Emotion Regulation and Cognitive Control in Adults with ADHD

Adina Maeir Maayan Cohen Mor Nahum
School of occupational therapy, Faculty of Medicine, Hadassah and Hebrew University

Background: Emotion dysregulation (ED) is defined as the inability to modulate one's emotional experience and expression in order to reach one's goals. ED is highly prevalent and estimated at 30-70% of adults with ADHD. ED has been shown to have a negative effect on major life activities, such as social and occupational functioning, educational history, driving risks, criminal history, marital satisfaction and parental stress. The high prevalence and functional significance of ED has led researchers to identify ED as a neglected feature of ADHD. Considering the executive functioning hypotheses in ADHD, there is a strong rationale to examine the relationship between cognitive control and ED. In order to gain a better understanding of the impact of ED and its underlying mechanisms, the purpose of this study is threefold:

  1. To examine the impact of EF on quality of life, beyond that accounted for by ADHD symptoms.
  2. To examine the relationship between cognitive control as measured by single cognitive test performance (MOXO) and ED
  3. To examine the relationship between cognitive control as measured by continuous ecological momentary assessment (EMA) and ED

Methods: to examine the first two questions we measured ED using the emotion regulation scale of the Behavioral Rating Inventory of Executive Functions (BRIEF), cognitive control with the MOXO and Qol with the AAQoL questionnaire. We analyzed data from a sample of 80 students with (n=40) and without (n=40) ADHD (age 26.3 ± 3). To examine the last question we conducted a pilot study on 13 students 7/6 with and without ADHD who participated in EMA of emotional states and cognitive control (Breath tracking task) 5 x day over 3 consecutive days, using smartphone technology.
Results: The ED scale of the BRIEF showed a significant correlation with AAQoL (r=.498,p=.001) and was higher in ADHD than controls (t=10.85,p<.000). In addition, ED predicted AAQoL beyond what is predicted by ADHD symptoms (ASRS) alone (R2change=.233, F change=12.13, df=1,37, p=.001). The MOXO scales showed no significant correlations with ED scores. Results of the pilot EMA study demonstrated a significant effect of emotional state on cognitive control F=3.371, P=.038, which was marked in the ADHD group (group x state interatction: F=2.683,p=.062).
Conclusions: Findings demonstrate the negative impact of ED on QoL and show that a single cognitive control test cannot predict ED in daily life. The initial EMA findings are promising and warrant further study and may provide a potential avenue for remediating ED.

Adina Maeir
Adina Maeir








Powered by Eventact EMS