DESR: “Does ADHD Emotional Dysregulation Ever Fade?”

DESR: “Does ADHD Emotional Dysregulation Ever Fade?”

Emotional dysregulation is a core facet of ADHD that is excluded from official diagnostic criteria and most symptom tests — a contradiction that is pushing researchers and clinicians to further investigate the connection. One such ADHD expert is Russell Barkley, Ph.D., who has coined the term deficient emotional self-regulation (DESR) to describe this fundamental trait.

Because DESR is a novel concept to many, questions abound. Below, I answer several posed during my recent ADDitude webinar titled “Deficient Emotional Self-Regulation: The Overlooked ADHD Symptom That Impacts Everything.”

Q: Does emotional dysregulation change over time? Does it ever improve?

Emotional dysregulation does change and it can improve, but it depends on the individual and the factors involved. For instance, emotional self-regulation is rarely elevated as an issue in toddlers. We don’t expect 4-year-olds to manage their emotions very well. Parents are typically more concerned with the impulsive aspect of emotion at this stage.

But by the time we get into late adolescence, and especially adulthood, we do expect individuals to have developed that second stage of emotional control: top-down executive management (or moderating emotional reactions to evocative events). However, DESR impairs just that —processes related to emotional self-regulation. And that leads to more disparaging moral judgment about adults with ADHD than it would in much younger individuals.

It’s almost like the two components of this emotion problem in ADHD — emotional impulsivity (EI) and DESR — trade places as individuals age. The former is more problematic in children, while the latter becomes a more compelling deficit for the adult individual.

We also know that ADHD symptoms fluctuate over time for many individuals, which may mean that issues like emotional dysregulation also change in severity or degree of impairment. And keep in mind that ADHD mostly persists to some degree from childhood to adulthood for 90% of people.

But can emotional regulation be “trained?” In children, the chances of that are quite slim because they haven’t yet developed the appropriate self-regulation skills that such training would require. Interventions like medication, parent training, and controlling for environmental triggers may be most helpful for this stage. Adults, however, may benefit from cognitive behavioral therapy (CBT) and mindfulness-based programs especially reformulated for adult ADHD in recent books, both of which help the individual deal with many aspects of emotional dysregulation.

Q: Do men and women with ADHD experience emotional dysregulation differently?

Generally, we know that males are more prone to exhibit aggression and hostility, which are associated with externalizing disorders, while females are more prone to anxiety and mood disorders. Both, however, do struggle with impatience and frustration, and the emotional dysregulation component in ADHD will only exacerbate that.

Q: When might DESR symptoms start to appear in children?

DESR usually appears between ages 3 and 5, though it may be quite obvious in a younger child who is significantly hyperactive and impulsive. Still, many families write off this behavior, believing it to be developmentally normal (i.e. the terrible twos), only realizing later on that the child is quite hot-headed and emotional compared to peers. Some of these children will go on to develop oppositional defiant disorder (ODD). If we accept DESR as a core feature of ADHD, we can see why the disorder poses such a significant risk for ODD and related disorders.

I blamed myself for my child’s disability

I blamed myself for my child’s disability

Parents have to ensure that they do not let society’s misconceptions make them feel guilty. DR RADICA MAHASE

“I blamed myself for my child’s disability. I felt that as his mother, I must have done something wrong when I was pregnant with him. Maybe I ate too much junk food? Maybe I didn’t take the right vitamins or should have taken more vitamins? Maybe I did something wrong in the first year of his life?

“I mean, he was my first child, I didn’t know anything about taking care of a child, supposed I hit his head, or didn’t breastfeed him enough?

“My son is now five years old and the guilt I felt when we found out he had developmental issues is now gone. After years of reading up on my son’s disability and sessions of counselling, I am finally in the place where I accept my son fully and I don’t blame myself anymore. Instead, I just focus on him and helping him with his daily challenges.”

Natalie, the mom above, is just one of many parents who blame themselves for their children’s disabilities. Many parents feel a deep sense of guilt when their children experience developmental delays and often it takes some time to process feelings of guilt. Many parents blame themselves for their child’s disability. Why do parents blame themselves? For many, both mothers and fathers, a child with a disability is just not what they imagine their child would be or what they imagine parenthood would be.

