Emotion Dysregulation in Attention Deficit Hyperactivity Disorder

Summary & key facts

This review looked at research on emotion dysregulation (problems managing emotions) in people with ADHD. It found three main points: emotion dysregulation is common across the lifespan and causes substantial problems; it may come from trouble noticing, recognizing, or paying attention to emotional cues tied to a brain circuit that includes the striatum, amygdala, and medial prefrontal cortex; and current ADHD treatments often also reduce emotion dysregulation, which suggests new ways to study and treat the combined symptoms. The authors note there is no consensus on how to define this clinical area and present three models to explain the overlap with ADHD.

Key facts:

• The authors reviewed the literature using both quantitative and qualitative methods.
• Emotion dysregulation is prevalent in people with ADHD throughout the lifespan and is a major contributor to functional impairment.
• The review suggests emotion dysregulation in ADHD may come from deficits in orienting to, recognizing, or allocating attention to emotional stimuli.
• These attention and emotion processing deficits point to possible dysfunction in a brain network involving the striatum, the amygdala, and the medial prefrontal cortex.
• Current treatments for ADHD often also reduce emotion dysregulation, but the authors say focusing on the combined symptoms could lead to new therapeutic approaches.
• The paper presents three models to explain the overlap: (1) emotion dysregulation and ADHD are correlated but distinct, (2) emotion dysregulation is a core feature of ADHD, and (3) the combination is a separate diagnostic entity.
• The authors state there is no consensus yet on how to conceptualize emotion dysregulation within ADHD.

Abstract

Although it has long been recognized that many individuals with attention deficit hyperactivity disorder (ADHD) also have difficulties with emotion regulation, no consensus has been reached on how to conceptualize this clinically challenging domain. The authors examine the current literature using both quantitative and qualitative methods. Three key findings emerge. First, emotion dysregulation is prevalent in ADHD throughout the lifespan and is a major contributor to impairment. Second, emotion dysregulation in ADHD may arise from deficits in orienting toward, recognizing, and/or allocating attention to emotional stimuli; these deficits implicate dysfunction within a striato-amygdalo-medial prefrontal cortical network. Third, while current treatments for ADHD often also ameliorate emotion dysregulation, a focus on this combination of symptoms reframes clinical questions and could stimulate novel therapeutic approaches. The authors then consider three models to explain the overlap between emotion dysregulation and ADHD: emotion dysregulation and ADHD are correlated but distinct dimensions; emotion dysregulation is a core diagnostic feature of ADHD; and the combination constitutes a nosological entity distinct from both ADHD and emotion dysregulation alone. The differing predictions from each model can guide research on the much-neglected population of patients with ADHD and emotion dysregulation.

Topics

Attention Deficit Hyperactivity Disorder Mind wandering and attention Sleep and related disorders

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Attention deficit Attention deficit hyperactivity disorder Attention deficits Cognition Developmental psychology Emotional dysregulation Neuroscience Psychiatry Psychology