Regulation of emotion in ADHD: can children with ADHD override the natural tendency to approach positive and avoid negative pictures?

Studies have demonstrated inefficient use of antecedent-focused emotion regulation strategies in children with ADHD attention-deficit/hyperactivity disorder (ADHD). In the current study we tested for the first time if ADHD is also associated with difficulties in response-focused strategies by measuring the ability to override action tendencies induced by emotional information. Performance data on a computer-based approach-avoidance paradigm of 28 children with ADHD and 38 typically developing children between 8 and 15 years of age were analyzed, by comparing a congruent condition in which they were instructed to approach positive and avoid negative pictures and an incongruent condition where they had to override these automatic reactions and approach negative and avoid positive pictures. Children also rated the valence and salience of the pictures. Children with ADHD and typically developing children rated the emotional valence of the pictures appropriately and similarly, while positive pictures were rated as more arousing by children with ADHD. Solid congruency effects were found indicating that the task measured response-focused emotion regulation; however groups did not differ in this respect. Our findings do not support a deficit in emotion regulation in ADHD in terms of the ability to override natural tendencies to approach positive and avoid negative pictures.

Developmental changes in neural correlates of cognitive reappraisal: An ERP study using the late positive potential.

OBJECTIVE: The reduction of the amplitude of the late positive potential (LPP) following cognitive reappraisal has been used as a neural marker of emotion regulation. However, studies employing this neural marker in children are scarce and findings are not conclusive, with most studies showing a lack of LPP modulation after reappraisal in children in the age range of 5-12 years. The aim of the current study was therefore to investigate developmental changes in sensitivity of LPP modulation to cognitive reappraisal. To do so, LPP modulation due to cognitive reappraisal of negative pictures was compared between two age groups (8- to 11- versus 12- to 15-year-olds) and regression analyses were applied within the total sample to test whether sensitivity of LPP modulation shows a linear increase with age. METHOD: In 63 children the LPP was measured after negative pictures that were either combined with a negative story or with a neutral, reappraising story. RESULTS: Although groups did not differ for self-reports on reappraisal, a significant reduction of LPP following cognitive reappraisal was only found in the older children, whereas such an effect was absent in the younger children. Findings were similar for boys and girls. Additional analyses showed a linear increase in sensitivity of LPP modulation with age. CONCLUSIONS: The results indicate that LPP modulation as measured in the current paradigm can be used as a valid index of emotion regulation in boys and girls but that caution is recommended using it in younger children.

To make a molehill out of a mountain: An ERP-study on cognitive reappraisal of negative pictures in children with and without ADHD.

OBJECTIVE: We investigated cognitive reappraisal in children with ADHD by means of the late positive potential (LPP) and self-report ratings. We expected diminished LPP modulation following reappraisal and lower self-report scores in children with ADHD. METHODS: Eighteen children with ADHD and 24 typically developing (TD) children (8-12years) performed a cognitive reappraisal task, while EEG was recorded, and filled out a questionnaire on cognitive reappraisal. RESULTS: Despite the lack of main reappraisal effects on LPP, the LPP was less positively modulated during reappraisal in ADHD compared to TD children. CONCLUSIONS: Children with ADHD reported less use of reappraisal and could be distinguished from TD children based on LPP modulation. However the lack of main effects of reappraisal on LPP in both groups hinders clear interpretation of this finding and questions the suitability of LPP modulation within the current paradigm as a neural index of reappraisal in children 8-12years old, and warrants further research on the inter-individual variability and sensitivity of LPP modulation as a neural index of emotion regulation in children. SIGNIFICANCE: This is the first study investigating the LPP during cognitive reappraisal in children with ADHD.

"Turning down the heat": Is poor performance of children with ADHD on tasks tapping "hot" emotional regulation caused by deficits in "cool" executive functions?

Emotional dysregulation in daily life is very common in children with attention deficit hyperactivity disorder (ADHD). It is however not clear whether this reflects a specific deficit or that it may be the result of generic executive function (EF) deficits. The current study addresses this question by means of an emotional working memory (WM) task with 2 memory load conditions and four possible backgrounds (blank screen, neutral, positive or negative picture), which was administered to 38 typically developing children and 29 children with ADHD. Children responded slower on trials when negative pictures were presented at the background versus when neutral pictures were presented, indicating an emotional interference effect; however crucially, groups did not differ in this respect. Reaction times were also slower on trials with a neutral picture as background versus trials without a picture, with children with ADHD showing an enhanced interference effect. There was a main effect of WM load on performance, but it did not interact with interference or group effects. To summarize, the findings indicate a generic interference control deficit in the children with ADHD in the current sample, while they could not provide support for an emotional interference deficit.