Emotional Dysregulation In Adults Research Articles

A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study.

Many adults with attention-deficit/hyperactivity disorder (ADHD) experience difficulties related to emotion regulation. Such difficulties are known to substantially impact quality of life and overall functioning. Yet, there is a lack of treatment interventions specifically designed to address these challenges. This study aimed to describe the development and assess the feasibility, along with the initial clinical outcomes, of a novel blended intervention for adults with ADHD. The blended intervention combines both face-to-face and digital components and is specifically designed to address emotion dysregulation in ADHD. This intervention was an 8-week blended intervention combining weekly face-to-face group sessions with a supplementary digital companion app. The intervention is based on elements from dialectic behavioral therapy skills training and positive psychology. To evaluate its feasibility, we performed a 10-week feasibility study with an uncontrolled pre-post study design, including 16 adults with ADHD and co-occurring emotion dysregulation. The feasibility measures encompassed adherence, satisfaction, and perceived credibility of the intervention. Clinical outcomes were evaluated by self-reported symptoms of emotion dysregulation, inattention, hyperactivity-impulsivity, executive function, depression, anxiety, and a measure of quality of life. Paired sample 2-tailed t tests were used to analyze clinical outcomes with a Bonferroni-corrected significance level. Both treatment credibility and treatment satisfaction were rated favorably by the majority of the participants. In particular, the participants emphasized meeting others with ADHD as beneficial. In terms of adherence, 3 participants withdrew before initiating the intervention, while another 4 participants did not complete the intervention. On average, the participants who enrolled in the intervention attended 6.2 of the 8 group sessions and completed 6.7 of the 8 skills training modules in the companion app. In terms of clinical outcomes, there was a reduction in symptoms of emotion dysregulation from before to after the intervention (d=2.0). Significant improvements were also observed in measures of inattention (d=1.1) and hyperactivity-impulsivity (d=0.9). However, no significant improvements were found in the domains of depression, anxiety, quality of life, and executive functioning. The results are encouraging, both in terms of feasibility and the preliminary clinical results on emotion dysregulation. The blended format, combining digital and face-to-face elements, may also seem to offer some advantages: the group-based format was valued as it facilitated peer interaction, while a rather high completion of modules in the companion app highlights its potential to enhance skills training between the group sessions. Future randomized controlled trials are called for to further evaluate the clinical effectiveness of the intervention. ClinicalTrials.gov NCT05644028; https://clinicaltrials.gov/study/NCT05644028.

Targeting emotion dysregulation in adults with ADHD: A pilot study of a blended digital and face-to-face intervention

Targeting emotion dysregulation in adults with ADHD: A pilot study of a blended digital and face-to-face intervention

Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood.

The concept of emotional dysregulation (ED) has recently gained interest in the scientific literature and is commonly defined as the inability to use the modulatory mechanisms involved in emotion regulation, resulting in a functioning meaningfully below the baseline. Even though the data available are still limited, an increasing number of studies have hypothesized a promoting role for some of the core features of autism spectrum disorder (ASD) in the development of ED, in particular being repetitive behaviors, social difficulties and alexythimia. In this framework, the purpose of this study was to review the literature that is currently available about presence and correlates of ED in young adults with autism spectrum conditions as well as to offer some insights about possible implications for illness trajectories. The data reported seems to point to a shared etiology between ED and repetitive/restricted ASD symptoms, with perseveration features serving as the foundation for the inability to control one's emotions. In this context, a neurodevelopmental basis for ED could be consistent with the transnosographic conceptualization of ASD, which hypothesizes a potential neurodevelopmental basis for several psychiatric disorders, whose autistic traits would be the phenotypical presentation.

