The Role of ADHD, Anxiety, and ODD in Positive and Negative Emotionality in Children

• In Event: Poster Session 14
  In Poster Session: PS 14 Topic - Developmental Disabilities

Abstract

Introduction: Attention-deficit hyperactivity disorder (ADHD) is characterized by hyperactivity, impulsivity, and inattention at developmentally inappropriate levels. It is estimated that between 40–60% of children with ADHD have one or more comorbid diagnoses, including Oppositional Defiant Disorder (ODD) and anxiety disorders. Comorbidity in ADHD is associated with more difficulties with emotional lability. Emotional lability is characterized by intense, unpredictable emotional shifts and low frustration tolerance. Emotional lability has also been linked to higher ADHD severity and impairment. Although the literature has largely focused on emotional lability in negative affect (NA), emotional lability has also been found in positive affect (PA) levels. Studies have suggested that ADHD may be linked with surgency, which is a temperament trait associated with positive affect and reflects the tendency to express excitement and happiness while internalizing and externalizing disorders may be more associated with negative affectivity. The present study hypothesized that anxiety disorders and ODD would uniquely impact emotional lability in children with ADHD. The study also examined different patterns in emotional lability for NA and PA.

Method: The present study consisted of 213 parents of children aged 7 to 12 years (58.7% male; Mage=9.15, SD=1.40) with and without ADHD (n=127), anxiety (n=44) and ODD (n=79). Parents completed the Diagnostic Interview Schedule for Children (DISC-IV) to assess for child diagnoses. Parents also completed the Positive and Negative Affect Scale-Parent Report (PANAS-PR) via ecological momentary assessment (EMA) three times a day for seven days. Mean squared successive differences (MSSD) were calculated to determine emotional lability for PA and NA.

Results: Two separate ANCOVAs were conducted to determine the unique and interactive effects of these three diagnoses on PA and NA variability. Age and sex were entered as covariates, and all 2-way interactions were included. Results suggest a significant main effect of anxiety, F(1)= 10.85, p=.001, partial η2 =.05, and ODD F(1)= 11.80, p=.001, partial η2 =.06, such that these diagnoses were uniquely associated with increased NA lability. Results also suggest a significant main effect of ADHD F(1)= 4.54, p=.03, partial η2 =.02, such that ADHD was associated with increased PA lability. There was no significant main effect of anxiety on PA lability, but there was a significant interaction between ADHD and anxiety, F(1)= 5.15, p=.02, partial η2 =.03, such that greatest PA lability was present for children with comorbid ADHD and anxiety.

Conclusions: These results emphasize the differential impact of ADHD, anxiety, and ODD on PA and NA lability in children. Emotional lability is often considered a hallmark of ADHD. However, comorbidity is common among children with ADHD, and these findings highlight the impact of comorbid anxiety and/or ODD on the positive and negative emotional lability of children with ADHD. Indeed, it was anxiety and ODD, not ADHD, that were associated with negative lability, and the impact of ADHD on positive lability was moderated by anxiety disorders. These findings suggest that PA lability along with NA lability should be considered when developing treatments targeted towards children with ADHD, especially among those with other comorbid disorders.

Authors

• Anna Olczyk, University of Louisville
  Presenting Author

• Meaghan Flynn, University of Louisville
  Non-Presenting Author

• Paul J Rosen, University of Louisville
  Non-Presenting Author