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*Corresponding Author: Raquel Rodríguez-Alcántara, National Autonomous University of Mexico (UNAM). Mexico City, México
Citation: R. Rodríguez-Alcántara, B.E.Barcelate-Eguiarte, M. Mirna García-Méndez, M.E. Bermúdez-Jaimes, and N.I. González-Arratia, (2020) Examining the Mediating Role of Coping and Emotion Regulation in Stress Models in Adolescents; J. Psychology and Mental Health Care. 4(6). DOI: 10.31579/2637-8892/107
Copyright: © 2020 Raquel Rodríguez-Alcántara, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,provided the original author and source are credited.
Received: 04 November 2020 | Accepted: 28 November 2020 | Published: 04 December 2020
Keywords: adolescence; coping; emotion regulation; marginalized settings; mediation analysis; sobel test; stress
The aim of this research was to analyze the relationship between stressful events, coping, and emotion regulation in adolescents from marginalized settings. A cross-sectional study was conducted with 523 adolescents aged 13 to 15 years. The Global Scale of Perceived Stress for Adolescents, the Coping Scale for Adolescents, and the Multidimensional Scale of Emotion Regulation for Adolescents, were used. Several mediation models were tested considering whether coping mediated the relationship between stressful events and emotion regulation responses, or, on contrary, emotion regulation assumes a mediating role between stressful events and coping. Data indicate significant direct and indirect effects in all models, with the highest explained variance in the models which included emotion regulation as a mediating variable. Results are discussed considering the role of coping and emotion regulation as mediating variables, and their relationship with diverse stressful events. In this research, emotion regulation strategies lead to adolescent coping.
Running head: Mediating role of coping and emotion regulation in stress models
From a transactional perspective, stress is a dynamic and complex process that emerges when an individual perceives internal or external demands as threatening, challenging or harmful [1]. So, stress is a consequence of the interaction between both the individual and the environment. Conceptual models of stress in adolescence [2, 3, 4] propose that stressful life events are determined when the adolescent's assessment of the situation or environmental conditions is experienced as a threat [5, 6]. Stress in adolescence are often relational nature associated with family, school, and life project, which may include puberty concerns, conflicts with peers and family, academic problems, school transitions, initiating and maintaining romantic relationships [4]. There are, a large variability of responses to stress, due to individual factors, such as, subjective appraisal and perceived control of situation, associated with gender and age [4, 6]. For example, girls report more stressors in interpersonal domain and react higher, whereas boys report more stressors related with academic issues and lower gradient of stress [7, 8]. Also, contextual factors, for example, sources or domain of stress [8], the characteristics of a stressor situation (e. g. kind of stressor, frequency, intensity), as suggested by Fluori and Kallis [9], are elements that should be considered in research with adolescents. Events can be major life events, which affect many adolescents with a great emotional impact (e.g. death of parents) and minor life events (e.g. physical changes) and daily life events or daily hassles, with high frequency but apparently with less emotional impact [5]. Therefore, both major or minor life events in diverse domains could represent a potential threat to the well-being and healthy development of adolescents via accumulation, so, daily hassles, can lead negative outcomes as depression or anxiety, in the same way that major life events [2, 10]. There is evidence that intensity of stress depends on perceived control of situation as well as the way of coping of adolescent [6, 11]. However, adolescents are not passive receptors to environmental demands, they can actively determine their environment [12]. In this sense, coping is a mechanism that involves cognitive and behavioral effort oriented to manage, reduce, minimize, or tolerate external and internal demands that generate stress [2]. During adolescence, coping implies dealing with stressors through concrete actions to face or avoid the situation, so, coping can be functional or dysfunctional. Functional or active coping involves efforts to manage the situation or problem which has been associated with positive outcomes and resilience [12, 13, 14], such as, prosocial behavior despite adverse events [9], or social competence facing stressful interpersonal relationships [15]. On the other hand, dysfunctional o passive coping involved avoiding the source of stress due to an anticipated negative appraisal of the situation and the own resources to deal with, so, is related with negative outcomes, for example, victimization [16], internalizing behaviors [17], and suicide risk [18]. Coping is a fundamental adaptive process which involves the regulation of multiple subsystems (e. g. emotion and attention) that are activated by stress and which also show regular development according to how this regulation is achieved [14]. However, more recently it has been proposed that coping and emotion regulation are different, but at the same time, linked adaptive mechanisms [19, 20].
