Is emotional dysregulation part of the psychopathology of ADHD in adults?

Abstract

Attention-deficit hyperactivity disorder is a common condition in adulthood. The disorder is characterized by symptoms of inattention, hyperactivity, and impulsivity. Alongside these symptoms, it is discussed whether symptoms of emotional dysregulation could add additional and better description of the psychopathology of ADHD. Neither the current ICD-10 and DSM-IV nor the upcoming DSM-5 includes symptoms of emotional dysregulation as a core aspect of ADHD. Several authors (e.g., Wender 1995) describe adult ADHD in a more differentiated way and propose concepts of the disorder that consider the subjective experiences of the adult patient by introducing the symptomatology of emotional symptoms. Empirical studies attest this dimension sufficient reliability and validity. Symptoms of emotional dysregulation are definable and seem to be distinct factors of the psychopathology of adult ADHD. Pharmacological and psychotherapeutic interventions help to alleviate this type of symptoms. This review attests a decisive role to the emotional symptoms in the ADHD symptomatology, which should be taken in serious consideration by future research.

Emotional symptoms and their contribution to functional impairment in adults with attention-deficit/hyperactivity disorder

“…Current research leaves no doubt about the fact that emotional symptoms are frequent in ADHD and that these symptoms increase the risk of functional impairment as well as the severity of impairment. The findings of this study strengthen previous calls for including emotional symptoms in the theoretical conceptualization of diagnostic criteria for ADHD (Barkley 2010;Barkley and Fischer 2010;Barkley and Murphy 2010;Corbisiero et al 2012;Mitchell et al 2012). Because of their high impact on impairment, it is imperative to address emotional symptoms in diagnosis and therapy of ADHD.…”

“…Because ADHD core symptoms cannot fully explain the number and severity of functional impairments (Anastopoulos et al 2011;Barkley 2010; Barkley and Fischer 2010;Barkley and Murphy 2010;Skirrow and Asherson 2013;Szuromi et al 2013), secondary domains, such as emotional symptoms, have become the focus of research over the past few years (overview: Corbisiero et al 2012;Retz et al 2012;Shaw et al 2014). Current studies reveal that the majority of people with ADHD report emotional symptoms (Barkley and Fischer 2010;Reimherr et al 2005) for which researchers use different definitions and labels such as emotional dysregulation (Wender 1995), emotional impulsiveness (Barkley 2006(Barkley , 2010, or emotional lability (Conners et al 1999).…”

Types of adult attention-deficit hyperactivity disorder (ADHD): baseline characteristics, initial response, and long-term response to treatment with methylphenidate

“…Surman et al (2013) also reported higher emotional symptoms leading to increased impairment in adults with ADHD. Corbisiero et al (2013) and Barkley (2010) argued that emotional symptoms are a fundamental part of the disorder, and Merwood et al (2014) presented genetic data pointing to a close association between hyperactivity/restlessness, impulsivity, inattention, and emotional dysregulation. Several studies have found that during treatment, emotional symptoms improve in parallel with the conventional symptoms of inattention, hyperactivity/ restlessness, and impulsivity Reimherr et al 2007;Rösler et al 2010;Wender et al 2011).…”

Attention disorder with hyperactivity: possible persistence in the adult and working difficulty

“…Because of this developmental change in symptom expression, many adults will not fully exhibit the criteria for the diagnosis, while remaining significantly impaired (28). In addition to the core symptoms, ADHD in adults is strongly associated with emotional dysregulation (increased irritability, low tolerance for frustration and stress, emotional lability) (29). People with ADHD are a vulnerable group, in many cases with limited autonomy.…”