The Resting Electrophysiological Profile in Adults With ADHD and Comorbid Dysfunctional Anger

Abstract

Although dysfunctional anger is not a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision [DSM-IV-TR]) diagnosis, it sometimes presents as a primary clinical complaint and as a comorbid feature in a subset of adults with attention-deficit/hyperactivity disorder (ADHD). No known studies have examined electroencephalographic (EEG) profiles in adults with comorbid dysfunctional anger and ADHD (ADHD + anger). Resting EEG was recorded in 14 ADHD + anger adults (11 males) and 14 controls. Relative power was assessed at standard frequencies, as was frontal absolute α power asymmetry. A modest increase was noted in β1 power in the ADHD + anger group. Unexpectedly, relatively decreased left (or increased right) frontocortical activity (α assessed) was noted in the ADHD + anger group, which was also characterized by a more diffuse θ/β ratio scalp distribution. Nonmedicated ADHD + anger adults exhibited modest resting cortical hyperarousal, consistent with the findings in a subset of children with ADHD characterized by anger-associated problems. The unexpected frontal α asymmetry may reflect enhanced activity of frontal inhibitory mechanisms.

Is Excessive Electroencephalography Beta Activity Associated with Delinquent Behavior in Men with Attention-Deficit Hyperactivity Disorder Symptomatology?

“…Increased beta responses mainly over frontal, central and parietal brain regions were related to negative emotions elicited by angry facial expressions [54] or pictures with negative emotional content [55]. Similarly, ADHD adults with dysfunctional anger and emotional dysregulation showed more beta activity than a control group [41]. The processing of negative emotions seems to be associated with increased beta activity and may thus be related to delinquent behavior.…”

“…Excessive beta activity was not limited to frontal areas in our study, but appeared also on central and parietal electrodes. This might indicate a hypervigilant state, being associated with overreactions to relatively harmless stimuli [41], which may in turn predispose to delinquent behavior. Therefore, excessive beta activity over frontal, central and parietal brain regions might constitute a risk-factor for delinquent behavior in subjects with ADHD symptomatology.…”

“…Excessive beta power seems to be present in a subgroup of adults with ADHD [13,41] as well as in a subgroup of offenders [30,32]. We hypothesize therefore that a beta excess may be associated with delinquent behavior in subjects with ADHD symptomatology.…”

“…The authors assumed that excessive beta activity may be associated with antisocial behavior in children with ADHD. Similarly, a subtype of adult ADHD subjects with excessive anger reactions [40] showed more beta activity than a control group [41]. Other studies presented different results regarding children with disruptive behavior.…”

Intentionality in frontal asymmetry research

“…There has been some consistent evidence that ADHD is linked to relative greater left frontal cortical activity (Baving, Laucht, & Schmidt, ; Hale et al, ; Hale, Smalley et al, 2009; Keune et al, ; Keune, Wiedemann, Schneidt, & Schonenberg, ), yet—as always in frontal asymmetry research—there is also some unsupportive evidence (Gordon, Palmer, & Cooper, ) and a contradictory finding (Jaworska et al, ). Of particular importance for the present context, Keune et al () analyzed ADHD and depressive symptoms and showed that ADHD mediated the relation between relative greater left frontal alpha activity and depression.…”