Liu Qianrong, Feng Yuan, Chen Wai, Zhu Yu, Preece David A, Gao Yuan, Luo Xiangsheng, Dang Chen, Wang Yufeng, Sun Li, Liu Lu
NHC Key Laboratory of Mental Health (Peking University), Peking University Sixth Hospital, Institute of Mental Health, Beijing, 100191, China.
National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
Eur Child Adolesc Psychiatry. 2025 Jan 17. doi: 10.1007/s00787-025-02643-7.
Important associations between emotional dysregulation (ED) and ADHD have been identified in adults, with a key manifestation of this being differential use of emotion regulation strategies: reduced use of cognitive reappraisal (CR), but elevated expressive suppression (ES). These associations have been observed at both behavioral and neuroimaging levels. The present study aims to explore the use of CR and ES in children with ADHD, and their relationship to ED. 148 children with ADHD and 265 healthy controls (age 9-16 years) were recruited and evaluated and correlated their ED, CR, and ES. Resting-state fMRI functional connectivity, with 6 amygdala subregions as regions-of-interest, were analyzed in a subsample to identify potential neural correlates. Children with ADHD showed significant higher ED, and lower use of both CR and ES. A significant negative correlation was found between CR and ED. Mediation analysis indicated that CR has an indirect influence on the relationship between ADHD diagnosis and ED. In the neuroimaging analyses, the functional connectivity between the right superficial amygdala and left middle occipital gyrus showed a significant group-by-ES interaction, highlighting potential neural correlates for elevated ED in children with ADHD. Children with ADHD expressed elevated levels of ED, and used less CR and ES compared to healthy controls. The lower use of ES may relate to abnormal amygdala connectivity in children with ADHD. This finding suggested that brain immaturity in children may preclude effective deployment of ES in emotion regulation processes.
成人中已发现情绪调节障碍（ED）与注意力缺陷多动障碍（ADHD）之间存在重要关联，其一个关键表现是情绪调节策略的差异使用：认知重评（CR）的使用减少，但表达抑制（ES）增加。这些关联在行为和神经影像学层面均有观察到。本研究旨在探讨ADHD儿童中CR和ES的使用情况及其与ED的关系。招募了148名ADHD儿童和265名健康对照（年龄9 - 16岁），对他们的ED、CR和ES进行评估并进行相关性分析。在一个子样本中分析了以6个杏仁核亚区域为感兴趣区域的静息态功能磁共振成像功能连接，以确定潜在的神经关联。ADHD儿童表现出显著更高的ED，且CR和ES的使用均较低。发现CR与ED之间存在显著负相关。中介分析表明，CR对ADHD诊断与ED之间的关系有间接影响。在神经影像学分析中，右侧浅表杏仁核与左侧枕中回之间的功能连接显示出显著的组间 - ES交互作用，突出了ADHD儿童中ED升高的潜在神经关联。与健康对照相比，ADHD儿童表现出更高水平的ED，且使用CR和ES较少。ES使用较少可能与ADHD儿童杏仁核连接异常有关。这一发现表明，儿童大脑不成熟可能妨碍在情绪调节过程中有效部署ES。
