Skip to main content

Advertisement

Log in

Attention-Deficit/Hyperactivity Disorder (ADHD) and Emotion Regulation Over the Life Span

  • Attention-Deficit Disorder (A Rostain, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Emotional symptoms are common and persistent in youth and adults with attention-deficit/hyperactivity disorder (ADHD) and cause clinically significant impairments. We review recent neuropsychological, neurophysiological, and peripheral psychophysiological evidence for emotion and emotion regulation deficits in ADHD across youth and adults.

Recent Findings

Central and autonomous nervous system correlates argue in favor of more general self-regulation deficits and also specific emotional deficits in ADHD. These include general performance deficits in executive functions, and structural as well as functional impairments in neuronal networks associated with top-down self-regulation. Specific deficits with bottom-up emotional activation in the amygdala and emotion evaluation associated with the orbitofrontal cortex have also been described. Furthermore, vagally mediated, high-frequency heart rate variability is associated with emotional self-regulation deficits throughout the life span. The current evidence is based on multilevel studies that assess associations of emotion regulation. However, further studies that adequately consider the processual recursive character of emotion generation and regulation may give important new insights into emotional regulation of ADHD.

Summary

Emotion regulation deficits in ADHD are associated with specific as well as general self-regulation deficits traceable on the level of neuropsychological, neurophysiological, and psychophysiological assessments. The temporal dynamics of the interplay of those different systems need further study in order to optimize and personalize treatment of emotion regulation difficulties, including emotional reactivity, in patients with ADHD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. ICD-10: international statistical classification of diseases and related health problems: tenth revision. 2nd ed. Geneva: WHO; 2004.

  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: American Psychiatric Association; 2013.

    Book  Google Scholar 

  3. Fischer M, Barkley R. The persistence of ADHD into adulthood: (once again) it depends on whom you ask. ADHD Report. 2007;15:7–16.

    Article  Google Scholar 

  4. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164:942–8. https://doi.org/10.1176/ajp.2007.164.6.942.

    Article  PubMed  Google Scholar 

  5. Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43:434–42. https://doi.org/10.1093/ije/dyt261.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Fayyad J, Sampson NA, Hwang I, Adamowski T, Aguilar-Gaxiola S, Al-Hamzawi A, et al. The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord. 2017;9:47–65. https://doi.org/10.1007/s12402-016-0208-3.

    Article  PubMed  Google Scholar 

  7. Simon V, Czobor P, Bálint S, Mészáros A, Bitter I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry. 2009;194:204–11. https://doi.org/10.1192/bjp.bp.107.048827.

    Article  PubMed  Google Scholar 

  8. Kessler R. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006;163:716. https://doi.org/10.1176/appi.ajp.163.4.716.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Anastopoulos AD, Smith TF, Garrett ME, Morrissey-Kane E, Schatz NK, Sommer JL, et al. Self-regulation of emotion, functional impairment, and comorbidity among children with AD/HD. J Atten Disord. 2011;15:583–92. https://doi.org/10.1177/1087054710370567.

    Article  PubMed  Google Scholar 

  10. Skirrow C, Asherson P. Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. J Affect Disord. 2013;147:80–6. https://doi.org/10.1016/j.jad.2012.10.011.

    Article  PubMed  Google Scholar 

  11. Szuromi B, Bitter I, Czobor P. Functional impairment in adults positively screened for attention-deficit hyperactivity disorder: the role of symptom presentation and executive functioning. Compr Psychiatry. 2013;54:974–81. https://doi.org/10.1016/j.comppsych.2013.04.002.

    Article  PubMed  Google Scholar 

  12. Barkley RA. Deficient emotional self-regulation is a core component of ADHD. J ADHD Relat Disord. 2010:5–37.

  13. Reimherr FW, Marchant BK, Strong RE, Hedges DW, Adler L, Spencer TJ, et al. Emotional dysregulation in adult ADHD and response to atomoxetine. Biol Psychiatry. 2005;58:125–31. https://doi.org/10.1016/j.biopsych.2005.04.040.

