The association of emotional lability and emotional and behavioral difficulties among children with and without ADHD

Abstract

Children with ADHD often demonstrate a pattern of emotional lability characterized by sudden and intense shifts in affect. Emotional lability has been linked to emotional and behavioral problems in children with and without ADHD, but few studies have examined emotional lability over time. This study examined the effects of emotional lability over time on the behavioral and emotional difficulties of children with and without ADHD using an ecological momentary assessment (EMA) methodology. One hundred and two children aged 8-12 years (56 with ADHD and 46 without ADHD) and their parents completed baseline measures of the children's behavioral and emotional difficulties. Parents then completed a 28-day 3-times daily EMA assessment protocol to rate their child's emotional lability. Results suggested that emotional lability was associated with internalizing and/or externalizing diagnoses independent of ADHD diagnostic status, but was not directly associated with ADHD. Hierarchical regression analyses supported ADHD diagnostic status as a moderator of the association of greater EMA-derived emotional lability with children's behavioral difficulties, such that greater emotional lability was associated with greater behavioral difficulties among children with ADHD but not among children without ADHD. Results indicated that greater emotional lability was directly linked with greater emotional difficulties and that this relation was not moderated by ADHD diagnostic status. Overall, this study suggested that emotional lability is related to emotional difficulties independent of ADHD, but is differentially related to behavioral difficulties among children with and without ADHD.

The premonitory urge revisited: An individualized premonitory urge for tics scale

“…Although highlighting consistent associations between the PUTS total score and internalizing symptoms, there is a need to expand evaluations to include related constructs that may contribute to urge phenomenology. Indeed, rage (Chen et al 2013; Storch et al 2012), dysregulation (McGuire et al 2013), distress tolerance (Cougle et al 2011), and emotional lability (Rizzo et al 2014; Rosen et al 2015) have been found to be important in TD and related conditions and may provide clarifying information on clinical construct associated with premonitory urges.…”

Emotion dysregulation as a dynamic process

“…The idea that emotions interfere with human rationality and social propriety harkens back to humankind's earliest known writings. The Instructions of Shuruppak, Sumerian tablets dated around 4800 BCE that are regarded as a father's advice to his son about virtuous behavior, warn the son about negative emotion, especially the destructive influences of quarreling and hate (Robson et al, 1998). Understanding that emotions can interfere with rational thought and appropriate behavior also appears in 5th-century BCE Eastern and Western philosophies (Scarantino & de Sousa, 2018;Tuske, 2016).…”

Comorbid Internalizing and Externalizing Disorders Predict Lability of Negative Emotions Among Children With ADHD

“…The PANAS-PR (Phillips, Lonigan, Driscoll, & Hooe, 2002) assesses the presence and intensity of positive and negative affect. Several studies have used repeated administrations of the PANAS-PR at multiple time points to assess EL (Anestis et al, 2010; Cohn, Zeichner, & Seibert, 2008; Rosen, Walerius, Fogleman, & Factor, 2015; Silk et al, 2011). For the current study, the PANAS-PR was administered three times per day for a 28-day period in conjunction with EMA protocol to assess changes in negative emotions in children.…”