Exploring deficient emotion regulation in adult ADHD: electrophysiological evidence

  • Anna Shushakova
  • Patricia Ohrmann
  • Anya Pedersen
Original Paper


Emotional dysregulation (ED) is being increasingly recognized as a core feature of attention-deficit/hyperactivity disorder (ADHD), but the pathophysiological underpinnings remain unclear. In this study, we provide meaningful electrophysiological evidence of ED in adult patients with ADHD (n = 39) compared to healthy controls (n = 40) by exploring the electrophysiological correlates of the emotion regulation strategies reappraisal, distraction, and expressive suppression. Event-related potentials (ERPs) were recorded during passive viewing of neutral and negative images, as well as during emotion regulation. The patients with ADHD exhibited increased frontal late positive potential (LPP) amplitudes during passive viewing of the aversive images and during emotion regulation. Compared with the healthy controls, a subgroup of medication-naïve patients with ADHD (n = 25) also exhibited larger centroparietal LPP amplitudes and provided more negative ratings of the aversive and neutral images. Both the frontal and centroparietal LPP amplitudes were associated with ADHD symptom severity. However, no significant deficit in LPP modulation during emotion regulation was found. These findings strongly support the clinical observation of increased emotional responsivity toward negative stimuli and difficulty during the implementation of emotion regulation strategies and thus encourage the implementation of emotion regulation modules in the treatment of adult patients with ADHD.


Reappraisal Distraction Expressive suppression Late positive potential EEG/ERP 



The authors would like to thank Claudia Schmidt and David Jendryczko for their support during data acquisition.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


This work was supported by the Deutsche Forschungsgemeinschaft (DFG, PE 1882/2-1).


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Authors and Affiliations

  1. 1.Clinical Psychology and Psychotherapy, Department of PsychologyUniversity of KielKielGermany
  2. 2.Clinical Psychology and Psychotherapy, Department of PsychologyUniversity of MünsterMünsterGermany
  3. 3.Department of Psychiatry, School of MedicineUniversity of MünsterMünsterGermany

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