A Developmental Psychopathology Perspective on ADHD and Comorbid Conditions: The Role of Emotion Regulation

Abstract

Research investigating attention-deficit/hyperactivity disorder (ADHD) and co-occurring disorders such as oppositional defiant disorder, conduct disorder, anxiety, and depression has surged in popularity; however, the developmental relations between ADHD and these comorbid conditions remain poorly understood. The current paper uses a developmental psychopathology perspective to examine conditions commonly comorbid with ADHD during late childhood through adolescence. First, we present evidence for ADHD and comorbid disorders. Next, we discuss emotion regulation and its associations with ADHD. The role of parenting behaviors in the development and maintenance of emotion regulation difficulties and comorbid disorders among children with ADHD is explored. An illustrative example of emotion regulation and parenting over the course of development is provided to demonstrate bidirectional relations among these constructs. We then present an integrated conceptual model of emotion regulation as a shared risk process that may lead to different comorbid conditions among children with ADHD. Implications and directions for future research are presented.

The Association among Default Mode Network Functional Connectivity, Mentalization, and Psychopathology in a Nonclinical Sample: An eLORETA Study

“…Furthermore, a growing body of studies [53,57,60] show that the medial frontal lobe and ACC are crucial in the topdown control of emotion (e.g., inhibiting negative emotional processing in the limbic system). Therefore, consistent with our results, the association between several psychopathological symptoms and reduced DMN connectivity in these brain nodes may reflect a top-down emotion regulation deficit which is related with both internalizing (e.g., major depression and anxiety disorders) [61,62] and externalizing (e.g., impulsivity) behavior problems [review: 63,64]. Indeed, it is known [65] that difficulties in emotion regulation are detected in almost all mental disorders included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition [66], and "can take on multiple forms including an absence of affect (anhedonia), an excess of uncomfortable affect (as seen with anxiety and depression), and engaging in harmful or destructive behaviors as an attempt to control or alleviate excessive negative affect" [53].…”

Prenatal smoking exposure and neuropsychiatric comorbidity of ADHD: a finnish nationwide population-based cohort study

“…Simultaneously, smoking is also associated with harsh parenting practices [33] which are associated with disruptive behavior of the offspring [34]. Furthermore, poor parenting skills have been suggested to increase the risk of comorbid psychiatric conditions among children with ADHD who might be especially vulnerable to harsh or non-supportive parenting styles [35]. …”

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“…Emotional response differences are prevalent in ADHD [5,6] and their presence is related to functional impairment [5,6] and risk for comorbid disorders [7,8]. Although the recent emphasis in the clinical literature has been on differences in negative emotions [9,10], emotional differences is not specific to negative valence contexts and can also manifest as differences in expression of positive emotions, such as excitement [5].…”