Reactivity of Emotions in Adolescents - Caregivers' Tool (React): Development and Validation of a Novel Parent-Rated Measure for Assessing Emotional Dysregulation in Youth.

Emotional Dysregulation (ED) is characterized by the inability to manage emotions effectively, leading to maladaptive behaviors, and often co-occurs with psychiatric conditions carrying significant long-term consequences. Early diagnosis of ED is thus essential for targeted interventions. To address this need, we developed and validated the "Reactivity of Emotions in Adolescents: Caregivers' Tool" (REACT), a novel parent-rated questionnaire designed to assess ED in adolescents. The present study involved two samples, one drawn from the general population (n = 89 healthy controls from local schools) and the other composed of clinical patients (n = 76 adolescents with different psychiatric and/or neurodevelopmental conditions). Patients' diagnoses were confirmed through the clinical interview K-SADS-PL to explore the presence of any psychopathological conditions. Participants from both groups completed the RIPoSt-Y questionnaire, providing a measure of ED, while their parents filled out the ARI, measuring affective reactivity in youth. Confirmatory and exploratory factor analyses were performed to refine the questionnaire's internal structure. The final REACT questionnaire consists of 55 items distributed across three subscales, namely Negative Emotionality, Irritability, and Excitability. Psychometric evaluation showed that these subscales demonstrated excellent internal consistency and strong construct validity, with clinical patients scoring higher on all subscales compared to healthy controls. The REACT questionnaire showed also high convergent validity by exhibiting significant positive correlations with established measures of ED. This novel tool represents a valuable improvement in the assessment of ED in adolescence as it may facilitate tailored interventions to provide emotional well-being and long-term outcomes.

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Competing interests: Dr Gabriele Masi has received institutional research grants from Lundbeck, Laborest and Humana, was on an advisory board for Angelini, and has been a speaker for Angelini, Janssen, Lundbeck, and Otsuka. All the other authors have no interests to disclose.