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. 2022 Jun;50(6):721-735.
doi: 10.1007/s10802-021-00883-0. Epub 2021 Nov 11.

Executive Functioning and Emotion Regulation in Children with and without ADHD

Nicole B Groves  1 , Erica L Wells  2 , Elia F Soto  1 , Carolyn L Marsh  1 , Emma M Jaisle  1 , T Kathy Harvey  3 , Michael J Kofler  4
Affiliations

Executive Functioning and Emotion Regulation in Children with and without ADHD

Nicole B Groves et al. Res Child Adolesc Psychopathol. 2022 Jun.

Abstract

Difficulties with emotion regulation affect the majority of youth with attention-deficit/hyperactivity disorder (ADHD) and predict greater functional impairment than ADHD symptoms alone. Deficits in executive functioning are also present for most children with ADHD, and have been linked with emotion regulation difficulties in both clinical and neurotypical populations throughout development. The current study was the first to assess all three core executive functions (working memory, inhibitory control, set shifting) simultaneously in a clinically-diverse sample of children with and without ADHD and common comorbidities and investigate the extent to which they uniquely predict emotion dysregulation. A sample of 151 children ages 8-13 years (M = 10.36, SD = 1.52; 52 girls; 70.2% White/Non-Hispanic) were assessed using a criterion battery of executive functioning tasks, teacher-reported ADHD symptoms, and parent-reported emotion regulation. Results of the bias-corrected, bootstrapped conditional effects path model revealed that better-developed working memory predicted better emotion regulation (β = 0.23) and fewer ADHD symptoms (β = -0.21 to -0.37), that ADHD symptoms (β = -0.18 to -0.20) independently predicted emotion dysregulation, and that working memory exerted indirect effects on emotion regulation through both inattention and hyperactivity/impulsivity (β = 0.04-0.07). Sensitivity analyses indicated that these effects were generally robust to control for age, sex, executive function interrelations, and inclusion/exclusion of children with co-occurring ASD. These findings underscore the importance of working memory (relative to inhibitory control and set shifting) and its relations with ADHD symptoms for understanding children's emotion regulation skills, and may help explain the limited efficacy of first-line ADHD treatments, which do not target working memory, for improving emotion regulation skills.

Keywords: ADHD; Emotion regulation; Executive function; Working memory.

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Conflict of interest statement

Conflict of Interest

The authors have no conflicts of interest to report.

Figures

Fig. 1
Fig. 1
Path diagram depicting primary model results. Significant pathways are indicated by 95% CIs that exclude zero, and are shown in black/bold font. Nonsignificant pathways are shown in grey font
See this image and copyright information in PMC

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