Does Short-Term Memory Moderate the Relation Between Attention-Deficit/Hyperactivity Disorder Symptom Dimensions and...

Emotion regulation (ER) difficulties affect many children with attention-deficit/hyperactivity disorder (ADHD). ADHD is also associated with working memory (WM) and related short-term memory (STM) impairments, including functionally and anatomically distinct phonological (PH) and visuospatial (VS) subsystem deficits. Neurocognitive deficits in PH and VS may moderate the link between ADHD symptoms and anger dysregulation, which the current study tested in children diagnosed with ADHD.

Participants were 168 children aged 8-12 years with ADHD. Caregivers and teachers completed ADHD inattentive (IN) and hyperactivity-impulsivity (HI) symptom ratings. Children reported on their responses to anger including suppression, dysregulation, and coping and completed PH and VS WM tasks from which STM variables were derived. Multivariate linear models evaluated whether PH and VS factors and their interactions with IN and HI were associated with anger regulation, controlling for sex and medication status.

Main effects were observed for caregiver-rated HI on anger dysregulation and coping; for VS on anger suppression, dysregulation, and coping; and PH on anger dysregulation. Significant caregiver-rated HI × VS interactions for anger dysregulation and coping emerged, as well as a significant caregiver-rated IN × PH interaction for anger dysregulation. Higher HI symptoms were associated with more anger dysregulation and lower anger coping only at high (stronger) levels of VS performance. Higher IN symptoms were associated with lower anger dysregulation only at very low (poorer) levels of PH performance. No significant findings emerged for teacher-rated ADHD symptoms.

The findings add to the literature suggesting that ADHD symptoms, particularly HI, play a role in anger regulation, and that the association may be partially modulated by STM. Future studies of ER in ADHD should consider specific anger management strategies, in addition to disaggregating VS and PH, given that both interacted with the association of caregiver-rated ADHD and anger regulation. Implications for intervention are discussed.