Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review
Open accessAbstract
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder, with an onset in childhood, that accompanies the person throughout their life, with prevalence between 3 and 5% in adults. Recent studies point towards a fourth core symptom of the disorder related to the emotional information processing that would explain the repercussions that ADHD has on the social, academic, and professional life of the people affected. This review aims to describe emotion dysregulation features as well as the brain activity associated in adults with ADHD. A search of the scientific literature was launched in specialized databases: PsycInfo, Medline, Eric, PsycArticle, Psicodoc and Scopus, following PRISMA guidelines. Twenty-two articles met the inclusion criteria: (a) an ADHD clinical diagnosis, (b) participants over 18 years old, (c) emotion regulation measurement, (d) empirical studies, and (c) in English. Due to the heterogeneity of the studies included, they were classified into three sections: measures and features of emotion regulation (ER) in people with ADHD, neurological and psychophysiological activity related to ER, and treatments. The studies found that meet the selection criteria are scarce and very heterogeneous both in aims and in sample features. Adults with ADHD show a more frequent use of non-adaptive emotion regulation strategies compared to people without ADHD symptoms. Moreover, emotion dysregulation was associated with symptom severity, executive functioning, psychiatric comorbidities, and even with criminal conviction. Different patterns of brain activity were observed when people with and without ADHD were compared. These results may suggest that psychopharmacological treatments as well as behavioral therapies could be useful tools for improving emotional difficulties in adult ADHD.
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Emotion regulation problems and impulsive emotional reactions are extremely common in adults with ADHD.
“consensus among clinicians and researchers is that emotion regulation problems and impulsive emotional reactions are extremely common in adults with this disorder [104]”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [104]
The Discussion (page unavailable) reports emotion dysregulation in 34–70% of adults with ADHD, supporting that it is common, but describes the evidence as preliminary rather than a clinician-and-researcher consensus. The Results section associates emotion dysregulation with impulsivity; it does not establish that impulsive emotional reactions are themselves extremely common. (LLM, conf=0.85)
Experimental — accuracy not yet measuredEmotion regulation problems and impulsive emotional reactions contribute substantially to functional impairment, affecting relationships, work, and well-being.
“They contribute substantially to functional impairment, affecting relationships, work, and well-being.”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [104]
The Discussion (page not available) says higher emotion dysregulation scores may be associated with greater socio-functional impairment and suggests possible effects on occupational performance, personal relationships, and self-esteem. This supports the domains in the claim, but the review hedges those links and does not establish that emotion-regulation problems and impulsive emotional reactions contribute substantially to impairment as a causal fact. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAffective problems in adult ADHD tend to be linked with greater overall symptom severity, executive deficits, and comorbid conditions.
“such affective problems tend to be linked with greater overall symptom severity, executive deficits, and comorbid conditions [104]”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [104]
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- Authors
- Soler-Gutiérrez, A.-M., Pérez-González, J.-C., & Mayas, J.
- Affiliations
- Universidad Nacional de Educación a Distancia (ES)
- Corresponding author
- Mayas, Julia
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2023-01-06
- Volume
- 18
- Issue
- 1
- Pages
- e0280131
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC9821724
- OpenAlex
- W4313598901
- Cited by
- 152
- References
- 101
- Citations by year
- 2026: 63 · 2025: 46 · 2024: 35 · 2023: 8
- FWCI
- 6.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UNED repository (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Zenodo (CERN European Organization for Nuclear Research) (cc-by)
- Funders
- Universidad Nacional de Educación a Distancia (Beca FPI-UNED)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- adult ADHD, emotional dysregulation, emotion regulation strategies, executive function, psychiatric comorbidity, criminal conviction, brain activity, psychopharmacological treatment, behavior therapy, emotional processing
- MeSH terms
- Emotional Regulation, Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Emotions, Humans, Executive Function
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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