    Article  CAS  PubMed  Google Scholar 

  14. Corbisiero S, Stieglitz R-D, Retz W, Rösler M. Is emotional dysregulation part of the psychopathology of ADHD in adults? Atten Defic Hyperact Disord. 2013;5:83–92. https://doi.org/10.1007/s12402-012-0097-z.

    Article  PubMed  Google Scholar 

  15. •• Shaw P, Stringaris A, Nigg J, Leibenluft E. Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry. 2014;171:276–93. https://doi.org/10.1176/appi.ajp.2013.13070966 Comprehensive review on emotion regulation in ADHD from a multilevel perspective. The authors finally suggest three conceptual models to explain the overlap between emotion regulation and ADHD.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Biederman J, Spencer T, Lomedico A, Day H, Petty CR, Faraone SV. Deficient emotional self-regulation and pediatric attention deficit hyperactivity disorder: a family risk analysis. Psychol Med. 2012;42:639–46. https://doi.org/10.1017/S0033291711001644.

    Article  CAS  PubMed  Google Scholar 

  17. Sobanski E, Banaschewski T, Asherson P, Buitelaar J, Chen W, Franke B, et al. Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence. J Child Psychol Psychiatry. 2010;51:915–23. https://doi.org/10.1111/j.1469-7610.2010.02217.x.

    Article  PubMed  Google Scholar 

  18. Surman CBH, Biederman J, Spencer T, Yorks D, Miller CA, Petty CR, et al. Deficient emotional self-regulation and adult attention deficit hyperactivity disorder: a family risk analysis. Am J Psychiatry. 2011;168:617–23. https://doi.org/10.1176/appi.ajp.2010.10081172.

    Article  PubMed  Google Scholar 

  19. • Skirrow C, Ebner-Priemer U, Reinhard I, Malliaris Y, Kuntsi J, Asherson P. Everyday emotional experience of adults with attention deficit hyperactivity disorder: evidence for reactive and endogenous emotional lability. Psychol Med. 2014;44:3571–83. https://doi.org/10.1017/S0033291714001032 This study used real-time ambulatory assessment in a sample of individuals with ADHD without comorbidity and healthy controls. The authors showed that adults with ADHD reported heightened intensity and instability of negative emotions in daily life.

    Article  CAS  PubMed  Google Scholar 

  20. •• Graziano PA, Garcia A. Attention-deficit hyperactivity disorder and children’s emotion dysregulation: a meta-analysis. Clin Psychol Rev. 2016;46:106–23. https://doi.org/10.1016/j.cpr.2016.04.011 Most recent meta-analysis on emotion regulation in children with ADHD.

    Article  PubMed  Google Scholar 

  21. •• Faraone SV, Rostain AL, Blader J, Busch B, Childress AC, Connor DF, et al. Practitioner review: Emotional dysregulation in attention-deficit/hyperactivity disorder—implications for clinical recognition and intervention. J Child Psychol Psychiatry. 2018. https://doi.org/10.1111/jcpp.12899 This review addresses important issues regarding emotion regulation in ADHD (conceptual clarifications, similarities, and differences between emotion regulation deficits in ADHD and other disorders, ERD treatment responses). They provide a temporal model of emotion-processing impairments in ADHD, separating emotional reactivity from emotion regulation components.

  22. Stringaris A, Goodman R. Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. J Am Acad Child Adolesc Psychiatry. 2009;48:404–12. https://doi.org/10.1097/CHI.0b013e3181984f30.

    Article  PubMed  Google Scholar 

  23. Stringaris A, Maughan B, Goodman R. What’s in a disruptive disorder? Temperamental antecedents of oppositional defiant disorder: findings from the Avon longitudinal study. J Am Acad Child Adolesc Psychiatry. 2010;49:474–83.

    PubMed  Google Scholar 

  24. Barkley RA, Fischer M. The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. J Am Acad Child Adolesc Psychiatry. 2010;49:503–13. https://doi.org/10.1016/j.jaac.2010.01.019.

