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Cited by 190Attention Deficit Hyperactivity DisorderDevelopmental and Educational NeuropsychologyChild and Adolescent Psychosocial and Emotional Development

Emotional dysregulation is a primary symptom in adult Attention-Deficit/Hyperactivity Disorder (ADHD)

Hirsch, Oliver, Chavanon, MiraLynn, Riechmann, Elke, Christiansen, Hanna·2018·Journal of Affective Disorders
DOI 10.1016/j.jad.2018.02.007
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Abstract

Background Clinical observations suggest that adults have more diverse deficits than children with Attention Deficit/Hyperactivity Disorder (ADHD). These seem to entail difficulties with emotionality, self-concept and emotion regulation in particular, along with the cardinal symptoms of inattention, impulsivity, and hyperactivity for adult patients. Here, we probed a model that explicitly distinguished positive and negative affect, problems with self-concept and emotion regulation skills as distinct but correlating factors with the symptom domains of inattention, hyperactivity, and impulsivity.Methods Participants were 213 newly diagnosed adults with ADHD (62.9% male, mean age 33.5 years). Symptoms were assessed via self-report on the Conners' Adult ADHD Rating Scales, a modified version of the Positive and Negative Affect Scale and the Emotion Regulation Skill Questionnaire. A confirmatory factor analysis with the R package lavaan, using a robust Maximum Likelihood estimator (MLR) for non-normal data, was conducted to test our new non-hierarchical 7-factor model.Results All calculated model-fit statistics revealed good model-fit (χ 2/df ratio = 2.03, robust RMSEA = .07). The SRMR in our model reached .089, indicating an acceptable model fit. Factor loadings on the postulated factors had salient loadings ≥ .31 except for one item on the hyperactivity factor. Latent factor associations were especially salient between emotional dysregulation and problems with self-concept, and also partially with impulsivity/emotional lability.Limitations The three models of ADHD and emotion regulation as suggested by Shaw et al. (2014) could not be disentangled in this study, though the overall results support the model with shared neurocognitive deficits. Further, we did not separately analyze ADHD with or without comorbid disorders. As our sample of clinical cases with ADHD is highly comorbid (47.9%), other disorders than ADHD might account for the emotion regulation deficits, though a sensitivity analysis revealed no such differences.Conclusions Our model adequately characterizes the relations between and among clinically and therapeutically relevant symptoms in adult ADHD, thus potentially informing future therapeutic interventions by targeting the successful and flexible use of adaptive emotion regulation skills.

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  • Adult ADHD typically involves not only inattention and behavioral impulsivity, but also pervasive difficulties in regulating emotions, even though the latter lie outside the formal DSM symptom criteria.

    “adult ADHD typically involves not only inattention and behavioral impulsivity, but also pervasive difficulties in regulating emotions, even though the latter lie outside the formal DSM symptom criteria [105]”

    From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [105]

  • Adult ADHD shows additional symptoms, such as emotional dysregulation, problems with self-concept, low self-esteem, low self-efficacy, or low sense of mastery.

    “Moreover, adult ADHD shows additional symptoms, such as emotional dysregulation, problems with self-concept, low self-esteem, low self-efficacy, or low sense of mastery (Christiansen et al. 2014; Corbisiero et al. 2013; Hirsch et al. 2018; Retz et al. 2012).”

    From ADHD and associated psychopathology in older adults in a German community sample (2023) · cites this paper as Hirsch et al. 2018

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Authors
Hirsch, O., Chavanon, M., Riechmann, E., & Christiansen, H.
Affiliations
Philipps University of Marburg (DE)
Corresponding author
Hirsch, Oliver
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2018-05
Volume
232
Pages
41-47
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2018.02.007
OpenAlex
W2791479952
Cited by
190
References
68
Citations by year
2026: 25 · 2025: 35 · 2024: 21 · 2023: 28 · 2022: 23 · 2021: 22 · 2020: 17 · 2019: 14 · 2018: 5
FWCI
11.33
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
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
adult ADHD, emotional dysregulation, emotion regulation, self-concept, positive and negative affect, impulsivity, hyperactivity, inattention, emotional lability, symptom structure, comorbidities, factor models
MeSH terms
Adolescent, Adult, Affective Symptoms, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Emotions, Female, Humans, Impulsive Behavior, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Surveys and Questionnaires, Self Concept, Models, Statistical, Young Adult

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