A Multi-Method Investigation of Intrinsic and Extrinsic Emotion Regulation in Attention-Deficit/Hyperactivity Disorder
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Attention-deficit/hyperactivity disorder (ADHD) likely involves fundamental alterations in self-regulation. These problems typically have been viewed as involving disruptions in the regulation of cognition and behavior. However, they also have been hypothesized to involve disruptions in emotion regulation. If so, parenting behaviors may take on renewed importance in ADHD, because parents play an essential role in children developing the ability to regulate their emotions independently. Three studies examined the association between emotion regulation and ADHD. Study 1 examined autonomic nervous system functioning during the experience and regulation of both positive and negative emotions. Study 2 examined coherence among autonomic and behavioral emotional systems. Finally, Study 3 examined the roles of parenting behavior, parental expressed emotion, and child autonomic nervous system functioning. In Studies 1 and 2, participants with ADHD and typically developing youth aged 7 to 11 years old completed an emotion induction and suppression procedure. For Study 3, participants completed a parent-child interaction task coded for parental behavior, and parents completed a five-minute speech sample coded for expressed emotion. Electrocardiogram and impedance cardiography were monitored for children across all three studies. The following results were notable. In Study 1, children with ADHD showed atypical autonomic inflexibility (i.e., elevated parasympathetic and sympathetic responding across task conditions). Additionally, children with ADHD were divided according to levels of prosocial behavior. Unlike other children with ADHD, children with very low levels of prosocial behavior displayed blunted autonomic activity across task conditions. In Study 2, specific patterns of reduced coherence among emotion regulatory systems (i.e., facial affective behavior and autonomic nervous system reactivity) were observed among children with ADHD. Finally, in Study 3, high levels of parental expressed emotion were associated uniquely with ADHD, even after controlling for comorbid symptoms. In contrast, parental intrusiveness was associated uniquely with child oppositional defiant and low prosocial behavior, even after controlling for ADHD symptoms. Furthermore, specific, different patterns of autonomic reactivity during the parent-child interaction were associated with ADHD and oppositional defiant behaviors. Across these studies, it is concluded that intrinsic and extrinsic emotion and emotion regulatory systems are disrupted among children with ADHD.