Executive Functions and Emotion Regulation in Attention-Deficit/Hyperactivity Disorder and Borderline Intellectual Disability
Abstract
:1. Introduction
2. Experimental Section
2.1. Participants
2.2. Instruments
- Visual attention domain measures visual attention speed and accuracy [16]. The children’s task is to scan a linear array of pictures and to mark the targets as quickly and accurately as possible. For school-aged children, we used the cats and faces targets.
- Tower subtest is a task that assesses a series of executive functions such as planning, monitoring, problem-solving, and self-regulation [16]. The children must move the three colored balls to target positions, on three pegs, following some rules. The task is time-limited (30–60 s), and its difficulty varies according to the number of moves and complexity.
- Block construction is a visuospatial processing task that requires children to build constructions using a different number of blocks. This task has a medium level of difficulty, and every subset has a time limit of 30 to 60 s.
- Delayed faces memory assesses children’s memory capacity. Children are shown 16 pictures of boys and girls, and they must memorize them. After 30 minutes, the experimenter shows the children 16 sets of pictures, each containing three pictures, and the children’s task is to recognize the person that they have seen before from every set of pictures. During the delayed memory task, children must hold in mind for several minutes some visual information. We considered the delayed memory task a measure of short-term memory (STM).
2.3. Procedure
3. Results
3.1. Differences in Cognitive Functioning, Emotion Regulation, and Behavioral and Emotional Problems Across Diagnoses
3.2. The Relation between Emotion Regulation, Cognitive Functioning, Emotional and Behavioral Problems
3.3. Testing the Relationship between Maladaptive Strategies, Planning, and Conduct Problems
4. Discussion and Conclusions
Author Contributions
Funding
Conflicts of Interest
Appendix A
Measurements | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Visual attention (NEPSY) | 1 | |||||||||||||||||||
2. Delayed memory (NEPSY) | 0.394 ** | 1 | ||||||||||||||||||
3. Planning (NEPSY) | 0.374 ** | 0.569 ** | 1 | |||||||||||||||||
4. Visuospatial processing (NEPSY) | 0.756 ** | 0.513 ** | 0.546 ** | 1 | ||||||||||||||||
5. Visual focusing | −0.051 | 0.206 | 0.221 | 0.037 | 1 | |||||||||||||||
6. Verbal focusing | 0.239 * | 0.110 | 0.080 | 0.232 | 0.098 | 1 | ||||||||||||||
7. Anger expression | 0.217 | 0.058 | 0.040 | 0.052 | −0.028 | 0.084 | 1 | |||||||||||||
8. Resignation | −0.276 * | −0.359 ** | −0.238 * | −0.265 * | −0.076 | 0.125 | 0.082 | 1 | ||||||||||||
9. Solution orientation | −0.115 | 0.087 | −0.104 | −0.111 | 0.139 | −0.064 | −0.255 * | −0.431 ** | 1 | |||||||||||
10. Substituting the anger | 0.279 * | 0.233 | 0.194 | 0.352 ** | −0.082 | 0.129 | −0.201 | −0.141 | −0.049 | 1 | ||||||||||
11. Verbalizing the strategies | 0.383 ** | 0.267 * | 0.322 ** | 0.306 ** | 0.315 ** | 0.130 | 0.024 | −0.203 | 0.060 | −0.019 | 1 | |||||||||
12. Maladaptive strategies | 0.218 | 0.104 | 0.099 | 0.148 | 0.329 ** | 0.762 ** | 0.622 ** | 0.280 * | −0.220 | −0.075 | 0.157 | 1 | ||||||||
13. Adaptive strategies | 0.256 | 0.298 * | 0.364 ** | 0.246 * | 0.202 | 0.053 | −0.208 | −0.533 ** | 0.785 ** | 0.313 ** | 0.489 ** | −0.115 | 1 | |||||||
