Poster #55 - Emotion Regulation and Internalizing Symptoms in Adolescents With and Without ADHD: Moderating Role of Parents

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Developmental Psychopathology

Integrative Statement

Emotion regulation (ER) is the ability to monitor, evaluate, and modify one’s emotional responses to fit environmental demands (Hofmann, et al., 2012). Importantly, ER problems represent a unique treatment target as they are a transdiagnostic construct that underlie both internalizing (anxiety, depression) and externalizing (attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder) disorders. In fact, ADHD is associated with higher rates of ER difficulties and internalizing problems (e.g., Hurtig et al., 2007; Shaw, et al., 2014). Additionally, given that internalizing symptoms increase during adolescence, this is an important developmental period in which to study the association of ER with internalizing symptoms (e.g., Beesdo et al., 2007; Costello et al., 2003). As such, the goal of this study was to examine if the relation between adolescent- and parent-reported ER problems and adolescent reported internalizing symptoms differed for adolescents with and without ADHD using multigroup path models in Mplus7 (Muthén & Muthén, 2012). Further, we explored if these relations were moderated by parenting behaviors and parent psychopathology.
Participants were 302 (Mage = 13.17, SD = 0.40; 55% male) eighth graders recruited for a larger study. Half of the adolescents met DSM-5 criteria for ADHD (n = 162), the other half (n = 140) displayed ≤3 symptoms of inattention and/or hyperactivity/impulsivity. The total score from the adolescent-report Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) and the total score of the parent-report Emotion Regulation Checklist (ERC; Shields & Cicchetti, 1997) were used to assess adolescents’ ER skills. Internalizing symptoms were assessed using the total internalizing composite from the Revised Child and Anxiety and Depression Scale (RCADS; Chorpita, et al., 2015). Parenting was assessed using the Parental Behavior Scale (Van Leeuwen & Vermault, 2004), and parent psychopathology was assessed using the Barkley Adult ADHD Rating Scale (Barkley, 2011) and the Depression Anxiety Stress Scale (Lovibond & Lovibond, 1995).
Multigroup analyses indicated that letting paths vary across group (ADHD vs. comparison) significantly improved fit over the fixed paths model, χ2(3)=18.165, p<.001. For the comparison group, both the ERC (β=.136, SE=.065, p=.038) and the DERS (β=.657, SE=.051, p<.001) were associated with higher internalizing symptoms. In contrast, for the ADHD group, only the DERS was associated with higher internalizing symptoms (β=.408, SE=.069, p<.001), above and beyond the influence of medication status. Contrary to our hypothesis, parenting behaviors and parent ADHD did not moderate the relation between ER and internalizing symptoms for adolescents with ADHD (ps > .187); however, parent depression-anxiety-stress significantly moderated this relation such that having a parent with elevated depression-anxiety-stress increased the relation between parent- (β=.533, SE=.203, p=.009) and adolescent-reported (β=.481, SE=.206, p=.019) ER and adolescent internalizing symptoms.
Despite higher rates of ER and internalizing problems in adolescents with ADHD, relations between these two variables were stronger for comparison adolescents. Additionally, results suggest that having a parent who experiences internalizing symptoms (depression-anxiety-stress) may increase the risk of adolescents with both ADHD and poor ER to experience comorbid internalizing symptoms. These findings and their clinical implications will be discussed.

Authors

• Hana-May Eadeh, University of Iowa
  Presenting Author

• Rosanna P Breaux, Virginia Commonwealth University
  Non-Presenting Author

• Alyssa W Sullivan, University of Iowa
  Non-Presenting Author

• Joshua M Langberg, Virginia Commonwealth University
  Non-Presenting Author

• Stephen P. Becker, Cincinnati Children’s Hospital
  Non-Presenting Author