Paying Attention to Your Emotions: A Mixed-Methods Study on Alexithymia and Emotional Dysregulation in Adults with Attention Deficit Hyperactivity Disorder

Abstract

Emotional dysregulation is increasingly recognized as a major source of impairment in adults with attention-deficit/hyperactivity disorder (ADHD), yet the factors contributing to these emotional difficulties remain understudied. One factor that may heighten emotional dysregulation is alexithymia, defined as difficulty understanding, identifying and describing emotional states. The primary aims of the present study are to clarify the association of emotion dysregulation with ADHD symptoms by examining alexithymia as a potential moderator of this association as well as examining qualitative data regarding participants’ experiences of emotion dysregulation and ADHD symptoms. Using a cross-sectional online survey, N = 100 young adults with self-reported ADHD completed validated measures of ADHD symptoms using the Conners Adult ADHD Rating Scale, emotional dysregulation using the Difficulties in Emotion Regulation Scale, alexithymia using the Toronto Alexithymia Scale, and autistic traits using the Autism Quotient 10. Age, gender, and treatment status were included as additional control variables. Open-ended questions regarding participants’ experiences of emotional dysregulation and emotional awareness were analyzed using deductive thematic analysis. Using a convergent parallel mixed-methods design, we integrate quantitative and qualitative findings to provide a comprehensive understanding of emotional difficulties in adults with ADHD. This study aims to clarify how alexithymia may influence the association of emotional dysregulation with ADHD symptom severity, highlight differences between inattentive and hyperactive/impulsive symptom pathways, and inform more emotionally attuned clinical intervention strategies for adults with ADHD.