The heterogeneity of attention‐deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition, emotion regulation, emotionality, and disorganized attachment

Abstract

This study examined the contributions of several important domains of functioning to ADHD symptoms and conduct problems. Specifically, we investigated if cognitive inhibition, emotion regulation, emotionality and disorganized attachment made independent and specific contributions to these externalizing behavior problems from a multiple pathways perspective.The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behavior problems.Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms.Keywords: ADHD, conduct problems, cognitive inhibition, emotion regulation, emotionality, disorganized attachment. HETEROGENEITY OF EXTERNALIZING BEHAVIOR PROBLEMS 1The Heterogeneity of ADHD Symptoms and Conduct Problems:Cognitive Inhibition, Emotion Regulation, Emotionality and Disorganized Attachment Externalizing behavior problems, such as Attention-Deficit/Hyperactivity Disorder (ADHD) and conduct problems, are increasingly suggested to be etiologically heterogeneous (Dodge & Pettit, 2003;Nigg, Willcutt, Doyle, & Sonuga-Barke, 2005;Sonuga-Barke, 2005).Indeed, the development of conduct problems has long been related to impairments in a multitude of factors, such as emotion regulation, emotionality, cognitive inhibition, and attachment (Dodge & Pettit, 2003). Similarly, current theoretical models of ADHD suggest multiple pathways to the disorder (Nigg, Goldsmith, & Sachek, 2004;Sonuga-Barke, 2005), and recently deficits in emotion regulation and extreme emotionality (Martel, 2009), as well as insecure attachment have been emphasized (Thorell, Rydell, & Bohlin, 2012; for a discussion see Nigg, 2006). There is a shortage of studies simultaneously investigating factors from multiple domains of functioning in relation to both ADHD symptoms and conduct problems. Moreover, few studies have accounted for the substantial overlap between ADHD symptoms and conduct problems. Addressing these limitations would clarify impairment specificity for respective type of externalizing behavior problems, which in turn would help to improve intervention targets (Moffitt et al., 2011; Sonuga-Bark, 2005).Externalizing behavior problems have been shown to be best understood from a dimensiona...

Explaining the relationship between temperament and symptoms of psychiatric disorders from preschool to middle childhood: hybrid fixed and random effects models of Norwegian and Spanish children

“…As our methodological approach ruled out the confounding effects of such alleged common causes, the results presented herein suggest that low effortful control and surgency do play an etiological role in the development of ADHD-symptoms. Negative emotions such as sadness, anger, and anxiousness are often seen in children with ADHDsymptoms (De Pauw & Mervielde, 2011;Forslund, Brocki, Bohlin, Granqvist, & Eninger, 2016). The present results indicate that when such negativity is dispositional (i.e.…”

“…Negative emotions such as sadness, anger, and anxiousness are often seen in children with ADHD‐symptoms (De Pauw & Mervielde, ; Forslund, Brocki, Bohlin, Granqvist, & Eninger, ). The present results indicate that when such negativity is dispositional (i.e.…”

Diminished ability to identify facial emotional expressions in children with disorganized attachment representations

“…Of the 89 organized children, 57 children (54.3%) were coded as ‘secure‐resourceful’, 27 children (25.7%) as ‘insecure/avoidant‐inactive’, and 5 children (4.8%) as ‘insecure/ambivalent‐aggressive’. The distribution of disorganized attachment corresponds well with meta‐analytic data regarding the general prevalence of disorganized attachment in low‐risk samples (Van IJzendoorn, Schuengel & Bakermans‐Kranenburg, ), and with previous research in low‐risk samples in Sweden (Forslund et al ., ).…”

“…The point-biserial correlation (r pb ) was used for correlations with disorganized attachment as this variable was coded as a discrete dichotomy, a common approach in attachment research (e.g. Bohlin, Eninger, Brocki & Thorell, 2012;Thorell, Rydell & Bohlin, 2012;Forslund, Brocki, Bohlin, Granqvist & Eninger, 2016).…”

Disorganized attachment and defense: exploring John Bowlby’s unpublished reflections

“…One clue from cross-sectional research indicates that the link between disorganized attachment and difficulty with attention may be rooted in dysregulated emotionality (Forslund, Brocki, Bohlin, Granqvist, & Eninger, 2016). Given Bowlby’s theory, it might be that pharmacological support for the functioning of effector equipment increases the coherence of attention, expectation, affect, and behavior, thus reducing the expression of disorganization, at least for forms that can be assessable using representational measures.…”