    Article  PubMed  Google Scholar 

  25. Wender PH. Attention-deficit hyperactivity disorder in adults. New York: Oxford University Press; 1995.

    Google Scholar 

  26. Barkley RA. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. 4th ed. New York: Guilford; 2018.

    Google Scholar 

  27. Conners CK, Erhardt D, Epstein JN, Parker JDA, Sitarenios G, Sparrow E. Self-ratings of ADHD symptoms in adults I: factor structure and normative data. J Atten Disord. 1999;3:141–51.

    Article  Google Scholar 

  28. Schmidt-Atzert L, Peper M, Stemmler G. Emotionspsychologie: Ein Lehrbuch. 2nd ed. Stuttgart: Kohlhammer; 2014.

    Google Scholar 

  29. Gross JJ, Jazaieri H. Emotion, emotion regulation, and psychopathology: an affective science perspective. Clin Psychol Sci. 2014;2:387–401.

    Article  Google Scholar 

  30. • Waugh CE, Shing EZ, Avery BM. Temporal dynamics of emotional processing in the brain. Emot Rev. 2015;7:323–9. https://doi.org/10.1177/1754073915590615 This recent review on affective neuroscience highlights the importance of examining neural temporal dynamics of emotions to better understand emotional phenomena.

    Article  Google Scholar 

  31. •• Gross JJ. Emotion regulation: current status and future prospects. Psychol Inq. 2015;26:1–26. https://doi.org/10.1080/1047840X.2014.940781 This target article by Gross and its discussion in the same issue is an inspiring and valuable contribution to the theoretical and empirical challenges within the field of emotion regulation.

    Article  Google Scholar 

  32. Thompson RA. Emotion regulation: a theme in search of definition. Monogr Soc Res Child Dev. 1994;59:25–52.

    Article  CAS  PubMed  Google Scholar 

  33. Webb TL, Miles E, Sheeran P. Dealing with feeling: a meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychol Bull. 2012;138:775–808. https://doi.org/10.1037/a0027600.

    Article  PubMed  Google Scholar 

  34. Sheppes G, Suri G, Gross JJ. Emotion regulation and psychopathology. Annu Rev Clin Psychol. 2015;11:379–405. https://doi.org/10.1146/annurev-clinpsy-032814-112739.

    Article  PubMed  Google Scholar 

  35. Overgaard KR, Aase H, Torgersen S, Reichborn-Kjennerud T, Oerbeck B, Myhre A, et al. Continuity in features of anxiety and attention deficit/hyperactivity disorder in young preschool children. Eur Child Adolesc Psychiatry. 2014;23:743–52. https://doi.org/10.1007/s00787-014-0538-7.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Stringaris A, Goodman R. Mood lability and psychopathology in youth. Psychol Med. 2009;39:1237–45. https://doi.org/10.1017/S0033291708004662.

    Article  CAS  PubMed  Google Scholar 

  37. Ambrosini PJ, Bennett DS, Elia J. Attention deficit hyperactivity disorder characteristics: II. Clinical correlates of irritable mood. J Affect Disord. 2013;145:70–6. https://doi.org/10.1016/j.jad.2012.07.014.

    Article  PubMed  Google Scholar 

  38. Sjöwall D, Roth L, Lindqvist S, Thorell LB. Multiple deficits in ADHD: executive dysfunction, delay aversion, reaction time variability, and emotional deficits. J Child Psychol Psychiatry. 2013;54:619–27. https://doi.org/10.1111/jcpp.12006.

    Article  PubMed  Google Scholar 

  39. Biederman J, Spencer TJ, Petty C, Hyder LL, O’Connor KB, Surman CB, et al. Longitudinal course of deficient emotional self-regulation CBCL profile in youth with ADHD: prospective controlled study. Neuropsychiatr Dis Treat. 2012;8:267–76. https://doi.org/10.2147/NDT.S29670.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Sasser TR, Kalvin CB, Bierman KL. Developmental trajectories of clinically significant attention-deficit/hyperactivity disorder (ADHD) symptoms from grade 3 through 12 in a high-risk sample: predictors and outcomes. J Abnorm Psychol. 2016;125:207–19. https://doi.org/10.1037/abn0000112.

