Much attention has been given to the relationship between attention-deficit hyperactivity disorder (ADHD) and deficient emotional self-regulation (DESR). Some research suggests that DESR, which is characterized by outbursts, anger, and extreme emotional response, is a component and symptom of ADHD, while other research has indicated that DESR may be a separate psychological impairment altogether. Understanding if and how these two conditions influence each other could help clinicians better identify those at risk for ADHD or DESR. Additionally, DESR has been shown to be a common condition among children with bipolar (BP), but little evidence has been provided to suggest that DESR is a predictor of BP. Because the genetic relationship between BP, DESR, and ADHD is still unclear, Joseph Biederman, MD, Chief of the Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital in Boston, led a study exploring how the three issues influence each other.
For this most recent study, Biederman assessed 242 children who had been diagnosed with ADHD and 224 children without ADHD. He evaluated them using the Child Behavior Checklist (CBCL) and focused on the sections for BP, DESR, and anxious/depressed, attention, and aggression (AAA). Biederman looked at how family history affected the levels of ADHD, DESR, and BP in the participants and found that the siblings of ADHD participants were more likely to have DESR and BP than those without a family history of ADHD. He also discovered that individuals with a family member with ADHD and BP were more likely to develop BP than those without any history of either.
Biederman also found that DESR did not increase the risk of ADHD in family members. Instead, a family history of ADHD, regardless of DESR, directly increased the chances of a sibling or child developing ADHD. However, the study did reveal a link between AAA and DESR. Consistent with other studies, there was a high level of co-occurring DESR and ADHD among the participants. Biederman noted that although there was no clear relationship between DESR and BP, the participants with a family history of co-morbid BP and ADHD were at the highest risk for a mental health problem, including anxiety, oppositional defiance, or substance abuse. Biederman added, “Further work using different approaches to measuring DESR are needed to see if it is possible to better distinguish an ADHD-associated DESR that is independent of the mood dysregulation associated with bipolar disorder.”
Biederman, J., T. Spencer, A. Lomedica, H. Day, C.R. Petty, and S.V. Faraone. “Deficient Emotional Self-regulation and Pediatric Attention Deficit Hyperactivity Disorder: A Family Risk Analysis.” Psychological Medicine 42.3 (2012): 639-46. Print.
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