The clinical utility of the BRIEF2 <i>ERI</i> in detecting comorbid conditions associated with ADHD: a retrospective cohort analysis of clinically referred school-aged children

The majority of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) meet the criteria for at least one comorbid diagnosis. Prior literature has suggested that the assessment of emotion regulation may be helpful in the differential diagnosis of ADHD comorbidity. Thus, a primary goal of this study was to examine the clinical utility of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) <i>Emotion Regulation Index (ERI)</i> in detecting symptoms commonly comorbid with ADHD (i.e. disruptive and internalizing behaviors). This study also considered the extent to which the <i>ERI</i> may contribute to the overall detection of ADHD and comorbid symptoms, as compared to the BRIEF2 <i>Behavior Regulation Index (BRI)</i> and <i>Cognitive Regulation Index (CRI)</i>. Archival data representing 211 male (<i>n</i> = 151) and female (<i>n</i> = 60) children ages 5 to 12 (<i>M</i> = 8.00, <i>SD</i> = 1.63) seen through a university-based ADHD Evaluation Clinic were used. Parent and teacher ratings were analyzed separately. Results revealed that the BRIEF2 <i>ERI</i> reliably detected the presence of ADHD comorbid symptomatology across informants. However, unlike select findings from the <i>BRI</i> and <i>CRI</i>, the <i>ERI</i> and its associated clinical scales did not differentiate between types of comorbidities. Overall, current data suggests that the <i>ERI</i> may make only a small contribution beyond what is already explained by the other two indexes on the BRIEF2 in the assessment of ADHD comorbidity. Nonetheless, from a transdiagnostic perspective, the BRIEF2 <i>ERI</i> clinical scales may provide helpful information for clinicians to help guide assessment and treatment recommendations.