    Article  PubMed  PubMed Central  Google Scholar 

  41. • Brocki KC, Forslund T, Frick M, Bohlin G. Do individual differences in early affective and cognitive self-regulation predict developmental change in ADHD symptoms from preschool to adolescence? J Atten Disord. 2017:1087054717693372. https://doi.org/10.1177/1087054717693372 A longitudinal study that emphasizes the importance of distinguishing between cognitive and affective self-regulation in relation to inattention and hyperactivity/impulsivity over time.

  42. Langner R, Leiberg S, Hoffstaedter F, Eickhoff SB. Towards a human self-regulation system: common and distinct neural signatures of emotional and behavioral control. Neurosci Biobehav Rev. 2018;90:400–10. https://doi.org/10.1016/j.neubiorev.2018.04.022.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Shaw P, Sudre G, Wharton A, Weingart D, Sharp W, Sarlls J. White matter microstructure and the variable adult outcome of childhood attention deficit hyperactivity disorder. Neuropsychopharmacology. 2015;40:746–54. https://doi.org/10.1038/npp.2014.241.

    Article  PubMed  Google Scholar 

  44. Walcott CM, Landau S. The relation between disinhibition and emotion regulation in boys with attention deficit hyperactivity disorder. J Clin Child Adolesc Psychol. 2004;33:772–82. https://doi.org/10.1207/s15374424jccp3304_12.

    Article  PubMed  Google Scholar 

  45. Banaschewski T, Jennen-Steinmetz C, Brandeis D, Buitelaar JK, Kuntsi J, Poustka L, et al. Neuropsychological correlates of emotional lability in children with ADHD. J Child Psychol Psychiatry. 2012;53:1139–48. https://doi.org/10.1111/j.1469-7610.2012.02596.x.

    Article  PubMed  PubMed Central  Google Scholar 

  46. van Cauwenberge V, Sonuga-Barke EJS, Hoppenbrouwers K, van Leeuwen K, Wiersema JR. "turning down the heat": is poor performance of children with ADHD on tasks tapping "hot" emotional regulation caused by deficits in "cool" executive functions? Res Dev Disabil. 2015;47:199–207. https://doi.org/10.1016/j.ridd.2015.09.012.

    Article  PubMed  Google Scholar 

  47. Villemonteix T, Marx I, Septier M, Berger C, Hacker T, Bahadori S, et al. Attentional control of emotional interference in children with ADHD and typically developing children: an emotional N-back study. Psychiatry Res. 2017;254:1–7. https://doi.org/10.1016/j.psychres.2017.04.027.

    Article  PubMed  Google Scholar 

  48. Posner J, Rauh V, Gruber A, Gat I, Wang Z, Peterson BS. Dissociable attentional and affective circuits in medication-naïve children with attention-deficit/hyperactivity disorder. Psychiatry Res. 2013;213:24–30. https://doi.org/10.1016/j.pscychresns.2013.01.004.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Marx I, Domes G, Havenstein C, Berger C, Schulze L, Herpertz SC. Enhanced emotional interference on working memory performance in adults with ADHD. World J Biol Psychiatry. 2011;12(Suppl 1):70–5. https://doi.org/10.3109/15622975.2011.599213.

    Article  PubMed  Google Scholar 

  50. Surman CBH, Biederman J, Spencer T, Miller CA, McDermott KM, Faraone SV. Understanding deficient emotional self-regulation in adults with attention deficit hyperactivity disorder: a controlled study. Atten Defic Hyperact Disord. 2013;5:273–81. https://doi.org/10.1007/s12402-012-0100-8.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Christiansen H, Hirsch O, Philipsen A, Oades RD, Matthies S, Hebebrand J, et al. German validation of the conners adult ADHD rating scale-self-report: confirmation of factor structure in a large sample of participants with ADHD. J Atten Disord. 2013;17:690–8. https://doi.org/10.1177/1087054711435680.

