1
|
Bodalski EA, Flory K, Meinzer MC. A Scoping Review of Factors Associated With Emotional Dysregulation in Adults With ADHD. J Atten Disord 2023; 27:1540-1558. [PMID: 37470198 DOI: 10.1177/10870547231187148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Emotion dysregulation is frequently seen in adults with ADHD and is associated with many adverse outcomes. We conducted a scoping review of factors associated with emotion dysregulation in adults with ADHD. METHOD PubMed and PsycInfo (EBSCO) were searched. Articles were included if they measured ADHD, emotional dysregulation or some aspect of emotional dysregulation, and at least one other construct. Studies examining physiological underpinnings as well as clinical trials examining the effect of ADHD medications on emotional dysregulation were excluded because recent reviews have already examined these topics. RESULTS Thirty-five studies were included in the review. Factors such as biological sex, comorbidities, attachment style, using certain emotional regulation strategies, and ADHD subtype tend to be related to emotion dysregulation. CONCLUSION Clinicians working with adults with ADHD can collect information on these factors to better understand risk for emotion dysregulation, and emotion regulation skills may be one area for intervention.
Collapse
Affiliation(s)
| | - Kate Flory
- University of South Carolina, Columbia, USA
| | | |
Collapse
|
2
|
Rádosi A, Ágrez K, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Concurrent and Prospective Associations of Reward Response with Affective and Alcohol Problems: ADHD-Related Differential Vulnerability. J Youth Adolesc 2023:10.1007/s10964-023-01794-7. [PMID: 37270465 DOI: 10.1007/s10964-023-01794-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/19/2023] [Indexed: 06/05/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder. Data on the role of transdiagnostic, intermediate phenotypes in ADHD-relevant characteristics and outcomes are needed to advance conceptual understanding and approaches to precision psychiatry. Specifically, the extent to which the association between neural response to reward and ADHD-associated affective, externalizing, internalizing, and substance use problems differ depending on ADHD status is unknown. Aims were to examine, in 129 adolescents, whether concurrent and prospective associations of fMRI-measured initial response to reward attainment (relative to loss) with affectivity and externalizing, internalizing, and alcohol use problems differs between youth at-risk for (i.e., subclinical) (n = 50) and not at-risk for ADHD. Adolescents were, on average, 15.29 years old (SD = 1.00; 38% female), 50 were at-risk for (Mage = 15.18 years, SD = 1.04; 22% female) and 79 not at-risk for (Mage = 15.37 years, SD = 0.98; 48.1% female) ADHD. Both concurrent and prospective relations differed given ADHD risk: across analyses, in at-risk youth, greater superior frontal gyrus response was associated with lower concurrent depressive problems but in not at-risk youth, these characteristics were not related. Controlling for baseline use, in at-risk youth, greater putamen response was associated with greater 18-month hazardous alcohol use, whereas in not at-risk youth, greater putamen response was associated with lower use. Where in brain and for which outcomes modulate (direction of) observed relations: superior frontal gyrus response is relevant for depressive problems whereas putamen response is relevant for alcohol problems and greater neural responsivity is linked to less depressive but to more alcohol problems in adolescents at-risk for ADHD and less alcohol problems in adolescents not at-risk. Differences in neural response to reward differentially confer vulnerability for adolescent depressive and alcohol problems depending on ADHD risk.
Collapse
Affiliation(s)
- Alexandra Rádosi
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Kristóf Ágrez
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Bea Pászthy
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - István Ulbert
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.
| |
Collapse
|
3
|
Rojas-Jara C, Polanco-Carrasco R, Caycho-Rodríguez T, Acuña-Espinoza R, González-Serrano C, Roa-Méndez P, Rojas-Román A, Sepúlveda-López MA. Experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez: un análisis de la evidencia. UNIVERSITAS PSYCHOLOGICA 2021. [DOI: 10.11144/javeriana.upsy20.eaiu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
El objetivo de este estudio es la revisión de la evidencia actual sobre la relación entre la vivencia de experiencias adversas en la infancia y el posterior uso de drogas en la adolescencia y adultez, y sus características. La metodología utilizada fue una revisión sistemática de publicaciones científicas, entre el periodo 2013-2017, disponibles en la base de datos Scopus sobre experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez que arrojó un total de 69 publicaciones incluidas en el estudio. Las experiencias adversas en la infancia presentan una elevada relación con el uso y/o abuso de drogas en la adolescencia y adultez. El consumo de drogas en adolescentes y adultos expuestos a experiencias traumáticas en la infancia se da principalmente en hombres. Las drogas mayormente usadas son alcohol, tabaco, cannabis y fármacos no recetados y, en menor medida, opioides, cocaína y anfetaminas. Las drogas, en este sentido, cumplen el rol de barrera química para distanciar el dolor emocional que deriva del recuerdo de las experiencias traumáticas y su intensa carga psíquica. Se requieren acciones de promoción del buen trato en la infancia, así como el abordaje terapéutico temprano de niños expuestos a experiencias traumáticas.
