Emotional dysregulation and Attention-Deficit/Hyperactivity Disorder

It has long been recognized that many individuals with ADHD also have difficulties with emotion regulation but lack of consensus on how to conceptualize this clinically challenging domain renders a review timely. The authors examine the current literature using both quantitative and qualitative methods. Three key findings emerge. First, emotion dysregulation is prevalent in ADHD throughout the lifespan and is a major contributor to impairment. Second, emotion dysregulation in ADHD may arise from deficits in orienting towards, recognizing and/or allocating attention to emotional stimuli; these deficits that implicate dysfunction within a striatoamygdalo-medial prefrontal cortical network. Third, while current treatments for ADHD often also ameliorate emotion dysregulation, a focus on this combination of symptoms reframes clinical questions and could stimulate novel therapeutic approaches. Three models to explain the overlap between emotion dysregulation and ADHD are considered: emotion dysregulation and ADHD are correlated but distinct dimensions; emotion dysregulation is a core, diagnostic feature of ADHD; and the combination constitutes a nosological entity, distinct from both ADHD and emotion dysreguation alone. The differing predictions from each model can guide future research into this much-neglected population. Correspondence to: Philip Shaw, [email protected]. Disclosures. All authors declare no conflict of interest. NIH Public Access Author Manuscript Am J Psychiatry. Author manuscript; available in PMC 2015 January 02. Published in final edited form as: Am J Psychiatry. 2014 March ; 171(3): 276–293. doi:10.1176/appi.ajp.2013.13070966. N IH -P A A uhor M anscript N IH -P A A uhor M anscript N IH -P A A uhor M anscript