Adult patients with ADHD differ from healthy controls in implicit, but not explicit, emotion regulation

Abstract

Background: There is increasing evidence that people with attention-deficit/hyperactivity disorder (ADHD) are impaired in emotion regu lation, but psychophysiological and functional MRI data on emotion processing in adult patients with ADHD are scarce. We investigated the neural correlates of reappraisal as one of the most efficient emotion-regulation strategies. Methods: We included 30 adult patients with ADHD and 35 healthy controls in our study. We applied a well-established reappraisal paradigm in functional MRI and assessed behavioural emotion-regulation strategies with standardized questionnaires. We hypothesized that patients with ADHD would demonstrate impaired reappraisal related to reduced activations in the frontoparietal cognitive control network. Results: Despite our hypothesis, we found no significant activation differences in the neural reappraisal network between patients with ADHD and controls. As well, both groups revealed similar reappraisal success on the immediate behavioural ratings in the scanner. Interestingly, patients with ADHD revealed significantly increased activations in the dorsal and ventral anterior cingulate cortex (ACC) compared with controls when viewing negative > neutral pictures. These ACC activations were significantly correlated with the prevalence of habitual use of reappraisal in patients with ADHD only. Limitations: Patients withdrew medication only 24 hours before the experiment; we investigated negative, but not positive, emotion processing and regulation. Conclusion: Although emotion dysregulation is regarded as a core symptom of ADHD, explicit reappraisal does not seem to be impaired in adult patients. However, increased activation of the ACC implies stronger implicit emotion regulation induced by negative stimuli. This might be explained by emotional hyperresponsivity in patients with ADHD compared with controls.

Emotion Control Training Enhances Reappraisal Success Among Individuals With Reported ADHD Symptoms

“…Speci cally, while the negativity and signi cance of the event were reduced in both samples following the instructed reappraisal assignment, this effect was more prominent among individuals reporting ADHD symptoms. These results support prior ndings showing that individuals with ADHD symptoms demonstrate reappraisal success similar to that of controls (Materna et al, 2019) and ndings showing that these individuals tend to use positive reappraisal in stressful situations (Young, 2005), especially when they are instructed to do so (Young & Bramham, 2006). Therefore, these results imply that while individuals with ADHD symptoms may show lower levels of trait reappraisal (Bodalski et al, 2019;Shushakova et al, 2018;Van Cauwenberge et al, 2017), they do use reappraisal when recalling an adverse event, as well as able to use reappraisal effectively to reduce negative mood, even more than typical individuals.…”

Brief Report: Emotion Regulation Influences on Internalizing and Externalizing Symptoms Across the Normative-Clinical Continuum

“…Adults with ASD, anxiety or mood disorders showed less activation in the prefrontal cortex (PFC), specifically bilateral dorsolateral PFC in ASD and dorsomedial and ventrolateral PFC in anxiety and mood disorders (58,59). In contrast, a recent study did not find any significant activation differences in the PFC between adults with ADHD and controls (60). Further work is needed to expand the current findings by investigating the continuities and discontinuities of the neurobiological underpinnings of emotion regulation across normative and clinical populations.…”

Psychometric Properties of the Korean version of the Emotion Regulation Questionnaire (K-ERQ) in a Clinical Sample

“…64 Impairments in emotion regulation are also found in ADHD, with patients engaging in expressive suppression more frequently and cognitive reappraisal less frequently than the healthy controls. 65,66 Therefore, one possible explanation on why the PTSD group scored significantly higher on the cognitive reappraisal scale than few of the other diagnostic groups could be that patients with PTSD may not differ in the selfreported frequency of cognitive reappraisal when compared to the non-clinical group. However, they may exhibit less efficient usage, or their level of cognitive reappraisal combined with other types of emotion regulation could be associated with a negative outcome.…”