DESR: Why Deficient Emotional Self-Regulation is Central to ADHD (and Largely Overlooked)

DESR: Why Deficient Emotional Self-Regulation is Central to ADHD (and Largely Overlooked)

Deficient emotional self-regulation (DESR) is a relatively new term used to describe the problem of impulsive emotion coupled with emotional self-regulation difficulties long associated with attention deficit hyperactivity disorder (ADHD or ADD). DESR may be new to the ADHD lexicon, however I argue that it is a core and commonly overlooked component of the disorder — and one that can help predict a patient’s impairments, and even improve diagnostic and treatment practices.1

Emotional dysregulation is noticeably missing from diagnostic criteria for ADHD. However, most patients and experts recognize that it is central to the disorder2. DESR, a manifestation of emotional dysregulation, specifically refers to deficiencies with these four components of emotional self-regulation3:

  • Ability to inhibit inappropriate behavior triggered by strong emotions. I argue that this emotional impulsiveness (EI) is an aspect of poor inhibition associated with ADHD that is illustrated by low frustration tolerance, impatience, being quick to anger, aggression, greater emotional excitability, and other negative reactions, all of which are related to the impulsivity dimension of the disorder
  • Ability to self-soothe and down-regulate a strong emotion to reduce its severity
  • Ability to refocus attention from emotionally provocative events
  • Ability to organize or substitute more moderate, healthier emotional responses in the service of goals and long-term welfare

To understand the role of EI and DESR in ADHD is to acknowledge the prominent role of emotional control difficulties in the disorder’s appearance and outlook, including understanding the following:

  • Why these issues are prevalent in individuals with ADHD
  • Why major comorbid disorders often develop as a result of these challenges
  • The major life impairments not adequately explained by traditional symptoms of ADHD

A wealth of compelling evidence — from ADHD’s clinical conceptualization over time to neuroanatomical and psychological research — clearly shows that EI and DESR are key components of ADHD and should be incorporated into the disorder’s diagnostic criteria and treatment practices.

EI and DESR: Evidence of Its ADHD Ties

1. EI and DESR in Historical Concepts of ADHD

Conceptualizations of ADHD have included emotional control problems for centuries. One of the earliest references to attention disorder in western medical literature4, a textbook written by German physician Melchior Adam Weikard in 1770, characterizes those who have a “lack of attention” as “unwary,” “flighty,” “careless,” mercurial,” and “bacchanal.”

EI and DESR through history4:

Is it OK to step in when your child is having a dispute?

Is it OK to step in when your child is having a dispute?

Teacher, friendship expert and founder of a social-emotional wellbeing program for kids, Dana Kerford, explains the desire of parents to become involved usually stems from good intentions.

“That love you feel for your child is raw and visceral,” she says.

“But the second you find out [your child is in pain and] the pain came from another child, that sweet, warm mother hen morphs into Mama Bear.

“What once was warmth and compassion is now anger.”

And while emotions can run strong, Ms Kerford says it is important (in the majority of cases) to try not get involved in your child’s dispute for a whole host of reasons. Here, she outlines five of them.

Your kids fighting might give you a headache, but it can give them important life skills. Experts give tips on what you can do and whether you should do anything at all.

Ms Kerford says that often “involving the other child’s parent is humiliating, embarrassing, and erodes trust” between the parent and child.

2. You can’t view the situation or your child objectively

As a parent, “no matter how hard you try to see things from all perspectives, you will naturally have a bias towards your own child,” Ms Kerford says.

“You not only love your child; you also have a very large sample size of their behaviour to draw conclusions.”

3. Involvement can be charged by emotions

“When we picture anything negative happening to our child, we immediately experience an innate, sometimes even physical reaction,” Ms Kerford says.

While this is normal, it isn’t always helpful, she explains.

4. Your perspective is different than your child

“What’s huge to you might be small for them or vice-versa,” she says.

While you may think it warrants interception, your child may have moved past the issue by the next day.

5. It makes things unnecessarily awkward between you and that parent

“In the one out of 10 times where the conversation seems to go relatively well, even if both parents are well-meaning, it is often the beginning of the end,” she says.

“Your relationship with that parent will naturally feel awkward and one or both of you will come away feeling defensive,” something Ms Kerford says is instinctive.

This awkwardness and sense of discomfort became the reality for Amanda after she was contacted by Carly. She also says that she felt a prevalent bias by the other mother to her son.

Social Emotional Learning in Schools for an Enriched Learning Environment

Social Emotional Learning in Schools for an Enriched Learning Environment

The current times call for a need to envision education with the demands of the present situation and for that very reason we must make changes to adapt well. The society we live in is constantly evolving and for the ever-changing world we also require education that garners tools that helps students to be not only academically excellent but also compassionate, responsible towards others and themselves. For this, we need to add something in the education system, that is, social-emotional learning. As of now, education is missing SEL which is a highly sensitive part of the system. Research in SEL shows that focusing on social and emotional aspects of children also helps in developing other academic skills from the early years of their life. Also, we need to take into account that both academic as well as emotional intelligence plays a huge role when we talk about education for the whole child.