14. Emotion regulation | 0.528 * | 0.270 * | 0.181 | 0.513 ** | 0.008 | 0.143 | 0.242 * | −0.326 ** | −0.106 | 0.282 * | 0.262 * | 0.183 | 0.175 | 1 | ||||||
15. Affective problems (CBCL) | −0.030 | −0.124 | −0.134 | −0.134 | −0.016 | 0.155 | 0.046 | −0.056 | −0.026 | −0.031 | −0.030 | 0.114 | −0.035 | 0.145 | 1 | |||||
16. Anxiety (CBCL) | 0.061 | −0.169 | −0.235 * | −0.052 | −0.125 | 0.156 | −0.020 | −0.070 | −0.029 | −0.010 | −.053 | 0.043 | −0.030 | 0.119 | 0.552 ** | 1 | ||||
17. Somatic problems (CBCL) | −0.084 | 0.082 | −0.047 | −0.009 | −0.017 | −0.231 | −0.076 | −0.176 | 0.177 | 0.060 | −0.100 | −0.232 | 0.123 | 0.136 | 0.424 ** | 0.235 * | 1 | |||
18. ADHD (CBCL) | −0.096 | −0.207 | −0.221 * | −0.190 | 0.001 | 0.093 | 0.134 | 0.103 | −0.016 | −0.002 | −0.071 | 0.155 | −0.038 | 0.070 | 0.616 ** | 0.527 ** | 0.286 ** | 1 | ||
19. Oppositional-defiant (CBCL_ | 0.031 | −0.198 | −0.198 | −0.081 | −0.031 | 0.121 | 0.238 * | −0.050 | −0.025 | 0.050 | −0.091 | 0.196 | −0.023 | 0.293 * | 0.617 ** | 0.600 ** | 0.389 ** | 0.777 ** | 1 | |
20. Conduct problems (CBCL) | −0.112 | −0.237 * | −0.276 * | −0.156 | −0.007 | 0.206 | 0.204 | −0.023 | −0.017 | 0.085 | −0.075 | 0.245 * | −0.007 | 0.299 * | 0.553 ** | 0.398 ** | 0.303 ** | 0.668 ** | 0.790 ** | 1 |
Measurements 7–9 years | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |
1. Visual attentions (NEPSY) | 1 | |||||||||||||||||||
2. Delayed memory (NEPSY) | −0.189 | 1 | ||||||||||||||||||
3. Planning (NEPSY) | 0.007 | −0.215 | 1 | |||||||||||||||||
4.Visuospatial processing (NEPSY) | 0.120 | 0.094 | −0.084 | 1 | ||||||||||||||||
5. Visual focusing | −0.019 | 0.223 | 0.186 | 0.242 | 1 | |||||||||||||||
6. Verbal focusing | 0.000 | 0.217 | −0.384 | −0.016 | −0.065 | 1 | ||||||||||||||
7. Anger expression | 0.170 | −0.011 | −0.266 | −0.076 | 0.162 | 0.034 | 1 | |||||||||||||
8. Resignation | 0.267 | 0.162 | −0.008 | −0.227 | −0.090 | 0.382 | 0.331 | 1 | ||||||||||||
9. Solution orientation | 0.029 | −0.243 | 0.397 | −0.073 | −0.252 | −0.411 | −0.346 | −0.373 | 1 | |||||||||||
10. Substituting the anger | −0.462 * | 0.047 | −0.175 | 0.216 | −0.305 | −0.162 | −0.381 | −0.178 | 0.077 | 1 | ||||||||||
11. Verbalizing the strategies | 0.137 | 0.008 | 0.413 | 0.135 | 0.567 ** | 0.234 | −0.032 | 0.287 | −0.008 | −0.356 | 1 | |||||||||
12. Maladaptive strategies | 0.106 | 0.231 | −0.369 | −0.012 | 0.274 | 0.789 ** | 0.586 ** | 0.532 * | −0.579 ** | −0.402 | 0.335 | 1 | ||||||||
13. Adaptive strategies | −0.090 | −0.222 | 0.509* | 0.105 | −0.046 | −0.310 | −0.472 * | −0.249 | 0.814 ** | 0.286 | 0.387 | −0.498 * | 1 | |||||||
14. Emotion regulation | −0.019 | 0.021 | −0.360 | −0.423 | −0.065 | 0.053 | 0.225 | 0.092 | 0.011 | −0.196 | −0.212 | 0.142 | −0.237 | 1 | ||||||
15. Affective problems (CBCL) | −0.581 ** | 0.167 | −0.134 | −0.278 | −0.138 | 0.205 | −0.036 | −0.222 | 0.195 | −0.137 | −0.096 | 0.077 | 0.048 | 0.165 | 1 | |||||
16. Anxiety (CBCL) | −0.368 | 0.305 | −0.271 | −0.084 | −0.144 | 0.066 | −0.169 | −0.279 | −0.138 | −0.126 | −0.424 | −0.099 | −0.245 | 0.077 | 0.524 * | 1 | ||||
17. Somatic problems (CBCL) | −0.097 | 0.202 | −0.037 | −0.224 | −0.250 | −0.364 | 0.169 | −0.146 | 0.354 | −0.009 | −0.483 * | −0.270 | 0.014 | 0.359 | 0.487 * | 0.409 | 1 | |||