Collapse
|
4
|
Link between History of Childhood Maltreatment and Emotion Dysregulation in Adults Suffering from Attention Deficit/Hyperactivity Disorder or Borderline Personality Disorder. Biomedicines 2021; 9:biomedicines9101469. [PMID: 34680586 PMCID: PMC8533068 DOI: 10.3390/biomedicines9101469] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 01/26/2023] Open
Abstract
Childhood maltreatment (CM) may have a long-term effect on emotion regulation. This study aimed to explore the relationship between CM and emotion dysregulation (ED) in a heterogeneous population. Four hundred seventy French-speaking outpatients (N = 279 ADHD, N = 70 BPD, N = 60 ADHD + BPD, N = 61 clinical controls) completed the Emotion Reactivity Scale (ERS), the Cognitive Emotional Regulation Questionnaire (CERQ), the Childhood Trauma Questionnaire (CTQ), and the Relationship Scales Questionnaire (RSQ). Reports of childhood maltreatment experiences were significantly associated with increased levels of emotion reactivity in all our groups and in the whole population, with a greater use of non-adaptive cognitive emotion regulation strategies and insecure attachment patterns. Emotional abuse showed the strongest effect. Further analysis indicated that an anxious attachment style significantly mediated the relationship between CM and the use of non-adaptive cognitive emotion regulation strategies and emotion reactivity. The results of our study suggest an impact of CM on ED and a potentially marked effect of emotional abuse. They also indicate a potentially mediating role of insecure attachment in the relationship between a history of childhood abuse and emotion reactivity and a higher use of non-adaptive cognitive emotion regulation strategies in adulthood.
Collapse
|
5
|
The association between reinforcement sensitivity and substance use is mediated by individual differences in dispositional affectivity in adolescents. Addict Behav 2021; 114:106719. [PMID: 33160749 DOI: 10.1016/j.addbeh.2020.106719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/26/2020] [Accepted: 10/18/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Adolescence marks the onset of substance use experimentation and adolescents are particularly vulnerable to certain negative effects of substances. Some evidence indicates reinforcement sensitivity is associated with substance use, though little is known about mechanisms underlying such association. AIMS in the current study were to examine, (1) associations between behavioral activation (BAS) and behavioral inhibition (BIS) system sensitivity, positive (PA) and negative affectivity (NA), and alcohol use and alcohol problems as well as tobacco, and marijuana use, and whether (2) associations are mediated by PA or NA. METHODS Participants were a community sample of N = 125 adolescents (Mage = 15.67 years; SD = 0.93; 52% boys) who completed self-report measures. RESULTS evinced associations, generally as expected, across variables (all ps < 0.05). In mediation analyses, an association emerged between BIS sensitivity and alcohol use, mediated by NA (95%CIs [0.034; 0.390]); greater BIS sensitivity was associated with greater NA and greater NA was associated with greater alcohol use. These findings were replicated with alcohol problems. An association also emerged between BAS sensitivity and marijuana use, mediated by PA (95%CIs [-0.296; -0.027]); greater BAS sensitivity was associated with greater PA and greater PA was associated with lower marijuana use. Finally, BIS sensitivity was associated with tobacco use through NA (95%CIs [0.023; 0.325]) and PA (95%CIs [0.004; 0.116]), with NA linked to greater, but PA linked to lower tobacco use. BAS sensitivity was also associated with tobacco use through PA (95%CIs [-0.395; -0.049]), with PA linked again to lower tobacco use. CONCLUSIONS There are unique and shared effects of domains of reinforcement sensitivity on adolescent substance use and these vary with index of dispositional affectivity and type of substance considered.
Collapse
|
6
|
Monopoli WJ, Evans SW, Benson K, Allan NP, Owens JS, DuPaul GJ, Bunford N. Assessment of a conceptually informed measure of emotion dysregulation: Evidence of construct validity vis a vis impulsivity and internalizing symptoms in adolescents with ADHD. Int J Methods Psychiatr Res 2020; 29:1-14. [PMID: 32898309 PMCID: PMC7723178 DOI: 10.1002/mpr.1826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Despite advances in understanding associations among attention-deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD-relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent-report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de-escalation. METHODS Participants were 209 adolescents with ADHD (78% male; 13.5-17.8 years old [M = 15.2 SD = 0.91]). Questionnaire items were selected from parent-report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses. RESULTS The EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de-escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self-report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity. CONCLUSION These results inform our understanding of ADHD-relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD-related impairment.
