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17 Mar 2016

Mörstedt B et al. Atten Defic Hyperact Disord 2016; 8: 21-33.

A study has shown that emotional symptoms of ADHD may connect ADHD core symptoms to the functional impairment experienced by many adults with ADHD.

Researchers from the University of Basel recruited 176 participants from an adult ADHD Special Consultations Unit (146 diagnosed with ADHD, 30 without ADHD) in order to investigate the relationship between ADHD core symptoms, functional impairment and emotional symptoms. The participants were assessed for ADHD – which involved a semi-structured background and diagnostic interviews, and a variety of self-report and other report scales* – in addition to emotional symptoms and functional impairment. As well as multiple regression analysis, a structural equation model (SEM) was developed by the researchers, which comprised four domains of daily impairment (work, organisation, family life and social life), in addition to core ADHD symptoms and emotional symptoms.

Emotional symptoms were found to be directly related to adult ADHD. Pearson’s correlations were found between emotional symptoms and inattention, hyperactivity and impulsivity symptoms, with results of the SEM indicating that emotional symptoms were connected to impulsivity and inattention symptoms in particular. Emotional symptoms also had a strong negative influence on the four different domains of daily impairment.

Hierarchical regression analysis found strong evidence that emotional symptoms mediated the relationship between ADHD core symptoms and functional impairment. In particular, connections between impulsivity and family life, and inattention and social life, were fully mediated by emotional symptoms.

The researchers noted that the cross-sectional design was an important limitation of this study, meaning results can only suggest causality between the relationships identified. Furthermore, they explained that this was the first study to use an SEM approach in a sample of adult ADHD patients, and that it requires validation with data from a larger sample. In conclusion, the authors state that emotional problems are an important aspect of ADHD in adults, which can mediate the relationship between ADHD core symptoms and functional impairment.

Read more about emotional symptoms in adult ADHD here


*Wender-Reimherr Adult Attention Deficit Disorder Scale; Conners’ Adult ADHD Rating Scale; ADHD German Self-Rating Behaviour Questionnaire

Adult Attention Deficit Disorder Scale
Barkley Functional Impairment Scale for Adults; Sheehan Disability Scale; Adult Interview

Mörstedt B, Corbisiero S, Bitto H, et al. Emotional symptoms and their contribution to functional impairment in adults with attention-deficit/hyperactivity disorder. Atten Defic Hyperact Disord 2016; 8: 21-33.

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