The Emotional Pendulum in ADHD: Insights From Ecological Momentary Assessment of Emotional States in Young Adults

Emotion dysregulation, and specifically emotional instability, characterizes adults with ADHD. This study utilized ecological momentary assessment (EMA) to track emotional states and examine patterns of emotional instability within individuals over different time scales. Specifically, it focused on two aspects: overall emotional variability over time, and emotional lability, reflected in emotional states fluctuations within and across days. We further examined the interaction of these emotional instability factors with the subjective experience of emotion regulation difficulties. Young adults with (n = 57) and without (HC; n = 54) ADHD diagnosis completed a self-report questionnaire for emotion regulation difficulties, followed by a 5-day EMA protocol of 5 emotion reports/day. Individuals with ADHD displayed significantly higher intra-individual emotional variability, but no group differences were found for emotional lability, both between and across days. This higher emotional variability was linked to self-reported emotion regulation difficulties in the ADHD group. Finally, using cluster analysis, we found a higher probability of individuals with ADHD being included in a cluster characterized by elevated emotional variability and emotion regulation difficulties. This study demonstrates that young adults with ADHD may experience a broader range of emotions in their daily lives, which may be related to the way they evaluate their challenges in emotion regulation. The findings highlight the need to address emotion dysregulation difficulties in clinical practice, as understanding these emotional dynamics could enhance personalized therapeutic strategies for ADHD, and help design interventions tailored to the breadth and intensity of emotional experiences in ADHD.