A Scoping Review of Factors Associated With Emotional Dysregulation in Adults With ADHD

Objective: Emotion dysregulation is frequently seen in adults with ADHD and is associated with many adverse outcomes. We conducted a scoping review of factors associated with emotion dysregulation in adults with ADHD. Method: PubMed and PsycInfo (EBSCO) were searched. Articles were included if they measured ADHD, emotional dysregulation or some aspect of emotional dysregulation, and at least one other construct. Studies examining physiological underpinnings as well as clinical trials examining the effect of ADHD medications on emotional dysregulation were excluded because recent reviews have already examined these topics. Results: Thirty-five studies were included in the review. Factors such as biological sex, comorbidities, attachment style, using certain emotional regulation strategies, and ADHD subtype tend to be related to emotion dysregulation. Conclusion: Clinicians working with adults with ADHD can collect information on these factors to better understand risk for emotion dysregulation, and emotion regulation skills may be one area for intervention.

Does the gender matter?: Anxiety symptoms and emotion dysregulation in adults with autism and intellectual disabilities.

Research shows high rates of anxious symptoms in people autistic spectrum disorder (ASD). Finding factors related to the development of anxiety in ASD is necessary. Emotion regulation (ER) is associated with anxiety in ASD. Moreover, some studies find higher rates of anxiety in women with ASD. A total of 121 adults (M=35.46 years, SD=9.46) with ASD and intellectual disabilities were evaluated to verify moderating role of gender and mediating role of ER. A moderated mediation analysis supported the moderated role of gender in the relationship mediated by emotional dysregulation between ASD and anxiety. These findings suggest that interventions designed to prevent or reduce anxiety symptoms in women with ASD should include among their goals emotional regulation. LAY SUMMARY: If we want to reduce or prevent anxiety symptoms in women with ASD we must work on emotional regulation.

Emotion dysregulation in adults with ADHD: The role of cognitive reappraisal and expressive suppression

BackgroundEmotion dysregulation (ED) is a common clinical feature of attention-deficit/hyperactivity disorder (ADHD). The present study examined the role of cognitive reappraisal (CR) and expressive suppression (ES) in adults with ADHD. In addition, resting-state fMRI (rs-fMRI) data were analyzed to identify neural substrates of CR/ES-ED relationships. MethodsA total of 309 adults with ADHD and 163 healthy controls were recruited. ED was assessed using the ‘emotional control’ (EC) subscale from Behavior Rating Inventory of Executive Function-Adult Version. The Emotion Regulation Questionnaire was used to measure CR and ES. The functional connectivities (FCs) with the amygdala as Region of Interest, were analyzed in a subsample to explore their association with CR, ES and EC, respectively. ResultsHigher EC scores (indicative of lesser emotional control), as well as lower CR and higher ES utilization were detected in adults with ADHD compared with healthy controls. CR and ES were both negatively correlated with EC in adults with ADHD. Mediation analysis detected a potential effect of ADHD diagnosis on EC via CR. In addition, a unique significant mediation effect was found between ES-related FC of the right amygdala-prefrontal cortex and ED expression in adults with ADHD, confirming the ‘↑ES → ↓FCs [amygR-PFC] →↓EC’ relationship. LimitationsOnly self-reported scales and rs-fMRI data were included in these analyses. ConclusionsOur findings provide preliminary evidence that in adults with ADHD, less frequent use of CR accounts for ED expression, while more frequent use of ES may play a unique compensatory role in emotion regulation.

Emotional Dysregulation in Adults from 10 World Societies: An Epidemiological Latent Class Analysis of the Adult-Self-Report

Background/ObjectiveEmotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. MethodWe examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. ResultsIn each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. ConclusionsAlthough the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.

Automatic Assessment of Emotion Dysregulation in American, French, and Tunisian Adults and New Developments in Deep Multimodal Fusion: Cross-sectional Study.

