Emotional Dysregulation, Emotional Lability, Emotional Impulsiveness and Emotion in Adults with ADHD: Do All Scales Define the Same Concept?

Background: Various studies highlight emotional symptoms as a crucial component of ADHD in adulthood, suggesting independent diagnostic approaches that incorporate patients’ emotional experiences into the assessment. However, the emotional symptomatology appears to be defined differently within the disorder’s different constructs: Emotional Dysregulation (ED), Emotional Lability (EL), Emotional Impulsiveness (EI) and Emotion (E). Hence, the question arises: Do these symptom domains represent the same psychopathological spectrum? Method: A total of 1240 adults seeking diagnostic evaluation at the ADHD specialist consultation in two different clinics (University Psychiatric Clinics (UPK) in Basel and Central Institute of Mental Health in Mannheim) were examined, whereas 611 participants were diagnosed with ADHD. They were further assessed in regard of their emotional symptoms using the following scales: ED, EL, EI and E. Additionally, affective lability was measured as a control using the Affective Lability Scale (ALS-18). Results and discussion: The convergent and construct validity using correlations and principal component analysis (PCA) revealed that individuals with ADHD experience distinct emotional symptoms divergent from a general concept of affective lability as assessed by the ALS-18. The PCA shows that the ADHD-specific emotional symptoms may be classified into (1) difficulties with temper control and anger, (2) emotional distress and (3) emotional overreactivity and mood changes.