Emotion dysregulation in adults suffering from attention deficit hyperactivity disorder (ADHD), a comparison with borderline personality disorder (BPD)

Eva Rüfenacht,Paco Prada,Roland Hasler,Sebastian Euler,Nader Perroud,Rosetta Nicastro,Sébastien Weibel,Eléonore Pham,Karen Dieben

doi:10.1186/s40479-019-0108-1

Abstract

BackgroundEmotional dysregulation (ED) is now considered as an important symptom of attention deficit hyperactivity disorder (ADHD). It is believed to have a considerable impact on the severity of the disorder, one’s global functioning, and the prognosis. Our research aimed to evaluate and compare ED and cognitive emotional regulation strategies between ADHD and borderline personality disorder (BPD) patients.MethodsFour hundred six French-speaking outpatients (N = 279 ADHD, N = 70 BPD, N = 60 BPD + ADHD) were assessed with the Emotion Reactivity Scale (ERS), the Cognitive Emotional Regulation Questionnaire (CERQ), The Basic Empathy Scale (BES-A), the Adult ADHD Self-Report Scale (ARSV-v1.1) and the Beck Depression Inventory II (BDI-II). ADHD, BPD and comorbid patients were compared with each other and with samples of controls extracted from already published data.ResultsADHD patients, although having higher ED than samples derived from the general population, had less ED, better control over their emotions with higher use of adaptive cognitive strategies and lesser use of non-adaptive strategies than BPD patients. However, ADHD subjects had similar scores as BPD subjects when looking at difficulties in perceiving self and others. ED generated considerable distress in all groups and was also positively associated with ADHD symptomatology. ADHD patients with comorbid BPD had the highest scores of ED.ConclusionsOur results suggest that there may be similarly inefficient cognitive emotional regulation skills leading to ED in both disorders (ADHD and BPD). However, ADHD patients showed a higher use of adaptive cognitive emotional strategies and a lower level of ED than BPD patients.

Highlights

Emotional dysregulation (ED) is considered as an important symptom of attention deficit hyperactivity disorder (ADHD)
borderline personality disorder (BPD) and BPD + ADHD patients were more likely to be female than ADHD patients (X2 = 89.7; p < 0.001)
Taken together 63.44% (N = 177/279) of ADHD patients did have at least one comorbidity compared to 97.14% (N = 68/70) of BPD patients and 93.33% (N = 56/60) of the ADHD+BPD patients

Summary

Introduction

Emotional dysregulation (ED) is considered as an important symptom of attention deficit hyperactivity disorder (ADHD). Our research aimed to evaluate and compare ED and cognitive emotional regulation strategies between ADHD and borderline personality disorder (BPD) patients. Several studies suggest that besides attentional and hyperactive-impulsive symptoms, Studies have estimated that 34 to 70% of adults suffering from ADHD have difficulties regulating their emotions [4,5,6]. ED in BPD is considered a fundamental mechanism of the disorder, and this dimension concerns at least two of the DSM-5 criteria for the disorder This makes BPD the “gold standard” disorder to which other disorders (such as ADHD) can be compared to assess their level of ED. Few studies directly compared ED in BPD and ADHD and none considered comorbid ADHD+BPD patients [14,15,16]

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