(PS1-B50) A Scoping Review of Factors Associated with Emotional Dysregulation in Adults with ADHD

Objective: Emotion dysregulation is frequently seen in adults with ADHD and is associated with many adverse outcomes including higher levels of psychological distress, worse educational and occupational outcomes, lower quality of life, and greater psychopathology. We conducted a scoping review of factors associated with emotion dysregulation in adults with ADHD to identify risk factors and potential areas for intervention.

Method: A comprehensive review was conducted using PubMed and PsycInfo (EBSCO). Articles were included if they measured ADHD, emotional dysregulation or some aspect of emotional dysregulation, and at least one other construct (e.g., gender, comorbid conditions, attachment style) and were published between 2014 and 2022. Studies examining physiological underpinnings as well as clinical trials examining the effect of ADHD medications on emotional dysregulation were excluded because recent reviews have already examined these topics.

Results: Thirty-five studies were included in the review. Being female, having an insecure attachment style, relying more on maladaptive emotional regulation strategies like suppression and less on adaptive strategies like reappraisal, having comorbid conditions, having a combined presentation of ADHD, and having more severe symptoms of ADHD are all factors that might influence the likelihood that an adult with ADHD will also struggle with emotional dysregulation.

Conclusion: Clinicians working with adults with ADHD should consider assessing information on these factors (attachment style, comorbidities, emotion regulation strategy use, ADHD symptom severity and presentation) to better understand risk for emotion dysregulation. Additionally, clinicians may want to introduce emotion regulation skills in their work with adults with ADHD to reduce the risk for negative psychological consequences. Future work should examine how to best target emotion dysregulation among adults with ADHD. Results of the current study suggest that an intervention that helps patients decrease the use of suppression and avoidance while increasing reliance on reappraisal as a more adaptive emotion regulation strategy may be most effective. Combining components from mindfulness interventions, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Acceptance and Commitment Therapy may be a useful approach in working towards these goals.