5 - (OP29) Preschooler Emotion Regulation Development Within a Randomized Controlled Trial of Maternal DBT Skills Training

The preschool period represents a critical window for emotion regulation (ER) development. Maladaptive ER development during this time is associated with increased risk for later psychopathology, necessitating examination of environmental risk factors contributing to meaningful change in ER. The influence of primary caregivers is especially salient to preschooler ER development, and understanding of effective ER strategies (e.g., problem solving) may take shape in the context of parental ER modeling. Notably, rates of mental health challenges within families remain high, and mothers with elevated ER difficulties may inadvertently model more ineffective ER strategies, an early factor implicated in the transmission of risk. However, our understanding of ER development is largely informed cross-sectionally, hindering identification of malleable environmental risk factors and intervention targets (e.g., maternal ER difficulties). Maternal participation in dialectical behavior therapy (DBT) skills group—a leading evidence-based intervention for improving ER—may offer one avenue for mitigating intergenerational risk. To date, few studies have examined child-level outcomes among parents participating in DBT, and no randomized controlled trials (RCT) have tested downstream effects of DBT skills group for adults on offspring development.

The present study leveraged repeated assessments within an RCT design to model preschooler ER strategy understanding (ER-SU) development and examine prospective intergenerational impacts of maternal ER difficulties and DBT skills group participation on rate of change. 178 mothers (Mage = 31.16 years; 28% ethnoracially minoritized) and their preschool-aged children (Mage = 42.31 months; 52% female; 37% ethnoracially minoritized) enrolled, including 85 non-clinical (NC) mothers and 93 mothers with elevated ER difficulties randomized to DBT skills group (n = 46) or family services as usual (FSU; n = 47). DBT participation involved one year of weekly, 2.5-hour skills group, including standard skills modules (mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness), case management, and phone coaching. Therapists sat on a weekly consultation team.

Dyads completed a baseline, 4-month, and 8-month follow-up assessment. Preschoolers completed a behavioral task assessing ER-SU at each time point. Multigroup latent growth curve models indicated significant positive change in ER-SU among preschoolers of mothers in the NC and DBT groups, but not among those in the FSU group. Group comparisons revealed marginal differences in growth between NC and FSU groups, while growth did not significantly differ between DBT and NC or DBT and FSU groups. Intercept means did not differ across groups (i.e., no baseline differences in preschooler ER-SU). These findings suggest that DBT skills group for mothers with elevated ER difficulties may represent a promising, preventative tool supporting preschooler ER development. As a widely disseminated, evidence-based treatment with growing empirical support across diverse populations, we underscore DBT’s prospective utility as an accessible intervention with intergenerational impacts.