Relation of emotion regulation and empathy skills with maternal emotion regulation and attachment in children diagnosed with ADHD

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood neurodevelopmental disorder. Difficulties in the areas of emotion regulation and empathy were found in prior studies. Mother-child attachment is important in the development of emotion regulation and empathy. We aimed to examine the relation emotional regulation and empathy skills in children with ADHD and emotion regulation and attachment properties in their mothers and to compare with healthy controls. Methods: The study group consisted of 61 children (8-12 years old) diagnosed with ADHD. The control group (87 children) comprised patients of other clinics at hospital and was matched for gender and age to the ADHD patients. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was used to diagnose ADHD and allowed comorbidities. We evaluated disorder severity at the time of assessment using the DuPaul Attention Deficit and Hyperactivity Disorder Rating Scale. All patients were treatment-naive. Emotional Regulation Checklist (ERC) and KA-SI empathy scale were used to examine children emotional regulation and empathy. Difficulties in Emotion Regulation Scale (DERS) was used to indicate maternal emotional dysregulation status and Experiences in Close Relationship Scale-II was used to evaluate attachment properties in mothers. Results: Children with ADHD had statistical significant lower scores in the areas of affective empathy, cognitive empathy, total empathy score and emotion regulation and cases had statistical significant higher scores in emotion lability. Mothers of children with ADHD had higher scores in anxious and avoidant attachment styles and all subscales of DERS. The correlation between, ADHD symptoms, KA-SI Empathy, ERC, Attachment Scale, and DERS was evaluated by Pearson’s correlation analysis. Negative correlation was found between both attention deficit and hyperactivity scores of Du Paul scale and affective, cognitive empathy scores of KA-SI Emphatic Tendency Scale and emotion regulation scores of ERC; a positive correlation was determined between attention deficit and hyperactivity scores of Du Paul scale, mothers’ anxious and avoidant attachment and DERS total scores, and emotional lability scores of ERC. Discussion: Mother-child attachment and maternal emotion regulation skills have important roles in the emotion regulation and empathy skills of children. Better understanding of neuropsychologic development process of attachment, empathy and emotion regulation skills and their relations with each other may contribute to the treatment of children with ADHD.