Self-regulation and internal resources in school-aged children with ADHD symptomatology: An investigation using the Rorschach inkblot method

Abstract

This study assesses the capacity for emotional self-regulation and internal resources in a sample of urban children with ADHD symptomatology using the Rorschach Inkblot Method (RIM). Because these children have profound difficulty with modulating their affect, it is hypothesized that this difficulty would be reflected on RIM variables that have traditionally been thought to reflect the internal resources necessary for these children to regulate emotions. Children with greater ADHD symptoms were found to display lower scores on variables indicating internal resources for emotional self-regulation and stress tolerance (M, EA) relative to a comparison group with fewer ADHD symptoms. The research and clinical implications of these findings are discussed.

Emotional dysregulation in children with attention-deficit/hyperactivity disorder

“…Negative Emotionality was related to oppositional defiance. Resiliency was primarily related to inattention–disorganization as rated by both parents and teachers; Effortful Control was related uniquely to inattention in parent but not teacher dataLow levels of Reactive Control may have led to high levels of hyperactivity–impulsivity, and low levels of resiliency or Effortful Control may have been related to high levels of inattentionChildren with ADHD may have arrived at their disorder via multiple streams of temperamental vulnerabilityMeehan et al (2008)Age 7–10 yearsTotal, n  = 42 (27 boys, 15 female)ODD, CD, anxiety disorder, depressive disorderSchedule for affective disorders and schizophrenia for school aged childrenRorschach inkblot methodChildren with greater ADHD symptoms displayed lower scores on variables indicating internal resources for emotional self-regulation and stress tolerance relative to a comparison groupMelnick and Hinshaw (2000)Age 6–12 yearsADHD, n  = 45; controls, n  = 34Video-taped family interactions and summer camp interactions rated by trained observersParenting behaviors rated by assessors based on positive/negative parenting and parents’ ability to self-regulate their own emotionsPeer-nominated sociometric assessmentsDifferences in emotion regulation were not attributable to severity of ADHD symptomsA generalized difficulty with emotion regulation was not shown in the ADHD population, but was a specific vulnerability among the highly aggressive subgroupEmotion regulation abilities were modestly related to underlying problems with impulse control and hyperactivityThe aggressive subgroup of boys with ADHD had a slight tendency toward more intense emotional reactivity, however, emotional reactivity was predictive of neither core ADHD symptomatology nor social outcomesMusser et al (2011)Age 7–9 yearsADHD, n  = 32 (ADHD-C, n  = 19; ADHD-I, n  = 13 [AD, 10 %; OD, 13.3 %; SD, 13.3 %]); controls, n  = 34 (AD, 5.6 %; OD, 2.8 %; SD, 2.8 %)Conners’ Rating ScaleStrengths and Difficulties QuestionnaireWechsler’s intelligence scale for children—4th versionWechsler individual achievement test–2nd editionCardiac pre-ejection periodRespiratory sinus arrhythmiaChildren with ADHD displayed a stable pattern of elevated parasympathetic activity across all task conditions compared to baselineADHD in childhood was associated with abnormal parasympathetic mechanisms involved in emotion regulationMusser et al (2013)Age 7–11 yearsADHD-C, n  = 75 ([ADHD only, n  = 54; MD, 3.7 %; AD, 23.9 %; ODD 24.7 %; tic disorder, 3.7 %; SD, 7.1 %]; [ADHD + low prosocial, n  = 21; MD, 3.7 %, AD, 4.7 %; ODD 23.8 %; SD, 4.7 %]); controls, n  = 75 (MD, 2.7 %; AD, 21.3 %; ODD 8.1 %; SD, 5.4 %)Strengths and Difficulties QuestionnaireProsocial Behavior ScaleCardiac pre-ejection periodRespiratory sinus arrhythmiaADHD-typical prosocial group displayed atypically elevated parasympathetic reactivity (emotion dysregulation) during positive induction, along with increased sympathetic activity (elevated arousal)ADHD-low prosocial group displayed reduced parasympathetic reactivi...…”

“…Evidence for a relationship between disturbed emotional self-regulation (the capacity to regulate affect and sustain attention) and the severity of symptoms of ADHD was provided using the Rorschach inkblot method (Meehan et al 2008). Although without a formal diagnosis of ADHD, children with higher ADHD symptom scores exhibited reduced access to internal resources compared with the comparison group.…”

Desarrollo adaptativo y funcionamiento ejecutivo en niños con diagnóstico de trastorno disocial y trastorno de déficit de atención/hiperactividad tipo hiperactivo-impulsivo

“…2014). En estudios experimentales se ha observado que los niños con mayores síntomas de TDAH tienen menor acceso a sus recursos internos y, en consecuencia, presentan insuficiencia en habilidades como la autorregulación emocional, la tolerancia al estrés, la ca-pacidad para postergar la gratificación y el control inhibitorio (Donfrancesco et al, 2015;Meehan et al, 2008;Shiels y Hawk, 2010;Villanueva-Bonilla y Ríos-Gallardo, 2018).…”

Funciones ejecutivas en el TDAH: Una mirada a través del test de Rorschach

“…Los niños diagnosticados de TDAH manifiestan también baja tolerancia a la frustración, dificultades para controlar los afectos y demorar la recompensa, y déficits en la planificación de acciones, en la inhibición conductual, en la regulación de la motivación y en la memoria de trabajo (Barkley, 1997(Barkley, , 2013Orjales, 2011;Sanfeliu, 2011). Presenta además comorbilidad con otros trastornos externalizantes infantiles como el trastorno de conducta y el trastorno oposicionista o negativista desafiante (Manga et al, 2008;Meehan et al, 2008).…”