title: Toward defining deficient emotional self-regulation in children with attention-deficit/hyperactivity disorder using the Child Behavior Checklist: a controlled study.
abstract: OBJECTIVE
  Deficient emotional self-regulation (DESR) is characterized by deficits in self-regulating the physiological arousal caused by strong emotions. We examined whether a unique profile of the Child Behavior Checklist (CBCL) would help identify DESR in children with attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Subjects included 197 children with ADHD and 224 children without ADHD. We defined DESR if a child had an aggregate cut-off score of > 180 but < 210 on the Anxiety/Depression, Aggression, and Attention scales of the CBCL (CBCL-DESR). This profile was selected because of: 1) its conceptual congruence with the clinical concept of DESR; and 2) because its extreme (> 210) form has been previously associated with severe forms of mood and behavioral dysregulation in children with ADHD. All subjects were comprehensively assessed with structured diagnostic interviews and a wide range of functional measures.
  
  
  RESULTS
  Forty-four percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (P < 0.001). The CBCL-DESR profile was associated with elevated rates of anxiety and disruptive behavior disorders, as well as significantly more impairments in emotional and interpersonal functioning.
  
  
  CONCLUSIONS
  The CBCL-DESR profile helped identify a subgroup of children with ADHD who had a psychopathological and functional profile consistent with the clinical concept of DESR.
authors: Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114, USA. tspencer@partners.org
authors: Thomas J
authors: TJ
authors: Spencer
authors: Stephen V
authors: SV
authors: Faraone
authors: Craig B H
authors: CB
authors: Surman
authors: Carter
authors: C
authors: Petty
authors: Allison
authors: A
authors: Clarke
authors: Holly
authors: H
authors: Batchelder
authors: Janet
authors: J
authors: Wozniak
authors: Joseph
authors: J
authors: Biederman
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology; D057189:Checklist; D002648:Child; D002652:Child Behavior; D056348:Emotional Intelligence; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000592:standards; D012917:Social Adjustment