Deficient Emotional Self-Regulation and Adult Attention Deficit Hyperactivity Disorder: A Family Risk Analysis
Publication: American Journal of Psychiatry
Abstract
Objective:
A growing body of research suggests that deficient emotional self-regulation (DESR) is prevalent and morbid among patients with attention deficit hyperactivity disorder (ADHD). Family studies provide a method of clarifying the co-occurrence of clinical features, but no family studies have yet addressed ADHD and DESR.
Method:
Participants were 83 probands with and without ADHD and 128 siblings. All were assessed for axis I DSM-IV conditions with structured diagnostic interviews. The authors defined DESR in adult probands and siblings using items from the Barkley Current Behavior Scale. Analyses tested hypotheses about the familial relationship between ADHD and DESR.
Results:
Siblings of ADHD probands were at elevated risk of having ADHD, irrespective of the presence or absence of DESR in the proband. The risk for DESR was elevated in siblings of ADHD plus DESR probands but not in siblings of ADHD probands. ADHD and DESR cosegregated in siblings. The risk for other psychiatric disorders was similar in siblings of the ADHD proband groups.
Conclusions:
The pattern of inheritance of ADHD with DESR preliminarily suggests that DESR may be a familial subtype of ADHD. Our data suggest that DESR is not an expression of other axis I DSM-IV disorders or of nonfamilial environmental factors. The authors cannot exclude contribution of non-axis-I DSM-IV disorders to risk for DESR and cannot determine whether the cosegregation of ADHD in DESR within families is a result of genes or familial environmental risk factors. Further investigation of DESR and its correlates and treatment both in and outside the context of ADHD is warranted.
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History
Received: 18 August 2010
Revision received: 9 November 2010
Revision received: 6 December 2010
Accepted: 13 December 2010
Published online: 1 June 2011
Published in print: June 2011
Authors
Funding Information
Dr. Surman has received research support from Abbott, Alza, Cephalon, Eli Lilly, the Hilda and Preston Davis Foundation, McNeil, Merck, the National Institutes of Health, New River, Organon, Pfizer, Shire, and Takeda; he has been sponsored by Janssen-Ortho, McNeil, Novartis, and Shire for speaking and educational activities and has been a consultant/advisor to McNeil, Shire, and Takeda; and he has received honoraria from Reed Medical Education (a logistics collaborator for the Massachusetts General Hospital Psychiatry Academy [commercial entities supporting the Massachusetts General Hospital Psychiatry Academy are listed on the Academy's website, http://www.mghcme.org]). Dr. Biederman is currently receiving research support from Elminda, Janssen, McNeil, and Shire; in 2010, he received a speaker's fee from Fundación Dr. Manuel Camelo A.C. and honoraria from the Massachusetts General Hospital Psychiatry Academy for a tuition-funded CME course; in 2009, he received speaker's fees from Fundacion Areces, Medice Pharmaceuticals, and the Spanish Child Psychiatry Association; in previous years, he received research support, consultation fees, or speaker's fees from Abbott, Alza, AstraZeneca, Bristol-Myers Squibb, Celltech, Cephalon, Eli Lilly, Esai, Forest, GlaxoSmithKline, Gliatech, Janssen, McNeil, Merck, NARSAD, the National Institute of Child Health and Human Development, the National Institute on Drug Abuse, the National Institute of Mental Health, Neurosearch, New River, Novartis, Noven,Organon, Otsuka, Pfizer, Pharmacia, the Prechter Foundation, Shire, the Stanley Foundation, UCB Pharma, and Wyeth. Dr. Spencer has received research support from, has served as a speaker or on a speaker's bureau for, or has been an advisor or served on an advisory board for Cephalon, Eli Lilly, Glaxo-SmithKline, Janssen, McNeil, the National Institutes of Mental Health, Novartis, Pfizer, and Shire. In the past year, Dr. Faraone has received consulting fees from and served on advisory boards for Shire Development in addition to receiving research support from the National Institutes of Health and Shire; in previous years, he received consulting fees from or served on advisory boards of or participated in continuing medical education programs sponsored by Eli Lilly, Janssen, McNeil, Novartis, Pfizer, and Shire; he has also received research support from Eli Lilly, the National Institutes of Health, Pfizer, and Shire; and he receives royalties from a book published by Guilford Press. Ms. Yorks, Ms. Miller, and Mr. Petty report no financial relationships with commercial interests.Supported in part by National Institutes of Health grant R01MH-57934 (Dr. Faraone) and a grant from Shire Pharmaceuticals.
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