BackgroundEmotion dysregulation is a key dimension of adult psychological functioning. There is an interest in developing a computer-based, multimodal, and automatic measure.ObjectiveWe wanted to train a deep multimodal fusion model to estimate emotion dysregulation in adults based on their responses to the Multimodal Developmental Profile, a computer-based psychometric test, using only a small training sample and without transfer learning.MethodsTwo hundred and forty-eight participants from 3 different countries took the Multimodal Developmental Profile test, which exposed them to 14 picture and music stimuli and asked them to express their feelings about them, while the software extracted the following features from the video and audio signals: facial expressions, linguistic and paralinguistic characteristics of speech, head movements, gaze direction, and heart rate variability derivatives. Participants also responded to the brief version of the Difficulties in Emotional Regulation Scale. We separated and averaged the feature signals that corresponded to the responses to each stimulus, building a structured data set. We transformed each person’s per-stimulus structured data into a multimodal codex, a grayscale image created by projecting each feature’s normalized intensity value onto a cartesian space, deriving each pixel’s position by applying the Uniform Manifold Approximation and Projection method. The codex sequence was then fed to 2 network types. First, 13 convolutional neural networks dealt with the spatial aspect of the problem, estimating emotion dysregulation by analyzing each of the codified responses. These convolutional estimations were then fed to a transformer network that decoded the temporal aspect of the problem, estimating emotional dysregulation based on the succession of responses. We introduce a Feature Map Average Pooling layer, which computes the mean of the convolved feature maps produced by our convolution layers, dramatically reducing the number of learnable weights and increasing regularization through an ensembling effect. We implemented 8-fold cross-validation to provide a good enough estimation of the generalization ability to unseen samples. Most of the experiments mentioned in this paper are easily replicable using the associated Google Colab system.ResultsWe found an average Pearson correlation (r) of 0.55 (with an average P value of <.001) between ground truth emotion dysregulation and our system’s estimation of emotion dysregulation. An average mean absolute error of 0.16 and a mean concordance correlation coefficient of 0.54 were also found.ConclusionsIn psychometry, our results represent excellent evidence of convergence validity, suggesting that the Multimodal Developmental Profile could be used in conjunction with this methodology to provide a valid measure of emotion dysregulation in adults. Future studies should replicate our findings using a hold-out test sample. Our methodology could be implemented more generally to train deep neural networks where only small training samples are available.

Link between History of Childhood Maltreatment and Emotion Dysregulation in Adults Suffering from Attention Deficit/Hyperactivity Disorder or Borderline Personality Disorder.

Childhood maltreatment (CM) may have a long-term effect on emotion regulation. This study aimed to explore the relationship between CM and emotion dysregulation (ED) in a heterogeneous population. Four hundred seventy French-speaking outpatients (N = 279 ADHD, N = 70 BPD, N = 60 ADHD + BPD, N = 61 clinical controls) completed the Emotion Reactivity Scale (ERS), the Cognitive Emotional Regulation Questionnaire (CERQ), the Childhood Trauma Questionnaire (CTQ), and the Relationship Scales Questionnaire (RSQ). Reports of childhood maltreatment experiences were significantly associated with increased levels of emotion reactivity in all our groups and in the whole population, with a greater use of non-adaptive cognitive emotion regulation strategies and insecure attachment patterns. Emotional abuse showed the strongest effect. Further analysis indicated that an anxious attachment style significantly mediated the relationship between CM and the use of non-adaptive cognitive emotion regulation strategies and emotion reactivity. The results of our study suggest an impact of CM on ED and a potentially marked effect of emotional abuse. They also indicate a potentially mediating role of insecure attachment in the relationship between a history of childhood abuse and emotion reactivity and a higher use of non-adaptive cognitive emotion regulation strategies in adulthood.

Verbal working memory and processing speed: Correlations with the severity of attention deficit and emotional dysregulation in adult ADHD.

ObjectivesThe Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), emphasizes symptoms severity with regard to the diagnosis of attention deficit hyperactivity disorder (ADHD). Many clinicians use neuropsychological test results as objective measures of cognitive functions as part of the diagnostic work‐up. The aim of this study was to investigate whether the psychometric test results regarding verbal working memory and processing speed are useful as indicators of the severity of attention deficits and emotional dysregulation in adults with ADHD.MethodsThis observational cross‐sectional clinical study included 418 adults diagnosed with ADHD according to the DSM‐5. Attention deficit severity was defined based on the inattentive subscale of the Adult ADHD Self‐Report Scale. Emotional dysregulation was assessed with the Deficient Emotional Self‐Regulation scale. Verbal working memory was measured with the Working Memory Index (WMI), and processing speed was measured with the Processing Speed Index (PSI) from the Wechsler Adult Intelligence Scale, third edition.ResultsThe full‐scale intelligence quotients of the participants were in the normal range, with expected reductions in verbal working memory and processing speed. Only processing speed was associated with attention deficits (β = −.056, p = .003). The association between the psychometric test result for verbal working memory and processing speed and that between the severity of attention deficits and emotional dysregulation were weak (R2 < .1) and mostly non‐significant.ConclusionThe psychometric index scores for verbal working memory (WMI) and processing speed (PSI) seem to have limited utility as indicators of the severity of attention deficits and emotional dysregulation in adult ADHD patients.

