Emotional dysregulation subgroups in patients with adult Attention-Deficit/Hyperactivity Disorder (ADHD): a cluster analytic approach

Hirsch, Oliver; Chavanon, Mira‐Lynn; Christiansen, Hanna

doi:10.1038/s41598-019-42018-y

Cited by 37 publications

(47 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 Funnel Plot a) refers to the meta-analysis comparing ED in ADHD and healthy controls b) refers to the meta-analysis of the correlation coefficients between measures of ADHD symptom severity and ED is a distinct feature of adult ADHD. Furthermore, the severity of ADHD symptoms significantly correlates with dimensions of ED such as emotional lability, emotion recognition, and emotional responses, replicating other studies in the field (e. g., [78]). In addition, classic domains of inattention, hyperactivity, and impulsivity do not sufficiently explain the entire symptom spectrum.…”

Section: Discussionsupporting

confidence: 83%

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

2020

Self Cite

View full text Add to dashboard Cite

Background: Emotional 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. Methods: Two 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. Results: Compared 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). Conclusions: Our 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.

show abstract

Section: Discussionsupporting

confidence: 83%

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

2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…24 Each included additional measures of symptoms or dysfunction, usually an assessment of childhood ADHD symptoms, social adjustment, and adult emotional symptoms. The studies ( Table 1) fall into 2 groups: those from our 2015 report 20 and those constituting our new sample.…”

Section: Methodsmentioning

confidence: 99%

“…Using these 2 factors in a sample of 136 adults with ADHD, we categorized subjects into 2 types based on levels of emotional symptoms. 20 All subjects had high levels of attention difficulties and/or disorganization but greater variability in other WRAADDS domains. Subjects high in emotionality were labeled as having "ADHD emotional dysregulation presentation, " and those low in emotionality were labeled as having "ADHD inattentive presentation. "…”

mentioning

confidence: 90%

Types of Adult Attention-Deficit/Hyperactivity Disorder

Reimherr¹,

Roesler

Marchant

et al. 2020

J. Clin. Psychiatry

View full text Add to dashboard Cite

Objective: Research supports the importance of emotional symptoms in adults with attention-deficit/hyperactivity disorder (ADHD), which are not reflected in the DSM-5 or ICD-10 criteria. The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) assesses these symptoms, plus inattention, hyperactivity, and impulsivity. This scale allowed us to divide adult ADHD into 2 subtypes in a 2015 publication: ADHD inattentive presentation and ADHD emotional dysregulation presentation. The present study refines this observation using a larger, more diverse sample. Methods:Eight double-blind adult ADHD clinical trials (encompassing 1,490 subjects) were selected because they included assessment with the WRAADDS; a second, alternative ADHD measure; and the Clinical Global Impressions-Severity of Illness scale (CGI-S). These data were subjected to confirmatory factor analyses, and ADHD presentations were compared, including treatment response. Results:The original factor structure fit poorly with these new data. However, an alternative 2-factor solution fit both the original and the new subjects. ADHD inattentive presentation (n = 774) was defined by the inattention factor, and ADHD emotional dysregulation presentation (n = 620) was defined by additional elevation of the emotional dysregulation factor. The proportion of ADHD emotional dysregulation presentation ranged from 25% to 73% across the 8 studies. The emotional dysregulation presentation was associated with both a greater severity as measured by the CGI-S (P < .001) and more manifestations of childhood ADHD as measured by the Wender Utah Rating Scale (P < .001). Conclusions:Factor analytic results supported the validity of 2 adult ADHD presentations based on levels of emotional dysregulation. This system offers a more clinically relevant approach to the diagnosis of ADHD in adults than does the DSM system. J Clin Psychiatry 2020;81(2):19m13077 To cite: Reimherr FW, Roesler M, Marchant BK, et al. Types of adult attention-deficit/hyperactivity disorder: a replication analysis. J Clin Psychiatry. 2020;81(2):19m13077. To share: https://doi.org/10.4088/JCP.19m13077

show abstract

“…In fact, adult ADHD is a highly comorbid disorder 2 – 5 . Specifically, disorders such as developmental disability, depressive disorder, and anxiety disorders 3 as well as disorders associated with emotion dysregulation, a common symptom in ADHD 4 , 6 , co-occur with adult ADHD. For instance, personality disorders, especially borderline personality disorder (BPD) is closely associated with ADHD according to a recent review 7 .…”

Section: Introductionmentioning

confidence: 99%

Use of machine learning to classify adult ADHD and other conditions based on the Conners’ Adult ADHD Rating Scales

Christiansen

Chavanon

Hirsch³

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

A reliable diagnosis of adult Attention Deficit/Hyperactivity Disorder (ADHD) is challenging as many of the symptoms of ADHD resemble symptoms of other disorders. ADHD is associated with gambling disorder and obesity, showing overlaps of about 20% with each diagnosis. It is important for clinical practice to differentiate between conditions displaying similar symptoms via established diagnostic instruments. Applying the LightGBM algorithm in machine learning, we were able to differentiate subjects with ADHD, obesity, problematic gambling, and a control group using all 26 items of the Conners’ Adult ADHD Rating Scales (CAARS-S: S) with a global accuracy of .80; precision (positive predictive value) ranged between .78 (gambling) and .92 (obesity), recall (sensitivity) between .58 for obesity and .87 for ADHD. Models with the best 5 and best 10 items resulted in less satisfactory fits. The CAARS-S seems to be a promising instrument to be applied in clinical practice also for multiclassifying disorders displaying symptoms resembling ADHD.

show abstract

Emotional dysregulation subgroups in patients with adult Attention-Deficit/Hyperactivity Disorder (ADHD): a cluster analytic approach

Cited by 37 publications

References 68 publications

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

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

Types of Adult Attention-Deficit/Hyperactivity Disorder

Use of machine learning to classify adult ADHD and other conditions based on the Conners’ Adult ADHD Rating Scales

Contact Info

Product

Resources

About