Cited by 127Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentAutism Spectrum Disorder Research

Toward Defining Deficient Emotional Self-Regulation in Children with Attention-Deficit/Hyperactivity Disorder Using the Child Behavior Checklist: A Controlled Study

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Spencer, Thomas J., Faraone, Stephen V., Surman, Craig B. H., Petty, Carter, Clarke, Allison, Batchelder, Holly, Wozniak, Janet, Biederman, Joseph·2011·Postgraduate Medicine

Abstract

OBJECTIVE: Deficient emotional self-regulation (DESR) is characterized by deficits in self-regulating the physiological arousal caused by strong emotions. We examined whether a unique profile of the Child Behavior Checklist (CBCL) would help identify DESR in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Subjects included 197 children with ADHD and 224 children without ADHD. We defined DESR if a child had an aggregate cut-off score of > 180 but < 210 on the Anxiety/Depression, Aggression, and Attention scales of the CBCL (CBCL-DESR). This profile was selected because of: 1) its conceptual congruence with the clinical concept of DESR; and 2) because its extreme (> 210) form has been previously associated with severe forms of mood and behavioral dysregulation in children with ADHD. All subjects were comprehensively assessed with structured diagnostic interviews and a wide range of functional measures. RESULTS: Forty-four percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (P < 0.001). The CBCL-DESR profile was associated with elevated rates of anxiety and disruptive behavior disorders, as well as significantly more impairments in emotional and interpersonal functioning. CONCLUSIONS: The CBCL-DESR profile helped identify a subgroup of children with ADHD who had a psychopathological and functional profile consistent with the clinical concept of DESR.

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Crossref · 10.3810/pgm.2011.09.2459

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  • Most epidemiological research in children finds a strong association between ADHD and emotion dysregulation.

    “Most epidemiological research has focused on children and finds a strong association between ADHD and emotion dysregulation (35, 51-56)(Table 1).”

    From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [54]

    The Results (‘Rates of DESR in Children with and without ADHD’; page unavailable) report a strong association in this study: 44% of children with ADHD had the CBCL-DESR profile, versus 2% of controls. The paper does not establish what most epidemiological research has studied; its Discussion also cautions that its clinically referred sample may not generalize to community samples. (LLM, conf=0.88)

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  • After controlling for hyperactive/impulsive and inattentive symptoms, emotional lability independently contributed to higher rates of incarceration, poorer academic achievement, more driving accidents, and more problematic social and marital relations.

    “After controlling for the influence of hyperactive/impulsive and inattentive symptoms, the study found that emotional lability independently contributed to higher rates of incarceration, poorer academic achievement, more driving accidents, and more problematic poor social and marital relations.”

    From Using Stimulants to Treat ADHD-Related Emotional Lability (2014) · cites this paper as [13]

    The Results (Impact of CBCL-DESR on Social Functioning; page unavailable) report poorer peer functioning in children with ADHD and DESR after controlling for comorbid disorders, not after controlling for hyperactive/impulsive and inattentive symptoms. The Results (School and Family Functioning and Treatment History; page unavailable) found no added impairment in school or family functioning, and the Discussion explicitly says the study did not find added academic impairment. Our copy does not report incarceration, driving accidents, or marital outcomes. (LLM, conf=0.87)

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  • Emotional lability was found to have a larger effect on patients' overall impairment than hyperactive/impulsive symptoms.

    “Moreover, emotional lability was found to have a larger effect on patients’ overall impairment than hyperactive/impulsive symptoms [13].”

    From Using Stimulants to Treat ADHD-Related Emotional Lability (2014) · cites this paper as [13]

    The Results section (“Impact of CBCL-DESR on Social Functioning,” page unavailable) reports greater social impairment in children with ADHD who had the deficient emotional self-regulation profile than in other children with ADHD. The paper does not compare the effect of emotional lability with that of hyperactive/impulsive symptoms on overall impairment. (LLM, conf=0.86)

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Research works printed but not linked: 3

  1. [2]Barkley RA Deficient Emotional Self-Regulation: A Core Component of Attention-Deficit/Hyperactivity Disorder Journal of ADHD and Related Disorders 2010 1 2 5 37
  2. [22]Moos RH Moos BS Manual for the Family Environment Scale Palo Alto, CA Consulting Psychologists Press 1974
  3. [24]Rosen PJ Epstein JN A Pilot Study of Ecological Momentary Assessment of Emotion Dysregulation in Children Journal of ADHD and Related Disorders 2010 1 4 39 52

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Authors
Spencer, T. J., Faraone, S. V., Surman, C. B. H., Petty, C., Clarke, A., Batchelder, H., Wozniak, J., & Biederman, J.
Affiliations
  • Harvard University (US)
  • SUNY Upstate Medical University (US)
  • Massachusetts General Hospital (US)
Corresponding author
Spencer, Thomas J.
Venue
Postgraduate Medicine
Published
2011-09
Volume
123
Issue
5
Pages
50-59
ISSN
  • 0032-5481 (ISSN-L)
  • 1941-9260
OpenAlex
W2152662256
Cited by
127
References
32
Citations by year
2026: 3 · 2025: 5 · 2024: 9 · 2023: 9 · 2022: 6 · 2021: 11 · 2020: 7 · 2019: 6 · 2018: 9 · 2017: 16 · 2016: 8 · 2015: 15 · 2014: 11 · 2013: 5 · 2012: 7
FWCI
4.97
Type
journal article
Language
en
Open access
Locations
  • Postgraduate Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute for Health and Care Research
  • Shire
  • National Institutes of Health
  • National Institute of Mental Health (R01MH050657)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD036317)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, Child Behavior Checklist, anxiety, disruptive behavior disorders, emotional dysregulation, interpersonal functioning
MeSH terms
Attention Deficit Disorder with Hyperactivity, Child, Child Behavior, Family, Female, Humans, Male, Psychiatric Status Rating Scales, Social Adjustment, Emotional Intelligence, Checklist

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