Sobanski, E., Banaschewski, T., Asherson, P., Buitelaar, J. K., Chen, W., Franke, B., Holtmann, M., Krumm, B., Sergeant, J. A., Sonuga-Barke, E. J. S., Stringaris, A. K., Taylor, E.A., Anney, R. J. L., Ebstein, R. P., Gill, M., Miranda, A., Mulas, F., Oades, R. D., Roeyers, H., Rothenberger, A., Steinhausen, H-C., & Faraone, S. V.

Emotional lability in children and adolescents with Attention Deficit/Hyperactivity Disorder (ADHD): Clinical correlates and familial prevalence. Journal of Child Psychology and Psychiatry, 51, 915-923.doi:10.1111/j.1469-7610.2010.02217.x [Request a copy] - View Article

Introduction: This article provides data on the prevalence, severity and clinical correlates of emotional lability (EL) in children & adolescents with ADHD. Further it explores the range of predictive factors contributing to EL in ADHD & investigates familiality of EL in ADHD.

Methods: From the IMAGE consortium 1186 clinically referred children with ADHD-combined type, and 1827 siblings (6-18y) were compared on the basis of a clincal interview and parent and teacher ratings of psychopathology - (SDQ; CPRS-R:L; CTRS-R:L). Analyses of variance, regression analyses, c2-tests or loglinear models were applied .

1 -
Severity of EL was significantly higher in the ADHD group with respect to their siblings -- Mean age-gender standardized ratings of EL in ADHD were > 1.5 SD above the mean in normative samples.

2 - Severity of EL was correlated with severity of ADHD & most strongly with the severity of hyperactive-impulsive symptoms.

3 - Severe EL was associated with the highest rates of comorbid oppositional-defiant and conduct disorders, depression and substance-use disorders.

4 - Age, hyperactive-impulsive, oppositional, & emotional symptoms accounted for 30% of the variance in EL.

5 - Hyperactive-impulsive symptoms did not account for EL variance when co-existing oppositional & emotional problems were taken into account, but oppositional symptoms explained 12% of EL variance specifically.

6 - Severity of EL in probands increased the severity of EL in siblings, but not the prevalence rates of ADHD or ODD.

7 - EL & ADHD do not co-segregate within families. -- EL is a frequent clinical problem in children with ADHD.

Discussion: a) Severe EL is associated with increased severity of ADHD core symptoms and additional psychopathology (oppositional, affect & substance-use). b) Severe EL symptoms are transmitted within ADHD-families; they are only partly explicable in terms of comorbid oppositional or affective symptoms and the severity of hyperactive-impulsive symptoms. c) EL in ADHD seems to be more closely related to ODD than to ADHD core symptoms, and is only partly explainable by the severity of ADHD core symptoms & associated psychopathology. d) Although EL symptoms are transmitted within families, EL in children with ADHD does not increase the risk of ADHD & ODD in their siblings.

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