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Neuropsychological correlates of emotional lability in children with ADHD
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BACKGROUND: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms. METHODS: A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 6-18 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned four-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively. RESULTS: Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate-to-low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account. CONCLUSIONS: The neuropsychological parameters examined, herein, predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD cannot be explained by these cognitive or motivational deficits. Alternative mechanisms, including overlapping genetic influences (pleiotropic effects) and/or alternative neuropsychological processes need to be considered.
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“Our meta-analysis found that ADHD was also moderately associated with this preference (effect size of 0.6, CI 0.4 to 0.79), albeit with considerable heterogeneity in results (35, 37) (–Figure 1C.”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [37]
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“Similarly, modest correlations have been reported between deficits in emotional processes –such as deficits in emotion recognition and frustration tolerance- and the executive dysfunction often held to be a core feature of the disorder (35, 37).”
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“A larger study of 424 children with ADHD and their siblings found that, while a range of neuropsychological variables correlated with emotional lability this link was not direct but mediated almost entirely by the severity of ADHD symptoms (37).”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [37]
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Metadata
- Authors
- Banaschewski, T., Jennen‐Steinmetz, C., Brandeis, D., Buitelaar, J. K., Kuntsi, J., Poustka, L., Sergeant, J. A., Sonuga‐Barke, E. J., Frazier‐Wood, A. C., Albrecht, B., Chen, W., Uebel, H., Schlotz, W., van der Meere, J. J., Gill, M., Manor, I., Miranda, A., Mulas, F., Oades, R. D., Roeyers, H., Rothenberger, A., Steinhausen, H., Faraone, S. V., & Asherson, P.
- Affiliations
- Heidelberg University (DE)
- University of Zurich (CH)
- Radboud University Nijmegen (NL)
- King's College London (GB)
- Vrije Universiteit Amsterdam (NL)
- University of Göttingen (DE)
- University of Southampton (GB)
- St. James's Hospital (IE)
- Geha Mental Health Center (IL)
- Universitat de València (ES)
- Hospital Universitari i Politècnic La Fe (ES)
- Ghent University (BE)
- University of Basel (CH)
- SUNY Upstate Medical University (US)
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2012-08-06
- Volume
- 53
- Issue
- 11
- Pages
- 1139-1148
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC3472099
- OpenAlex
- W2134134095
- Cited by
- 122
- References
- 58
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 7 · 2023: 10 · 2022: 4 · 2021: 8 · 2020: 9 · 2019: 8 · 2018: 13 · 2017: 11 · 2016: 8 · 2015: 9 · 2014: 12 · 2013: 11 · 2012: 2
- FWCI
- 7.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- VU Research Portal (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- University of Regensburg Publication Server (University of Regensburg) (acceptedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- DuEPublico (University of Duisburg-Essen) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- GRO (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Eli Lilly and Company
- National Institutes of Health
- Medical Research Council (G03001896)
- National Institute of Mental Health (R01 MH 62873, R01MH081803, R01MH062873)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- emotional lability, attention deficit hyperactivity disorder, children, neuropsychological correlates, processing speed, response variability, executive function, choice impulsivity, delay aversion, motivation, pleiotropy
- MeSH terms
- Adolescent, Child, Emotions, Female, Humans, Male, Neuropsychological Tests, Psychomotor Performance, Severity of Illness Index, Attention Deficit and Disruptive Behavior Disorders, Siblings
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