Emotion regulation in children and adolescents: a systematic review and quality assessment of behavioral and physiological assessment methods and their theoretical foundations

Abstract Background Emotion regulation (ER) is crucial for understanding mental health and disorders. Valid and reliable ER measures are needed to develop models for mental health promotion and treatment. This systematic review provides a comprehensive overview of ER behavioral observation and physiological measures of children and adolescents, including their theoretical embedding and psychometric properties. Methods Following PRISMA guidelines, we conducted a systematic literature search in PubMed, PsycINFO, Psyndex plus, and Web of Science without language restrictions. We included empirical studies assessing ER as an outcome variable in children and adolescents aged 0–15 years using at least one behavioral or physiological ER measure. Studies on secondary literature were excluded. Measurement types, theoretical grounding, and psychometric properties (reliability, validity, objectivity) were extracted and compared across age groups using descriptive statistics and chi-square tests. Results A total of 516 studies met inclusion criteria. Only 5% reported validity evidence, 62% reliability, and 20% objectivity. Few studies referenced an ER definition or empirically tested an ER model. LAB-TAB and Delay of Gratification tasks were the most common behavioral observation measures, whereas RSA and EEG dominated physiological measures. Behavioral observation was more frequently used in younger children, whereas physiological measures were more common in older children ( p < .001; V = .37). Most studies focused on the regulation of negative emotions (91%), and 90% relied on a single ER measure. Conclusion ER measurement in children and adolescents is characterized by limited psychometric reporting and insufficient theoretical integration. This review provides an overview of available methods and their psychometric properties, facilitating the selection of appropriate measures for future research. Greater emphasis on validity, multimethod approaches, theoretical grounding, and the inclusion of positive emotions is needed to improve measurement standards and advance ER research.