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Background: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms. Methods: A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 618 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned four-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively. Results: Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate-to-low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account. Conclusions: The neuropsychological parameters examined, herein, predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD cannot be explained by these cognitive or motivational deficits. Alternative mechanisms, including overlapping genetic influences (pleiotropic effects) and/or alternative neuropsychological processes need to be considered.
Keywords
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, DEFICIT HYPERACTIVITY DISORDER, COGNITIVE-ENERGETIC MODEL, LARGE MULTICENTER ADHD, FAMILY RISK ANALYSIS, DELAY AVERSION, SELF-REGULATION, RESPONSE-INHIBITION, DIAGNOSTIC-APPROACH, CRITERION VALIDITY, ADHD, neuropsychological performance, emotional lability, executive functions, delay aversion

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Chicago
Banaschewski, Tobias, Christine Jennen-Steinmetz, Daniel Daniel Brandeis, Jan K Buitelaar, Jonna Kuntsi, Luise Poustka, Joseph A Sergeant, et al. 2012. “Neuropsychological Correlates of Emotional Lability in Children with ADHD.” Journal of Child Psychology and Psychiatry 53 (11): 1139–1148.
APA
Banaschewski, T., Jennen-Steinmetz, C., Daniel Brandeis, D., Buitelaar, J. K., Kuntsi, J., Poustka, L., Sergeant, J. A., et al. (2012). Neuropsychological correlates of emotional lability in children with ADHD. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY, 53(11), 1139–1148.
Vancouver
1.
Banaschewski T, Jennen-Steinmetz C, Daniel Brandeis D, Buitelaar JK, Kuntsi J, Poustka L, et al. Neuropsychological correlates of emotional lability in children with ADHD. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY. 2012;53(11):1139–48.
MLA
Banaschewski, Tobias, Christine Jennen-Steinmetz, Daniel Daniel Brandeis, et al. “Neuropsychological Correlates of Emotional Lability in Children with ADHD.” JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY 53.11 (2012): 1139–1148. Print.
@article{2961390,
  abstract     = {Background: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms. Methods: A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 618 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned four-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively. Results: Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate-to-low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account. Conclusions: The neuropsychological parameters examined, herein, predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD cannot be explained by these cognitive or motivational deficits. Alternative mechanisms, including overlapping genetic influences (pleiotropic effects) and/or alternative neuropsychological processes need to be considered.},
  author       = {Banaschewski, Tobias and Jennen-Steinmetz, Christine and Daniel Brandeis, Daniel and Buitelaar, Jan K and Kuntsi, Jonna and Poustka, Luise and Sergeant, Joseph A and Barke, Edmund and Frazier-Wood, Alexis C and Albrecht, Bj{\"o}rn and Chen, Wai and Uebel, Henrik and Schlotz, Wolff and van der Meere, Jaap J and Gill, Michael and Manor, Iris and Miranda, Ana and Mulas, Fernando and Oades, Robert D and Roeyers, Herbert and Rothenberger, Aribert and Steinhausen, Hans-Christoph and Faraone, Stephen V and Asherson, Philip},
  issn         = {0021-9630},
  journal      = {JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY},
  keyword      = {ATTENTION-DEFICIT/HYPERACTIVITY DISORDER,DEFICIT HYPERACTIVITY DISORDER,COGNITIVE-ENERGETIC MODEL,LARGE MULTICENTER ADHD,FAMILY RISK ANALYSIS,DELAY AVERSION,SELF-REGULATION,RESPONSE-INHIBITION,DIAGNOSTIC-APPROACH,CRITERION VALIDITY,ADHD,neuropsychological performance,emotional lability,executive functions,delay aversion},
  language     = {eng},
  number       = {11},
  pages        = {1139--1148},
  title        = {Neuropsychological correlates of emotional lability in children with ADHD},
  url          = {http://dx.doi.org/10.1111/j.1469-7610.2012.02596.x},
  volume       = {53},
  year         = {2012},
}

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