Emotion regulation implies responses aimed at the generation and modulation of emotions, that is, involves extrinsic and intrinsic processes of supervision, evaluation and modification of emotional expression specially their intense and temporal characteristics in order to maintaining, increasing or suppressing an ongoing affective state [21, 22]. Although emotions can arise in response to stressful and adverse situations, emotions can occur as part of ongoing normative experiences of daily lives that do not involve stressful events or adverse circumstances [20, 23]. Studies showed that negative strategies of emotion regulation, such as, expressive suppression, are linked to negative outcomes, such as, maladaptive social functioning and internalizing problems [24], whereas positive strategies, are associated with adaptive behavior and psychological adjustment, nevertheless, depend on the context and the source of stress, therefore, it is important examining the interplay of both coping and emotion regulation at different situations or stressors. In addition, recent research indicates gender differences on coping and emotion regulation strategies, with girls using problem-solving coping strategies, emotional expression, wishful thinking and rumination, more often than boys, however, boys use more positive thinking, cognitive restructuring, and acceptance than girls did [25] and boys have difficulty regulating negative emotions according to contextual demands and thus may lead them to show, for example, greater levels of unmodulated anger, and used suppression more often than avoidance. [26].
Summarizing, coping and emotion regulation are important processes in mental health, maintenance of a wide range of psychological disorders and psychopathology during adolescence [19], So the adolescent mental health outcome can be considered as result of the complex interaction of coping and emotional mechanisms which involved diverse individual and contextual variables [27], for example, the characteristics and nature of stressor which are important issues involved in coping and emotion regulations responses [4, 10, 11]. So, ability to cope with stressful events and regulate emotions through situations, takes account the individual's resources and the interactional context in which adolescent development take place [3] contributing in building resilience and reducing risk of psychopathology during childhood and adolescence [11, 12, 14].
Although some contextual conditions cannot be changed, programs that involve the teaching of coping strategies [3], emotional regulation skills [28], and ways of reframe the perception of events, or cognitive reappraisal [29], could be designed from a preventive intervention perspective aimed to teach productive way of coping and positive emotion regulations strategies during adolescence to improve resilience [30].
Summarizing, despite the extensive research on coping and emotion regulation, examining their relationship is important since controversies remain about their relationship. Some researchers suggest that coping and emotional regulation are different but related processes [19, 20], whereas others refer to emotion regulation process as if they were coping strategies [23]. In addition, some types of stressors, as daily stressors or daily hassles, have been less studied in comparison with major events, in relationship with emotion regulation, even though the daily stressors have been linked with psychopathology, due their seeming emotional low impact; however, they are high probability of occurs in social risk and marginalized contexts [31], impacting the physical and well-being, due ineffective coping and emotion regulation strategies [32, 33].
So, we ask some questions: is coping mediator between stressful situations and emotional responses? or conversely, emotion management leads the way of the adolescent cope with stressful situations? Strategies of coping and emotion regulation change depending on the stressful situation? The general purpose of this study was to analyze the relationship between stressful events, coping, and emotion regulation. Therefore, this study examined whether coping mediated the relationship between stressful events and emotion regulation responses, or, on contrary, emotion regulation assumes a mediating role between stressful events and coping.
The general conceptual model guiding the current study propose as an independent variable, the specific source of stress or type of stressors, mediating the emotional responses by coping (path a) or the specific sources of stress or stressors, mediating the coping strategies by emotional responses (path b). We expect that: a. Type of stressful events, coping and emotion regulation strategies are related; b. The way of coping and emotion regulation strategies change depending on type of stressful events; c. Coping is a mediator between stressful events and emotion regulation strategies; and d. Emotion regulation strategies are mediator between stressful events and coping.
Participants
A sample of 523 adolescents aged between 13 and 15 years old was intentionally selected (M = 13.89; SD = .777). Participants were students from public high schools in marginalized metropolitan areas of Mexico City. According to the National Population Council of Mexico [34], marginalized areas are characterized by low development rates ranging from 1,10318 to 1,22461, with overcrowding, a high rate of violence, poor health and education services, and low income [35]. As part of the inclusion and exclusion criteria, only students from high school located in marginalized areas of Mexico City were included in this research. A cross-sectional correlational study was conducted.
