All That Emotion? Researchers Suggest It Should Be Diagnostic for ADHD

There has been a lot of buzz about emotional dysregulation and ADHD lately – as there should be.  It was hot at the CHADD 2019 conference on ADHD.  Dr. Dodson has become famous suggesting virtually everyone with ADHD has something he calls ‘Rejection Sensitive Dysphoria’ meaning that they organize their responses to others based in trying to avoid rejection.  (For more on RSD, go to this page.)  As early as 2014 research suggested emotional lability is a ‘core characteristic’ of ADHD.

While emotionality is up front and center for many with ADHD, Rejection Sensitive Dysphoria never really fit with what I observed in my own family or with many of my ADHD clients.  Some are highly sensitive to rejection and criticism (which they view as a form of rejection) while others are generally ‘chill.’

And while the inattentive vs. hyperactive split found in the current diagnostic manual (the DSM-V) is easy to observe, many (not all!) lose their hyperactivity by adulthood.  Making it hard to utilize for determining effective treatment.

Now it seems there may be a better way to classify types of ADHD people have – as an inattentive type and an emotional dysregulation type.  The research, which was published in the Journal of Clinical Psychology separates those who have high levels of attention issues (distraction; organization, etc.) but little emotional dysregulation from those who have high levels of emotional over-reactivity and attention issues.

Besides helping improve the reliability of diagnosis, this also may provide information for treatment.  Patients in the emotional dysregulation group responded particularly well to methylphenidate and atomoxetine.

For some additional information about this research, go to this research overview.