Negative Affectivity and Emotion Dysregulation as Mediators between ADHD and Disordered Eating: A Systematic Review.

Sarah El Archi,Paul Brunault,Nicolas Ballon,Christian Réveillère,Samuele Cortese,Arnaud De Luca,Servane Barrault

doi:10.3390/nu12113292

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2 September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research.

Highlights

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by impairing levels of inattention and/or hyperactivity-impulsivity, which is thought to begin generally in childhood and significantly interferes with social, academic, and/or occupational functioning
This systematic review included publications investigating the association between ADHD and addictive-like eating behavior such as loss of control overeating, binge eating, and preoccupation with food, which are the main FA symptoms, and some DSM-5 EDs such as BN and BED, which show high FA prevalence [19,20]
No data about behavioral features of eating (n = 38), including 30 publications which focused on the association between ADHD and body mass index (BMI) [8,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85]

Summary

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by impairing levels of inattention and/or hyperactivity-impulsivity, which is thought to begin generally in childhood (before the age of 12) and significantly interferes with social, academic, and/or occupational functioning. Childhood ADHD prevalence is estimated to be between 5 and 7% [1,2,3]. The prevalence of adult ADHD is between 1.4 and 3.6% [1]. The treatment for individuals with ADHD includes pharmacologic [5] and non-pharmacologic [6] options. It has been demonstrated that both childhood and adult ADHD is associated with higher prevalence and risk of a large number of medical and psychiatric comorbidities. According to Kooij and colleagues (2019), 60–80% of individuals with

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