Keywords
attention-deficit/hyperactivity disorder (ADHD)
borderline personality disorder
emotion regulation
How to Cite
Abstract
Introduction: Emotional dysregulation is estimated to affect between 30% and 70% of individuals with ADHD, regardless of the presence of comorbid psychiatric disorders. The present study aimed to compare adaptive and maladaptive emotion regulation strategies, symptoms of anxiety and depression, and borderline personality disorder traits in adults with and without ADHD. Additionally, the interrelationships among these variables were examined. Material and Methods: A total of 216 adults with ADHD (M = 33.13, SD = 8.40) and 215 individuals in the control group (M = 34.18, SD = 10.10), aged between 18 and 65 years, completed the following questionnaires: the Adult ADHD Self-Report Scale v1.1 (ASRS), the Cognitive Emotion Regulation Questionnaire (CERQ), the Emotion Regulation Questionnaire (ERQ), the Hospital Anxiety and Depression Scale (HADS), and The BPD Checklist. Relationships between variables were analysed using independent-samples t-tests, correlation analyses, and linear regression models. Results: Participants with ADHD reported significantly more frequent use of maladaptive emotion regulation strategies, particularly self-blame and rumination, compared with the control group. The clinical group also exhibited higher levels of anxiety, depression, and borderline personality disorder traits than the control group. Regression analyses demonstrated that both adaptive and maladaptive emotion regulation strategies significantly predicted the severity of anxiety and depressive symptoms, as well as borderline personality disorder traits. Conclusions: The findings highlight the importance of emotion regulation and co-occurring psychopathological symptoms in the adult ADHD population.
References
Adler, L. A., Faraone, S. V., Sarocco, P., Atkins, N., & Khachatryan, A. (2019). Establishing US norms for the Adult ADHD Self-Report Scale (ASRS-v1.1) and characterising symptom burden among adults with self-reported ADHD. International Journal of Clinical Practice, 73(1), e13260. https://doi.org/10.1111/ijcp.13260
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Ben-Dor Cohen, M., Eldar, E., Maeir, A., & Nahum, M. (2021). Emotional dysregulation and health-related quality of life in young adults with ADHD: A cross-sectional study. Health and Quality of Life Outcomes, 19(1), 270. https://doi.org/10.1186/s12955-021-01904-8
Ben-Dor Cohen, M., Nahum, M., Traub Bar-Ilan, R., Eldar, E., & Maeir, A. (2024). Coping with emotional dysregulation among young adults with ADHD: A mixed-method study of self-awareness and strategies in daily life. Neuropsychological Rehabilitation, 34(8), 1161–1185. https://doi.org/10.1080/09602011.2023.2279181
Bloo, J., Arntz, A., & Schouten, E. (2017). Lista kontrolna zaburzenia osobowości z pogranicza (BPD): Ocena psychometryczna i struktura czynnikowa w próbie klinicznej i nieklinicznej [Borderline Personality Disorder (BPD) Checklist: Psychometric evaluation and factor structure in clinical and nonclinical samples]. Roczniki Psychologiczne / Annals of Psychology, 20(2), 281–309. https://doi.org/10.18290/rpsych.2017.20.2-3pl
Bodalski, E. A., Knouse, L. E., & Kovalev, D. (2019). Adult ADHD, emotion dysregulation, and functional outcomes: Examining the role of emotion regulation strategies. Journal of Psychopathology and Behavioral Assessment, 41(1), 81–92. https://doi.org/10.1007/s10862-018-9695-1
Corbisiero, S., Mörstedt, B., Bitto, H., & Stieglitz, R. D. (2017). Emotional dysregulation in adults with attention-deficit/hyperactivity disorder: Validity, predictability, severity, and comorbidity. Journal of Clinical Psychology, 73(1), 99–112. https://doi.org/10.1002/jclp.22317
D’Agati, E., Curatolo, P., & Mazzone, L. (2019). Comorbidity between ADHD and anxiety disorders across the lifespan. International Journal of Psychiatry in Clinical Practice, 23(4), 238–244. https://doi.org/10.1080/13651501.2019.1628277
D’Avanzato, C., Joormann, J., Siemer, M., & Gotlib, I. H. (2013). Emotion regulation in depression and anxiety: Examining diagnostic specificity and stability of strategy use. Cognitive Therapy and Research, 37, 968–980. https://doi.org/10.1007/s10608-013-9537-0
Ditrich, I., Philipsen, A., & Matthies, S. (2021). Borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD) revisited: A review-update on common grounds and subtle distinctions. Borderline Personality Disorder and Emotion Dysregulation, 8(1), 22. https://doi.org/10.1186/s40479-021-00162-w
