Abstract Objective To study the mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder (ADHD). Methods Convenience cluster sampling was performed to select 435 eligible children with ADHD from 10 211 students in 10 elementary schools in Kashgar of Xinjiang Uygur Autonomous Region. SNAP-IV Assessment Scale, Emotion Regulation Questionnaire for Children and Adolescents, and Conners Parent Symptoms Questionnaire were used to obtain relevant information. The Spearman correlation analysis and the moderated mediation method were used for data analysis. Results For the children with ADHD, the score of cognitive reappraisal was negatively correlated with the scores of symptoms and anxiety problems (rs=-0.254 and -0.270 respectively, P<0.001), and the score of symptoms was positively correlated with the score of anxiety problems (rs=0.329, P<0.001). The analysis of mediating effect showed that cognitive reappraisal played a partial mediating role between symptoms and anxiety problems, with a 95% confidence interval of 0.008-0.027, and the mediating effect accounted for 16.10% of the total effect. In addition, sex played a regulatory role in this mediation model (P<0.001). Conclusions Cognitive reappraisal plays a mediating role between symptoms and anxiety problems in children with ADHD, while sex regulates the relationship of symptoms with cognitive reappraisal and anxiety problems in these children.
ZHONG Lin,ZHANG Jing,ZUO Peng-Xiang. The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder[J]. CJCP, 2023, 25(3): 259-264.
ZHONG Lin,ZHANG Jing,ZUO Peng-Xiang. The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder[J]. CJCP, 2023, 25(3): 259-264.
Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis[J]. BMC Psychiatry, 2017, 17(1): 32. PMID: 28103833. PMCID: PMC5244567. DOI: 10.1186/s12888-016-1187-9.
Weibel S, Menard O, Ionita A, et al. Practical considerations for the evaluation and management of attention deficit hyperactivity disorder (ADHD) in adults[J]. Encephale, 2020, 46(1): 30-40. PMID: 31610922. DOI: 10.1016/j.encep.2019.06.005.
Inci SB, Ipci M, Akyol Ard?? U, et al. Psychiatric comorbidity and demographic characteristics of 1,000 children and adolescents with ADHD in Turkey[J]. J Atten Disord, 2019, 23(11): 1356-1367. PMID: 27581245. DOI: 10.1177/1087054716666954.
D'Agati E, Curatolo P, Mazzone L. Comorbidity between ADHD and anxiety disorders across the lifespan[J]. Int J Psychiatry Clin Pract, 2019, 23(4): 238-244. PMID: 31232613. DOI: 10.1080/13651501.2019.1628277.
Viering T, Hoekstra PJ, Philipsen A, et al. Emotion dysregulation and integration of emotion-related brain networks affect intraindividual change in ADHD severity throughout late adolescence[J]. Neuroimage, 2021, 245: 118729. PMID: 34813971. DOI: 10.1016/j.neuroimage.2021.118729.
Cleminshaw CL, DuPaul GJ, Kipperman KL, et al. Social deficits in high school students with attention-deficit/hyperactivity disorder and the role of emotion dysregulation[J]. Sch Psychol, 2020, 35(4): 233-242. PMID: 32673052. DOI: 10.1037/spq0000392.
Predescu E, Sipos R, Costescu CA, et al. Executive functions and emotion regulation in attention-deficit/hyperactivity disorder and borderline intellectual disability[J]. J Clin Med, 2020, 9(4): 986. PMID: 32244788. PMCID: PMC7231040. DOI: 10.3390/jcm9040986.
Mohammadi MR, Zarafshan H, Khaleghi A, et al. Prevalence of ADHD and its comorbidities in a population-based sample[J]. J Atten Disord, 2021, 25(8): 1058-1067. PMID: 31833803. DOI: 10.1177/1087054719886372.
Bussing R, Fernandez M, Harwood M, et al. Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample[J]. Assessment, 2008, 15(3): 317-328. PMID: 18310593. PMCID: PMC3623293. DOI: 10.1177/1073191107313888.
14 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5[M]. 5th ed. Arlington, VA, USA: American Psychiatric Association, 2013: 55-57.
Hagstr?m J, Maigaard K, Pagsberg AK, et al. Reappraisal is an effective emotion regulation strategy in children with Tourette syndrome and ADHD[J]. J Behav Ther Exp Psychiatry, 2020, 68: 101541. PMID: 31855740. DOI: 10.1016/j.jbtep.2019.101541.
Kordahji H, Ben-David S, Elkana O. Attachment anxiety moderates the association between ADHD and psychological distress[J]. Psychiatr Q, 2021, 92(4): 1711-1724. PMID: 34245401. DOI: 10.1007/s11126-021-09919-6.
Cai RY, Richdale AL, Dissanayake C, et al. Emotion regulation in autism: reappraisal and suppression interactions[J]. Autism, 2019, 23(3): 737-749. PMID: 29792076. DOI: 10.1177/1362361318774558.
O'Neill S, Rudenstine S. Inattention, emotion dysregulation and impairment among urban, diverse adults seeking psychological treatment[J]. Psychiatry Res, 2019, 282: 112631. PMID: 31685283. DOI: 10.1016/j.psychres.2019.112631.
R?ll J, Koglin U, Petermann F. Emotion regulation and childhood aggression: longitudinal associations[J]. Child Psychiatry Hum Dev, 2012, 43(6): 909-923. PMID: 22528031. DOI: 10.1007/s10578-012-0303-4.
Preston T, Carr DC, Hajcak G, et al. Cognitive reappraisal, emotional suppression, and depressive and anxiety symptoms in later life: the moderating role of gender[J]. Aging Ment Health, 2022, 26(12): 2390-2398. PMID: 34842002. DOI: 10.1080/13607863.2021.1998350.