(PS1-C72) Children’s Emotion Dysregulation Predicts ADHD Symptom Severity at Six Months Beyond ADHD Symptom Severity at Baseline

Children (N = 68, 67.6% male; 70.6% white) with (n = 35) and without (n = 33) ADHD ages 7-12 (Mage = 9.76, SD = 1.34) and their parents were recruited from a community sample. ADHD was assessed at baseline using the Diagnostic Interview Schedule for Children-Parents. Parents completed the Vanderbilt ADHD Parent Rating Scale (VPRS) and the Emotion Regulation Checklist (ERC) at baseline and follow-up; VPRS subscales: inattention, hyperactivity, and total severity scores; ERC subscales: Lability/Negativity and Emotion Regulation. Lastly, parents completed the Positive and Negative Affect Scale 3 times daily for 28 days as part of an ecological momentary assessment protocol; average negative affect (NA) was calculated as well as children’s variability from their mean NA (NA variability).
 

Hierarchical multiple regression analyses assessed whether emotion regulation at baseline predicted ADHD symptom severity at follow-up beyond ADHD symptom severity at baseline. Age and sex were entered first as covariates, baseline ADHD total symptom severity, ADHD diagnostic status (diagnosed with ADHD or not), and mean NA in the second step, and ERC-LN and ERC-ER and NA variability in the third step; ADHD severity at follow-up was the dependent variable. Emotion regulation accounted for significant variance in ADHD total severity [R2 =.74, ΔR2 =.10, F(8, 56) = 19.73, p < .001], inattention severity [R2 =.70, ΔR2 =.05, F(8, 56) = 15.60, p < .001], and hyperactivity severity [R2 =.74, ΔR2 =.12, F(8, 56) = 20.20, p < .001] at follow-up (with higher ERC scores reflecting poorer emotion regulation). ERC-ER significantly predicted total severity (β = .40, p = .003), inattention severity (β = -.30, p = .037), and hyperactivity severity (β = -.40, p = .005). NA variability significantly predicted total severity (β = .30, p = .006) and hyperactivity severity (β = -.40, p < .001). ERC-LN was not a significant predictor.
 

Overall, results indicate that emotion dysregulation may better predict ADHD symptom severity over time than initial ADHD symptom severity. Even more, different aspects of emotion regulation differentially estimate severity across ADHD domains. General negativity predicted symptom severity in all domains, whereas emotional intensity and variability did not predict any domains. Additionally, NA variability predicted total and hyperactive symptom severity. General negativity may have the most pervasive influence on ADHD symptom severity in children. This study highlights the potential benefit of targeting emotion dysregulation in ADHD interventions.