Measures
To assess the stress responses, the Global Scale of Perceived Stress for Adolescents was used [36]. This scale consists of 48 items in a Likert scale of six points ranging from 0 to 5 (0 = It did not happen to me, 1 = It does not stress me, 2 = It stresses me little, 3 = It stresses me regularly, 4 = It stresses me a lot, 5 = It stresses me too much). Six factors are evaluated: 1. Critical events (α = .765) refers to unexpected and non-normative life events such as losses and accidents (e. g. "death of any of the parents") ; 2. Daily hassles (α = .756) identifies some daily events, which can be perceived as stressful, for example, not having internet or lack of transportation; 3. Social exposure (α = .807) explores situations in which adolescents may feel socially exposed, such as going to parties or traveling to school; 4. Family concerns (α = .788) assesses events that may occur in a family context and generate financial pressure, for example lack of money to buy school supplies; 5. Academic stressors (α =. 799) refers to events that can occur within the school context and that can generate pressure such as having too much homework or exposing in class; and 6. Social pressure (α = .763) includes situations related to limitations in social interaction and perception of difficulties in relating to others. The six factors explain the 46.69% of the variance and show a global Cronbach's alpha of .962.
The Coping Scale for Adolescents (EA-A) was administrated [37]. The scale includes 27 items on a five-point Likert scale (1= strongly disagree, 2= disagree, 3=neutral, 4= agree, 5= strongly agree). The scale evaluates seven factors: 1. Positive thinking and seeking solutions (α = .89) allows evaluating efficient coping strategies aimed at solving the problem and approaching it in a positive way (e. g. “I try to change things so that the problem does not recur”); 2. Physiological responses related to anxiety (α = .82) is an aspect of coping related to the possibility of developing physical illnesses (e. g. “I feel my heartbeat”); 3. Obsessive thoughts and hopelessness (α = .74) identifies dysfunctional strategies that involve negative thoughts and emotions that revolve around the problem (e. g. “I think about the problem a lot and I can't get it out of my head”); 4. Seeking family support (α = .84) refers to resorting to passive or active family intervention to solve the problem and obtain emotional support (e. g. “I discuss the problem with my parents and siblings for advice”); 5. Passive avoidant (α = .65) strategies that represent the denial and repression of the problem, which are reflected in attitudes and actions that lead to immobility or withdrawal (e. g. “I don't care about the situation”); 6. Seeking social support (α = .64) assesses the use of social resources, such as tools for solving the problem or emotional support (e. g. “I ask advice from a friend to solve the problem”); and 7. Religion (α = .68) implies resorting to religious beliefs to lessen the discomfort generated by a stressful or problematic situation (e. g. “I seek relief in religion”). The total scale explains 51.58% of the variance.
The Multidimensional Scale of Emotion Regulation for Adolescents was used [38]. The scale includes 47 items on a five-point Likert-type scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). The scale is distributed in eight factors that explain 49.3% of the variance: 1. Recognition of positive emotions (α = .930) allows to identify and differentiate the positive emotions that the individual experiences (e. g. “I can recognize when I’m glad”); 2. Expression of positive emotions (α = .870) is the behavioral manifestation of positive emotions and involves interaction with other people (e. g. “When I have positive emotions, I express them”); 3. Emotional control (α = .848) refers to the perception of the individual about the domain of the emotions and the way of expressing them (e. g. “I think I have control over my negative emotions”); 4. Suppression (α = .941) is the inhibition of the expressive behavior of the emotion that is being experienced (e. g. “I usually hide that I feel sad”); 5. Cognitive change (α = 852) assess the modification of the perception of the situation in addition to directing attention within the situation in order to influence emotion (e. g. “When I feel sad, I think of things that make me feel better”); 6. Physical responses (α = .906) refers to physical and physiological indicators of the emotional process in progress (e. g. “When I feel fear, I start to cry”); 7. Recognition of negative emotions (α = .953) allows the identification and distinction of the negative emotions that is being experienced (e. g. “I can recognize when I'm sad”); 8. Difficulty to regulate (α = .915) the behavioral manifestation of negative emotions in an exaggerated way (e. g. “I break things when I feel angry”).
Procedure
Authorization was requested from school authorities. For ethical issues participants received information regarding the study purpose and procedure and the voluntary nature and anonymous of the evaluation. Informed consent was obtained before administering the scales according to national and international ethical standards [39, 40]. The evaluation was carried out by two psychologists, in groups of 30 students and it took them, about 50 min to answer.
