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Linking ADHD and ASD Symptomatology with Social Impairment: The Role of Emotion Dysregulation

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Abstract

Children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often experience social impairments. These children also frequently struggle with emotion regulation, and extant literature suggests that emotion dysregulation predicts social impairment in both clinical and neurotypical populations. However, the evidence base linking ADHD/ASD with social impairment comes primarily from samples meeting full diagnostic criteria for ADHD and/or ASD despite evidence that both syndromes reflect extreme ends of natural continuums that are normally distributed across the general population. To our knowledge, the present study is the first to concurrently examine unique and overlapping relations among ADHD/ASD symptoms, emotion regulation, and social difficulties using multi-informant measures (parent, teacher) with a clinically-evaluated sample of 108 children ages 8–13 (40 girls; 66% White/Non-Hispanic) with and without clinically-elevated ASD and ADHD symptoms and other common clinical disorders. Bias-corrected, bootstrapped conditional effects modeling revealed that ADHD-inattentive (β=-0.23) and ASD-social communication (β=-0.20) symptoms predicted social impairment directly, whereas ADHD-hyperactive/impulsive (β=-0.06) and ASD-restricted/repetitive behavior/interests (β=-0.06) symptoms predicted social impairment only via their shared associations with emotion dysregulation. Sensitivity analyses revealed that most relations were robust to control for item overlap across measures. In contrast, only the ADHD-inattention/social impairment link was robust to control for mono-informant bias, highlighting the importance of multi-informant methods and the potential for different determinants of social functioning across settings. Overall, this study implicates emotion regulation skills and all four ADHD/ASD symptom clusters as potential influences on children’s social functioning, albeit with a more nuanced and potentially setting-specific pattern than suggested by prior work.

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Notes

  1. Results of the primary model reported below were unchanged when medication status (N/Y) was explored as an additional covariate, with one exception: The indirect effect of ASD RRB symptoms on social competence via emotion dysregulation was no longer significant (95%CI includes 0.0) despite the point estimate changing minimally (Beta = − 0.061 vs. − 0.055). Medication status did not uniquely predict social competence or emotion regulation (95%CIs include 0.0). This sensitivity analysis was added during the peer review process and thus should be considered exploratory.

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Acknowledgements

This work was supported in part by NIH grants (R34 MH102499, R01 MH115048, PI: Kofler). The sponsor had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

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  1. Department of Psychology, Florida State University, 1107 W. Call Street, 32306, Tallahassee, FL, USA

    Emma M. Jaisle, Nicole B. Groves, Katie E. Black & Michael J. Kofler

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Jaisle, E.M., Groves, N.B., Black, K.E. et al. Linking ADHD and ASD Symptomatology with Social Impairment: The Role of Emotion Dysregulation. Res Child Adolesc Psychopathol 51, 3–16 (2023). https://doi.org/10.1007/s10802-022-00982-6

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