Collapse
Affiliation(s)
- W John Monopoli
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Steven W Evans
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Kari Benson
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nóra Bunford
- 'Lendület' Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| |
Collapse
|
7
|
Zubovics EA, Fiáth R, Rádosi A, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Neural and self-reported reward responsiveness are associated with dispositional affectivity and emotion dysregulation in adolescents with evidence for convergent and incremental validity. Psychophysiology 2020; 58:e13723. [PMID: 33179791 DOI: 10.1111/psyp.13723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/30/2022]
Abstract
Adolescence is a developmental period characterized by heightened reward sensitivity which, in turn, confers risk for pertinent negative outcomes, underscoring the need to better understand biological bases and behavioral correlates of reward responsiveness during this developmental phase. Our goals in the current study were to examine, in a sample of 43 typically developing adolescents (Mage = 15.67 years; SD = 1.01; 32.6% boys), (1) evidence of convergent validity between neural and self-report reward responsiveness, (2) associations between neural reward responsiveness and self-report dispositional affectivity and emotion dysregulation (ED) and (3) evidence of incremental validity of self-report beyond neural reward responsiveness in predicting affectivity and ED. During electroencephalography (EEG), adolescents completed two experimental paradigms probing event-related potential (ERP) indices of reward anticipation and initial responsiveness to reward attainment. Following EEG, they completed self-report measures of reward responsiveness, affectivity, and ED. Findings indicated some evidence of convergent validity between enhanced ERP indices of reward anticipation and initial response to reward and greater reinforcement sensitivity; that ERP indices of both reward responsiveness aspects predicted lower negative affectivity and less ED; and evidence of incremental validity of self-report beyond neural reward responsiveness in predicting outcomes. Results underscore the utility of a multi-method framework in assessing adolescent reward responsiveness and support the relevance of reward responsiveness in explaining individual differences in dispositional affectivity and ED.
Collapse
Affiliation(s)
- Evelin A Zubovics
- "Lendület" Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Richárd Fiáth
- Comparative Psychophysiology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.,Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Alexandra Rádosi
- "Lendület" Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.,Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Bea Pászthy
- 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - István Ulbert
- Comparative Psychophysiology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.,Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Nóra Bunford
- "Lendület" Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| |
Collapse
|
8
|
Measurement Invariance Across Adult Self-Ratings of Current and Retrospective Childhood ADHD Symptoms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09802-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
9
|
Changes in College Student Endorsement of ADHD Symptoms across DSM Edition. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09797-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
10
|
Bunford N, Dawson AE, Evans SW, Ray AR, Langberg JM, Owens JS, DuPaul GJ, Allan DM. The Difficulties in Emotion Regulation Scale-Parent Report: A Psychometric Investigation Examining Adolescents With and Without ADHD. Assessment 2018; 27:921-940. [PMID: 30112924 DOI: 10.1177/1073191118792307] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Emotion dysregulation is associated with attention deficit/hyperactivity disorder (ADHD) and confers risk for behavior problems and functional impairment; however, there is little guidance on best practices for measurement in adolescents. We developed a parent-report version of the Difficulties in Emotion Regulation Scale (DERS-P). Evidence of reliability and validity was evaluated in a large community online sample (Study 1: n = 978; Mage = 13.52 years; SD = 1.93) and in two samples of adolescents with ADHD (Study 2, Sample 1: n = 78; Mage = 12.12 years, SD = 0.91; Sample 2: n = 206; Mage = 15.35 years; SD = 0.85). A four-factor solution of the DERS-P was obtained in Study 1 and confirmed in Study 2, with factors demonstrating acceptable internal consistency. The community sample was generally rated as less dysregulated than the ADHD samples. Support was obtained for convergent, concurrent, and incremental validity evidence. These findings provide preliminary evidence for the DERS-P as a psychometrically sound parent-report measure of emotion dysregulation in 11- to 17-year-old adolescents.
Collapse
Affiliation(s)
- Nóra Bunford
- Institute of Cognitive Neuroscience and Psychology, Budapest, Hungary.,Eötvös Loránd University, Budapest, Hungary.,Ohio University, Athens, OH, USA
| | | | | | | | | | | | | | | |
Collapse
|