Added to this is the fact that society in general places emphasis on the high achievers and there is the common misconception that children with disabilities will not be high achievers. The general perception, propagated by media, the education system, etc, is that children who are not high achievers are “less,” or are a “disappointment” and not as capable as contributing to society.

Sadly, as a society we always looking to place blame on someone or something – it is a dominant part of our social behaviour. Thus, parents of children with disabilities are made to feel they have brought “a lesser child” into this world.

One parent, Nigel, said, “When my son was born, I had a hard time accepting him. I felt like it was my fault, that maybe I passed on ‘bad’ genes to him.

“My neighbour organised counselling for me at the church nearby and I went and I regretted it. The pastor told me that I didn’t pray enough and that my child is paying for my sins. He said that the only way to ‘cure my child’ was to come to church regularly, make regular monetary contributions and let the pastor pray for her. He said that I had […]

13 Truths About Multigenerational Living No One Talks About

13 Truths About Multigenerational Living No One Talks About

If you’re considering moving in with extended family, you’re not alone. The number of families residing in a multigenerational household in America has nearly quadrupled over the past decade, according to a recent study from Generations United. They estimate that 66.7 million adults ages 18 and older live with three or more generations of relatives. In recent years, prolonged unemployment, young adults home from shuttered colleges, and other pandemic-related life changes have resulted in even more multigenerational households.

The fact that this type of living arrangement is on the rise is not surprising when you consider the benefits, such as shared expenses, reduced loneliness, and help with childcare and eldercare. While living with extended family can offer both emotional and financial benefits, it can also come with some challenges—many of which might surprise you.

Family Bonding

Rosemary Ruela has firsthand experience living in a multigenerational household. After arriving in the U.S., Ruela’s paternal grandparents bought a house for their extended family until her parents could buy one of their own. Later, when her maternal grandfather died, the family opened their doors to her grandmother, who resided with them until her passing. Ruela says she feels fortunate they had that time with her grandmother. “She cooked for us, told us stories, sang us songs, and took care of my brother and me,” remembers Ruela.

Too Much Togetherness

While sharing a home can facilitate bonding, it can also be a bit “smothering,” says Ruela. Families that reside together will want to figure out how to enable privacy for all. Ideally, each generation could have their own zone, with a minimum of a personal bathroom and bedroom, or perhaps a private in-law suite. For instance, growing up, Ruela’s family each had their own floor of the home. When that’s not possible, consider adding pocket doors, or sliding barn doors (available on Amazon) or curtains for separation.

Plentiful Unsolicited Advice

Grandma thinks the little ones have too much screen time, and everyone thinks she needs to get out of the house more. Opinions are plentiful among different generations, but there’s no one right way to run a household or raise children. Setting emotional boundaries is just as crucial as creating physical ones.

Family members must come together to decide who’s responsible for what decisions and to communicate their needs and expectations. Agree to share opinions only when asked, especially when it comes to personal choices. Speak up early and clearly to avoid tension and hurt feelings later.

Here’s what makes ‘authoritative parents’ different from the rest—and why psychologists say it’s the best parenting style

Here’s what makes ‘authoritative parents’ different from the rest—and why psychologists say it’s the best parenting style

We all want to raise intelligent, confident and successful kids. But where to begin? And what’s the best parenting style to go with?

There are four main parenting styles: Permissive, authoritative, neglectful and authoritarian. It might be that you use one or more of these styles at different times, depending on the situation and context.

The 4 Parenting Styles

But research tells us that authoritative parenting is ranked highly in a number of ways: Academic, social-emotional and behavioral. Similar to authoritarian parents, authoritative parents expect a lot from their children — but they expect even more from their own behavior.

What is authoritative parenting?

Authoritative parents are supportive and often in tune with their children’s needs. They guide their kids through open and honest discussions to teach values and reasoning.

Like authoritarian parents, they set limits and enforce standards. But unlike authoritarian parents, they’re much more nurturing.

