[Impact of emotional dysregulation on Attention Deficit Hyperactivity Disorder]

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in childhood. Beyond its core symptoms of inattention, hyperactivity, and impulsivity, approximately 25% to 45% of individuals with ADHD exhibit emotional dysregulation, which is associated with greater clinical severity and poorer functional outcomes. Emotion regulation refers to the ability to identify, modulate, and implement emotional responses that are appropriate to contextual demands and goal-directed behavior. Emotional dysregulation arises when these processes are disrupted, leading to disproportionate emotional responses, emotional lability, irritability, and maladaptive behaviors. Emotional dysregulation in ADHD constitutes a dimensional trait rather than a diagnostic criterion. Neurocognitive models highlight the contribution of atypical attentional orientation toward emotional stimuli, a preference for immediate rewards, and alterations in regulatory mechanisms. Executive functions play a central role in this process, particularly working memory, inhibitory control, and cognitive flexibility. Working memory emerges as the most consistent predictor of emotional dysregulation. Emotional lability has been identified as a frequent and relatively specific manifestation of ADHD, whereas irritability is considered a transdiagnostic construct associated with broader psychopathological trajectories. Emotional dysregulation is associated with reduced response to standard pharmacological and non-pharmacological treatments for ADHD, increased psychiatric comorbidity, and poorer quality of life. Systematic identification and targeted intervention of emotional dysregulation should therefore be an integral part of the assessment and management of ADHD.