Conflict of interest statement: The authors have no competing interests related to this work. For further disclosures, please see online supplementary material.
Neuropsychological correlates of emotional lability in children with ADHD
Version of Record online: 6 AUG 2012
© 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health
Journal of Child Psychology and Psychiatry
Special Issue: Mood dysregulation in child and adolescent psychopathology issue
Volume 53, Issue 11, pages 1139–1148, November 2012
How to Cite
Banaschewski, T., Jennen-Steinmetz, C., Brandeis, D., Buitelaar, J. K., Kuntsi, J., Poustka, L., Sergeant, J. A., Sonuga-Barke, E. J., Frazier-Wood, A. C., Albrecht, B., Chen, W., Uebel, H., Schlotz, W., van der Meere, J. J., Gill, M., Manor, I., Miranda, A., Mulas, F., Oades, R. D., Roeyers, H., Rothenberger, A., Steinhausen, H.-C., Faraone, S. V. and Asherson, P. (2012), Neuropsychological correlates of emotional lability in children with ADHD. Journal of Child Psychology and Psychiatry, 53: 1139–1148. doi: 10.1111/j.1469-7610.2012.02596.x
- Issue online: 15 OCT 2012
- Version of Record online: 6 AUG 2012
- Accepted for publication: 25 June 2012
- neuropsychological performance;
- emotional lability;
- executive functions;
- delay aversion
Background: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms.
Methods: A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 6–18 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned four-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively.
Results: Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate-to-low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account.
Conclusions: The neuropsychological parameters examined, herein, predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD cannot be explained by these cognitive or motivational deficits. Alternative mechanisms, including overlapping genetic influences (pleiotropic effects) and/or alternative neuropsychological processes need to be considered.