Affect Regulation and FASD

CanFASD has published research looking at affect regulation in individuals with fetal alcohol spectrum disorder.

From: Psychology Tools

Affect regulation, or emotion regulation, is the ability of an individual to modulate their emotional state in order to adaptively meet the demands of their environment.

Individuals with a broad range of affect regulation strategies will be able to flexibly adapt to a range of stressful situations.

Individuals with a more limited emotional regulation abilities may fall back upon a more limited range of stereotyped strategies that are not as successful in meeting their needs, or which come with more severe unintended consequences.

The ability to successfully regulate emotion is often viewed in the light of attachment theory (Bowlby, 1969/1982).

The Psychology Tools site has a variety of Cognitive Behavioral Therapy (CBT) Worksheets For Affect Regulation and downloadable manuals.

NOTE:  Always consult with a professional for a diagnosis or if you or someone you know needs assistance in this area. These resources are provided to help with understanding only

In case you are wondering about the difference between emotion regulation and affect regulation: Emotion regulation is a reflection of an individual’s mood rather than the ability to cope/act in a difficult situation regardless of their mood.

Affect regulation is tightly related to the quality of executive and cognitive functions and that is what distinguishes this concept from emotion regulation. One can have a low emotional control but a high level of control on his or her affect, and therefore, demonstrate a normal interpersonal functioning as a result of intact cognition.

So knowing this, we can now understand the context of the following information from the CanFASD blog:

Mental Health and Affect Regulation Impairment

in Fetal Alcohol Spectrum Disorder (FASD):

Results from the Canadian National FASD Database

Research led by two CanFASD Researchers, Jocelynn Cook and Mansfield Mela, as well as CanFASD Managing Director Kathy Unsworth.



Along with experiencing mental health issues, regulating one’s emotions, known as affect regulation (AR), is a common challenge for individuals with FASD.

The Canadian FASD diagnostic guidelines were updated in 2016 to include a domain for AR, which is impaired when the individual meets diagnostic criteria for depressive disorder(s) or anxiety disorder(s).

Using data from the National Database, the authors of the current study examined impairments in AR among children and adults with FASD and how these impairments were related to comorbid mental health disorders.

 Main findings

  • Out of 335 participants, 41% had impaired AR
  • There was no significant difference in IQ between individuals with AR impairment and without
  • Individuals with AR impairment were about 19.1 years old when diagnosed with FASD, while those without AR impairment were roughly 12.5 years old at the time of diagnosis
  • Those with AR impairment were noted as having generally higher neurodevelopmental impairment, with roughly 5.37 more domains of neurodevelopmental impairment, as assessed by the Canadian diagnostic criteria
  • AR impairment meant that individuals were more likely to be diagnosed with attachment disorder, conduct disorder, PTSD, or had experienced suicidal thoughts

Take-home message

Because individuals with FASD are at a particularly high risk of developing additional adverse outcomes, such as mental health disorders, if AR impairments can be detected early, there is an opportunity for proper intervention to prevent attachment disorders, PTSD, suicidality, and other mental health disorders.

Future research should examine additional disorders that might fall under affect regulation, how affect regulation might interact with other FASD diagnostic criteria, how other substances affect AR, and how AR is affected in other developmental disorders.

It’s Not All in Your Head: Affect Regulation in Psychotherapy 

An article by the Center for Healing and Imagery goes into a little more detail about the attachment relationship and ways to develop / improve affect regulation:

Such flexibility develops from an early secure attachment relationship. Allan Schore integrates modern neuroscience findings with the studies of John Bowlby. Schore describes how the mother’s attunement helps physiologically structure her infant’s nervous system. His work fits with earlier infant observation studies (Stern, Beebe). 

Affect regulation is governed by the autonomic nervous system (ANS), which keeps the body in homeostasis (balance). The ANS links the brain stem with the rest of the body. It is activated by external demands on the person. The sympathetic branch of the ANS energizes us to deal with challenges (e.g. fight/flight), while the parasympathetic branch discharges this arousal, so we can relax when encounters end. Under normal conditions, a gentle flow and rhythm prevails between the two, producing a feeling of well-being and confidence that we can handle what life hands us. 

Many clients suffer from a chronic imbalance of their autonomic nervous systems, due to early attachment problems and/or trauma. They don’t feel in charge of their bodies or their emotions. Many are highly reactive. Others use avoidance for fear of being triggered and feel deadened, lonely or depressed as a result. 

Therapists can teach how self-regulation is a normal task faced by everyone. Tools range from exercise to Ipods. We can ask patients how they achieve “a good mood”, e.g. gardening, talking with friends. Positive somatic memories are also antidotes to distress, as described by Babette Rothschild in The Body Remembers.

Let us know if you have any studies or additional resources that you use or have found helpful.