Evidence of Emotion Dysregulation as a Core Symptom of Adult ADHD: A Systematic Review

Author(s): Dr Jahan Zeb Khan, Dr Zeeshan Zafar.

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders, affecting approximately 5–7% of children and adolescents and 3–5% of adults. Traditionally defined by inattention, impulsivity, and hyperactivity, emerging evidence suggests that emotion dysregulation (ED) may represent a core feature of the disorder. ADHD is associated with executive function impairments, heterogeneous manifestations across the lifespan, and high rates of psychiatric comorbidity in adulthood, where diagnostic clarity remains challenging. Growing research indicates that emotional regulation deficits appear early in childhood ADHD and may persist into adulthood, although adult-specific data remain limited. This systematic review followed PRISMA guidelines and included empirical studies published in English involving adults (≥18 years) diagnosed with ADHD according to DSM-IV or later criteria and incorporating standardized emotion regulation measures. Database searches (EBSCOhost, PsycInfo, Medline, ERIC, PsycArticles, Psicodoc, Scopus) and supplementary Google Scholar screening yielded 231 studies, of which 22 met inclusion criteria. Findings were categorized into three domains: (1) studies examining measures and clinical features of emotion regulation in adults with ADHD; (2) studies investigating neurological and psychophysiological correlates of emotion regulation tasks; and (3) studies evaluating interventions targeting emotion regulation outcomes. The review highlights the growing recognition of ED as a clinically significant dimension of adult ADHD and underscores the need for greater diagnostic and therapeutic focus on emotional functioning in this population.