Adult ADHD, Emotion Dysregulation, and Functional Outcomes: Examining the Role of Emotion Regulation Strategies

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Emotion dysregulation is associated with Attention-Deficit/Hyperactivity Disorder (ADHD) and may contribute to the functional impairment experienced by people with this disorder. The present study addressed the following questions: 1) Does emotion dysregulation mediate the relationship between ADHD and key domains of functioning in adults with ADHD?, and, 2) If so, which emotion regulation strategies might further explain this relationship? 159 participants (59 ADHD, 100 non-ADHD) were recruited through Amazon’s Mechanical Turk. Participants completed a variety of online self-report measures assessing ADHD symptoms, emotion regulation deficits and strategies, symptoms of depression and anxiety, relationship satisfaction, and overall functional impairment. Deficits in emotion regulation mediated the relationship between ADHD and internalizing symptoms, relationship satisfaction, and overall functional impairment. In exploratory analyses, avoidance mediated the relationship between ADHD and deficits in emotion regulation, but reappraisal and suppression did not. Serial mediation analyses indicated that the indirect effects of avoidance alone, apart from deficits in emotion regulation, partially explained the relationship between ADHD and nearly all outcomes. These results are consistent with past literature indicating that emotion regulation problems help explain the presence of depressive symptoms and romantic relationship impairment in adults with ADHD, and add that anxiety symptoms, poorer friendship quality, and greater functional impairment also may be influenced by emotion regulation problems. This study also identifies a specific emotion regulation strategy – avoidance – as a potential contributor to these outcomes. Future work should investigate contexts in which avoidant coping is most problematic so that interventions can be adapted accordingly.