Study of emotional criteria for ADHD diagnosis

A 2015 study using emotional criteria to diagnose ADHD has been repeated and verified. The diagnostic test used identified people with ADHD in one of two presentations: Inattentive presentation, or Emotional Disregulation presentation.

The article about this study mentioned that many people with emotional disregulation might be mistaken for having a mood disorder or bipolar disorder.

It will still probably be years before emotional disregulation is added to the DSM-5 as diagnostic criteria, if ever, but studies like this help advance towards that possibility.

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thanks for this link!

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** My reflection on emotions as an Inattentive ADHDer**

I read an article this morning about a follow-up study which confirmed the former study. And I thought about a video featuring Dr. Russell Barkley in which he stated that emotions ought to be a diagnostic component.

The article about the study seems to me to imply a dichotomy, that either a person is Inattentive OR they have Emotional Dysregulation, which is an EITHER-OR split. This seems to be proposed as a replacement for a Inattentive/Hyperactive-Impulsive duality, which allows for overlap resulting in the Combined presentation.

I believe Dr. Barkley’s take on it is that there should be diagnostic criteria which address the emotional traits of ADHD. Emotional dysregulation often accompanies Hyperactive-Impulsive.


My emotional traits, and why I think they contribute to Anxiety.

I definitely have the Inattentive presentation ONLY. I’m a “still waters run deep” kind of personality. I’m definitely not hyperactive, or impulsive, or prone to emotional lability (which I understand to mean “rapidly-changing emotions”).

  • For example, when I made an “impulsive” purchase recently (a Black and Decker string trimmer “weed eater” I just bought, which my wife insisted that I return), it was after months of pondering and days of research (availability, customer ratings & price comparison). It wasn’t impulsive; I just kept it too myself until I made the well-thought-out decision that it was better to have a weed eater than to not have one.
  • When I have an emotional outburst, it is a “straw that broke the camel’s back” moment, the culmination of built up emotion, not a rapid change of emotion.

I don’t experience one emotion at a time. I experience many emotions simultaneously, at different intensities and different depths, all the time. The emotion that I’m exhibiting at any given time has almost certainly been there under the surface for a long, long time. It comes to the surface for some good reason, such as:

  • As a response to external conditions. e.g. Being happy and excited at a child’s birthday party, when I seemed serious the whole time they I was preparing for it. But in fact, I was excited with anticipation the whole time they I was preparing for it… I can finally show those emotions, because the conditions are right. (Meanwhile, the anxious planner is just under the surface, ready to appear in response to any issues popping up.)
  • Or when an emotion has built to critical mass, such that I can’t hold it back any longer. e.g. The one time in 27 years of working that I “blew up”, which was from pressure that had been building up for about 8 months of getting the 3-way run-around between my boss, his boss, and HR.
  • The exception to this is in response to a sudden event: e.g. a car accident, a child getting hurt, an unexpected loud & sharp sound which triggers my startle response. This, of course, is a natural human response.

I experience every type of emotion that I can imagine exists. I do have the ability to tamp down many negative emotions. Happiness and worry show plainly on my face at the moment they are felt (I can’t hide those particular emotions, unless a stronger emotion surfaces).


My thoughts on the emotional traits of Inattentive ADHD

Co-morbidities such as anxiety or depression might be naturally occurring in some individuals, being as inborn as their ADHD or their eye color. However, I think that other individuals develop anxiety or depression in response to a long-term buildup of emotion.

I don’t live with anxiety all the time, but I think I’ve experienced it many times in my life because I feel my emotions very deeply, and I internalize so much.

  • Resolving the cause of my emotions helps me to process them (even if the only resolution is an acknowledgement, when an apology or correction isn’t possible).
  • I often “take things personally” when neurotypical people would not think it is appropriate to do so. (Ironically, one sure-fire way to get me to take something personally is to say to me “don’t take it personally”! I think many people are the same way, simply because of the mental priming of saying the phrase.)

Emotional memory triggers

I have a better memory of how something made me feel than I do of the details of the event. I have trouble remembering names, the specific things said in a conversation (though I’ll recall basically what it was about), colors or most physical details. But years later, if you mention a particular event, I can recall how it made me feel.

Also, an emotional trigger can bring up memories of dissimilar events, simply because I experienced the same emotion.

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venn-diagram

Here’s a Venn diagram I made to illustrate the concept.

