of responding to stress. tion regulation and internalizing and externalizing symptoms in Further, both definitions emphasize coping as a controlled, effort- children and adolescents. We also consider three possible moder- ful process; that is, responses that require conscious, purposeful, ators of the association of coping and emotion regulation with and intentional thoughts and behaviors. However, Lazarus and symptoms of psychopathology: child age, the quality of measures Folkman (1984) emphasize cognitive appraisals of stress as pre- of coping and emotion regulation, and the use of single versus cipitants of coping responses, whereas Compas et al. (2001) focus multiple informants to measure coping and emotion