Fayyad, J., Sampson, N. A., Hwang, I., Adamowski, T., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H. S. G., Borges, G., de Girolamo, G., Florescu, S., Gureje, O., Haro, J. M., Hu, C., Karam, E. G., Karam, G., Lee, S., Navarro-Mateu, F., O’Neill, S., Pennell, B.-E., ... Kessler, R. C. (2017). The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. Attention Deficit and Hyperactivity Disorders, 9(1), 47–65. https://doi.org/10.1007/s12402-016-0208-3
Fu, X., Wu, W., Wu, Y., Liu, X., Liang, W., Wu, R., & Li, Y. (2025). Adult ADHD and comorbid anxiety and depressive disorders: A review of etiology and treatment. Frontiers in Psychiatry, 16, 1597559. https://doi.org/10.3389/fpsyt.2025.1597559
Garnefski, N., & Kraaij, V. (2007). The Cognitive Emotion Regulation Questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 23(3), 141–149. https://doi.org/10.1027/1015-5759.23.3.141
Garnefski, N., & Kraaij, V. (2018). Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety. Cognition and Emotion, 32(7), 1401–1408. https://doi.org/10.1080/02699931.2016.1232698
Gajewski, R., & Kucharska, K. (2023). Risk factors and protective factors of suicidal behavior in people diagnosed with depression. Kwartalnik Naukowy Fides Et Ratio, 56(4), 175-192. https://doi.org/10.34766/fetr.v56i4.1227
Giacobini, M., Ahnemark, E., Medin, E., Freilich, J., Andersson, M., Ma, Y., & Ginsberg, Y. (2023). Epidemiology, treatment patterns, comorbidities, and concomitant medication in patients with ADHD in Sweden: A registry-based study (2018–2021). Journal of Attention Disorders, 27(12), 1309–1321. https://doi.org/10.1177/10870547231177221
Gondek, T. M., Stramecki, F., Cieśla, M., Ziegart-Sadowska, K., Foryciarz, K., Główczyński, P., Krupa, A. J., Krysta, K., Malec, A., Rewekant, A., Szczegielniak, A., Szczubiał-Kamińska, A., Taracha, A., Tokarek, A., Wojtkiewicz, A., & Todzia-Kornaś, A. (2024). Diagnostyka i postępowanie terapeutyczne u dorosłych z ADHD. Rekomendacje Sekcji Kształcenia Specjalizacyjnego Polskiego Towarzystwa Psychiatrycznego i koalicji organizacji na rzecz osób z ADHD – 2024 r. [Diagnosis and therapeutic management of adults with ADHD: Recommendations of the Section for Specialist Training of the Polish Psychiatric Association and the coalition of organizations supporting people with ADHD—2024]. Psychiatria Spersonalizowana / Personalized Psychiatry, 3(3), 43–73. https://doi.org/10.5114/psychs.2024.142908
Gross, J. J., & John, O. P. (2003). Emotion Regulation Questionnaire (ERQ). APA PsycTests.
Houben, M., Kalokerinos, E. K., Koval, P., Erbas, Y., Mitchell, J., Pe, M., & Kuppens, P. (2024). The association between the selection and effectiveness of emotion-regulation strategies and psychopathological features: A daily life study. Clinical Psychological Science, 12(5), 973–983. https://doi.org/10.1177/21677026231203662
Karakuła, H., Grzywa, A., Spila, B., Baszak, J., Gieroba, A., Kosikowski, W., & Jędrych, M. (1996). Zastosowanie Skali Lęku i Depresji HADS w chorobach psychosomatycznych [Application of the Hospital Anxiety and Depression Scale (HADS) in psychosomatic disorders]. Psychiatria Polska, 30(4), 653–667.
Knouse, L. E., Zvorsky, I., & Safren, S. A. (2013). Depression in adults with attention-deficit/hyperactivity disorder (ADHD): The mediating role of cognitive-behavioral factors. Cognitive Therapy and Research, 37(6), 1220–1232. https://doi.org/10.1007/s10608-013-9569-5
Larionow, P., Mudło-Głagolska, K., & Preece, D. A. (2025). Latent structure and profiles of emotion regulation: Reappraisal and suppression patterns with the Polish version of the Emotion Regulation Questionnaire. Journal of Clinical Medicine, 14(2), 587. https://doi.org/10.3390/jcm14020587
Liu, Q., Chen, W., Preece, D. A., Xu, D., Li, H., Liu, N., Fu, G., & Liu, L. (2022). Emotion dysregulation in adults with ADHD: The role of cognitive reappraisal and expressive suppression. Journal of Affective Disorders, 319, 267–276. https://doi.org/10.1016/j.jad.2022.09.058
Liu, C., Chen, L., & Chen, S. (2020). Influence of neuroticism on depressive symptoms among Chinese adolescents: The mediation effects of cognitive emotion regulation strategies. Frontiers in Psychiatry, 11, 420. https://doi.org/10.3389/fpsyt.2020.00420
MacDonald, L., & Sadek, J. (2023). Management strategies for borderline personality disorder and bipolar disorder comorbidities in adults with ADHD: A narrative review. Brain Sciences, 13(11), 1517. https://doi.org/10.3390/brainsci13111517
Marszał-Wiśniewska, M., & Fajkowska, W. (2010). Właściwości psychometryczne kwestionariusza poznawczej regulacji emocji – wyniki badań na polskiej próbie [Psychometric properties of the Cognitive Emotion Regulation Questionnaire: Results from a Polish sample]. Studia Psychologiczne, 49(1), 19–39.
