Deficient Emotional Self-Regulation and Adult Attention Deficit Hyperactivity Disorder: A Family Risk Analysis
Journal Title
American Journal of Psychiatry
Keywords
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Term and Year
Publication Date
2011-06
Book Title
Publication Volume
168
Publication Issue
6
Publication Begin
617
Publication End
623
Number of pages
Research Projects
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Abstract
Objective: A growing body of research suggests that deficient emotional self-regulation (DESR) is prevalent and morbid among
patients with attention deficit hyperactivity
disorder (ADHD). Family studies provide a
method of clarifying the co-occurrence of
clinical features, but no family studies have
yet addressed ADHD and DESR.
Method: Participants were 83 probands
with and without ADHD and 128 siblings.
All were assessed for axis I DSM-IV conditions with structured diagnostic interviews. The authors defined DESR in adult
probands and siblings using items from
the Barkley Current Behavior Scale. Analyses tested hypotheses about the familial
relationship between ADHD and DESR.
Results: Siblings of ADHD probands were
at elevated risk of having ADHD, irrespective of the presence or absence of DESR
in the proband. The risk for DESR was
elevated in siblings of ADHD plus DESR
probands but not in siblings of ADHD probands. ADHD and DESR cosegregated in
siblings. The risk for other psychiatric disorders was similar in siblings of the ADHD
proband groups.
Conclusions: The pattern of inheritance
of ADHD with DESR preliminarily suggests
that DESR may be a familial subtype of
ADHD. Our data suggest that DESR is not
an expression of other axis I DSM-IV disorders or of nonfamilial environmental factors. The authors cannot exclude contribution of non-axis-I DSM-IV disorders to risk
for DESR and cannot determine whether
the cosegregation of ADHD in DESR within
families is a result of genes or familial environmental risk factors. Further investigation of DESR and its correlates and treatment both in and outside the context of
ADHD is warranted.