Physiological Emotion Regulation in Children with ADHD with and without Comorbid Internalizing Disorders: a Preliminary Study

  • Kirsten D. LeaberryEmail author
  • Paul J. Rosen
  • Nicholas D. Fogleman
  • Danielle M. Walerius
  • Kelly E. Slaughter


Children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience deficits in emotion regulation that can be measured physiologically under environmental stress conditions by examining respiratory sinus arrhythmia (RSA), a marker of parasympathetic nervous system (PNS) withdrawal. The current pilot study examined the impact of comorbid internalizing disorders and comorbid Oppositional Defiant Disorder (ODD) on emotion regulation in children with ADHD by measuring RSA as an indicator of dysregulated emotional reactivity. Twenty-four 7–10 year old children with ADHD participated in the current study. Children completed a 5-min resting attending baseline while electrocardiogram data (ECG) were recorded to examine baseline RSA. Children then completed a stress inducing, blocked goal, Card Sorting Task to measure RSA reactivity to stress. Results revealed a significant effect of internalizing disorder status on RSA difference score, F (1, 18) = 5.83, p = .03, η2 = .25. Children in the comorbid internalizing disorder group had a significantly greater decrease in RSA from the baseline time period to the card sorting task. There was no significant effect of ODD diagnostic status on RSA difference score, p > .05. The results of this preliminary study suggest that among children with ADHD, the presence of a comorbid internalizing disorder predicts greater withdrawal of the PNS. These findings represent an important step in understanding autonomic functioning of children with ADHD and comorbid disorders.


Physiological emotion regulation Attention-deficit/hyperactivity disorder Internalizing disorders Stress reactivity 


Author Contributions

All authors contributed significantly to the revision of this manuscript.


The authors received no financial support for the research, authorship, and/or publication of this article.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Conflict of Interest

Kirsten D. Leaberry, Paul J. Rosen, Nicholas D. Fogleman, Danielle M. Walerius, and Kelly E. Slaughter declare that they have no conflict of interest.

Experimental Participants

This article contains studies with human participants. Experimental participants provided informed consent for study participation.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kirsten D. Leaberry
    • 1
    Email author
  • Paul J. Rosen
    • 1
  • Nicholas D. Fogleman
    • 1
  • Danielle M. Walerius
    • 1
  • Kelly E. Slaughter
    • 1
  1. 1.Department of Psychological and Brain SciencesUniversity of LouisvilleLouisvilleUSA

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