Statistical analyses
Descriptive statistics, mean differences, bivariate and multivariate correlations analyses were performed with SPSS 24. Mediation models were carried out within a regression framework as described by Baron and Kenny [41]. The initial variable, the mediating variable and the outcome variable were analyzed to be significantly correlated. It was also evaluated that the initial variable and the mediating variable were significant predictors of the outcome variable in separate regression equations. It was analyzed whether the proposed mediator totally or partially mediated the relationship between the initial variable and the outcome variable. It was evaluated whether the proposed mediator mediates or partially mediates the relationship between the initial variable and the outcome variable. The Sobel test was used to assess whether the indirect effect was significant [42], since it provides a more direct test of an indirect effect and tests the product of the path that represents the relationship between the independent variable and the mediator and the path that represents the relationship between the mediator and the dependent variable [43]. The mediation analysis and the Sobel’s test were performed with the MedGraph-I [44].
Table 1 reports data of 523 adolescents, considering the variables of gender, age, family type, and monthly income. The table shows that almost half of adolescents belong to a nuclear family, and a quarter live with only one parent. Regarding the monthly economic income, it is shown that 15.3% report less than 125 dollars, and around half of the participants report an income between 125 and 335 dollars. According to the data provided by the National Institute of Statistics and Geography [35], the average total monthly income per household was 844.21 dollars. These data, compared to our sample, indicate that half of the participants in this study are well below the national average.
A mean difference analysis by gender was performed, and the results are shown in Table 2. Statistically significant differences were observed in critical events, daily hassles, and school stressors, with girls scoring higher than boy. In emotion regulation strategies such as recognition and expression of positive emotions, suppression, physical responses, and difficulty to regulate, girls obtained the highest scores. For coping strategies, differences by gender were observed in positive thinking and seeking solutions, obsessive thoughts and hopelessness, and seeking social support, with the highest means for girls. However, the effect size of these differences was small [45], therefore the entire sample was considered for subsequent analyzes.
Note. N=523. 1. Critical events; 2. Daily hassles; 3. Social exposure; 4. Family concerns; 5. Scholar stressors; 6. Social Pressure; 7. Positive thinking and seeking solutions; 8. Physiological responses related to anxiety; 9. Obsessive thoughts and hopelessness; 10. Seeking family support; 11. Passive avoidant; 12. Seeking social support; 13. Religion; 14. Recognition of positive emotions; 15. Cognitive change; 16. Physical responses; 17. Difficulty to regulate; 18. Expression of positive emotions; 19. Recognition of negative emotions; 20. Suppression; 21. Emotional control.
Table 3: Pearson’s correlations between stressors, coping and emotion regulation strategies (N= 523)
Table 3 shows the results of the Pearson’s correlation analysis between stressful events, coping and emotion regulation strategies. It was observed low to moderate statistically significant correlation coefficients between variables.
Mediation models were conducted based on proposed by Baron and Kenny [42], therefore, linear regression analyzes were performed using the enter method. The assumptions of homoscedasticity, independence of errors, non-collinearity, and normality were verified. Mediation analyzes were carried out to assess the direct relationship between stressful events and coping, and how this relationship changes when emotion regulation is included as a mediating variable. The direct relationship between stress and emotion regulation was also analyzed, and the change in this relationship with the inclusion of coping as a mediating variable.
Models one and two are shown in figure 1. In the first model, social pressure was considered as the initial variable, the dependent variable was obsessive thoughts and hopelessness, and the mediating variable was
physical responses such as emotion regulation. The results of this model showed that the indirect effect of physical responses was significant (estimate = .076; Sobel's test = 4.52; 95% CI [.03-.08]; p < 0 xss=removed xss=removed>F (2-520) = 62.38, p < 0 xss=removed xss=removed xss=removed xss=removed>F (2-520) = 50.52, p < 0>
***p<.001
Figure 1: Mediating models of social pressure with physical responses and obsessive thoughts and hopelessness as mediating variables
Note. For the first model, social pressure was the initial variable, the dependent variable was obsessive thoughts and hopelessness, and as a mediating variable the physical responses of emotion. For the second, the dependent variable and the mediator were exchanged. Path values indicate standardized regression coefficients (a, b, c) and c’ represents the direct effect.
