Difficulties in emotion regulation mediate the association between sensory over-responsiveness and motor coordination symptoms in community-dwelling midlife adults: a cross-sectional analysis

A groundbreaking study has shed new light on the complex interplay between sensory processing, emotional regulation, and motor coordination challenges in midlife adults. Research published recently indicates that difficulties in regulating emotions may serve as a key pathway linking sensory over-responsiveness (SOR) to symptoms of Developmental Coordination Disorder (DCD) in individuals around the age of 45. This finding is significant as it emerges from a community-based sample, suggesting these associations are not confined to clinically diagnosed populations and could impact a broader segment of the adult population.

Understanding the Conditions: DCD and Sensory Over-Responsiveness

Developmental Coordination Disorder (DCD), often referred to as dyspraxia, is a neurodevelopmental condition characterized by significant difficulties in acquiring and executing coordinated motor skills. These challenges are not attributable to intellectual disability or other neurological conditions and can persist from childhood into adulthood, affecting approximately 5-6% of school-aged children globally and a substantial portion of these into their adult lives. The impact of DCD extends beyond motor clumsiness, frequently impairing daily functioning, academic achievement, and occupational success.

Sensory over-responsiveness (SOR) is another condition that frequently co-occurs with DCD. It involves an exaggerated response to non-painful sensory stimuli, leading to heightened arousal, discomfort, and avoidance behaviors. This can manifest across various sensory modalities, including sound, light, touch, taste, smell, and movement. Both DCD and SOR have been associated with elevated levels of anxiety and depression.

Midlife: A Critical Developmental Stage

The study’s focus on midlife adults (around age 45) is particularly noteworthy. This period is often marked by significant neurobiological and psychosocial transitions. Age-related changes in the brain, such as declines in processing speed and volume loss in areas crucial for motor planning and executive control, begin to emerge. Simultaneously, individuals in midlife often face increased life demands, including career pressures, family responsibilities, and caregiving roles. These combined factors can place greater strain on both regulatory and motor systems, potentially exacerbating pre-existing conditions.

The Research Landscape: Bridging the Gaps

While considerable research has explored DCD and its associated emotional difficulties in childhood, adult DCD, especially in midlife, remains under-examined. Furthermore, the precise mechanisms linking sensory processing and motor coordination difficulties, particularly in adulthood, have not been fully elucidated. Previous studies have noted that children with DCD often exhibit sensory processing differences. However, the current research aims to investigate whether these links persist and how they are influenced by difficulties in emotion regulation – the ability to manage one’s emotional experiences and expressions – as distinct from general emotional symptoms like anxiety or depression. This distinction is crucial, as emotion regulation involves active processes that can be trained and improved.

Methodology: A Robust Cross-Sectional Study

The study, conducted by researchers from the Jerusalem Perinatal Study (JPS) cohort, involved 89 participants, with a mean age of 45.59 years, and 47% women. These individuals were functionally independent and community-dwelling, meaning they managed their daily and family responsibilities. Data were collected between November 2020 and December 2021 using validated self-report questionnaires.

Key instruments included:

• Adult Developmental Coordination Disorders/Dyspraxia Checklist (ADC): Used to assess current motor coordination difficulties in daily functioning. Subscales B and C, reflecting current self-perception of motor performance and functional/social consequences, were combined for this study.
• Sensory Responsiveness Questionnaire (SRQ): Specifically, the aversive subscale was employed to measure sensory over-responsiveness across various sensory modalities.
• Difficulties in Emotion Regulation Scale (DERS): This 36-item questionnaire assesses six facets of emotion regulation, including awareness, clarity, impulse control, goal-directed behavior, acceptance of emotions, and access to regulatory strategies.

Participants also provided demographic information, including sex, age, and Body Mass Index (BMI). Physical activity levels were also recorded as a potential covariate, given its known associations with both motor function and emotional well-being.

Key Findings: Emotion Regulation as a Mediator

The study’s results revealed a significant direct association between sensory over-responsiveness (SOR) and DCD symptomatology. However, when difficulties in emotion regulation were introduced into the statistical model as a mediator, this direct link became non-significant. Instead, the impact of SOR on DCD symptomatology was found to be fully explained by participants’ difficulties in emotion regulation.

