Objective: This study evaluated the concurrent validity of emotional lability (EL) in children with ADHD. Method: A total of 2,015 children with ADHD and 745 typically developed controls (TDCs) were assessed and compared on EL. Results: ADHD participants expressed higher EL scores than TDCs, not influenced by gender or IQ. Higher levels of EL symptoms were found in children with comorbid oppositional defiant disorder (ODD) and with ADHD-combined subtype. Receiver operating characteristic (ROC) analyses showed a strong screening efficacy of EL symptoms on ADHD. The effect of developmental age on EL showed a desisting pattern in TDCs, as opposed to a persisting pattern in ADHD (not influenced by ODD comorbid status). ODD symptoms in ADHD showed an ascending pattern. Conclusion: EL can potentially serve as a sentinel index for the presence of ADHD, especially when the ADHD presentation is atypical. ODD may embody a developmental entity distinct from EL.
AhujaA.MartinJ.LangleyK.ThaparA. (2013). Intellectual disability in children with attention deficit hyperactivity disorder. The Journal of Pediatrics, 163, 890-895.e1.
2.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
4.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
5.
AnastopoulosA. D.SmithT. F.GarrettM. E.Morrissey-KaneE.SchatzN. K.SommerJ. L.. . . Ashley-KochA. (2011). Self-regulation of emotion, functional impairment, and comorbidity among children with AD/HD. Journal of Attention Disorders, 15, 583-592.
6.
ArffaS. (2007). The relationship of intelligence to executive function and non-executive function measures in a sample of average, above average, and gifted youth. Archives of Clinical Neuropsychology, 22, 969-978.
7.
BanaschewskiT.Jennen-SteinmetzC.BrandeisD.BuitelaarJ. K.KuntsiJ.PoustkaL.. . . AshersonP. (2012). Neuropsychological correlates of emotional lability in children with ADHD. Journal of Child Psychology and Psychiatry, 53, 1139-1148.
8.
BarkleyR. A.FischerM. (2010). The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 503-513.
9.
BiedermanJ.PettyC. R.DayH.GoldinR. L.SpencerT.FaraoneS. V.. . . WozniakJ. (2012). Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder. Journal of Developmental and Behavioral Pediatrics, 33, 236-243.
10.
CorbisieroS.StieglitzR. D.RetzW.RoslerM. (2013). Is emotional dysregulation part of the psychopathology of ADHD in adults?Attention Deficit Hyperactive Disorders, 5, 83-92.
GrazianoP. A.GarciaA. (2016). Attention-deficit hyperactivity disorder and children’s emotion dysregulation: A meta-analysis. Clinical Psychology Review, 46, 106-123.
13.
HulvershornL. A.MennesM.CastellanosF. X.Di MartinoA.MilhamM. P.HummerT. A.RoyA. K. (2014). Abnormal amygdala functional connectivity associated with emotional lability in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 351-361.
14.
JensenC. M.SteinhausenH. C. (2015). Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. Attention Deficit and Hyperactivity Disorders, 7, 27-38.
15.
LichtensteinP.CarlströmE.RåstamM.GillbergC.AnckarsäterH. (2010). The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood. The American Journal of Psychiatry, 167, 1357-1363.
16.
LiuL.ChenW.VitoratouS.SunL.YuX.Hagger-JohnsonG.. . . WangY. (2019). Is emotional lability distinct from “angry/irritable mood,” “negative affect,” or other subdimensions of oppositional defiant disorder in children with ADHD?Journal of Attention Disorders, 23, 859-868. doi:10.1177/1087054715624228
17.
MaedgenJ. W.CarlsonC. L. (2000). Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes. Journal of Clinical Child Psychology, 29, 30-42.
18.
MeltzerH.GatwardR.GoodmanR.FordT. (2003). Mental health of children and adolescents in Great Britain. International Review of Psychiatry, 15, 185-187.
19.
MerwoodA.ChenW.RijsdijkF.SkirrowC.LarssonH.ThaparA.. . . AshersonP. (2014). Genetic associations between the symptoms of attention-deficit/hyperactivity disorder and emotional lability in child and adolescent twins. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 209-220.
20.
NoronaA. N.BakerB. L. (2014). The transactional relationship between parenting and emotion regulation in children with or without developmental delays. Research in Developmental Disabilities, 35, 3209-3216.
21.
PosnerJ.KassE.HulvershornL. (2014). Using stimulants to treat ADHD-related emotional lability. Current Psychiatry Reports, 16, Article 478.
22.
PosnerJ.RauhV.GruberA.GatI.WangZ.PetersonB. S. (2013). Dissociable attentional and affective circuits in medication-naïve children with attention-deficit/hyperactivity disorder. Psychiatry Research, 213, 24-30.
23.
QianY.ShuaiL.CaoQ.ChanR. C.WangY. (2010). Do executive function deficits differentiate between children with attention deficit hyperactivity disorder (ADHD) and ADHD comorbid with oppositional defiant disorder? A cross-cultural study using performance-based tests and the behavior rating inventory of executive function. Clinical Neuropsychologist, 24, 793-810.
24.
SjöwallD.RothL.LindqvistS.ThorellL. B. (2013). Multiple deficits in ADHD: Executive dysfunction, delay aversion, reaction time variability, and emotional deficits. Journal of Child Psychology and Psychiatry, 54, 619-627.
25.
SkirrowC.AshersonP. (2013). Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. Journal of Affective Disorder, 147, 80-86.
26.
SobanskiE.BanaschewskiT.AshersonP.BuitelaarJ.ChenW.FrankeB.. . . FaraoneS. V. (2010). Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): Clinical correlates and familial prevalence. Journal of Child Psychology and Psychiatry, 51, 915-923.
27.
SuL. Y.GengY. G.WangH.DuY. S.SunL.ZhaoF. T.FanF. (2006). Norm of ADHD Diagnostic Scale–Parent version in Chinese urban children. Zhong Guo Shi Yong Er Ke Za Zhi, 21, 833-836.
28.
XuT. Y. (1999). Rating scales for mental health. Beijing, China: Chinese Mental Health Journal.
29.
YangL.WangY.QianQ.GuB. (2001). Primary exploration of the clinical subtype of attention deficit hyperactivity disorder in Chinese children. Chinese Journal of Psychiatry, 34, 204-207.
30.
YuX.LiuL.ChenW.CaoQ.ZepfF. D.JiG.. . . WangY. (2016). Integrity of amygdala subregion-based functional networks and emotional lability in drug-naïve boys with ADHD. Journal of Attention Disorders. doi:10.1177/1087054716661419
31.
YüceM.ZorogluS. S.CeylanM. F.KandemirH.KarabekirogluK. (2013). Psychiatric comorbidity distribution and diversities in children and adolescents with attention deficit/hyperactivity disorder: A study from Turkey. Neuropsychiatric Disease and Treatment, 9, 1791-1799.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