Even The New Education Policy recognises the importance of Social-Emotional Learning for holistic development of children from early childhood. “Based on the developments that have taken place in the world of cognitive science, there is now deep engagement with the idea that these social and emotional competencies must be acquired by all learners and that all learners should become more academically, socially and emotionally competent”. (National Education Policy, 2019)

Social-Emotional Learning is a new way of looking at education, where students develop skills to be intellectually intelligent as well as grow to be kinder, compassionate, and responsible citizens of the society.

Here, we will try to understand what SEL is, why it is needed in schools, and some applications.

What is SEL?

As we break down each term separately, we could say that it is “an approach of learning that deals with society (Social/Outward) and with oneself (Emotional/Inward).” Maurice J Ellias stated, “Social-emotional skills, or ‘emotional intelligence’, is the name given to the set of abilities that allows students to work with others, learn effectively, and serve essential roles in their families, communities and places of work.” (The International Academy of Education, 2003). SEL is a process where children learn self-awareness, management, empathy, responsible decision making, etc.

SEL instructions are provided in schools to students by incorporating it through curriculum, activities, games, play, etc. This cultivates a sense of belongingness, caring, compassion towards each other and also with themselves. Social Emotional Learning provides an enriching environment and empowers students to be kinder, compassionate, and resilient not only for today but also for the unpredictable future. These skills equip children of today with better and positive interventions for tomorrow.

We can also say that SEL is more than a course or a subject. It is not something which is taught once and our work is finished. SEL is a life goal, it is continuous and ever changing.

School, Content, and Pedagogy

What we have seen till now is that curriculum, the content which is taught in schools primarily focus on academic excellence and social and emotional learning takes a back seat. Then, we say “Education is for a whole child”. When we talk about the whole child, why do we only focus academically? As we know that the traditional teaching model in schools is not of today but was designed many years ago as per the needs of that time. The present situation requires a change in the system. Which could be met when children not only excel academically but also socially and emotionally.

Here’s what to do when your children say school is boring

In my elementary school days, I’d set up my teddy bears and teach them how to read. I’d make up math tests for the My Little Ponies and quiz them with flashcards. When friends came over, we’d write stories and take turns being the teacher, grading them.

It wasn’t until middle school that I realized a large group of my peers thought school was boring and couldn’t wait for it to be over.

My love of school evolved into my career as a school psychologist. I tend to work with youngsters who tell me they hate school and find it boring. Students are referred to me when they are underachieving or struggling, and my job is to figure out why.

My love of school evolved into my career as a school psychologist. I tend to work with youngsters who tell me they hate school and find it boring. Students are referred to me when they are underachieving or struggling, and my job is to figure out why.

One of the first activities I do with students is try to find out how they think and feel about school, and themselves as learners. I provide the beginning of a sentence, and ask them to complete it with the first thing that comes to mind:

Many of the students who are struggling will say the thing they love is “nothing,” the thing they hate is “everything” and school is “boring.”

Some well-meaning adults may have an instinct to dismiss the claim, saying boredom is common and to be expected at school. They may try to normalize that boredom is something that is just part of school and life — some things will be boring from time to time.

I’ve learned that “boring” means something very different to each student. “Boring” is the tip of the iceberg — it’s what the student says on the surface, but the underlying reasons can be more complex.

A recent study by Michael Furlong and his colleagues sheds some light on what students may actually mean when they report boredom at school. Instead of viewing boredom as being limited to a particular subject or classroom, they studied students who report broader unfavorable school attitudes, or a “School Boredom Mindset.”

The researchers found that 1 in 8 middle and high school students expressed strong negative views of school, describing it as boring and of low value.

According to their review of the literature, school boredom may be a signal of internal mindsets, external situations or a deeper emotional challenge:

  • Trouble with the subject matter or task demands (being over-challenged)
  • A need for more or new sources of stimulation (being under-challenged)
  • Limited interest or motivation in a particular subject
  • A mismatch between a student’s ability and the skill required to complete a task
  • A low perceived value of what is being taught
  • Disengagement and dissatisfaction
  • Helplessness and sadness
  • Depression, anxiety, apathy

The researchers also draw a distinction between experiences of boredom being a temporary state — this class/subject/situation is boring. Or a more stable trait — a general pattern of experiencing boredom in school and in life.

