Executive Functioning and Emotion Regulation in Children with and without ADHD
Open accessAbstract
Difficulties with emotion regulation affect the majority of youth with attention-deficit/hyperactivity disorder (ADHD) and predict greater functional impairment than ADHD symptoms alone. Deficits in executive functioning are also present for most children with ADHD, and have been linked with emotion regulation difficulties in both clinical and neurotypical populations throughout development. The current study was the first to assess all three core executive functions (working memory, inhibitory control, set shifting) simultaneously in a clinically-diverse sample of children with and without ADHD and common comorbidities and investigate the extent to which they uniquely predict emotion dysregulation. A sample of 151 children ages 8-13 years (M = 10.36, SD = 1.52; 52 girls; 70.2% White/Non-Hispanic) were assessed using a criterion battery of executive functioning tasks, teacher-reported ADHD symptoms, and parent-reported emotion regulation. Results of the bias-corrected, bootstrapped conditional effects path model revealed that better-developed working memory predicted better emotion regulation (β = 0.23) and fewer ADHD symptoms (β = -0.21 to -0.37), that ADHD symptoms (β = -0.18 to -0.20) independently predicted emotion dysregulation, and that working memory exerted indirect effects on emotion regulation through both inattention and hyperactivity/impulsivity (β = 0.04-0.07). Sensitivity analyses indicated that these effects were generally robust to control for age, sex, executive function interrelations, and inclusion/exclusion of children with co-occurring ASD. These findings underscore the importance of working memory (relative to inhibitory control and set shifting) and its relations with ADHD symptoms for understanding children's emotion regulation skills, and may help explain the limited efficacy of first-line ADHD treatments, which do not target working memory, for improving emotion regulation skills.
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A large ADHD literature proposes that executive function deficits are either causal mechanisms, non-causal factors that aid developmental recovery, or epiphenomenal.
“An expansive literature in ADHD spanning nearly three decades29,31–34 posits that executive function deficits are either causal mechanisms that give rise to ADHD behavioral symptoms; non-causal factors that nonetheless aid in developmental recovery from ADHD; or epiphenomenal”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [32]
The Introduction (‘ADHD and Executive Functioning’; page unavailable) says many theories view ADHD as a disorder of executive dysfunction, and the Method (‘Data Analysis Plan’; page unavailable) says executive functions are often conceptualized as underlying causal factors. Our copy does not set out the other attributed possibilities: executive-function deficits as non-causal aids to developmental recovery or as epiphenomenal. (LLM, conf=0.87)
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- Authors
- Groves, N. B., Wells, E. L., Soto, E. F., Marsh, C. L., Jaisle, E. M., Harvey, T. K., & Kofler, M. J.
- Affiliations
- Florida State University (US)
- Florida International University (US)
- Corresponding author
- Kofler, Michael J.
- Venue
- Research on Child and Adolescent Psychopathology
- Published
- 2021-11-11
- Volume
- 50
- Issue
- 6
- Pages
- 721-735
- ISSN
- 0091-0627 (ISSN-L)
- 2730-7166
- 2730-7174
- PMC
- PMC9091051
- OpenAlex
- W3212927816
- Cited by
- 110
- References
- 133
- Citations by year
- 2026: 33 · 2025: 38 · 2024: 19 · 2023: 14 · 2022: 6
- FWCI
- 6.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34 MH102499)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, executive function, emotion regulation, emotional dysregulation, working memory, inhibitory control, set-shifting, ADHD symptoms, inattention, hyperactivity/impulsivity, children, comorbidities, autism spectrum disorder
- MeSH terms
- Emotional Regulation, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Female, Humans, Memory, Short-Term, Executive Function
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