The results of the mediation analysis with social pressure as the independent variable, obsessive thoughts and hopelessness as the dependent variable, and difficulty to regulate as the mediating variable are shown in figure 2. The indirect effect of difficulty to regulate on obsessive thoughts and hopelessness was significant (estimate = 0.066; Sobel test = 4.16, 95% CI [0.02, 0.07]; p < 0 xss=removed>p < 0 xss=removed>F (2-520) = 58.32, p < 0>
Another model was carried out with social pressure as the initial variable, the difficulty to regulate as the dependent variable and obsessive thoughts and hopelessness was the mediating variable (figure 2). The indirect effect of obsessive thoughts and hopelessness on difficulty to regulate was significant (estimate = 0.098; Sobel's test = 5.19, 95% CI [0.05, 0.11]; p < 0 xss=removed xss=removed>F (2-520) = 43.75, p < 0>
***p<.001
Figure 2: Mediating models of social pressure with difficulty to regulate and obsessive thoughts and hopelessness as mediating variables
Note: For the first model, social pressure was the initial variable, the dependent variable was obsessive thoughts and hopelessness, and as a mediating variable the difficulty to regulate. For the second, the dependent variable and the mediator were exchanged. Path values indicate standardized regression coefficients (a, b, c) and c’ represents the direct effect.
A model was carried out with daily hassles as the independent variable, obsessive thoughts and hopelessness as the dependent variable, and the difficulty to regulate emotions as the mediating variable (Figure 3). The indirect effect of difficulty to regulate on obsessive thoughts and hopelessness was significant (estimate = 0.067, Sobel's test = 4.17, 95% CI [0.02, 0.07], p <.001). The total effect of daily hassles on obsessive thoughts and hopelessness was significant (β = 0.266; p <0 xss=removed>
0.153; p < 0>F (2-520) = 53.29, p < 0>
To examine whether the obsessive thoughts and hopelessness mediates the association between daily stressors and the difficulty to regulate emotions, a simple mediation analysis was carried out (Figure 3). The results showed that the indirect effect of obsessive thoughts and hopelessness on the difficulty to regulate was significant (estimate= 0.088, Sobel's test= 4.87, 95% CI [0.04, 0.10], p <0 xss=removed xss=removed>F (2-520) = 44.33, p < .001), and explain 14.6% of the total variance of difficulty to regulate emotions.
***p<.001
Note. For the first model, daily hassles were the initial variable, the dependent variable was obsessive thoughts and hopelessness, and as a mediating variable the difficulty to regulate. For the second, the dependent variable and the mediator were exchanged. Path values indicate standardized regression coefficients (a, b, c) and c’ represents the direct effect.
Figure 3: Mediating models of daily hassles with difficulty to regulate and obsessive thoughts and hopelessness as mediating variables
Discussion
This study examined whether coping mediated the relationship between stressful events and emotion regulation responses, or, on contrary, emotion regulation assumes a mediating role between stressful events and coping. In first place we observed mean differences between boys and girls showed that girls had slightly higher scores than boys in seeking social support and recognition and expression of positive emotions, which is consistent with previous findings with the adolescent population [23,
25, 26], however, the effect size in whole differences was considered small [45]. Regarding the first hypothesis the relationship between stressful events, coping and emotion regulation has been investigated, and associations ranging from moderate to high have been reported between these variables [20], however, in this study, low to moderate correlations were observed between coping strategies and emotion regulation and stressors, which may be is related to low perception of the stressful event, since the sample comes from a marginalized setting in which is usual to lead with a wide type of stressors [31]. Besides, the stress levels perception, as wells as, the stress tolerance depend on that each adolescent has [7], as this research show.
Examining coping and emotion regulation strategies simultaneously, provides a more complete picture of stress responses in marginalized youth, since stress exposure is the most potent risk factor for psychopathology during childhood, adolescence, and adulthood, as previous studies have showed by examining their relationship to specific coping strategies and emotion regulation, taking into account the development context of adolescents [19, 20].
In the three pairs of mediational models, it was observed that when we included the emotion regulation strategy as a mediating variable between stressors and coping, the total explained variance of each model was greater, whereas, in the mediational models that we included coping as a mediating variable between stressors and emotion regulation, a greater indirect effect was observed. In the first of two mediational models, an increase in the indirect effect was obtained by including obsessive thoughts and hopelessness as a mediating variable between social pressure and physical responses; however, it was also observed that the variance explained in this model was less than which on model that included coping strategies such as obsessive thoughts and hopelessness as outcome variables. These results were similar in the subsequent models that included obsessive thoughts and hopelessness as mediating variable, between social pressure and difficulty to regulate, as well as in the model of daily hassles and difficulty to regulate. It should be considered that coping strategies in youth are developed based on the demands of the environment and the resources to face them, which may change depending on the stage of adolescence [14, 19, 21]. The sources of stress in early and middle adolescence are often family and relational in nature, such as interaction with parents and peers [5]. In this sample, daily stressors and social pressure were associated with dysfunctional strategies as obsessive thoughts and hopelessness that reflect a problem is not resolved and which are characterized by thoughts that include denial, and rumination, which leads avoidance of source of stress by adolescent [37].