18. ADHD (CBCL) | −0.123 | 0.245 | −0.065 | −0.104 | −0.097 | −0.311 | 0.265 | −0.117 | 0.229 | −0.003 | −0.421 | −0.142 | −0.015 | 0.005 | 0.386 | 0.465 * | 0.732 ** | 1 | ||
19. Oppositional-defiant (CBCL) | 0.062 | 0.215 | −0.074 | −0.128 | −0.068 | −0.173 | 0.042 | −0.304 | 0.316 | 0.050 | −0.527 * | −0.159 | −0.042 | 0.244 | 0.299 | 0.442 | 0.650 ** | 0.745 ** | 1 | |
20. Conduct problems (CBCL) | 0.145 | 0.152 | −0.273 | −0.185 | −0.220 | 0.012 | −0.039 | −0.214 | −0.249 | 0.073 | −0.467 * | −0.089 | −0.029 | 0.438 | 0.016 | 0.048 | 0.425 | 0.208 | 0.636 ** | 1 |
Measurements 9–11 years | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |
1. Visual attentions (NEPSY) | 1 | |||||||||||||||||||
2. Delayed memory (NEPSY) | 0.318 | 1 | ||||||||||||||||||
3. Planning (NEPSY) | 0.091 | 0.398 | 1 | |||||||||||||||||
4. Visuospatial processing (NEPSY) | 0.313 | 0.227 | 0.160 | 1 | ||||||||||||||||
5. Visual focusing | 0.042 | 0.169 | 0.216 | 0.251 | 1 | |||||||||||||||
6. Verbal focusing | 0.356 | −0.191 | 0.272 | 0.161 | 0.095 | 1 | ||||||||||||||
7. Anger expression | 0.046 | −0.090 | −0.528 * | −0.458 * | −0.033 | −0.084 | 1 | |||||||||||||
8. Resignation | 0.230 | −0.395 | −0.174 | −0.058 | 0.292 | −0.341 | 0.102 | 1 | ||||||||||||
9. Solution orientation | −0.029 | 0.475 * | 0.213 | −0.065 | −0.120 | −0.114 | −0.248 | −0.586 ** | 1 | |||||||||||
10. Substituting the anger | 0.138 | 0.118 | 0.219 | −0.007 | 0.051 | 0.258 | −0.221 | 0.145 | −0.066 | 1 | ||||||||||
11. Verbalizing the strategies | 0.245 | 0.244 | 0.010 | −0.058 | −0.102 | −0.103 | 0.172 | −0.287 | −0.400 | −0.328 | 1 | |||||||||
12. Maladaptive strategies | 0.324 | −0.203 | −0.473 * | −0.099 | 0.349 | 0.733 ** | 0.534 * | 0.524 * | −0.344 | 0.088 | −0.040 | 1 | ||||||||
13. Adaptive strategies | 0.126 | 0.595 ** | 0.312 | 0.024 | −0.083 | −0.093 | −0.247 | −0.581 ** | 0.859 ** | 0.246 | 0.503 ** | −0.318 | 1 | |||||||
14. Emotion regulation | 0.176 | 0.351 | −0.047 | 0.308 | 0.070 | −0.099 | 0.077 | 0.117 | −0.043 | 0.111 | 0.247 | 0.010 | 0.017 | 1 | ||||||
15. Affective problems (CBCL) | −0.051 | 0.008 | 0.049 | −0.058 | 0.257 | 0.179 | 0.109 | 0.094 | 0.002 | −0.183 | 0.310 | 0.271 | −0.077 | 0.330 | 1 | |||||
16. Anxiety (CBCL) | 0.165 | −0.020 | −0.208 | 0.285 | 0.099 | 0.289 | −0.013 | 0.162 | −0.092 | −0.255 | 0.324 | 0.246 | −0.200 | 0.439 * | 0.665 ** | 1 | ||||
17. Somatic problems (CBCL) | 0.017 | −0.006 | −0.131 | 0.271 | 0.172 | −0.270 | −0.115 | −0.106 | 0.058 | −0.038 | 0.237 | −0.229 | −0.204 | 0.173 | 0.212 | −0.021 | 1 | |||
18. ADHD (CBCL) | 0.106 | −0.087 | −0.198 | 0.178 | 0.239 | 0.344 | 0.048 | 0.316 | −0.051 | −0.187 | 0.355 | 0.380 | −0.158 | 0.470 * | 0.798 ** | 0.809 ** | 0.197 | 1 | ||
19. Oppositional-defiant (CBCL) | −0.032 | −0.094 | −0.270 | 0.103 | 0.341 | 0.158 | 0.314 | 0.154 | −0.046 | −0.135 | 0.246 | 0.407 | −0.148 | 0.481 * | 0.811 ** | 0.624 ** | 0.334 | 0.819 ** | 1 | |
20. Conduct problems (CBCL) | 0.075 | −0.106 | −0.267 | −0.012 | 0.199 | 0.247 | 0.395 | 0.168 | −0.146 | −0.064 | 0.159 | 0.482* | −0.245 | 0.507* | 0.732 ** | 0.452* | 0.173 | 0.634 ** | 0.836 ** | 1 |
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M (SD) TD (n = 42) | M (SD) ADHD (n = 27) | M (SD) Borderline ID (n = 16) | ||
---|---|---|---|---|
Cognitive functions | Visual attention | 8.95 (1.03) | 7.45 (5.23) | 3.81 (2.00) |