Emotional dysregulation in adults: The influence of rumination and negative secondary appraisals of emotion

BackgroundEmotional dysregulation is commonly discussed as a transdiagnostic factor in clinical populations. The present study aims to investigate cognitive factors (rumination and negative appraisals of emotion) in the maintenance of emotional dysregulation in a normative sample in order to partially validate a cognitive model of emotional dysregulation and to examine the potential clinical relevance of addressing cognitive factors in the treatment of emotional dysregulation. MethodsPeople who were 18 or older were asked to participate via a university research system and social media. Participants (N = 216) were asked to fill out online surveys regarding emotional dysregulation, rumination and negative secondary appraisals of emotion. ResultsPeople who had higher emotional dysregulation levels displayed a greater tendency to ruminate and were more prone to negative secondary appraisals of emotion. There was a positive association between rumination and negative secondary appraisals of emotion, and this association was mediated by emotional dysregulation. LimitationsThe present study was solely based on self-report measurements and the collected data were cross-sectional. ConclusionsThe present study showed that a wide spectrum of experiences of emotional dysregulation occurred in a normative sample. The significant mediation highlighted the maintaining role of rumination and negative appraisals in emotional dysregulation. These data highlight the importance of addressing cognitive factors in emotional dysregulation.

Emotion dysregulation in adult ADHD: Introducing the Comprehensive Emotion Regulation Inventory (CERI)

ABSTRACT Introduction Previous research has shown that Attention-Deficit Hyperactivity Disorder (ADHD) is linked to emotion dysregulation, but we still do not know enough about the specific nature of this deficit. The aim of the present study was therefore to study emotion dysregulation in adult ADHD using a new self-rating instrument, the Comprehensive Emotion Regulation Inventory (CERI). Methods The study included 390 participants, both adults diagnosed with ADHD and a comparison group. The CERI was created based on Gross’ process model of emotion. Unlike instruments already available, the CERI enables a detailed analysis of different strategies for regulating both positive and negative emotions and of the impact emotion dysregulation has on daily life. Results Results showed that the CERI has good psychometric properties, and a 5-factor solution was identified. Adults with ADHD differed from the comparison group with regard to how often they use different strategies, although effect sizes were small to medium. However, large effect sizes were found between ADHD and the comparison group with regard to problems implementing the use of various regulatory strategies and the negative impact on daily life functioning with regard to friendships, work/studies, or romantic relations. Within-group differences showed that adults with ADHD use the less advanced strategy suppression significantly more often compared to the more advanced strategies attentional deployment and reappraisal. Conclusions The CERI appears to be a valuable instrument for gaining more in-depth insights into emotion dysregulation in adults with mental disorders. Future research needs to examine what aspects of emotion dysregulation are shared between different mental disorders and what aspects might be specifically related to ADHD.

Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis

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.

Application of Chaos Theory in the Assessment of Emotional Vulnerability and Emotion Dysregulation in Adults.

