Scientists from the University of Cambridge have found that problems with regulating emotions may be a key symptom of attention deficit hyperactivity disorder (ADHD).
Researchers have found that as many as one in two children with ADHD also show signs of emotional dysregulation, and the commonly prescribed drug to help the condition, Ritalin, could be less effective at treating this symptom.
ADHD affects one in 14 young people under the age of 18, and in around half of these cases, it persists into adulthood.
ADHD and emotional regulation
The link between ADHD and the ability to regulate emotions is profound. Statistics show that one in 50 children with ADHD also have a mood disorder, such as depression, and more than one in four have an anxiety disorder. Many also have verbal or physical outbursts due to an inability to regulate emotions.
It was believed that emotional dysregulation was a result of other symptoms associated with ADHD, such as cognition, but this new study shows that regulating emotions occurs independently of these.
Is emotional dysregulation a characteristic of ADHD?
The research team pulled data from the ABCD study, gathering information from over 6,000 children with ADHD symptoms. The team attributed a score to each individual for the likelihood of having ADHD.
Researchers from Fudan University in Shanghai, China, and the University of Cambridge identified 350 individuals in the cohort who had symptom scores meeting the clinical threshold for ADHD. Of these, 65.7% were male.
The researchers found that over half (51.4%) of the individuals in the high-symptom group showed signs of emotional dysregulation, independent of cognitive and motivational problems.
In children with only low-ADHD symptoms at both ages 12 and 13 years, those with a high score of emotion dysregulation at age 13 years were 2.85 times more likely to have developed high-ADHD symptoms by age 14 years compared with those with a low score of emotion dysregulation.
Pars orbitalis: Could this part of the brain reveal vital information about ADHD?
The researchers also examined brain imaging data from a selection of participants, finding that a particular brain region called pars orbitalis was smaller in children who scored highly for ADHD and emotional problems. This part of the brain plays an important role in understanding and processing emotion and communication, and inhibitory control over behaviour, potentially explaining some behaviours seen in ADHD.
Professor Barbara Sahakian from the Department of Psychiatry at the University of Cambridge and a Fellow of Clare Hall said: “The pars orbitalis is a well-connected part of the brain, and if it hasn’t developed properly, it might make it difficult for individuals to control their emotions and communicate with others appropriately, especially in social situations.
“Parents and teachers often say they have problems controlling children with ADHD, and it could be that when the children can’t express themselves well – when they hit emotional difficulties – they may not be able to control their emotions and have an outburst rather than communicating with the parent, teacher or the other child.”
Finding potential strategies to help the child regulate their emotions
The findings could help develop strategies for managing emotions. One approach is to employ cognitive behavioural techniques, encouraging individuals to pause and consider before reacting impulsively, and to articulate their emotions verbally. Additionally, incorporating practices like exercise or relaxation methods can aid in managing symptoms of depression and anxiety, promoting a sense of calmness and well-being.
This could be particularly important as the researchers found that Ritalin, the drug used to help manage ADHD symptoms, does not appear to treat emotional dysregulation fully. By detecting the issue sooner, professionals can provide alternative and more efficient strategies for emotion management.
Professor Qiang Luo from Fudan University and a Life Member at Clare Hall, Cambridge, said: “If you are having trouble controlling your emotions, this can lead to problems with social interactions, which further exacerbates any depression or anxiety that you might have. It also might mean that you are saying things or doing things that exacerbate a situation rather than calming it down. Teaching vulnerable individuals from an early age how to manage their emotions and express themselves could help them overcome such problems further down the line.”