    Article  PubMed  Google Scholar 

  52. • Hirsch O, Chavanon M, Riechmann E, Christiansen H. Emotional dysregulation is a primary symptom in adult attention-deficit/hyperactivity disorder (ADHD). J Affect Disord. 2018;232:41–7. https://doi.org/10.1016/j.jad.2018.02.007 Recent study of our group that probed a model that explicitly distinguished positive and negative affect, problems with self-concept and emotion regulation skills as distinct but correlating factors with the symptom domains of inattention, hyperactivity, and impulsivity.

    Article  PubMed  Google Scholar 

  53. Hirsch O, Chavanon ML, Christiansen H. Emotional dysregulation subgroups in patients with adult attention-deficit/hyperactivity disorder (ADHD): a cluster analytic approach. Sci Rep. under review after revision.

  54. Hirsch O, Christiansen H. Factorial structure and validity of the quantified behavior test plus (Qb+©). Assessment. 2017;24:1037–49. https://doi.org/10.1177/1073191116638426.

    Article  PubMed  Google Scholar 

  55. Posner J, Nagel BJ, Maia TV, Mechling A, Oh M, Wang Z, et al. Abnormal amygdalar activation and connectivity in adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2011;50:828–37.e3. https://doi.org/10.1016/j.jaac.2011.05.010.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Yu X, Liu L, Chen W, Cao Q, Zepf FD, Ji G, et al. Integrity of amygdala subregion-based functional networks and emotional lability in drug-naïve boys with ADHD. J Atten Disord. 2016:108705471666141. https://doi.org/10.1177/1087054716661419.

  57. Koelsch S, Skouras S, Fritz T, Herrera P, Bonhage C, Küssner MB, et al. The roles of superficial amygdala and auditory cortex in music-evoked fear and joy. NeuroImage. 2013;81:49–60. https://doi.org/10.1016/j.neuroimage.2013.05.008.

    Article  PubMed  Google Scholar 

  58. Plichta MM, Vasic N, Wolf RC, Lesch K-P, Brummer D, Jacob C, et al. Neural hyporesponsiveness and hyperresponsiveness during immediate and delayed reward processing in adult attention-deficit/hyperactivity disorder. Biol Psychiatry. 2009;65:7–14. https://doi.org/10.1016/j.biopsych.2008.07.008.

    Article  PubMed  Google Scholar 

  59. Albrecht B, Uebel-von Sandersleben H, Gevensleben H, Rothenberger A. Pathophysiology of ADHD and associated problems-starting points for NF interventions? Front Hum Neurosci. 2015;9:359. https://doi.org/10.3389/fnhum.2015.00359.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Johnstone SJ, Barry RJ, Clarke AR. Ten years on: a follow-up review of ERP research in attention-deficit/hyperactivity disorder. Clin Neurophysiol. 2013;124:644–57. https://doi.org/10.1016/j.clinph.2012.09.006.

    Article  PubMed  Google Scholar 

  61. Shiels K, Hawk LW. Self-regulation in ADHD: the role of error processing. Clin Psychol Rev. 2010;30:951–61. https://doi.org/10.1016/j.cpr.2010.06.010.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Downes M, Bathelt J, de Haan M. Event-related potential measures of executive functioning from preschool to adolescence. Dev Med Child Neurol. 2017;59:581–90. https://doi.org/10.1111/dmcn.13395.

    Article  PubMed  Google Scholar 

  63. Lansbergen MM, Kenemans JL, van Engeland H. Stroop interference and attention-deficit/hyperactivity disorder: a review and meta-analysis. Neuropsychology. 2007;21:251–62. https://doi.org/10.1037/0894-4105.21.2.251.

    Article  PubMed  Google Scholar 

  64. Alderson RM, Rapport MD, Kofler MJ. Attention-deficit/hyperactivity disorder and behavioral inhibition: a meta-analytic review of the stop-signal paradigm. J Abnorm Child Psychol. 2007;35:745–58. https://doi.org/10.1007/s10802-007-9131-6.

