GENDER DIFFERENCES IN EMOTIONAL REGULATION AMONG ADOLESCENTS WITH ELEVATED ADHD SYMPTOMS: A SCHOOL-BASED STUDY

Executive function deficits are consistently associated with attention-deficit/hyperactivity disorder (ADHD), yet the expression of specific executive domains may differ across genders. Emotional regulation difficulties have been increasingly recognized as an important component of ADHD, particularly among adolescent girls, although evidence from large community-based samples remains limited.

This study examined gender differences across executive function domains in adolescents, with particular emphasis on emotional regulation among those with elevated ADHD symptoms.

A school-based cross-sectional study was conducted with 1,260 adolescents aged 11-18 years. Executive functioning was assessed using the Behavior Rating Inventory of Executive Function - Self Report (BRIEF-SR), and ADHD symptoms were measured with the Youth Self Report (YSR). Participants scoring in the clinical range on the YSR Attention Problems scale were classified as the high ADHD symptom group. A subsample underwent neurocognitive testing using the Stroop Color-Word Test and the Go/No-Go task. Group comparisons, correlational analyses, and interaction models were used to examine executive function domains and the influence of gender.

ADHD symptoms were strongly associated with global executive dysfunction (r=0.703, p<0.001). Adolescents in the high ADHD symptom group showed substantially greater impairment across behavioral, emotional, and cognitive regulation domains compared with peers below the clinical threshold. A gender difference was observed specifically in the emotional regulation domain, with females reporting higher levels of impairment than males, while overall ADHD symptom scores did not differ significantly by gender. Neurocognitive testing in the subsample indicated longer reaction times in the incongruent condition of the Stroop task among adolescents with elevated ADHD symptoms.

Emotional dysregulation appears to represent a particularly salient executive difficulty among female adolescents with elevated ADHD symptoms. These findings support the inclusion of emotional regulation measures in routine assessment and highlight the potential value of gender-sensitive approaches in the identification and intervention of adolescents with ADHD-related difficulties.