Lukito Steve, Chandler Susie, Kakoulidou Myrofora, Griffiths Kirsty, Wyatt Anna, Funnell Eloise, Pavlopoulou Georgia, Baker Sylvan, Stahl Daniel, Sonuga-Barke Edmund
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Group for Research in Relationships and Neurodiversity - GRRAND, Research in Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London, London, UK.
J Child Psychol Psychiatry. 2025 Oct;66(10):1577-1592. doi: 10.1111/jcpp.70003. Epub 2025 Jul 24.
Mental health problems are elevated in adolescents with ADHD and/or autism. Emotion regulation deficits (ERD) have been hypothesised as a key driver of such difficulties. The Regulating Emotions - Strengthening Adolescent Resilience (RE-STAR) programme is examining an alternative pathway from neurodivergence to mental health problems, mediated by elevated emotional burden (EB) resulting from the interplay of increased exposure and an unusually intense emotional reaction to commonly upsetting events (CUEs). We present the development and application of the My Emotions in School Inventory (MESI), a self-report questionnaire co-produced with neurodivergent young people, focusing on EB in schools - a setting thought to be of particular significance in this regard.
The MESI, containing 25 school-related CUEs rated on their frequency and the intensity of negative emotions they induce, was completed by secondary school students meeting symptom cut-offs on clinically validated scales of ADHD (n = 100), autism (n = 104), ADHD + autism (n = 79) and neurotypical students (n = 452). Psychometric properties were examined. The ability of the MESI to discriminate adolescents with ADHD and/or autism from neurotypical adolescents, and to predict depression and anxiety, independently of ERD, was explored.
Adolescents in the ADHD and/or autism groups experienced higher CUE frequency and intensity of reaction than their neurotypical peers. Overall levels of EB, most robustly indexed by 24 MESI CUEs, were higher in the three neurodivergent groups, though they did not differ from each other. EB in the autism and ADHD groups was generated by distinctly different CUEs. EB and ERD each contributed independently to the prediction of higher depression or anxiety.
Our findings illustrate the potential value of the MESI as an instrument to measure the contribution of EB alongside ERD in relation to adolescent mental health risks in ADHD and/or autism. Future studies need to investigate its role longitudinally.
患有注意力缺陷多动障碍（ADHD）和/或自闭症的青少年心理健康问题更为突出。情绪调节缺陷（ERD）被认为是导致这些困难的关键因素。调节情绪——增强青少年复原力（RE-STAR）项目正在研究一条从神经发育差异到心理健康问题的替代途径，该途径由因接触增加与对常见烦心事（CUEs）异常强烈的情绪反应相互作用而导致的情绪负担（EB）加重所介导。我们介绍了学校中我的情绪量表（MESI）的开发与应用，这是一份与神经发育差异的年轻人共同编制的自我报告问卷，重点关注学校中的EB——这一环境在这方面被认为具有特殊意义。
MESI包含25个与学校相关的CUEs，根据其发生频率和引发的负面情绪强度进行评分，由在ADHD（n = 100）、自闭症（n = 104）、ADHD + 自闭症（n = 79）临床验证量表上达到症状临界值的中学生以及神经典型学生（n = 452）完成。对其心理测量特性进行了检验。探讨了MESI区分ADHD和/或自闭症青少年与神经典型青少年，以及独立于ERD预测抑郁和焦虑的能力。
ADHD和/或自闭症组的青少年经历的CUE频率和反应强度高于他们的神经典型同龄人。三个神经发育差异组的EB总体水平更高，最有力的指标是24个MESI CUEs，不过它们之间没有差异。自闭症组和ADHD组的EB由明显不同的CUEs产生。EB和ERD各自独立地对更高的抑郁或焦虑预测有贡献。
我们的研究结果表明MESI作为一种工具，在测量EB与ERD对ADHD和/或自闭症青少年心理健康风险的贡献方面具有潜在价值。未来的研究需要纵向调查其作用。
