Emotional Dysregulation Is a Core, Taxing ADHD Trait: New Study
ADHD assessments that consider emotional stability and maladaptive personalities may unlock better understanding and tailored interventions, according to new research that identified three unique ADHD profiles.
June 17, 2024
Emotional dysregulation (ED) and maladaptive personality traits may cause relatively high functional impairment among college students with ADHD and warrant consideration during clinical assessments, suggests a new study published in the Journal of Attention Disorders.1
The study analyzed survey data collected from 2020 to 2023 on symptom severity, ED, and emotional instability among 1,858 college students across eight universities in the United States. Among subjects with self-reported ADHD symptoms, three profiles with distinct emotional dysregulation dimensions, impairments, and personality traits emerged:
ADHD Profile #1: Primarily Inattentive with ED Present/Emotionally Unstable
The Primarily Inattentive Profile reported the highest level of
- inattention
- anxiety
- internalizing problems
- self-concept impairment
- nonacceptance of emotional responses
- difficulties engaging in goal-directed behavior
Participants who fit this profile also reported the lowest levels of emotional stability and limited access to emotional regulation strategies.
ADHD Profile #2: Moderate ADHD Severity with ED Absent/Normative Personality Traits
The Moderate ADHD Severity profile reported the lowest levels of ADHD impairment and internalizing problems compared to the other ADHD profiles.
ADHD Profile #3: High ADHD Severity with ED Absent/Normative Personality Traits
The High ADHD Severity profile reported the highest levels of risk-taking behaviors. Students who fit this profile also had elevated levels of inattention, hyperactivity, and internalizing emotions compared to those without ADHD, despite levels of ED being consistent with the non-ADHD profile.
Subjects with all three ADHD profiles reported more significant impairments in life skills and school domains compared to the non-ADHD group.
“Although personality traits and ED have generally been studied separately, they share conceptually apparent relations, particularly with respect to emotional stability,” wrote the team of researchers from the University of Hawaiʻi at Mānoa and Appalachian State University.
Why ADHD Diagnostic Criteria Exclude Emotional Dysregulation
This study suggests that examining ED and personality traits simultaneously during an ADHD assessment may provide clinicians with a better understanding of inherent risk markers and impairments related to the disorder. However, some clinicians overlook ED altogether because it is not included in the current ADHD diagnostic criteria.
“The most impairing feature of ADHD at all ages, emotional dysregulation, was not mentioned in the DSM-5 as a fundamental component because emotions are hard to research,” explains William Dodson, M.D. “Emotions are not always present. They are difficult to measure. People are embarrassed when they cannot control their own emotions and, thus, hide the very impairments that need to be studied.”
The researchers saw this among the college students they surveyed. “A sizeable group of college students who report prior or current elevations in ADHD symptoms and impairment may not report elevated ED or maladaptive patterns of personality,” they wrote.
Emotional dysregulation is the most debilitating symptom of ADHD for many people. “People with ADHD feel emotions more intensely than do people without the condition,” says Joel Nigg, Ph.D., a clinical psychologist and a professor in the departments of psychiatry and behavioral sciences at Oregon Health & Science University. “For many, emotional dysregulation is one of the most difficult symptoms to manage.”
The researchers report that the study’s findings could “help inform the development of tailored interventions aimed at producing benefits not only for ADHD symptoms but also for the impairment and internalizing problems that commonly co-occur with them.
Source
1Goh, P.K., Suh, D.E., Wong, A.W.W.A., Bodalski, E.A., Canu, W.H. (2025). Extending the ADHD phenotype and parsing heterogeneity via emotional dysregulation and personality: a latent profile analysis in college students. J Atten Disord. https://doi.org/10.1177/10870547251326676
