Lower Cardiac Vagal Activity Predicts Self-Reported Difficulties With Emotion Regulation in Adolescents With ADHD.

Author: Kvadsheim E1, Fasmer OB2, Osnes B1, Koenig J3,4, Adolfsdottir S1,5, Eichele H1, Plessen KJ6,7, Sørensen L1
Affiliation: <sup>1</sup>Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway. <sup>2</sup>Department of Clinical Medicine, University of Bergen, Bergen, Norway. <sup>3</sup>Section for Experimental Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. <sup>4</sup>University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. <sup>5</sup>Department of Visual Impairments, Statped West - National Service for Special Needs Education, Bergen, Norway. <sup>6</sup>Child and Adolescent Mental Health Center, Capital Region Psychiatry, Copenhagen, Denmark. <sup>7</sup>Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Conference/Journal: Front Psychiatry.
Date published: 2020 Apr 17
Other: Volume ID: 11 , Pages: 244 , Special Notes: doi: 10.3389/fpsyt.2020.00244. eCollection 2020. , Word Count: 254

Objective: To investigate the relation between cardiac vagal activity (CVA), a measure of autonomic nervous system (ANS) flexibility, and self-reported emotion regulation (ER) difficulties in adolescents with attention-deficit/hyperactivity disorder (ADHD) and controls.

Methods: The sample comprised 11-17-year-old adolescents with ADHD (n=34) and controls (n = 33). Multiple linear regression analyses investigated the relation between CVA, as indexed by high frequency heart rate variability (HF-HRV), and ER difficulties as assessed by the Difficulties in Emotion Regulation Scale (DERS). Supplemental analyses were performed in ADHD and control groups separately. Analyses assessed effects of body mass index (BMI), physical activity levels, and HF peak as a surrogate of respiration on CVA.

Results: Lower CVA was associated with ER difficulties, and specifically with limited access to effective ER strategies. When investigating the relation between CVA and ER in the ADHD and control groups separately, there was a tendency of lower CVA predicting limited access to effective ER strategies in the ADHD group, and not in the control group.

Conclusion: The results suggest that lower CVA, i.e., reduced ANS flexibility, in adolescents with ADHD and controls is associated with self-reported ER difficulties, and specifically with limited access to effective ER strategies. There was a tendency for lower CVA to predict limited ER strategies only in the adolescents with ADHD and not controls.

Copyright © 2020 Kvadsheim, Fasmer, Osnes, Koenig, Adolfsdottir, Eichele, Plessen and Sørensen.

KEYWORDS: attention-deficit/hyperactivity disorder; autonomic nervous system; cardiac vagal activity; difficulties in emotion regulation scale; emotion regulation; heart rate variability

PMID: 32362841 PMCID: PMC7181562 DOI: 10.3389/fpsyt.2020.00244