# Adaptive and maladaptive cognitive emotion regulation in child- and adolescent ADHD

**Authors:** Rebecka Astenvald, Matilda A. Frick, Johan Lundin Kleberg, Johan Isaksson

PMC · DOI: 10.1016/j.ijchp.2025.100660 · 2026-01-08

## TL;DR

Children and adolescents with ADHD use fewer adaptive emotion regulation strategies and more maladaptive ones, but these effects may be linked to depressive symptoms rather than ADHD itself.

## Contribution

This study explores cognitive emotion regulation in ADHD, identifying associations with depressive symptoms and acceptance strategies.

## Key findings

- ADHD was linked to lower self-rated and task-specific use of adaptive strategies.
- ADHD was associated with higher self-rated use of maladaptive strategies.
- Lower self-rated acceptance was robustly linked to ADHD.

## Abstract

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience difficulties with emotion regulation. Specific use of cognitive emotion regulation strategies may contribute to these challenges, albeit research in this area remain limited.

Self-rated and task-specific use of adaptive and maladaptive cognitive emotion regulation strategies was assessed in children and adolescents with ADHD and typically developing controls (N=176, 10–17 years, 55.1% girls; subsample for self-rated use: N=94, 13–17 years, 61.7% girls). Self-rated use was measured with the short version of the Cognitive Emotion Regulation Questionnaire. Task-specific use was assessed by an experimental task involving viewing emotion-eliciting photos. Regression analyses were utilized to assess associations between ADHD and cognitive emotion regulation. Effects of sex and age were explored. Adjustments were made for co-occurring psychiatric symptoms.

ADHD was associated with lower self-rated (β =-0.21, p = .044) and task-specific (β =-0.09, p = .015) use of adaptive strategies, and greater use of self-rated maladaptive strategies (β =0.27, p = .010). No associations remained after adjusting for co-occurring psychiatric symptoms and multiple comparisons. Rather, depressive symptoms may contribute to the self-rated use of maladaptive strategies. Post-hoc analyses revealed that ADHD was robustly linked to less self-rated use of acceptance (β =-0.38, p = .005).

Lower use of self-rated acceptance may be characteristic for ADHD. Depressive symptoms may play a more vital role for maladaptive cognitive emotion regulation than ADHD. More studies are needed to explore the longitudinal relation between ADHD, emotion regulation and depression.

## Linked entities

- **Diseases:** attention-deficit/hyperactivity disorder (MONDO:0007743), depression (MONDO:0002050)

## Full-text entities

- **Diseases:** Depressive symptoms (MESH:D003866), psychiatric symptoms (MESH:D001523), ADHD (MESH:D001289)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12813563/full.md

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Source: https://tomesphere.com/paper/PMC12813563