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Poor emotional control runs in some families with attention deficit hyperactivity disorder

Some adults with attention deficit hyperactivity disorder, or ADHD, also exhibit excessive emotional reactions to everyday events, and this combination of ADHD and emotional reactivity appears to run in families. A study from a Massachusetts General Hospital–based research team finds that siblings of people with both ADHD and deficient emotional GinosPhotos/istockself–regulation (DESR) have a significantly greater risk of having both conditions than did siblings of those with ADHD alone. The study appears in the June issue of the American Journal of Psychiatry.

“Our research offers strong evidence that heritable factors influence how we control our emotions,” says Craig Surman, an HMS instructor in psychiatry at Mass General and the study’s lead author. “Emotion—like capacities such as the ability to pay attention or control physical movement—is probably under forms of brain control that we are just beginning to understand. Our findings also indicate that ADHD doesn’t just impact things like reading, listening, and getting the bills paid on time; it also can impact how people regulate themselves more broadly, including their emo­tional expression.”

Along with the classic ADHD symptoms of trouble paying attention, excessive physical activity, and poor impulse control, many people with ADHD display high levels of anger, frustration, and impatience. In contrast to mood disorders, which are characterized by the persistence of specific emotions and behaviors, DESR involves emotional expressions that are brief and occur in reaction to situations that would be expected to produce far less extreme responses in most people, such as reacting to minor disappointments by snapping at family members.

The study began with a group of 83 participants—23 with ADHD alone, 27 with ADHD plus DESR, and 33 comparison participants with neither condition—and then enrolled one or more siblings of each of the original participants. As expected, ADHD was more common in the siblings of the original participants with ADHD than in the comparison group. Co–occurrence of both ADHD and DESR was found almost exclusively, however, among siblings of the original participants who reported both conditions.

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