The mediational model with the highest explained variance was that included social pressure as an input variable, physical responses as a mediating variable, and obsessive thoughts and hopelessness as an output variable, while the model with the highest indirect effect was that also included social pressure as an input variable, obsessive thoughts and hopelessness as a mediating variable, and physical responses as an output variable, both models are presented in Figure 1. This finding suggests that the stressors like social pressure can be predictors of the ability to express and control emotions, which in turn ca be predicted adolescents’ use of maladaptive coping strategies. According to some authors [28, 30] it should be considered that the patterns of emotion regulation can influence the adaptive functioning of adolescents under certain conditions, since such patterns can support the adaptation or becoming symptoms of psychopathology. Specific emotion regulation strategies should be studied in the context of other coping strategies and their linking with emotional symptoms. Adolescents who use maladaptive regulation strategies and who have difficulty regulating their emotions like in this study, may have higher levels of depressive symptoms than adolescents who use other adaptive emotion regulation strategies, nevertheless, in this research, development outcomes (e. g. depression, anxiety ) no were assessed [18]. The mediating role of difficulty to regulate emotions in the models presented, suggests a decrease in obsessive thoughts and hopelessness in response to stress, as Gross [21], has been suggested, who refers that the emotion control contribute to adolescents to act front a specific situation, but does not determine his final response, since it has to go throughout a modulation process that can changes the intensity and duration of the emotion, before it is expressed in to observable behaviors..
Given the remain controversy regarding emotion regulation and coping's
relationship, whether to include the process of emotion regulation as part of the coping [23], or considering it as different but related process, as well as, our second, third, and fourth hypotheses, our results provide evidence on the second statement, that coping and emotion regulation are different processes, and that type of stressor are associated and modify both processes [19, 20]. The nature of stressors and the perception of stress by adolescents was an important issue in this study. Although the adolescents of this sample did not perceive high levels of stress, the coping and emotion regulation strategies that they employ in face to stressful events can be considered dysfunctional and passive [17, 23, 25, 37].
Summarizing, this research provides data of a marginalized sample, supporting that coping and emotion regulation are different but linked processes, as wells as in both processes the type of stressful event of source of stress impact the way of coping and the emotion regulation too. Nevertheless, notice that these results are preliminary and cannot be generalized to other samples. Since limitations of this study, por example, the sample was only composed by high school students, it would be important to include larger and more diverse samples in future research (e. g. clinical samples), this would be support more comparative data and extended the findings. From a developmental perspective, comparative studies by age (e.g. earlier, middle, and older adolescents) are also needed to provide more evidence regarding the relationship among stressful events, coping, and emotion regulation during adolescence. In addition, it would be necessary put together more variables in the same study, including several stressors, as well as different emotion regulation and coping strategies to identify the direct and indirect effects on the relationship of these variables and their relationship with developmental outcomes, testing different models by structural equations via path analysis. Despite the limitations, our study contributes to understanding that stress can influence both, emotion regulation and coping processes, although the mediating effect of the emotion regulation on coping is greater.
In this sample, negative emotion regulation strategies lead the adolescent's path to cope with stressors. In future studies it would be also important to integrate adaptive emotion regulation strategies to assess the relationship with coping strategies and include the perception of control of the situation that could precede both emotion regulation and coping. Furthermore, the relationship between stressful events, coping and emotion regulation in adolescents should continue to be studied, since some strategies could reduce the negative impact of stressors. These findings may be useful to understand the complex relationship between emotional regulation and coping as separate processes in a sample of marginalized contexts. Future research should consider the influence of other variables associated with these processes such as the role of physiological and cognitive development, diet, the possibility of suffering from chronic diseases in later stages of development, and the quality of health and life [46, 47], given the combination of biological and psychosocial factors in the management of emotions and responses to stress during adolescence. These results can be the basis for designing evidence-based interventions, with educational and clinical implications, from a preventive perspective in youth from marginalized backgrounds.
This study was supported by PAPIIT IN308420, DGAPA, National University Autonomous of Mexico (UNAM) and the CONACYT scholarship program (CVU 771707 / 609166).
The authors declare no conflicts of interest.
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International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
