Incremental Validity of Trait Impulsivity, Dysfunctional Emotional Regulation, and Affect Lability in the Predictions of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms in Adults

Abstract

Difficulties in emotion regulation (DER) is a defining feature of attention deficit hyperactivity disorder (ADHD), and arguments are being made for it to be considered as a defining feature of oppositional defiant disorder (ODD). However, the consensus is that it is better viewed as an important correlate distinct from ADHD. This study examined the incremental validity of DER over and above trait impulsivity (TI) in the predictions of ADHD and ODD symptoms. It also examined the incremental validity of affect lability (AL) over and above TI and (DER) in these predictions. Five hundred and twenty-five adults from the general community completed a series of questionnaires. A model-based SEM approach for evaluating incremental validity indicated that TI predicted ADHD and ODD symptoms over age; DER predicted ADHD and ODD symptoms over age and TI; and AL did not predict ADHD and ODD symptoms over and above age, IT, or DER. In addition, AL predicted ADHD and ODD symptoms over age and TI, and DER also predicted ADHD and ODD symptoms over and above age, TI, and AL. In conclusion, TI is core to ADHD, and although DER is important, it is unlikely to be relevant as a diagnostic indicator for ADHD or ODD. These findings notwithstanding, there is need for caution when interpreting our findings, as the study did not control for potentially influencing factors on emotional regulation such as age, gender, culture, and existing psychopathologies.

Keywords: ADHD; ODD; affect lability; emotional regulation; incremental validity; trait impulsivity.

Figure 1

Structural model diagram for the incremental validity (in sequence) of trait impulsivity, dysfunctional emotional regulation, and affect lability predicting IA, HI, and ODD latent outcomes. Note. ANG = anger; DEP = depression; A/D = anxiety/depression; STA = strategies; UAC = unawareness; IMP = impulse; CLA = clarity; PEM = lack of perseverance; PER = lack of premeditation; SS = sensation seeking, NU = negative urgency; PU = positive urgency; AL = affect lability; DER = dysfunctional emotional regulation; AL = affect lability.