“Turning down the heat”: Is poor performance of children with ADHD on tasks tapping “hot” emotional regulation caused by deficits in “cool” executive functions?

Abstract

Emotional dysregulation in daily life is very common in children with attention deficit hyperactivity disorder (ADHD). It is however not clear whether this reflects a specific deficit or that it may be the result of generic executive function (EF) deficits. The current study addresses this question by means of an emotional working memory (WM) task with 2 memory load conditions and four possible backgrounds (blank screen, neutral, positive or negative picture), which was administered to 38 typically developing children and 29 children with ADHD. Children responded slower on trials when negative pictures were presented at the background versus when neutral pictures were presented, indicating an emotional interference effect; however crucially, groups did not differ in this respect. Reaction times were also slower on trials with a neutral picture as background versus trials without a picture, with children with ADHD showing an enhanced interference effect. There was a main effect of WM load on performance, but it did not interact with interference or group effects. To summarize, the findings indicate a generic interference control deficit in the children with ADHD in the current sample, while they could not provide support for an emotional interference deficit. What this paper adds:This paper adds to the existing literature on emotion regulation in children with ADHD by addressing the question whether emotional dysregulation in ADHD reflects a specific deficit or whether it may be understood as an integral part of impaired executive functioning. An emotional n-back task with different backgrounds was applied to distinguish between emotional interference and generic interference effects. The findings could not provide support for a specific emotional interference deficit. Rather, a generic interference control deficit was found, which may have important theoretical and clinical implications.

Regulation of emotion in ADHD: can children with ADHD override the natural tendency to approach positive and avoid negative pictures?

“…While several studies evidenced impaired emotion regulation in ADHD (e.g., Köchel et al, 2014;López-Martín et al, 2013;Maedgen & Carlson, 2000;Melnick & Hinshaw, 2000;Posner et al, 2011;Scime & Norvilitis, 2006;Walcott & Landau, 2004), others did not find a specific deficit in emotion regulation but were able to show that the difficulties in suppressing emotional interfering information in ADHD may be attributed to a generic interference deficit (Passarotti et al, 2010;Van Cauwenberge et al, 2015). The inconsistency between our findings and previous findings, evidencing impaired emotion regulation, could be attributed to a different focus on strategies of emotion regulation.…”

“…Whereas other experimental studies focused on antecedent-focused strategies, the current study is the first to investigate emotion regulation in ADHD by evaluating the ability to override natural action tendencies in responding to emotional pictures. The results of the approach-avoidance paradigm are less subject to differences in general cognitive control abilities as compared to the paradigms used in previous studies which measure cognitive OVERRIDDING APPROACH-AVOIDANCE TENDENCIES IN ADHD 17 control performance in a context of interfering irrelevant emotional stimuli (Van Cauwenberge et al, 2015). In the approach-avoidance paradigm, the load on other cognitive control abilities is minimal and importantly it involves an explicit instruction to regulate emotions rather than just the instruction to perform another task as good as possible in the context of emotionally provocative stimuli.…”

“…This is because, in the approach-avoidance paradigm, participants are specifically instructed to regulate their natural action tendencies to emotional stimuli, while load on other cognitive control abilities is kept to a minimum. In contrast, in other experimental paradigms, the aim is to maintain cognitive performance in the context of interfering irrelevant emotional stimuli and results also depend on general cognitive control abilities (Van Cauwenberge et al, 2015). This is the first study to use the approach-avoidance paradigm to study emotion regulation in ADHD.…”

“…Some studies have reported increased interference of emotional stimuli on task performance in children and adolescents with ADHD compared to typically developing peers (Köchel, Leutgeb, & Schienle, 2014;López-Martín, Albert, Fernández-Jaén, & Carretié, 2013;Posner et al, 2011), while other studies found no impairment in emotion regulation compared to a typically developing group. For instance, Passarotti, Sweeney, and Pavuluri (2010) and Van Cauwenberge, Sonuga-Barke, Hoppenbrouwers, Van Leeuwen, and Wiersema (2015) reported that patients with ADHD experienced no increase in interference specifically from irrelevant emotional information in a working memory task -patients with ADHD performed worse than controls on all tasks presenting irrelevant information irrespective of emotional content. The latter authors concluded that the clinically observed problems with emotion regulation in some children with ADHD may merely be a reflection of more generic problems with interference control (Van Cauwenberge et al, 2015).…”

“…For instance, Passarotti, Sweeney, and Pavuluri (2010) and Van Cauwenberge, Sonuga-Barke, Hoppenbrouwers, Van Leeuwen, and Wiersema (2015) reported that patients with ADHD experienced no increase in interference specifically from irrelevant emotional information in a working memory task -patients with ADHD performed worse than controls on all tasks presenting irrelevant information irrespective of emotional content. The latter authors concluded that the clinically observed problems with emotion regulation in some children with ADHD may merely be a reflection of more generic problems with interference control (Van Cauwenberge et al, 2015).…”