Emotion Dysregulation in Attention Deficit Hyperactivity Disorder

Summary & key facts

The authors reviewed many studies and papers about how people with attention deficit hyperactivity disorder, or ADHD, handle emotions. They found three main points: having trouble controlling emotions is common in ADHD and causes real-life problems; these emotion problems may come from difficulty paying attention to emotional signals, which involves certain brain areas; and current ADHD treatments often help emotion problems but thinking about both together could lead to better care and new research questions.

Key facts:

• Trouble regulating emotions is common for people with ADHD at all ages and makes daily life harder.
• The review suggests emotion problems in ADHD may come from weaknesses in noticing, recognizing, or focusing on emotional information, not just from impulsive behavior.
• Researchers link these attention-and-emotion problems to a brain network that includes the striatum, the amygdala, and the medial prefrontal cortex — areas involved in reward, threat, and thinking about feelings.
• Many existing ADHD treatments also reduce emotional problems, but the authors say treating attention and emotion together could change how clinicians think and find new treatments.
• There is no single agreed way to define or diagnose emotion dysregulation in ADHD. The authors outline three possible ideas: that emotion problems are separate but related to ADHD, that they are a core part of ADHD, or that the combination is its own condition.

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

Conditions & symptoms

ADHD Difficulty focusing Sadness or low mood