Examining Associations Between Familial Factors and Behavioral and Neural Indices of Emotion Regulation Among Youth With and Without Attention-Deficit/Hyperactivity Disorder

Although not inherent to the disorder, many youth with attention-deficit/hyperactivity disorder (ADHD) experience difficulties with emotion regulation (ER). Further, the tripartite model provides a theoretical framework whereby parent ER, parenting behaviors, and family environment contribute to ER development. Current gold-standard treatments for ADHD do not adequately address ER difficulties, making it important to identify specific behavioral and neural targets that are most salient. Despite preadolescence being a critical period for ER development due to simultaneous biological and cognitive changes, there is limited work in this area. This dissertation examined how familial factors are associated with behavioral and neural indices of ER via empirical and review work. In study 1, 4,165 preadolescent youth (793 with ADHD) and their parents completed behavioral measures of caregiving, family conflict, and child emotion dysregulation at the Adolescent Brain Cognitive Development Study baseline visit. While all youth experienced increased dysregulation with higher parent dysregulation and family conflict, youth with ADHD experienced more severe dysregulation. In study 2, we reviewed literature from 23 studies on parental factors and youth ER-related neurocircuitry. Most studies (73.9%) supported the dimensional model (i.e., frontolimbic and frontoparietal disruption), while two studies were consistent with the stress acceleration model (i.e., frontolimbic acceleration). In study 3, 3,268 preadolescents (546 with ADHD) from study 1 underwent functional magnetic resonance imaging at rest. The most robust findings found that parent emotion dysregulation predicted weaker, while parent monitoring predicted stronger, default mode within-network resting-state functional connectivity (rs-fc) across youth. Among youth with ADHD, aggressive dysregulation was associated with weaker frontoparietal network (FPN)-left amygdala rs-fc, while attentional dysregulation was associated with weaker FPN-right amygdala rs-fc. Our dissertation findings identified familial factors that are significantly associated with emotion dysregulation and ER-related rs-fc, as well as how they confer risk or protection among youth with and without ADHD during preadolescence. Importantly, this is one of the first studies to examine familial and ER-related brain-behavior associations among youth with ADHD.

Major Professor: Erica D. Musser