Abstract
BackgroundEmotional symptoms are increasingly considered a core feature of attention deficit/hyperactivity disorder (ADHD). We aimed to quantify the evidence of emotional dysregulation and its respective facets in individuals with adult ADHD compared to healthy controls using meta-analysis.MethodsTwo electronic databases (PubMed, PsycINFO) were reviewed to identify studies. Studies were eligible for inclusion that had reports on any measure of emotion (dys) regulation in adults (> 18 years of age) in clinically diagnosed patients with ADHD as well as healthy control participants. We included a total of 13 studies (N = 2535) to assess (1) the standardized mean difference in emotion dysregulation (ED) as a general factor and its specific facets (i.e., emotional lability, negative emotional responses, and emotion recognition) between adults with ADHD and healthy controls; and (2) the association between ADHD symptom severity and ED.ResultsCompared to healthy controls, adults with ADHD revealed significantly higher levels of general ED (Hedges’ g = 1.17, p < 0.001; Hedges’ g is the adjusted effect size). With regard to intermediate dimensions of ED, emotional lability exhibited the strongest weighted effect (Hedges’ g = 1.20, CI [0.57, 1.83], p < 0.001). Furthermore, symptom severity and general ED correlated significantly (r = 0.54, p < 0.001). Regarding intermediate dimensions of ED, negative emotional responses correlated closely with ADHD symptom severity (r = 0.63, p < 0.001) and emotional lability (r = 0.52, p < 0.001).ConclusionsOur findings support ED symptoms as a core feature of ADHD’s psychopathology. With respect to dimensions of ED, emotional lability, and negative emotional responses play a more definitive role in the psychopathology of adults with ADHD. Due to insufficient statistical reports in the included studies, we could not perform meta-regressions to control the role of moderator variables.
Highlights
Emotional symptoms are increasingly considered a core feature of attention deficit/hyperactivity disorder (ADHD)
Association of ED with severity of ADHD symptoms Answering our study’s second question regarding a correlation between ADHD symptoms in adults and emotion dysregulation dimensions, we found a strong correlation between the severity of ADHD symptoms and ED in general with an average effect size of r = 0.54
In line with these research objectives, we identified dimensions of ED based on our adopted conceptual models of ED
Summary
Emotional symptoms are increasingly considered a core feature of attention deficit/hyperactivity disorder (ADHD). Apart from the core symptoms, emotion regulation contributes independently to functional impairments in patients with ADHD [5,6,7]. In this regard, several studies reported that emotion dysregulation (ED) Terms like ED, emotional lability, emotional instability (i.e., irregular shifting between emotional states) and emotional impulsivity (i.e., overshooting emotional responses) are often applied interchangeably or rather idiosyncratically (for a review see [17]) This lack of consensus and clarity regarding the construct of emotion regulation and ED makes summarizing and integrating empirical findings in ADHD complicated [22]. To avoid working in “conceptual and definitional chaos” ([23], p. 330), we briefly define emotion regulation, ED, and facets of ED that contribute to functional and psychosocial impairments in patients with ADHD
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