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      Executive Functions and Emotion Regulation in Attention-Deficit/Hyperactivity Disorder and Borderline Intellectual Disability

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          Abstract

          The main objective of this study is to investigate the multiple relations and to determine the differences between executive functions (EFs), emotion regulation, and behavioral and emotional problems in children with attention-deficit/hyperactivity disorder (ADHD), borderline intellectual disability (ID), and typical development (TD). The sample included 85 children aged 6 to 11 years, 42 with typical development (TD), 27 with ADHD, and 16 with borderline ID. The results emphasized a positive correlation between adaptive emotion regulation strategies and EFs, and no significant relations between the maladaptive emotion regulation strategies and EFs. In addition, the executive function of planning correlated negatively with anxiety, ADHD symptoms, and conduct problems. The performance of both clinical groups regarding EFs was significantly lower than that of the TD group, and they differed significantly from each other only on visual attention. The presence of oppositional-defiant and conduct problems was higher in both clinical groups than in the TD group, and more anxiety symptoms were reported in children with ADHD. This study supports the idea that emotion regulation, Efs, and clinical symptoms are interconnected. It also profiles the deficits in cognitive functioning and emotion regulation in two clinical groups, thus helping future intervention programs.

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          Executive Functions

          Executive functions (EFs) make possible mentally playing with ideas; taking the time to think before acting; meeting novel, unanticipated challenges; resisting temptations; and staying focused. Core EFs are inhibition [response inhibition (self-control—resisting temptations and resisting acting impulsively) and interference control (selective attention and cognitive inhibition)], working memory, and cognitive flexibility (including creatively thinking “outside the box,” seeing anything from different perspectives, and quickly and flexibly adapting to changed circumstances). The developmental progression and representative measures of each are discussed. Controversies are addressed (e.g., the relation between EFs and fluid intelligence, self-regulation, executive attention, and effortful control, and the relation between working memory and inhibition and attention). The importance of social, emotional, and physical health for cognitive health is discussed because stress, lack of sleep, loneliness, or lack of exercise each impair EFs. That EFs are trainable and can be improved with practice is addressed, including diverse methods tried thus far.
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            Executive Functions and Developmental Psychopathology

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              Emotion dysregulation in attention deficit hyperactivity disorder.

              Although it has long been recognized that many individuals with attention deficit hyperactivity disorder (ADHD) also have difficulties with emotion regulation, no consensus has been reached on how to conceptualize this clinically challenging domain. The authors examine the current literature using both quantitative and qualitative methods. Three key findings emerge. First, emotion dysregulation is prevalent in ADHD throughout the lifespan and is a major contributor to impairment. Second, emotion dysregulation in ADHD may arise from deficits in orienting toward, recognizing, and/or allocating attention to emotional stimuli; these deficits implicate dysfunction within a striato-amygdalo-medial prefrontal cortical network. Third, while current treatments for ADHD often also ameliorate emotion dysregulation, a focus on this combination of symptoms reframes clinical questions and could stimulate novel therapeutic approaches. The authors then consider three models to explain the overlap between emotion dysregulation and ADHD: emotion dysregulation and ADHD are correlated but distinct dimensions; emotion dysregulation is a core diagnostic feature of ADHD; and the combination constitutes a nosological entity distinct from both ADHD and emotion dysregulation alone. The differing predictions from each model can guide research on the much-neglected population of patients with ADHD and emotion dysregulation.
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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                01 April 2020
                April 2020
                : 9
                : 4
                : 986
                Affiliations
                [1 ]Department of Neuroscience, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca Manastur Street no. 54 C, 400660 Cluj-Napoca, Romania; predescu.elena@ 123456umfcluj.ro
                [2 ]Special Education Department, Faculty of Psychology and Educational Sciences, Babes-Bolyai University, Sindicatelor Street no 7, 400029 Cluj-Napoca, Romania; christina.costescu@ 123456gmail.com
                [3 ]Department of Clinical Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, Babes-Bolyai University, Republicii Street no 37, 400015 Cluj-Napoca, Romania; anamaria.ciocan.ac@ 123456gmail.com (A.C.); rus.dianaioana@ 123456gmail.com (D.I.R.)
                Author notes
                [* ]Correspondence: Roxana.Sipos@ 123456umfcluj.ro ; Tel.: +40-723031996
                Author information
                https://orcid.org/0000-0001-5682-1850
                https://orcid.org/0000-0001-5017-6387
                https://orcid.org/0000-0001-9329-9918
                Article
                jcm-09-00986
                10.3390/jcm9040986
                7231040
                32244788
                641707d8-6457-4e4f-9571-336e4c8f45fa
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 26 February 2020
                : 31 March 2020
                Categories
                Article

                emotion regulation,executive function,behavioral/emotional problems,adhd,borderline intellectual disability

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