The Importance of Emotion in Understanding and Managing ADHD by Russell A. Barkley

Overview:

Current view of ADHD

History of emotional involvement in ADHD

Poor emotion regulation dates back to 1775 in ADHD
DSM-II eliminates emotional dysregulation from ADHD

Neuroanatomy of ADHD

Damage to the anterior cingulate cortex

Neuropsychology of ADHD

Involvement of “hot” emotional executive circuits

Review of psychological evidence

Emotional impulsivity
Emotional self-regulation

Unique contribution of emotional impulsivity to disability

The role of emotional impulsivity

Risk of coexisting rebellious and challenging disability

Implications of emotional dysregulation for diagnosis

Impact of poor emotional self-regulation on treatment

Explanation:

ADHD is now understood to be a disorder of attention, impulsivity, and hyperactivity that usually occurs in childhood or early adolescence, and most often persists for a long time. However, emotions have always been included in the conceptualization of disability until the 1970s, since the first medical paper was published in ADHD in 1798. Starting with DSM-II and up to the present, emotional dysregulation has been excluded from the clinical concept and diagnostic criteria of the disease and driven to the consequences of related problems or comorbidities.

This presentation reviews evidence from history, neuropsychology, neuroanatomy, and observational studies showing that emotional impulsivity and defective emotional self-regulation are integral parts of ADHD. Returning emotions to their legitimate place as a core function of disability also helps explain co-morbidities such as counter-resistive disorders and various life course disorders. Dr. Berkeley, an internationally recognized authority on ADHD, argued which aspects of the emotional adaptation problem in ADHD cases were likely to be the result of disability and possibly comorbidities or other life course situations. Discuss how to make a decision. He also addresses the implications of including emotions in ADHD for its management.