(PS6-89) Preschool-aged Children’s Daily Emotion Dysregulation Is Associated with Daily ADHD Behavior Severity and Impairment Beyond Baseline ADHD Symptom Severity

Introduction: Symptoms of attention-deficit/hyperactivity disorder (ADHD) impacts multiple domains of functioning (e.g., learning, peers, family). Elevated ADHD symptoms have been identified in children as early as preschool age and are associated with continued difficulties over time (O’Neill et al., 2017). Emotion dysregulation, which is common in ADHD, may exacerbate these difficulties. In fact, emotion dysregulation predicts ADHD symptom severity over time in middle childhood and young adulthood (Alacha et al., in press; Viering et al., 2021). However, there is limited research on this relation 1) in preschool-aged children and 2) measured daily. The current study examined whether emotion dysregulation predicted daily ADHD behavior and impairment in preschool-aged children. We hypothesized that daily emotion dysregulation would be associated with daily ADHD behavior and impairment while controlling for baseline ADHD symptom severity.

Method: Participants (N = 86) were parents (91.3% female) of a community sample of 3-5-year-old children (M_age= 4.30, SD = .90, 50.3% male, 65.1% White). Parents completed baseline measures, and a 16-day daily diary. ADHD symptoms were assessed at baseline (ADHD Rating Scale-IV Preschool Version) and ADHD behaviors (hyperactivity and impulsivity summed), emotion dysregulation, and impairment were each assessed daily on a 0-10 scale (not at all to extremely).

Results: Multilevel Modeling (MLM) was used to analyze daily diary data to examine associations between daily emotion dysregulation and daily hyperactivity and impulsivity and impairment and daily levels of child hyperactivity and impulsivity severity when controlling for baseline ADHD symptoms. Daily emotion dysregulation intensity was group-mean centered, and baseline ADHD was grand-mean centered. Greater daily emotion dysregulation was significantly associated with daily hyperactivity and impulsivity severity after controlling for baseline ADHD symptoms (B=.34, SE=.12, p< .01). Greater daily emotion dysregulation was also significantly associated with greater daily impairment due to hyperactivity and impulsivity (B=.24, SE=.11, p=.02) after controlling for baseline total ADHD symptoms.

Discussion: The results indicate that preschool-aged children’s daily emotion dysregulation was associated with daily ADHD behavior and impairment over a 16-day period beyond initial ADHD symptom severity. These findings are consistent with results that examined this relation over longer periods of time and in later developmental phases, and extends the literature to demonstrate the daily relation between emotion regulation, impairment, and ADHD behaviors in preschool-aged children. Further, the results suggest that emotion regulation may be an important target for prevention and intervention in preschool-aged children with elevated ADHD symptoms to potentially reduce impairment associated with these symptoms over time.