Can attachment predict core and comorbid symptoms of attention-deficit/hyperactivity disorder beyond executive functions and emotion regulation?

Attachment and comorbid anxiety in ADHD

Anxiety comorbidity is quite common in children with attention-deficit hyperactivity disorder (ADHD). What is known about the relationship between anxiety, attachment and emotion regulation in such children is still limited. We aimed to investigate the associations between attachment, emotion regulation and comorbid anxiety in children with ADHD. 100 children with ADHD and 100 children without any diagnosis aged 8-13 years were included. After the participants were clinically evaluated, Turgay ADHD Scale, Emotion Regulation Checklist, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and Kerns' Security Scale were completed. According to the RCADS-CV scores, ADHD/ANX(+), ADHD/ANX(-), and control groups were formed. The emotional lability/negativity levels were higher in the ADHD groups compared to the non-ADHD controls. Paternal and maternal attachment security levels were lower in the ADHD/ANX(+) group compared to the controls. The regression analysis indicated that higher hyperactivity/impulsivity symptom levels and lower maternal attachment quality were associated with higher anxiety in children with ADHD. These results suggest that focusing on attachment quality and emotion regulation problems may be significant in management of core symptoms and comorbid anxiety problems in children with ADHD.

Attachment and emotional regulation: examining the role of prefrontal cortex functions, executive functions, and mindfulness in their relationship

Attachment is a prominent area of psychological research, with its relevance linked to executive functions, mindfulness, and emotional regulation. The purpose of this study is to examine this relationship among these aforementioned four constructs and propose a model to be tested in the future. Based on the current trends using the Interpersonal Neurobiology approach, which assumes prefrontal cortex functions to include other socioemotional resources such as empathy, morality, insight, behavior, and body regulation. Our study included prefrontal cortical functions alongside executive functions. The assessment instruments used were Attachment-Based Cognitive Representations Scale, Prefrontal Cortex Functions Scale, Webexec, Five Facet Mindfulness Scale, and Difficulties in Emotion Regulation Scale. We hypothesized that attachment would be the strongest predictor of emotional regulation. The participants in the study were 539 college students (mean = 20.21; sd = 1.57); (68% female and 32%, male). Our a priori research hypothesis was supported, with an additional finding that trait mindfulness was also a significant predictor. The strongest correlations with attachment styles were with trait mindfulness and emotional regulation. We conducted path analyses of two different models for secure and insecure attachment. The path analyses showed that secure attachment scores were negatively related, and insecure attachment scores were positively related to difficulties in emotional regulation scores. Furthermore, trait mindfulness and prefrontal cortex functions also mediated this relationship. However, there was no significant relationship between executive functions and difficulties in emotional regulation scores, even though it was significantly related to attachment. Results and implications are discussed.