Emotion Dysregulation and Frustrative Non-Reward in Relation To ADHD Symptoms and Body Mass Index

Attention-deficit/hyperactivity disorder (ADHD) and obesity are both independently associated with emotion dysregulation, including low frustration tolerance. There is a lack of research examining shared and unique aspects of emotion dysregulation in relation to ADHD and obesity separately and when they co-occur. This study examined emotion dysregulation as assessed with questionnaires and tasks involving frustrative non-reward in children with and without ADHD with varying body mass index (BMI). Participants included 163 8-17 year-olds with varying levels of ADHD symptoms and BMI. Emotion regulation was assessed through parent- and youth-report questionnaires of trait-based emotion regulation, lability/negativity, and irritability. In addition, youth-report state-based measures of frustration were obtained pre- and post-frustrative non-reward tasks assessing cognitive control and task persistence. On trait measures, higher ADHD symptoms were associated with less emotion regulation and more irritability and lability/negativity, regardless of BMI. On state measures, ADHD symptoms tended to be positively associated with increased frustration and less persistence during a frustrating task, but these effects were not significant. Our results suggest that emotion dysregulation, as assessed in this study, may be largely specific to ADHD. Larger studies including children with stringent ADHD diagnostic classification and objective measures of body fat and eating behavior are warranted to advance our understanding of the role of emotion dysregulation in pediatric ADHD and overweight/obesity.