Relations between temperament traits, externalizing behaviors and internalizing symptoms in children with attention-deficit/hyperactivity disorder (ADHD)

Abstract

<p>Children with ADHD commonly present elevated externalizing behaviours and internalizing symptoms. Temperament models suggested the contribution of negative emotionality and self-regulation styles on one’s heightened difficulties. This study followed a cross-sectional design with questionnaire measures to examine how these temperament traits can explain the difficulties experienced by children with ADHD. A total of 315 children with ADHD (aged 9 – 15), parents and teachers participated in the study.</p><p>A two-step cluster analysis was performed and three clusters were identified with different self-regulation styles: Optimal (characterized by high effortful control and high adaptive reactive control; <em>n</em> = 92, 29.2%), Under-controlled (characterized by low effortful control and low adaptive reactive control; <em>n</em> = 128, 40.6%), and Over-controlled (characterized by high maladaptive reactive control; <em>n</em> = 95, 30.2%). Further analyses indicated that self-regulation styles moderated the positive association between negative emotionality and internalizing symptoms. The relationship was significantly stronger for children with ADHD who exhibited under-controlled or over-controlled self-regulation styles. Negative emotionality and self-regulation styles were both significant predictors of externalizing behaviours in children with ADHD, yet no significant interaction was found.</p><p>This study highlighted the importance of assessing temperament traits which can inform more targeted interventions for children with ADHD.</p>