Is Emotion Dysregulation Disorder-Specific in ADHD? Exploring Mechanisms Linking ADHD Traits and Mental Health

Objective: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Among adults with ADHD, emotion dysregulation—a difficulty in managing emotional responses—is prevalent and significantly impacts mental health. This study aimed to: (1) delineate the unique features of emotion dysregulation in adults with ADHD compared to neurotypical adults, and (2) elucidate the mechanisms by which ADHD tendencies and emotion regulation strategies influence mental health outcomes. Method: A web-based survey was conducted with 294 participants aged 18 and older, assessing ADHD tendencies using the Adults with ADHD Self-Report Scale (ASRS), emotion regulation strategies via the Emotion Regulation Questionnaire (ERQ), and mental health through the K6 scale. Participants were categorized into above-cutoff and below-cutoff groups based on ASRS scores. Results: Between-group comparisons revealed that adults in the above-cutoff group exhibited significantly poorer mental health outcomes. Partial correlation analyses indicated that, unlike their neurotypical counterparts, adults with higher ADHD tendencies did not show a significant correlation between reappraisal and suppression strategies, suggesting a less flexible use of emotion regulation strategies. Hierarchical multiple regression and structural equation modeling demonstrated that reappraisal strategies moderated the relationship between ADHD tendencies and mental health, with increased use of reappraisal associated with better mental health outcomes. Conclusion: These findings suggest that emotion dysregulation in adults with ADHD is qualitatively distinct from that in neurotypical adults, likely rooted in executive function deficits. The study underscores the importance of incorporating emotion regulation training, particularly enhancing reappraisal strategies, into therapeutic interventions for adults with ADHD to improve mental health outcomes.