Background: The regulation of emotion is essential for adaptive functioning. However, delineating the pathways of emotion regulation (ER) processes that lead to psychological adaptation remains under-studied, with mixed evidence for the specificity vs. generality of ER deficits in relation to specific forms of psychopathology. To examine this issue, this study investigated links among ER, social-contextual factors (family, peer), and psychological adjustment (internalizing, externalizing). Method: Participants were 140 adolescents (71% female, 83.3% Caucasian, M age = 16.03 years) who were consecutive psychiatric admissions over a one-year period. Adolescents completed measures on family environment and peer relationship experiences. Both adolescents and parents reported on adolescents' characteristic patterns of ER and psychopathology. Results: Discriminant analyses revealed that two functions, ER skills and impulsivity/lability, differentiated among adolescents who were elevated in internalizing symptoms only, in externalizing symptoms only, in both domains, or in neither domain. Regarding social contextual variables, family cohesion was associated with adaptive ER behaviors for girls along the internalizing dimension and all adolescents reporting externalizing behaviors. Relational victimization predicted difficulties with ER in both symptom domains for all adolescents. Within the internalizing domain, friendship support was related to adaptive ER. Conclusion: Facets of ER do differentiate between global indices of internalizing and externalizing behaviors and suggest that both general and specific factors contribute to adolescents' unique learning history with emotions and characteristic patterns for managing emotions.