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

Introduction – Developmental Coordination Disorder (DCD) is a neurodevelopmental condition characterized by motor coordination difficulties that impair daily functioning across the lifespan. Sensory over-responsiveness (SOR) frequently co-occurs with DCD; both conditions are associated with elevated anxiety and depression. However, the interplay among SOR, motor coordination difficulties, and emotional functioning remains under examined in midlife adults, a period marked by neurobiological and psychosocial transitions that may place greater demands on regulatory and motor systems. Moreover, no study has investigated difficulties in emotion regulation, as distinct from emotional symptoms, as a potential mechanism linking SOR and DCD symptomatology, particularly in community-dwelling adults whose motor coordination difficulties may not reach diagnostic thresholds. This cross-sectional study examined whether SOR is associated with DCD symptomatology in community-dwelling midlife adults, and whether this association is mediated by difficulties in emotion regulation. Methods – Eighty-nine participants from the Jerusalem Perinatal Study birth cohort (mean age = 45.59 years, SD = 0.68, range 44.33–46.87; 47% women) completed the Sensory Responsiveness Questionnaire (SRQ), the Adult Developmental Coordination Disorders/Dyspraxia Checklist (ADC subscales B and C), and the Difficulties in Emotion Regulation Scale (DERS). Mediation analysis (PROCESS Model 4; 5, 000 bootstrap resamples), controlling for physical activity. Results – SOR significantly predicted DCD symptomatology (total effect: B = 0.343, SE = 0.105, p = 0.002). When difficulties in emotion regulation were included as a mediator, the direct effect was no longer significant (B = 0.151, SE = 0.095, p = 0.114), while the indirect effect was significant (B = 0.192, 95% CI [0.084, 0.323]), consistent with full mediation. Discussion – These findings provide initial evidence that difficulties in emotion regulation may constitute one pathway linking SOR and DCD symptomatology in midlife, a previously unexamined mechanistic association with implications for age-appropriate assessment and intervention. Longitudinal research is needed to establish directionality.