Toward operationalizing deficient emotional self-regulation in newly referred adults with ADHD: A receiver operator characteristic curve analysis.
ADHD
comorbidity
psychopharmacology
Journal
European psychiatry : the journal of the Association of European Psychiatrists
ISSN: 1778-3585
Titre abrégé: Eur Psychiatry
Pays: England
ID NLM: 9111820
Informations de publication
Date de publication:
24 02 2020
24 02 2020
Historique:
entrez:
26
2
2020
pubmed:
26
2
2020
medline:
12
1
2021
Statut:
epublish
Résumé
A growing body of research suggests that deficient emotional self-regulation (DESR) is common and morbid among attention-deficit/hyperactivity disorder (ADHD) patients. The main aim of the present study was to assess whether high and low levels of DESR in adult ADHD patients can be operationalized and whether they are clinically useful. A total of 441 newly referred 18- to 55-year-old adults of both sexes with Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5) ADHD completed self-reported rating scales. We operationalized DESR using items from the Barkley Current Behavior Scale. We used receiver operator characteristic (ROC) curves to identify the optimal cut-off on the Barkley Emotional Dysregulation (ED) Scale to categorize patients as having high- versus low-level DESR and compared demographic and clinical characteristics between the groups. We averaged the optimal Barkley ED Scale cut-points from the ROC curve analyses across all subscales and categorized ADHD patients as having high- (N = 191) or low-level (N = 250) DESR (total Barkley ED Scale score ≥8 or <8, respectively). Those with high-level DESR had significantly more severe symptoms of ADHD, executive dysfunction, autistic traits, levels of psychopathology, and worse quality of life compared with those with low-level DESR. There were no major differences in outcomes among medicated and unmedicated patients. High levels of DESR are common in adults with ADHD and when present represent a burdensome source of added morbidity and disability worthy of further clinical and scientific attention.
Sections du résumé
BACKGROUND
A growing body of research suggests that deficient emotional self-regulation (DESR) is common and morbid among attention-deficit/hyperactivity disorder (ADHD) patients. The main aim of the present study was to assess whether high and low levels of DESR in adult ADHD patients can be operationalized and whether they are clinically useful.
METHODS
A total of 441 newly referred 18- to 55-year-old adults of both sexes with Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5) ADHD completed self-reported rating scales. We operationalized DESR using items from the Barkley Current Behavior Scale. We used receiver operator characteristic (ROC) curves to identify the optimal cut-off on the Barkley Emotional Dysregulation (ED) Scale to categorize patients as having high- versus low-level DESR and compared demographic and clinical characteristics between the groups.
RESULTS
We averaged the optimal Barkley ED Scale cut-points from the ROC curve analyses across all subscales and categorized ADHD patients as having high- (N = 191) or low-level (N = 250) DESR (total Barkley ED Scale score ≥8 or <8, respectively). Those with high-level DESR had significantly more severe symptoms of ADHD, executive dysfunction, autistic traits, levels of psychopathology, and worse quality of life compared with those with low-level DESR. There were no major differences in outcomes among medicated and unmedicated patients.
CONCLUSIONS
High levels of DESR are common in adults with ADHD and when present represent a burdensome source of added morbidity and disability worthy of further clinical and scientific attention.
Identifiants
pubmed: 32093797
doi: 10.1192/j.eurpsy.2019.11
pii: S0924933819000117
pmc: PMC7315889
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e21Références
Stat Med. 2012 Oct 15;31(23):2676-86
pubmed: 22307964
J Clin Psychiatry. 2007 Jan;68(1):93-101
pubmed: 17284136
Int J Methods Psychiatr Res. 2007;16(2):52-65
pubmed: 17623385
Biol Psychiatry. 2005 Jul 15;58(2):125-31
pubmed: 16038683
Eur Psychiatry. 2015 Jun;30(4):511-20
pubmed: 25649490
Psychopharmacol Bull. 1993;29(2):321-6
pubmed: 8290681
Eur Psychiatry. 2017 Jul;44:198-207
pubmed: 28646732
Neurosci Biobehav Rev. 2018 Jan;84:359-367
pubmed: 28837827
Psychol Bull. 1997 Jan;121(1):65-94
pubmed: 9000892
Am J Psychiatry. 2011 Jun;168(6):617-23
pubmed: 21498464
Psychol Med. 2005 Feb;35(2):245-56
pubmed: 15841682
J Child Psychol Psychiatry. 2019 Feb;60(2):133-150
pubmed: 29624671
Atten Defic Hyperact Disord. 2013 Sep;5(3):273-81
pubmed: 23413201
Pediatrics. 2013 Sep;132(3):e612-22
pubmed: 23979086