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Investigating emotional lability in adults with Attention Deficit Hyperactivity Disorder: an integrative approach

Student thesis: Doctoral ThesisDoctor of Philosophy

Adults with Attention-Deficit Hyperactivity Disorder (ADHD) frequently report emotional lability (EL: irritable moods with volatile and changeable emotions). Little is known about the clinical and behavioural features, or neurobiological correlates of EL in ADHD. The current thesis takes an integrative approach, using a diversity of methodologies to characterise EL, and examine the nature of its association with ADHD.

All analyses are based on data from the MIRIAD project, a case-control study of 88 adult males: 47 controls, and 41 with ADHD without comorbidity, medication or current substance abuse. The study incorporated reassessment after treatment with methylphenidate in ADHD participants, with matched follow-up for controls.

The first part of this thesis examined the clinical and behavioural features of EL using self-report measures and ambulatory monitoring. Results indicated significantly elevated EL in adults with ADHD, characterized by higher intensity and instability of negative emotions. Enhanced EL was not accounted for by antisocial behaviour, subthreshold comorbid symptomatology, and adverse life events. ADHD symptoms and EL were moderately correlated, and EL independently predicted a host of daily life impairments.

The second part of this thesis focused on identifying aetiological factors which may underpin both EL and ADHD, by exploring cognitive and neurophysiological deficits associated with ADHD and self-reported EL, and examining shared treatment response. Swift emotional changes were predicted by within-subject variability in reaction time, whilst EL characterized by negative emotions was associated with behavioural and neurophysiological indices of inhibitory function. Although ADHD symptoms and EL correlated moderately in their treatment response, treatment response of cognitive measures and EL were not correlated.

The research presented here has implications for the identification and treatment of ADHD in adulthood in the context of elevated EL and mood symptoms. Results from cognitive and neurophysiological investigations present some promising avenues for further examining shared neurobiology of EL and ADHD.
Original languageEnglish
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Award date2013

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