One in two adolescents with ADHD have trouble managing emotions: Study

NEW DELHI: One in every two adolescents having Attention Deficit Hyperactivity Disorder (ADHD) may have trouble managing their emotions, which can come out as explosive outbursts, depression or anxiety, according to a new study.

People with ADHD have short attention spans, along with hyperactivity, restlessness, or impulsivity. Being a neurodevelopmental disorder, it is commonly diagnosed in children and adolescents but can persist into adulthood.

It is known that people with ADHD have problems with self-control, which affects their ability to regulate and manage emotions.

While these problems of emotion dysregulation were thought to be due to ADHD symptoms which impact an individual’s motivation and ability to think (cognition), researchers showed that such people can have trouble managing their emotions regardless of those symptoms.

Emotional dysregulation can develop more ADHD symptoms

The team of researchers from the University of Cambridge, UK, and Fudan University, China, also found strong evidence that high levels of emotion dysregulation raises the likelihood of developing more ADHD symptoms. The findings are published in the journal Nature Mental Health.

“Parents and teachers often say they have problems controlling children with ADHD, and it could be that when the children can’t express themselves well – when they hit emotional difficulties – they may not be able to control their emotions and have an outburst rather than communicating with the parent, teacher or the other child,” author Barbara Sahakian from the University of Cambridge said.

For the study, the researchers included data from the Adolescent Brain Cognitive Development (ABCD) study, tracking brain development and mental health of children and adolescents across the US.

The researchers developed an ADHD-symptom score, based on data available for over 6,000 individuals from the ABCD study. The score indicated an individual’s chances of having the disorder.

Of the group, the team also identified 350 participants having high symptom scores that met the clinical criteria for ADHD.

Findings from the study

By responding to questionnaires, parents or guardians had previously provided information on how well or not their children coped when feeling upset, the researchers said. The responses were evaluated to score participants on their emotion dysregulation.

The authors found that more than half of those in the high-symptom group (51 per cent) showed signs of emotion dysregulation, regardless of problems with their cognition and motivation. Emotion dysregulation was also found to be a strong risk factor for developing more ADHD symptoms.

Of all the participants, children showing low symptoms of ADHD at ages 12 and 13 but having high emotion dysregulation at age 13, were 2.85 times more likely to have developed high-ADHD symptoms upon turning 14, compared to those having less trouble managing emotions, the team found.

Examining brain imaging data, the researchers found that children with high scores of ADHD symptoms and emotion dysregulation had smaller pars orbitalis, the brain region important for understanding emotions and exerting control over behaviour.

The finding could explain some of the behaviours noticed in people with ADHD, they said.

Acknowledging emotion dysregulation as a key part of ADHD will help people better understand the problems the child is experiencing, and could lead to using effective treatments for regulation of emotion, such as cognitive behavioural therapy, the researchers said.

This may be particularly important as Ritalin, the drug that helps manage ADHD symptoms, does not appear to fully treat symptoms of emotion dysregulation, they said.

Identifying the problem earlier would allow for alternative, more effective interventions to help the child better manage their emotions, potentially helping the individual in adulthood, the authors said.