Sensory Modulation Disorder and its Neural Circuitry in Adults with ADHD: A Pilot Study

The development and validation of the "SENSE" - Sensory and Behavioral Modulation Questionnaire for adults

Sensory modulation is critical for interacting with the physical and social environment. When sensory input from the environment is not properly perceived and modulated, it may elevate arausability, avoidant behavior, impair function and wellbeing. Sensory modulation difficulties (SMD) are mainly reported during childhood and are related to neurodevelopmental conditions such as Attention-Deficit Hyperactivity Disorder (ADHD). SMD in adulthood further deteriorate function and emotional status, hence should be screened and treated. Nonetheless, relevant measures of SMD for adults are limited. This study aims to establish the psychometric properties of the "SENSE" - Sensory and Behavioral Modulation Questionnaire for adults. Based on theoretical/clinical knowledge the SENSE measures sensitivity/arousability, habituation and avoidance. After establishing content and face validity, 663 participants aged 18-65 completed a sociodemographic and health questionnaire, the Adult ADHD Scale-5 (ASRS-5), the SENSE and the Highly Sensitive Person Scale (HSPS). Factor analysis approved the determination of SENSE scales. Medium- high internal consistency was found. SENSE discriminated between adults with/without ADHD and correlated with HSPS scores, confirming concurrent validity. CONCLUSIONS: SENSE has good psychometric properties and may be feasible for screening sensory-behavioral modulation difficulties in adults. Studies should further examine SENSE applicability to clinical populations.

Pain sensitivity and perceptual sensitivity are associated with severity of emotional dysregulation in children with ADHD: a cross-sectional analysis using the Temperament in Middle Childhood Questionnaire

PURPOSE

Nearly 50% of children with attention-deficit/hyperactivity disorder (ADHD) experience emotional dysregulation or sensory over-responsiveness; this study examines their association.

METHODS

This cross-sectional analysis (n = 124) used data from the Micronutrients for ADHD in Youth (MADDY) Study, which enrolled children aged 6-12 with ADHD and emotional dysregulation. Sensory responsiveness was assessed using two subscales from the factor-analyzed Temperament in Middle Childhood Questionnaire: Pain Sensitivity and Perceptual Sensitivity. Emotional dysregulation was assessed using the Emotional-Problems and Conduct-Problems subscales from the Strengths and Difficulties Questionnaire and a composite score from the Child & Adolescent Symptom Inventory-5. Multivariable linear regression measured the association of pain and perceptual sensitivity with the severity of emotional dysregulation.

RESULTS

In adjusted models, pain sensitivity was positively associated with Emotional Problems (β = 0.97; 95% CI: 0.52, 1.41; p < 0.0001), Conduct Problems (β = 0.83; 95% CI: 0.44, 1.21; p = 0.0001), and CASI-5 composite (β = 0.25; 95% CI: 0.16, 0.34; p < 0.0001). Perceptual sensitivity was positively associated with Emotional Problems (β = 0.75; 95% CI: 0.15, 1.35; p = 0.01) but not Conduct Problems (β = 0.27; 95% CI: -0.24, 0.77; p = 0.30) or CASI-5 composite (β = 0.12; 95% CI: -0.01, 0.24; p = 0.07).

CONCLUSION

Pain sensitivity was associated with the severity of emotional dysregulation in this ADHD sample. To better understand possible causal links, longitudinal studies are warranted.Implications for rehabilitationEmotional dysregulation and sensory over-responsiveness are both common in children with ADHD and contribute to added challenges in school and family life.Two types of sensory over-responsiveness, pain sensitivity and perceptual sensitivity, were associated with emotional dysregulation in children with ADHD in our study.Sensory over-responsiveness may be a modifiable treatment target.