Theory of mind and emotion regulation difficulties in children with ADHD

Social cognition deficits and emotion dysregulation (ED) are frequently separately studied in relation to ADHD. This study aimed to examine the link between theory of mind (ToM) abilities and ED in children with ADHD. Participants were 200 children aged 11-17 years (study group, n = 100; healthy controls, n = 100). Emotion regulation skills were quantified by using the Difficulties in Emotion Regulation Scale (DERS). ToM was quantified by three different tasks. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) Disruptive Behavior Disorders Rating Scale - parents form was used for determination of ADHD symptom severity (ADHD-SS). Children in the study group had more overall difficulties regulating their emotions than healthy controls. Within the study group, a significant correlation was found between the scores of DERS-total and ADHD-SS; and between the scores of DERS-total and gender. The linear regression showed that the predictor variables accounted for 56% of the variation in DERS-total. Unexpected Outcomes Test (UOT) scores significantly improved the accountability of the total variance when added to the linear regression. Our findings show that theory of mind deficits may partly explain ED in children with ADHD.