Specific Emotion Regulation Strategies Are Transdiagnostically Associated with Hippocampal Connectivity Markers of Vulnerability to Emotion Dysregulation

Emotion dysregulation (ED) is a core transdiagnostic feature of multiple psychiatric conditions and a key marker of vulnerability in high-risk populations, such as the offspring of patients with emotion dysregulation disorders (EDD; e.g., bipolar disorder, borderline personality disorder, attention-deficit/hyperactivity disorder). The hippocampus, central to integrating affective, cognitive, and sensorimotor processes, shows altered dynamic functional connectivity (dFC) in both EDD patients and their unaffected offspring. Building on our previous characterization of hippocampal dFC patterns using micro-coactivation patterns (μCAPs) in this cohort, the present study explored the relationship between these hippocampal connectivity patterns with specific cognitive emotion regulation strategies. We applied Partial Least Squares Correlation (PLS-C) to identify multivariate associations between hippocampal dFC and Cognitive Emotion Regulation Questionnaire (CERQ) scores in 201 participants (74 EDD patients, 57 offspring of EDD patients, and 70 healthy controls). One significant transdiagnostic latent component emerged ( p adj = 0.03), linking higher use of non-adaptive strategies (e.g., self-blame, rumination) to increased hippocampal dFC with the limbic and default mode networks, and greater reliance on adaptive strategies (e.g., positive reappraisal, putting into perspective) to hippocampal dFC with the sensorimotor network, a connectivity profile previously associated with resilience to ED. These associations did not differ significantly between diagnostic groups, underscoring their transdiagnostic relevance. By integrating hippocampal connectivity markers with detailed behavioral profiling, this study highlights specific cognitive strategies as potential modifiable targets for prevention and early intervention in individuals at risk for EDD, including the unaffected offspring of EDD patients.