Memory | 12.16 (2.15) | 8.33 (3.27) | 8.81 (3.01) | |
Planning | 12.92 (2.78) | 7.46 (5.98) | 7.68 (5.27) | |
Visuospatial processing | 14.04 (2.54) | 9.17 (3.82) | 7.06 (2.56) | |
Emotion regulation | Maladaptive strategies | 2.83 (2.25) | 3.46 (2.06) | 2.00 (1.47) |
Adaptive strategies | 5.07 (2.64) | 4.53 (3.09) | 4.50 (2.71) | |
Behavioral/emotional problems | Affective problems | 3.26 (3.54) | 4.59 (3.93) | 3.68 (4.20) |
Anxiety | 2.28 (2.07) | 3.11 (2.81) | 2.81 (2.80) | |
Somatic problems | 0.71 (1.33) | 0.51 (1.01) | 0.75 (1.61) | |
ADHD | 4.14 (3.15) | 6.96 (4.94) | 5.68 (3.94) | |
Oppositional-defiant | 2.33 (2.19) | 4.29 (3.67) | 2.62 (2.96) | |
Conduct problems | 1.78 (2.64) | 5.66 (6.33) | 3.50 (4.84) |
t-test | |||
---|---|---|---|
TD versus ADHD | TD versus Borderline ID | ||
Cognitive functions | Visual Attention | t(64) = 1.79, p = 0.00 | t(56) = 12.81, p = 0.00 |
Memory | t(64) = 5.73, p = 0.006 | t(56) = 4.73, p = 0.047 | |
Planning | t(66) = 5.11, p = 0.00 | t(56) = 4.92, p = 0.001 | |
Visuospatial processing | t(57) = 5.71. p = 0.09 | t(56) = 9.31, p = 0.572 | |
Emotion regulation | Maladaptive strategies | t(55) = −0.95, p = 0.907 | t(52) = 1.20, p = 0.205 |
Adaptive strategies | t(55) = 0.695, p = 0.06 | t(52) = 0.713, p = 0.328 | |
Behavioral/ Emotional problems | Affective problems | t(67) = −1.45, p = 0.648 | t(56) = −0.388, p = 0.363 |
Anxiety | t(67) = −1.39, p = 0.02 | t(56) = −0.781, p = 0.732 | |
Somatic problems | t(67) = 0.65, p = 0.188 | t(56) = −.086, p = 0.450 | |
ADHD | t(67) = −2.89, p = 0.002 | t(56) = −1.55, p = 0.097 | |
Oppositional-defiant | t(67) = −2.78, p = 0.00 | t(56) = −0.410. p = 0.036 | |
Conduct problems | t(67) = −3.52, p = 0.00 | t(56) = −1.727, p = 0.002 |
t-test | ||
---|---|---|
ADHD versus Borderline ID | ||
Cognitive functions | Visual Attention | t(38) = 2.65, p = 0.002 |
Memory | t(38) = −0.46, p = 0.65 | |
Planning | t(40) = −0.12, p = 0.32 | |
Visuospatial processing | t(31) = 1.85. p = 0.13 | |
Emotion regulation | Maladaptive strategies | t(25) = 2.06, p = 0.09 |
Adaptive strategies | t(25) = 0.029, p = 0.47 | |
Behavioral/ Emotional problems | Affective problems | t(41) = 0.71, p = 0.66 |
Anxiety | t(41) = 0.33, p = 0.27 | |
Somatic problems | t(41) = −0.57, p = 0.08 | |
ADHD | t(41) = 0.87, p = 0.29 | |
Oppositional-defiant | t(41) = 1.54, p = 0.25 | |
Conduct problems | t(41) = 1.17, p = 0.28 |
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Predescu, E.; Sipos, R.; Costescu, C.A.; Ciocan, A.; Rus, D.I. Executive Functions and Emotion Regulation in Attention-Deficit/Hyperactivity Disorder and Borderline Intellectual Disability. J. Clin. Med. 2020, 9, 986. https://doi.org/10.3390/jcm9040986
Predescu E, Sipos R, Costescu CA, Ciocan A, Rus DI. Executive Functions and Emotion Regulation in Attention-Deficit/Hyperactivity Disorder and Borderline Intellectual Disability. Journal of Clinical Medicine. 2020; 9(4):986. https://doi.org/10.3390/jcm9040986
Chicago/Turabian StylePredescu, Elena, Roxana Sipos, Cristina A. Costescu, Anamaria Ciocan, and Diana I. Rus. 2020. "Executive Functions and Emotion Regulation in Attention-Deficit/Hyperactivity Disorder and Borderline Intellectual Disability" Journal of Clinical Medicine 9, no. 4: 986. https://doi.org/10.3390/jcm9040986