Materna L., Wiesner C. D., Shushakova A., Trieloff J., Weber N., Engell A., Schubotz R. I., Bauer J., Pedersen A., and Ohrmann P. (2019). Adult patients with ADHD differ from healthy controls in implicit, but not explicit, emotion regulation. Journal of Psychiatry & Neuroscience, 44(5), 340–349. https://doi.org/10.1503/jpn.180139
Matthies, S. D., & Philipsen, A. (2014). Common ground in attention deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD): Review of recent findings. Borderline Personality Disorder and Emotion Dysregulation, 1, 3. https://doi.org/10.1186/2051-6673-1-3
Matthies, S., Philipsen, A., Lackner, H. K., Sadohara, C., & Svaldi, J. (2014). Regulation of sadness via acceptance or suppression in adult attention-deficit/hyperactivity disorder (ADHD). Psychiatry Research, 220(1–2), 461–467. https://doi.org/10.1016/j.psychres.2014.07.010
Mayer, J. S., Bernhard, A., Fann, N., Boxhoorn, S., Hartman, C. A., Reif, A., & Freitag, C. M. (2021). Cognitive mechanisms underlying depressive disorders in ADHD: A systematic review. Neuroscience & Biobehavioral Reviews, 121, 305–345. https://doi.org/10.1016/j.neubiorev.2020.12.018
Mayer, J. S., Brandt, G. A., Medda, J., Basten, U., Grimm, O., Reif, A., & Freitag, C. M. (2022). Depressive symptoms in youth with ADHD: The role of impairments in cognitive emotion regulation. European Archives of Psychiatry and Clinical Neuroscience, 272(5), 793–806. https://doi.org/10.1007/s00406-022-01382-z
Murgueitio, N., Trueba, A. F., & Pluck, G. (2025). The role of emotion regulation strategies in the association between physical abuse and borderline symptoms among deprived youth in Ecuador. Children and Youth Services Review, 176, 108430. https://doi.org/10.1016/j.childyouth.2025.108430
Powell, V., Agha, S. S., Jones, R. B., Eyre, O., Stephens, S., Weavers, B., Jennon, J., & Rice, F. (2021). ADHD in adults with recurrent depression. Journal of Affective Disorders, 295, 1153–1160. https://doi.org/10.1016/j.jad.2021.09.010
Quenneville, A. F., Kalogeropoulou, E., Nicastro, R., Weibel, S., Chanut, F., & Perroud, N. (2022). Anxiety disorders in adult ADHD: A frequent comorbidity and a risk factor for externalizing problems. Psychiatry Research, 310, 114423. https://doi.org/10.1016/j.psychres.2022.114423
Reimherr, F. W., Marchant, B. K., Gift, T. E., & Steans, T. A. (2017). ADHD and anxiety: Clinical significance and treatment implications. Current Psychiatry Reports, 19(12), 109. https://doi.org/10.1007/s11920-017-0859-6
Rüfenacht, E., Euler, S., Prada, P., Nicastro, R., Dieben, K., Hasler, R., Pham, E., & Weibel, S. (2019). Emotion dysregulation in adults suffering from attention-deficit/hyperactivity disorder (ADHD): A comparison with borderline personality disorder (BPD). Borderline Personality Disorder and Emotion Dysregulation, 6, 11. https://doi.org/10.1186/s40479-019-0108-1
Salgó, E., Szeghalmi, L., Bajzát, B., Berán, E., & Unoka, Z. (2021). Emotion regulation, mindfulness, and self-compassion among patients with borderline personality disorder compared to healthy control subjects. PLOS ONE, 16(3), e0248409. https://doi.org/10.1371/journal.pone.0248409
Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention-deficit/hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966
Shen, F., & Zhou, H. (2024). Advances in the etiology and neuroimaging of children with attention-deficit/hyperactivity disorder. Frontiers in Pediatrics, 12, 1400468. https://doi.org/10.3389/fped.2024.1400468
Soler-Gutiérrez, A. M., Pérez-González, J. C., & Mayas, J. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLOS ONE, 18(1), e0280131. https://doi.org/10.1371/journal.pone.0280131
Weiner, L., Perroud, N., & Weibel, S. (2019). Attention-deficit/hyperactivity disorder and borderline personality disorder in adults: A review of their links and risks. Neuropsychiatric Disease and Treatment, 15, 3115–3129. https://doi.org/10.2147/NDT.S192871
Yao, Y., Chen, J., & Xuan, Y. (2023). The relationship between anxiety and cognitive emotion regulation strategies: A meta-analysis. Applied Cognitive Psychology, 37(6), 1366–1383. https://doi.org/10.1002/acp.4129
Young, K. S., Sandman, C. F., & Craske, M. G. (2019). Positive and negative emotion regulation in adolescence: Links to anxiety and depression. Brain Sciences, 9(4), 76. https://doi.org/10.3390/brainsci9040076
Zaid, S. M., Hutagalung, F. D., Abd Hamid, H. S. B., & Taresh, S. M. (2025). The power of emotion regulation: How managing sadness influences depression and anxiety. BMC Psychology, 13(1), 38. https://doi.org/10.1186/s40359-025-02354-3
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
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