Effects of marital dispute, divorce on children

Effects of marital dispute, divorce on children

Few would dispute that the different relationships that exist within a family affect the other members of the family as well. The most important relationship in this dynamic is that of parents and its effect on children. The quality of these relationships can affect children’s emotional, cognitive and physical development and can imprint on their mental health as an adult as well.

No relationship is free from turmoil. Conflicts and turmoil help individuals build and grow their relationships. It is a mistake to believe that children are unaware when parents argue behind closed bedroom doors. Children are more receptive to their parents’ emotions than we give them credit for.

Marital dispute or conflict has various dimensions that can determine the kind of effect it can create on the children like frequency, intensity, content, and resolution. Cummings classified marital conflicts as destructive and constructive. Constructive arguments involve a healthy argument between parents that ends in a resolution of the matter.

While constructive arguments can benefit children in learning conflict resolution, destructive conflicts can expose the child to further problematic parental interactions.

Destructive arguments consist of verbal aggression like name-calling, insults, threats of abandonment or physical aggression like hitting and pushing, or silent tactics like avoidance or sulking and withdrawing. When parental conflicts are such, children are collateral damage as they threaten the perceived intactness of the family. Conflicts that are hostile and heated can be overwhelming for children and being raised in such environments can impact their ability to form meaningful relationships and their belief in love and security.

From as early as the 1930s, researchers have recognized that disputes between parents have potentially debilitating effects on children’s development. While most children are exposed to periodic conflicts, intense, frequent, and poorly resolved conflicts are indicated to be very harmful.

A child continuously learns from their environment ever since birth. They learn most from their parents and their relationships. They undergo various physical, social, and emotional changes in life that are dependent on the nature of the relationships that surround them.

Marital conflict is a significant source of stress for children of all ages. These influences can be direct or indirect eliciting unhealthy internalized or externalized behavior in children.

Research indicates that during infancy, exposure to distress can result in hampered physical growth and psycho-social withdrawal. Young children may express fear, anxiety, anger, and sadness by displaying overt behavior like being non-compliant or being aggressive in school and among peers. They may also have trouble sleeping and communicating their feelings to their parents and act socially withdrawn. Conflicts during adolescence can result in decreased self-esteem, isolation, and delinquency.

Children often feel emotionally insecure in the family when they see their parents arguing. As a result, they may act out, or […]

Suicide attempts by children have spiked during the pandemic, especially among girls

Suicide attempts by children have spiked during the pandemic, especially among girls

Five years ago, if a child younger than 13 arrived at Maine Medical Center for treatment following a suicide attempt, it was rare and notable.

It’s no longer rare.

If your life or someone else’s life is in immediate danger, dial 911.

For immediate assistance during a mental health crisis, call or text the Maine 24-Hour Crisis Hotline at 888-568-1112.

For any other support or referrals, call the NAMI Maine Help Line at 800-464-5767 or email helpline@namimaine.org.

National resources are also available. The number for the National Suicide Prevention Lifeline is 1-800-273-8255. You can also contact the National Crisis Text Line by texting HOME to 741741.

Warning signs of teen suicide might include:

  • Talking about suicide, including making statements like “I’m going to kill myself” or “I won’t be a problem for you much longer”
  • Withdrawing from social contact
  • Having mood swings
  • Increased use of alcohol or drugs
  • Feeling trapped, hopeless or helpless about a situation
  • Changing normal routine, including eating or sleeping patterns
  • Doing risky or self-destructive things
  • Giving away belongings when there is no other logical explanation for why this is being done
  • Developing personality changes or being severely anxious or agitated when experiencing some warning signs listed above

What to do if you suspect your teen is suicidal:

If you suspect your teen might be thinking about suicide, talk to them immediately. Don’t be afraid to use the word “suicide.” Talking about suicide won’t plant ideas in their head.

Ask your teen about their feelings and listen. Don’t dismiss their problems.

Seek medical help for your teen and follow through with the treatment plan.

“We’re seeing more of them and they’re younger. We have seen as young as 7 to 9 years old, which we never saw,” said Dr. Robyn Ostrander, division director of child and adolescent psychiatry. “It’s hard to wrap your head around that a child of that age would even conceive of suicide or know what it is, but it happens.”

In Maine and across the country, the number of adolescents who attempt suicide has risen dramatically, setting off alarm bells for mental health and suicide prevention experts who say more focus needs to be placed on talking about it and providing access to mental health services.

The increase is being driven largely by girls, who experts say experience depression at higher rates than boys and may be more likely to seek help for self-inflicted injuries.

Nationwide, emergency room visits following suicide attempts by girls age 12 to 17 spiked in 2020 and the first months of 2021. The number of girls who went to the hospital after a suspected suicide attempt rose 51 percent from March 2019 to March 2021, according to a recent analysis by the U.S. Centers for Disease Control and Prevention. The increase among boys was 3.7 percent.