In this work, we propose an interdisciplinary chaos analysis of emotion dysregulation (ED) and emotional vulnerability in adults. One of the main goals was the assessment of incongruences that occur in the evaluation of one’s own emotional dysregulation mechanisms in the presence of an extremely weak stimulus (Butterfly Effect). Thus, we considered a “flavor” of the Lyapunov Function method based on the assumption that the effort of answering to the test is itself a small perturbation. In this context, we calculated the “instability coefficient” Δ defined as the Euclidean distance between the pairs of vectors that include similar and reverted items of a test. The relationship between Δ, ED, and emotional characteristics as quality (positive/negative) and type (trait/state) was highlighted. We hypothesized that a higher level of Δ should be significantly related with a higher ED and with the type and the quality of emotions. The results suggest that Δ is significantly correlated with trait emotions (positively with negative emotions, and negatively with positive ones) and with ED. Moreover, Δ significantly predicts ED in adults. Thus, we consider that this approach is promising with respect to the evolution of emotional mechanisms across time. The presence of an initial instability to a weak perturbation might predict future abnormal emotional functioning, which could put at risk the mental or psychosomatic systems.

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

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.

T64. An Experience Sampling Study of Emotional Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder and Borderline Personality Disorder

There is ongoing debate about the overlap between Attention-Deficit/Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD), mostly in regards to emotional dysregulation (ED). ED, characterised by rapid and exaggerated changes in emotional states, is an associated feature in ADHD and a core symptom in BPD.

52.4 Mood Dysregulation and Mood Disorders in Adult Attention-Deficit/Hyperactivity Disorder

This talk will review the clinical significance of symptoms of mood (emotional) dysregulation versus frank co-occurring mood disorders in adults with ADHD and examine evidence for the potential treatment of co-occurring mood disorders or symptoms of emotional dysregulation in adults with ADHD.

A-26The Functional Impact of Emotional Dysregulation in Adults with Frontotemporal Dementia

A-26The Functional Impact of Emotional Dysregulation in Adults with Frontotemporal Dementia

Does Emotion Dysregulation Mediate the Relationship between Early Maltreatment and Later Substance Dependence? Findings of the CANSAS Study

Background/Aims: Maltreatment in childhood and adolescence is a risk factor for substance use disorders (SUDs) in adulthood. This association has rarely been investigated in the light of emotion dysregulation. To fill this gap, this study examines emotion dysregulation and SUDs among adults with a history of early maltreatment. Methods: Comparison of emotion dysregulation in adults with a history of early abuse and neglect who developed either an SUD (n = 105) or no mental disorder (n = 54). Further, a mediation model for the association between the severity of early maltreatment and SUDs was tested. Participants completed research diagnostic interviews for psychopathology, the Difficulties in Emotion Regulation Scale, and the Childhood Trauma Questionnaire. Results: By using hierarchical regression techniques and mediational analyses controlling for age and gender, it was possible to provide evidence for the mediating role of emotion dysregulation between early emotional and physical maltreatment and later SUDs. Conclusions: Emotion dysregulation is a potential mechanism underlying the relationship between early emotional and physical maltreatment and the development of SUDs. In light of these findings, focusing on the early training of adaptive emotion regulation strategies after childhood maltreatment might be of considerable relevance to prevent the development of SUDs.

Emotional Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder-Validity, Predictability, Severity, and Comorbidity.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. However, this triad might not be able to explain the complete spectrum of ADHD symptoms, as emotional dysregulation (ED) frequently seems to accompany the disorder. The aim of this study was to further understand the role of ED in adult ADHD. The sample comprised 393 adults with ADHD without or with comorbidity, and 121 adults without ADHD or any other mental disorder. Additionally, the sample focused on ED. The contribution of core symptoms and the effect of comorbidity on ED were tested and the predictive value of ED for the ADHD diagnosis itself analyzed. Finally, all subjects were categorized into groups-No ADHD, ADHD, and ADHD + ED-to analyze the differences in the severity of ADHD symptomatology in the three groups. ED levels were found to be elevated in patients with ADHD. The core symptoms affected ED, and the ADHD diagnosis was predicted by ED. The addition of ED to a regression model with the core symptoms was shown to improve the predictability of the ADHD diagnosis. The presence of ED proved to be an indicator of the severity of adult ADHD independent of a present comorbidity. ED is a significant symptom in adult patients with ADHD and appears to be associated with ADHD itself. Whilst the presence of other mental disorders intensifies symptoms of ED, ED seems not to manifest solely as a consequence of comorbidity.