Cao Xiaolan, Wu Zhaomin, Liu Juan, Li Ying, Zhang Linlin, Wang Yufeng, Yang Binrang
Children's Healthcare and Mental Health Center, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China.
Children's Healthcare and Mental Health Center, Affiliated Shenzhen Children's Hospital of Shantou University Medical College, Shenzhen, Guangdong, People's Republic of China.
Psychol Res Behav Manag. 2025 Sep 10;18:1957-1968. doi: 10.2147/PRBM.S535898. eCollection 2025.
Emotional lability (EL), characterized by excessive emotional fluctuations and intense outbursts, frequently co-occurs with attention deficit hyperactivity disorder (ADHD) and may exacerbate functional impairments. This study aimed to explore the disparities in ADHD-related symptoms and functional impairments in children with ADHD who exhibited EL and those without it and to examine the unique contribution of EL to functional impairments.
A total of 427 children with ADHD, aged 6-14 years, were recruited from Shenzhen Children's Hospital. EL was assessed using the Conners'Parent Rating Scale, while ADHD-related symptoms were measured using the ADHD Rating Scale (ADHD-RS) and Child Behavior Checklist (CBCL). Functional impairment was assessed using the Weiss Functional Impairment Scale-Parent Form (WFIRS-P). Group comparisons were conducted between ADHD with EL and ADHD without EL, and correlations and multiple linear regressions were performed to explore the associations between EL, ADHD-related symptoms, and functional impairment.
EL prevalence in the study sample was 33.96%. Children with ADHD and EL exhibited significantly higher scores for inattention (P<0.001), hyperactivity/impulsivity (P<0.001), CBCL factors (P<0.001), and all domains of functional impairment (P<0.05) than those without EL. The two groups differed substantially in their distribution of ADHD subtypes (P=0.012). Moderate correlations were found between EL and functional impairment (r=0.40-0.45, P<0.001). After adjusting for ADHD-related symptoms, EL independently predicted impairments in family (P=0.001), life skills (P=0.001), self-concept domains (P=0.001), and total functional impairment (P=0.002). EL, along with attention scores, social problems, and delinquent behaviors, significantly predicted the overall functional impairment.
EL is a significant contributor to functional impairment in children with ADHD, exerting its influence independently of the core symptoms of ADHD. Our findings highlight the need for targeted interventions to address emotional regulation in ADHD and mitigate long-term functional impairments.
情绪不稳定（EL）的特征是情绪过度波动和强烈爆发，常与注意力缺陷多动障碍（ADHD）同时出现，并可能加剧功能损害。本研究旨在探讨有EL的ADHD儿童和无EL的ADHD儿童在ADHD相关症状和功能损害方面的差异，并检验EL对功能损害的独特影响。
从深圳儿童医院招募了427名6 - 14岁的ADHD儿童。使用康纳斯父母评定量表评估EL，同时使用ADHD评定量表（ADHD-RS）和儿童行为清单（CBCL）测量ADHD相关症状。使用韦斯功能损害量表家长版（WFIRS-P）评估功能损害。对有EL的ADHD组和无EL的ADHD组进行组间比较，并进行相关性和多元线性回归分析，以探讨EL、ADHD相关症状和功能损害之间的关联。
研究样本中EL的患病率为33.96%。与无EL的儿童相比，有ADHD且有EL的儿童在注意力不集中（P<0.001）、多动/冲动（P<0.001）、CBCL因子（P<0.001）以及所有功能损害领域（P<0.05）的得分显著更高。两组在ADHD亚型分布上有显著差异（P = 0.012）。EL与功能损害之间存在中等程度的相关性（r = 0.40 - 0.45，P<0.001）。在调整ADHD相关症状后，EL独立预测家庭功能损害（P = 0.001）、生活技能损害（P = 0.001）、自我概念领域损害（P = 0.001）和总体功能损害（P = 0.002）。EL与注意力得分、社交问题和违纪行为一起，显著预测了总体功能损害。
EL是ADHD儿童功能损害的重要因素，其影响独立于ADHD的核心症状。我们的研究结果强调了针对ADHD儿童情绪调节进行有针对性干预以减轻长期功能损害的必要性。
