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9 Jun 2015

Rosen PJ et al. Atten Defic Hyperact Disord 2015; 7: 281-294.

Emotional lability occurs with a similar prevalence in children with and without ADHD, but a relationship to behavioural difficulties is present only in children with ADHD, reports a recent US study.

The aim of this study was to investigate the effect of emotional lability on behavioural and emotional difficulties in children with (n=56; 63% male; mean age 10 years) and without* (n=46; 54% male; mean age 10 years) ADHD. At baseline, parents completed a structured diagnostic interview to assess for the presence of ADHD and other anxiety, mood or behavioural disorders in their child, supplemented by further questionnaires to assess emotional and behavioural problems. Parents were also trained in the ecological momentary assessment (EMA) protocol – a tool to collect real-time data on emotional lability – which included a Positive and Negative Affect scale to assess the overall, positive and negative effects of lability. The EMA was conducted by the same parent, three times a day for 28 days.

ANCOVA analyses did not demonstrate a difference in the prevalence of emotional lability in children with and without ADHD (overall emotional lability: p>0.1; negative emotional lability: p>0.7; positive emotional lability: p>0.3); with no significant differences evident in emotional lability by age, gender or active ADHD medication use. In addition, greater overall emotional lability was related to higher rates of parent-reported emotional difficulties (p<0.05) and emotional reactivity (p<0.05) irrespective of ADHD.

In contrast, greater emotional lability was significantly related to higher rates of parent-reported (p<0.05) and child-reported (p<0.01) behavioural difficulties, with the statistical model suggesting that this relationship only applied to children with ADHD.

Researchers concluded that although emotional lability is consistently related to parent-perceived emotional difficulties in children with/without ADHD, it appears to negatively impact the behaviour of children with ADHD only. As this study was limited by the inability to assess EMA whilst the child was at school (a situation that can cause stress in children with ADHD), which may have led to an underestimation of emotional lability, the authors recommend further study of the interaction between ADHD and emotional lability, with the aim of improving emotional and behavioural function in children with ADHD.

Read more about the relationship between emotional lability and emotional and behavioural difficulties in children with ADHD here


*This was a community sample rather than a control sample, therefore, children were not excluded from the study if they had symptoms of ADHD but did not meet the criteria for diagnosis. Eight children (17.0%) met criteria for at least one behavioural, mood or anxiety disorder.
The Diagnostic Interview Schedule for Children-Version IV, Parent-Report.

Rosen PJ, Walerius DM, Fogleman ND, et al. The association of emotional lability and emotional and behavioural difficulties among children with and without ADHD. Atten Defic Hyperact Disord 2015; 7: 281-294.

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