    Article  PubMed  Google Scholar 

  65. Mullane JC, Corkum PV, Klein RM, McLaughlin E. Interference control in children with and without ADHD: a systematic review of flanker and Simon task performance. Child Neuropsychol. 2009;15:321–42. https://doi.org/10.1080/09297040802348028.

    Article  PubMed  Google Scholar 

  66. Huang-Pollock CL, Karalunas SL, Tam H, Moore AN. Evaluating vigilance deficits in ADHD: a meta-analysis of CPT performance. J Abnorm Psychol. 2012;121:360–71. https://doi.org/10.1037/a0027205.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Albrecht B, Brandeis D, Uebel H, Heinrich H, Mueller UC, Hasselhorn M, et al. Action monitoring in boys with attention-deficit/hyperactivity disorder, their nonaffected siblings, and normal control subjects: evidence for an endophenotype. Biol Psychiatry. 2008;64:615–25. https://doi.org/10.1016/j.biopsych.2007.12.016.

    Article  PubMed  PubMed Central  Google Scholar 

  68. McLoughlin G, Albrecht B, Banaschewski T, Rothenberger A, Brandeis D, Asherson P, et al. Performance monitoring is altered in adult ADHD: a familial event-related potential investigation. Neuropsychologia. 2009;47:3134–42. https://doi.org/10.1016/j.neuropsychologia.2009.07.013.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Hajcak G, MacNamara A, Olvet DM. Event-related potentials, emotion, and emotion regulation: an integrative review. Dev Neuropsychol. 2010;35:129–55. https://doi.org/10.1080/87565640903526504.

    Article  PubMed  Google Scholar 

  70. Rosch KS, Hawk LW. The effects of performance-based rewards on neurophysiological correlates of stimulus, error, and feedback processing in children with ADHD. Psychophysiology. 2013;50:1157–73. https://doi.org/10.1111/psyp.12127.

    Article  PubMed  Google Scholar 

  71. Uebel H, Albrecht B, Asherson P, Börger NA, Butler L, Chen W, et al. Performance variability, impulsivity errors and the impact of incentives as gender-independent endophenotypes for ADHD. J Child Psychol Psychiatry. 2010;51:210–8. https://doi.org/10.1111/j.1469-7610.2009.02139.x.

    Article  PubMed  Google Scholar 

  72. López-Martín S, Albert J, Fernández-Jaén A, Carretié L. Emotional distraction in boys with ADHD: neural and behavioral correlates. Brain Cogn. 2013;83:10–20. https://doi.org/10.1016/j.bandc.2013.06.004.

    Article  PubMed  Google Scholar 

  73. López-Martín S, Albert J, Fernández-Jaén A, Carretié L. Emotional response inhibition in children with attention-deficit/hyperactivity disorder: neural and behavioral data. Psychol Med. 2015;45:2057–71. https://doi.org/10.1017/S0033291714003195.

    Article  PubMed  Google Scholar 

  74. • Shushakova A, Ohrmann P, Pedersen A. Exploring deficient emotion regulation in adult ADHD: electrophysiological evidence. Eur Arch Psychiatry Clin Neurosci. 2018;268:359–71. https://doi.org/10.1007/s00406-017-0826-6 This study suggests that the processing of aversive stimuli as well as emotion regulation is associated with greater cognitive effort in patients with ADHD than in healthy controls. The latter also suggests difficulties during the implementation of emotion regulation strategies.

    Article  PubMed  Google Scholar 

  75. Shushakova A, Wiesner CD, Ohrmann P, Pedersen A. Electrophysiological evidence of an attentional bias towards appetitive and aversive words in adults with attention-deficit/hyperactivity disorder. Clin Neurophysiol. 2018;129:1937–46. https://doi.org/10.1016/j.clinph.2018.06.019.