Specifically:

• SOR significantly predicted DCD symptomatology (total effect: B=0.343, p=0.002).
• When difficulties in emotion regulation were considered, the direct effect of SOR on DCD symptomatology was no longer significant (B=0.151, p=0.114).
• The indirect effect, where SOR influences DCD symptomatology through difficulties in emotion regulation, was statistically significant (B=0.192, 95% CI [0.084, 0.323]).

These findings suggest that individuals who experience sensory over-responsiveness are more likely to struggle with regulating their emotions, and it is these regulatory challenges, rather than a direct sensory-to-motor pathway, that contribute to their motor coordination difficulties.

Exploring the Mechanisms: A Deeper Dive

The researchers delved deeper into the nature of these associations, examining subscales of the Difficulties in Emotion Regulation Scale (DERS). They observed that subscales most reliant on executive functions, such as difficulty accessing effective regulatory strategies, controlling impulsive behavior when distressed, and engaging in goal-directed behavior when upset, showed the strongest associations with DCD symptomatology. This pattern suggests that the cognitive demands of emotion regulation, particularly those involving effortful control, may deplete resources needed for motor planning and execution.

This aligns with theoretical frameworks suggesting a "resource-competition" model. In individuals with pre-existing motor coordination challenges, the cognitive load of managing emotional responses could further compromise their ability to perform complex motor tasks efficiently. This is particularly relevant in midlife, a period where cognitive resources may already be under increased pressure due to age-related changes and life stressors.

Implications for Assessment and Intervention

The study’s findings carry significant implications for how DCD symptomatology is understood and addressed in midlife adults.

• Comprehensive Assessment: The results underscore the importance of assessing not only motor coordination but also sensory processing and emotion regulation in midlife adults presenting with motor difficulties. This broader approach can lead to a more accurate understanding of an individual’s functional profile.
• Targeted Interventions: The mediation by emotion regulation suggests that interventions aimed at improving these skills could be beneficial for individuals experiencing DCD symptomatology alongside SOR. Techniques such as mindfulness-based stress reduction, cognitive-behavioral strategies, and acceptance and commitment therapy, which focus on enhancing emotional regulation capacities, might offer complementary support to traditional motor-focused therapies.
• Understanding Co-occurring Conditions: The study acknowledges the frequent co-occurrence of DCD with conditions like ADHD and autism spectrum disorder, which are also independently linked to sensory and emotional regulation challenges. This highlights the need for comprehensive screening and tailored interventions that address the multifaceted nature of these neurodevelopmental profiles.

Looking Ahead: Future Research Directions

While this study provides valuable insights, its cross-sectional design means that causal relationships cannot be definitively established. Future research employing longitudinal designs is crucial to confirm the directionality of these associations. Understanding whether difficulties in emotion regulation cause motor coordination issues, or if there is a reciprocal influence, will be key.

Furthermore, the reliance on self-report measures, while appropriate for subjective experiences, could be supplemented with objective measures of motor performance and cognitive function in future studies. Investigating the specific neurobiological underpinnings of these associations and exploring how normative age-related changes in midlife might interact with these challenges are also important avenues for future research.

The study also noted limitations regarding the absence of data on co-occurring neurodevelopmental diagnoses such as ADHD or autistic traits, which could influence the observed relationships. Future studies should systematically assess these factors to gain a more nuanced understanding of their roles.

Conclusion: A Holistic View of Motor and Emotional Well-being

This research offers a compelling perspective on the complex factors influencing motor coordination in midlife adults. By demonstrating that difficulties in emotion regulation fully mediate the link between sensory over-responsiveness and DCD symptomatology, the study expands upon existing theoretical frameworks, such as the Environmental Stress Hypothesis, by highlighting a pathway where sensory and regulatory processes contribute to motor outcomes. This work emphasizes the interconnectedness of sensory processing, emotional regulation, and motor function, advocating for a more holistic approach to assessment and intervention for adults experiencing these challenges. The findings pave the way for a deeper understanding of neurodevelopmental trajectories across the lifespan and the development of more targeted and effective support strategies.