Emotion Dysregulation in Children with ADHD: Irritability is Associated with EEG-Measured Frontal Alpha Asymmetry in Response to Emotional Stimuli

TL;DR

This study shows that children with ADHD who are more irritable have a specific brain activity pattern when reacting to emotional images, suggesting a link between emotion regulation and brain function.

Contribution

The study provides new neurophysiological evidence linking irritability in ADHD to frontal alpha asymmetry in response to emotional stimuli.

Findings

Higher irritability in children with ADHD is associated with greater left frontal alpha asymmetry in response to emotional stimuli.

Early frontal alpha asymmetry (0-200 ms) is more strongly linked to irritability than later asymmetry (250–600 ms), indicating emotional impulsivity.

Lower alpha power over the left hemisphere suggests a stronger approach tendency in children with high irritability.

Abstract

A growing body of theoretical and empirical work supports an updated conceptualization of ADHD that includes emotion dysregulation as either a core feature or a specific subtype of the disorder; much of this work emphasizes emotions that are high in approach orientation, such as anger and high positive affect. This study sought to contribute to this body of work by examining relations between child- and parent-reported irritability and EEG biomarkers of emotion-related processing in 8- to 12-year-old children diagnosed with ADHD. We examined frontal alpha asymmetry (FAA), a neurophysiological index of the action tendency component of emotions, in response to emotionally evocative images, from 50 children. As expected, greater relative left FAA (reflecting greater approach tendency) in response to emotionally evocative (fearful and happy) stimuli was associated with higher irritability symptom levels. Early FAA (0-200 ms post-stimuli) was more strongly related to irritability than later FAA (250–600 ms post-stimuli), which supports the concept of emotional impulsivity. Furthermore, FAA findings seemed to be driven by lower alpha power over the left hemisphere, suggesting greater approach (vs. withdrawal) among those with high irritability. Overall, findings were consistent with previous research showing the impact of emotions in ADHD, and specifically of dimensions of irritability/anger-proneness and high positive affect. Findings build upon previous research by showing support at the neurophysiological level, and highlighting the importance of approach-related emotions, regardless of valence.