    Article  CAS  PubMed  Google Scholar 

  76. Perlman SB, Hein TC, Stepp SD. Emotional reactivity and its impact on neural circuitry for attention-emotion interaction in childhood and adolescence. Dev Cogn Neurosci. 2014;8:100–9. https://doi.org/10.1016/j.dcn.2013.08.005.

    Article  PubMed  Google Scholar 

  77. Porges SW. The polyvagal perspective. Biol Psychol. 2007;74:116–43. https://doi.org/10.1016/j.biopsycho.2006.06.009.

    Article  PubMed  Google Scholar 

  78. Musser ED, Backs RW, Schmitt CF, Ablow JC, Measelle JR, Nigg JT. Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD). J Abnorm Child Psychol. 2011;39:841–52. https://doi.org/10.1007/s10802-011-9499-1.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Karalunas SL, Fair D, Musser ED, Aykes K, Iyer SP, Nigg JT. Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria. JAMA Psychiatry. 2014;71:1015–24. https://doi.org/10.1001/jamapsychiatry.2014.763.

    Article  PubMed  PubMed Central  Google Scholar 

  80. • Musser ED, Nigg JT. Emotion dysregulation across emotion systems in attention deficit/hyperactivity disorder. J Clin Child Adolesc Psychol. 2017:1–13. https://doi.org/10.1080/15374416.2016.1270828 This is the first study that examined the coherence of emotion systems in children with and without ADHD. The authors demonstrated in a large sample that in youth with ADHD, emotion systems were more poorly coordinated.

  81. Thayer JF, Hansen AL, Saus-Rose E, Johnsen BH. Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med. 2009;37:141–53. https://doi.org/10.1007/s12160-009-9101-z.

    Article  PubMed  Google Scholar 

  82. Thayer JF, Ahs F, Fredrikson M, Sollers JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36:747–56. https://doi.org/10.1016/j.neubiorev.2011.11.009.

    Article  PubMed  Google Scholar 

  83. Jennings JR, Sheu LK, Kuan DC-H, Manuck SB, Gianaros PJ. Resting state connectivity of the medial prefrontal cortex covaries with individual differences in high-frequency heart rate variability. Psychophysiology. 2016;53:444–54. https://doi.org/10.1111/psyp.12586.

    Article  PubMed  Google Scholar 

  84. Beauchaine TP, Thayer JF. Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol. 2015;98:338–50. https://doi.org/10.1016/j.ijpsycho.2015.08.004.

    Article  PubMed  Google Scholar 

  85. Lane RD, McRae K, Reiman EM, Chen K, Ahern GL, Thayer JF. Neural correlates of heart rate variability during emotion. NeuroImage. 2009;44:213–22. https://doi.org/10.1016/j.neuroimage.2008.07.056.

    Article  PubMed  Google Scholar 

  86. Duschek S, Muckenthaler M, Werner N, del Paso GAR. Relationships between features of autonomic cardiovascular control and cognitive performance. Biol Psychol. 2009;81:110–7. https://doi.org/10.1016/j.biopsycho.2009.03.003.

    Article  PubMed  Google Scholar 

  87. Gentzler AL, Santucci AK, Kovacs M, Fox NA. Respiratory sinus arrhythmia reactivity predicts emotion regulation and depressive symptoms in at-risk and control children. Biol Psychol. 2009;82:156–63. https://doi.org/10.1016/j.biopsycho.2009.07.002.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Hansen AL, Johnsen BH, Thayer JF. Vagal influence on working memory and attention. Int J Psychophysiol. 2003;48:263–74. https://doi.org/10.1016/S0167-8760(03)00073-4.

    Article  PubMed  Google Scholar 

  89. Pu J, Schmeichel BJ, Demaree HA. Cardiac vagal control predicts spontaneous regulation of negative emotional expression and subsequent cognitive performance. Biol Psychol. 2010;84:531–40. https://doi.org/10.1016/j.biopsycho.2009.07.006.

    Article  Google Scholar 

  90. Zahn D, Adams J, Krohn J, Wenzel M, Mann CG, Gomille LK, et al. Heart rate variability and self-control—a meta-analysis. Biol Psychol. 2016;115:9–26. https://doi.org/10.1016/j.biopsycho.2015.12.007.

