Does emotion dysregulation mediate the association between ADHD symptoms and internalizing problems? A longitudinal within-person analysis in a large population-representative study
Background: Previous research has suggested that children with attention-deficit/hyperactivity disorder (ADHD) symptoms commonly show emotion dysregulation difficulties. It has been suggested that these difficulties may partly explain the substantial co-occurrence of internalizing problems such as anxiety and depression with ADHD symptoms. However, no study has yet provided a longitudinal analysis of the within-person links between ADHD symptoms, emotion dysregulation, and internalizing problems necessary to determine if emotion dysregulation mediates the links between ADHD symptoms and internalizing problems. Methods: We used data from three waves (age 3,5, and 7) of the large UK population-representative Millennium Cohort Study (n = 9619, 4885 males) and fit an autoregressive latent trajectory model with structured residuals (ALT-SR) to disaggregate within- and between-person relations between ADHD, emotion dysregulation, and internalizing problem symptoms. Results: Consistent with our hypothesis, we found that emotion dysregulation significantly mediated the longitudinal within-person association between ADHD symptoms and internalizing problems. Conclusions: Results underline the promise of targeting emotion dysregulation as a means of preventing internalizing problems co-occurring with ADHD symptoms.