Siblings may have more influence on each other than previously imagined.
New research has discovered that individuals who have a sibling with both attention deficit hyperactivity disorder (ADHD) and deficient emotional self-regulation (DESR) face a greater risk of developing both conditions than do siblings of those with ADHD alone.
Deficient emotional self-regulation means displaying excessive emotional reactions to everyday events or situations.
“Our research offers strong evidence that heritable factors influence how we control our emotions,” said lead author Craig Surman, MD, of the Massachusetts General Hospital’s Pediatric Psychopharmacology and Adult ADHD Program.
“Emotion and capacities such as the ability to pay attention or control physical movement are probably under forms of brain control that we are just beginning to understand.
“Our findings also indicate that ADHD doesn’t just impact things like reading, listening and getting the bills paid on time; it also can impact how people regulate themselves more broadly, including their emotional expression.”
Many individuals with attention deficit disorder often display high levels of frustration, anger and impatience along with the typical symptoms of trouble paying attention, excessive physical activity and poor impulse control.
Different from mood disorders, which include the persistence of certain emotions and behaviors, DESR involves brief emotional outbursts to situations that would generally elicit a similar response, but in a less extreme manner. For example, a person with DESR might consistently react to small disappointments by snapping at family members or co-workers.
Although some researchers have suggested that poor emotional control be included as one of the defining symptoms of ADHD, other studies have not clarified whether the two conditions are separate disorders that appear together by chance or if they are related. It was also unknown whether DESR is transmitted among family members, which is the case for ADHD.
The study began with 83 volunteers — 23 with ADHD alone, 27 with ADHD plus deficient emotional self-regulation (DESR), and 33 healthy controls — and then one or more siblings of each of the original participants were recruited as well. Investigators interviewed all participants to determine whether they met the criteria for ADHD and other mental health conditions.
Diagnoses were confirmed by experts who were unaware of participants’ diagnoses or their sibling status. Study participants reported any DESR-associated symptoms and were given DESR status if their control of emotional reactions was worse than that of 95 percent of a large group of individuals without ADHD, which included the comparison sample in this study.
The study showed that ADHD was more common in the siblings of original participants with ADHD than in the control group. However, co-occurrence of both ADHD and DESR was found almost exclusively in siblings of the original participants who had both disorders.
“Other research that we and another group have conducted found that individuals with ADHD who also display emotional overreaction have a reduced quality of life and difficulties with personal relationships and social success,” Surman said.
“Studies have shown that 4 percent of the adult population has ADHD, and this investigation is part of a larger study that found DESR in more than half of the enrolled adults with ADHD, suggesting that roughly 5 million adults in the U.S. may have the combination of ADHD and poor emotional control.”
“Increased recognition of emotional dysregulation, its frequency in adults with ADHD and the potential consequences of both conditions will help people get support for these challenges. Future research needs to examine both medication- and non-medication-based therapies and improve our understanding of who could benefit from these therapies,” he said.
The study appears in the American Journal of Psychiatry.
Source: Massachusetts General Hospital