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Everyday emotional experience of adults with attention deficit hyperactivity disorder: evidence for reactive and endogenous emotional lability

Published online by Cambridge University Press:  15 May 2014

C. Skirrow ,
U. Ebner-Priemer ,
I. Reinhard ,
Y. Malliaris ,
J. Kuntsi  and
P. Asherson
C. Skirrow
Affiliation:
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK Developmental Cognitive Neuroscience Unit, Institute of Child Health, University College London, UK
U. Ebner-Priemer
Affiliation:
Karlsruhe Institute of Technology (KIT), Germany Central Institute for Mental Health, Division of Biostatistics, Mannheim, Germany
I. Reinhard
Affiliation:
Central Institute for Mental Health, Division of Biostatistics, Mannheim, Germany
Y. Malliaris
Affiliation:
EDO the Hellenic Bipolar Organization and BipolarLab.com, Greece
J. Kuntsi
Affiliation:
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
P. Asherson*
Affiliation:
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: P. Asherson, MRCPsych., Ph.D., MRC Social, Genetic and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background.

Emotional lability (EL), characterized by negative emotional traits and emotional instability, is frequently reported in children and adults with attention deficit hyperactivity disorder (ADHD). However, EL is primarily assessed using retrospective self-report, which is subject to reporting bias and does not consider the potential influence of positive and negative everyday experiences.

Method.

Ambulatory assessment was carried out in 41 men with ADHD without co-morbidity, current medication or substance abuse, and 47 healthy control participants. Reports of negative and positive emotions (irritability, frustration, anger, happiness, excitement) and the occurrence of bad and good events were completed eight times daily during a working week. Group differences in emotional intensity and instability were investigated using multilevel models, and explored in relation to bad and good events and the Affective Lability Scale – Short Form (ALS-SF), an EL questionnaire.

Results.

The ADHD group reported significantly more frequent bad events, heightened intensity and instability of irritability and frustration, and greater intensity of anger. The results for positive emotions were equivocal or negative. Bad events significantly contributed to the intensity and instability of negative emotions, and showed a stronger influence in the ADHD group. However, covariation for their effect did not eliminate group differences. Small-to-moderate correlations were seen between intensity and instability of negative emotions and the ALS-SF.

Conclusions.

Adults with ADHD report heightened intensity and instability of negative emotions in daily life. The results suggest two components of EL in ADHD: a reactive component responsive to bad events and an endogenous component, independent of negative everyday events.

Keywords

Ambulatory monitoringattention deficit hyperactivity disorder (ADHD)co-morbidityemotional labilitymood instability
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 16 , December 2014 , pp. 3571 - 3583
Copyright
Copyright © Cambridge University Press 2014 

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