  • It’s just representative and not to scale, with overlaps showing combinations of traits. And frankly this image would imply that there is another presentation of ADHD which is solely composed of the Emotional traits, but there’s no data I know of to support that idea (though it might explain some people with heightened emotionality without other ADHD traits).

My point is that an Emotional combination with each of the Inattentive presentation and Combined presentation would explain why there’s an 85% occurrence of co-morbidities. (Of course, co-morbidities include learning differences and other disorders besides anxiety and depression.)

This is just my conceptualization, not an actual theory.

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Apparently , in the diagnostic criteria , emotional regulation is not part of the criteria, it should be.

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It use to be but it was. too hard to mesure emotions that they took it out

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Psychiatric disorders such as ADHD in itself is often misdiagnosed as set criterias that define the disorder may not be applicable to each and every patient. Preset criterias are based on the majority of cases and are not an absolute criterion to diagnose or rule out a condition. While including emotion into diagnosis criteria for ADHD would be ideal, it is certainly not feasible or practically applicable as subjective questionnaires can often have misleading results. But the only way to understand whether addition of emotions would be beneficial to diagnosis would be via extensive studies. There are free online services such as http://centrial.org that help patients find studies to participate in and improve the current diagnostic definitions of ADHD.

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@Sony_Sherpa I am a newbie here but I have had over a week experience. So I feel free to welcome you.

I am very emotional. I can become sad or happy very quickly but there is always a “trigger” for it. When I changed doctors we agreed to focus on the ADHD issues and see if the depression and anxiety solved themselves.

I was watching a TV program about a man that makes orthopedic appliances for animals. Seeing a dog run for the first time in her life made me happy cry. The joy that the dog expressed was so touching.

I think my emotional behavior is like an emotional hyperactivity. I lack control as some people can not sit still. I also am very sensitive about how others feel.

I have pain issues that can cause me to be very depressed. I think it maybe caused by brain :brain: chemistry. Time to do some research.

Welcome again.

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Welcome to the HowToADHD forums @Sony_Sherpa ! It’s always nice to have someone new join the conversation :slightly_smiling_face:.

This interests me. I often nerd-out over interesting research. :nerd_face: I would definitely consider being part of a research study.

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Have you heard the concept of the Highly Sensitive Person (HSP)? It is an explanation why some people are more sensitive (emotional, physical, &/or sensory…usually a combination of them).

  • There is psychological research into into it going back at least a couple of decades, mostly spearheaded by Elaine M. Aron, PhD. However, it is not included in the DSM, and thus less likely to be given as a diagnosis.

I found an interesting take by a therapist who has ADHD and identifies as an HSP showing the similarities and differences between the two. The Surprising Truth About HSP And ADHD

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I find that the alphabet soup frustrating and interesting at the same time. I have been diagnosed with depression and anxiety. Then I asked about ADHD and was diagnosed. I am afraid to bring up HSP or dyspraxia since I fit those symptoms also. I think all of this fits ADHD.

I also remember the symptoms all my life. I never crawled, I learned to read late, poor speller, could not memorize my times tables, needed to doodle to focus on teachers, organized by color, 99 percentile in visual perception, 1 percentile in spelling, bumped into things, tripped, startled easily, could focus on art work for hours. I was overwhelmed by sound, textures, crowds. I have physical problems with tendinitis, arthritis, nerve damage.

Was it my leg length discrepancy, lazy eye, inner ear infections, being ambidextrous, since the other syndromes were not considered. I always felt my left side and right of my body did not get along.

I now need to figure out if there is a disorder that causes bad reactions to medications. I have had some of the strangest side effects.

I am ok with it all if I can manage my physical symptoms. My brain :brain: has ways to cope with the rest and I am learning more tricks as time goes on.

Yes I also over share which is a symptom of ADHD. (sigh)

image

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Well, I think there is one categorization for each and every member of the human race alive today (as well as all who have lived, and all who ever will):
U.N.I.Q.U.E.

My favorite quote from “Robin Hood: Prince of Thieves” was Morgan Freeman’s character’s response to a little English girl about why God “painted” him:
“Because Allah loves wonderous variety.”

No two of us are truly alike. No matter the similarities between people, we will have differences. No matter our differences, we all have similarities. We’re all a part of this rich tapestry of humanity, full of so much wonder and variety.

…and I wouldn’t have it any other way!!!
:grin:

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