    Article  PubMed  Google Scholar 

  91. Suess PE, Porges SW, Plude DJ. Cardiac vagal tone and sustained attention in school-age children. Psychophysiology. 1994;31:17–22.

    Article  CAS  PubMed  Google Scholar 

  92. Calkins SD, Graziano PA, Keane SP. Cardiac vagal regulation differentiates among children at risk for behavior problems. Biol Psychol. 2007;74:144–53. https://doi.org/10.1016/j.biopsycho.2006.09.005.

    Article  PubMed  Google Scholar 

  93. Geisler FCM, Kubiak T, Siewert K, Weber H. Cardiac vagal tone is associated with social engagement and self-regulation. Biol Psychol. 2013;93:279–86. https://doi.org/10.1016/j.biopsycho.2013.02.013.

    Article  PubMed  Google Scholar 

  94. Beauchaine TP, Katkin ES, Strassberg Z, Snarr J. Disinhibitory psychopathology in male adolescents: discriminating conduct disorder from attention-deficit/hyperactivity disorder through concurrent assessment of multiple autonomic states. J Abnorm Psychol. 2001;110:610–24. https://doi.org/10.1037/0021-843X.110.4.610.

    Article  CAS  PubMed  Google Scholar 

  95. Utendale WT, Nuselovici J, Saint-Pierre AB, Hubert M, Chochol C, Hastings PD. Associations between inhibitory control, respiratory sinus arrhythmia, and externalizing problems in early childhood. Dev Psychobiol. 2014;56:686–99. https://doi.org/10.1002/dev.21136.

    Article  PubMed  Google Scholar 

  96. Graziano P, Derefinko K. Cardiac vagal control and children’s adaptive functioning: a meta-analysis. Biol Psychol. 2013;94:22–37. https://doi.org/10.1016/j.biopsycho.2013.04.011.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Musser ED, Galloway-Long HS, Frick PJ, Nigg JT. Emotion regulation and heterogeneity in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2013;52:163–171.e2. https://doi.org/10.1016/j.jaac.2012.11.009.

    Article  PubMed  PubMed Central  Google Scholar 

  98. McQuade JD, Breaux RP. Are elevations in ADHD symptoms associated with physiological reactivity and emotion dysregulation in children? J Abnorm Child Psychol. 2017;45:1091–103. https://doi.org/10.1007/s10802-016-0227-8.

    Article  PubMed  Google Scholar 

  99. Lackschewitz H, Hüther G, Kröner-Herwig B. Physiological and psychological stress responses in adults with attention-deficit/hyperactivity disorder (ADHD). Psychoneuroendocrinology. 2008;33:612–24. https://doi.org/10.1016/j.psyneuen.2008.01.016.

    Article  PubMed  Google Scholar 

  100. Oliver ML, Nigg JT, Cassavaugh ND, Backs RW. Behavioral and cardiovascular responses to frustration during simulated driving tasks in young adults with and without attention disorder symptoms. J Atten Disord. 2012;16:478–90. https://doi.org/10.1177/1087054710397132.

    Article  PubMed  Google Scholar 

  101. Kirschbaum C, Pirke KM, Hellhammer DH. The ‘Trier social stress test’—a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology. 1993;28:76–81. https://doi.org/10.1159/000119004.

    Article  CAS  PubMed  Google Scholar 

  102. Posner J, Kass E, Hulvershorn L. Using stimulants to treat ADHD-related emotional lability. Curr Psychiatry Rep. 2014;16:478. https://doi.org/10.1007/s11920-014-0478-4.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hanna Christiansen.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Attention-Deficit Disorder

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Christiansen, H., Hirsch, O., Albrecht, B. et al. Attention-Deficit/Hyperactivity Disorder (ADHD) and Emotion Regulation Over the Life Span. Curr Psychiatry Rep 21, 17 (2019). https://doi.org/10.1007/s11920-019-1003-6

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11920-019-1003-6

Keywords

Navigation