Some common traits of authoritative parents:

  • Responsive to their child’s emotional needs, while having high standards
  • Communicates frequently and takes into consideration their child’s thoughts, feelings and opinions
  • Allows natural consequences to occur, but uses those opportunities to help their child reflect and learn
  • Fosters independence and reasoning
  • Highly involved in their child’s progress and growth

Why experts agree authoritative parenting is the most effective style

Studies have found that authoritative parents are more likely to raise confident kids who achieve academic success, have better social skills and are more capable at problem-solving.

Instead of always coming to their kid’s rescue, which is more typical among permissive parents, authoritative parents allow their kids to make mistakes. This offers kids the opportunity to learn, while also letting them know that their parents will be there to support them.

Authoritative parenting is especially helpful when dealing with conflict, because the way we learn to deal with conflict at a young age plays a big role in how we handle our losses or how resilient we are in our adult lives.

With permissive parents, solutions to conflicts are generally up to the child. The child “wins” and the parent “loses.” I’ve seen this approach lead to kids becoming more self-centered and less able to self-regulate.

Of course, there are times when a punishment, like taking a time out, is necessary. But the problem with constant punishment is that it doesn’t actually teach your kid anything helpful. In most cases, it teaches them that the person with the most power wins, fair or not.

Let’s say your 10-year-old son begs not to go to soccer practice: “I don’t want to because I don’t think I’m good at it.”

In response,

  • A permissive parent might say, “It’s up to you.”
  • A neglectful parent might say, “Whatever you want … it’s your life.”
  • An authoritarian parent might say, “You have to. I don’t want to hear another word from you.”
  • An authoritative parent might say, “I understand that you don’t want to go. But sometimes, fighting the urge to avoid doing something hard is how you get better!”

While authoritative parents do set limits and expect their kids to behave responsibly, they don’t just demand blind obedience. They communicate and reason with the child, which can help inspire cooperation and teach kids the reason behind the rules.

Authoritative parenting doesn’t guarantee success

While experts give authoritative parenting the most praise, it’s important to note that using just one method does not always guarantee positive outcomes.

Parenting isn’t an exact science. In many ways, it’s more like an art. As a child psychologist and mother, my advice is to be loving and understanding — but to also create structure and boundaries.

What Is Parentification?

What Is Parentification?

Do you feel like you were pushed into taking care of your parents or siblings when you were only a child yourself? That you became an adult before you were ready for the role?

If you’re nodding, you may have been parentified. Being a “little parent” involves excessive responsibility or emotional burden that can impact a child’s development.

That said, it’s important to remember that some responsibility is a good thing. Helping out a parent on occasion and at the right level helps a child believe in themselves and their ability to one day also be an adult.

Let’s take a closer look at how and when the line into parentification is crossed.

In the typical order of things, parents give and children receive. Yes, sometimes — especially in the early morning hours when your baby is teething — the giving can seem never-ending.

But in general, parents are expected to give their children unconditional love and to take care of their physical needs (food, shelter, daily structure). Emotionally secure children whose physical needs are taken care of are then free to focus their energy on growing, learning, and maturing.

Sometimes, though, this gets reversed.

Instead of giving to their child, the parent takes from them. In this role reversal, the parent may relegate duties to the child. At other times, the child voluntarily takes them on.

Either way, the child learns that taking over the duties of the parent is the way to maintain closeness to them.

Children are pretty resilient. We’ve already said that some level of responsibility can help a child’s development — but 2020 research takes things further. The researchers suggest that sometimes, parentification can actually give a child feelings of self-efficacy, competence, and other positive benefits.

It seems that when a child feels positively about the person they’re caring for and the responsibilities that come with the role of caregiver, the child develops a positive self-image and feelings of self-worth. (Note that this isn’t a reason to pursue or justify parentification.)

Not all parents are able to take care of their children’s physical and emotional needs. In some families, the child takes over the role of caregiver in order to keep the family functioning as a whole.

Parentification can happen when a parent has a physical or emotional impairment, such as the following:

  • The parent was neglected or abused as a child.
  • The parent has a mental health condition.
  • The parent has an alcohol or substance use disorder.
  • The parent or a sibling is disabled or has a serious medical condition.

Parentification can also happen when life throws curveballs, like:

  • The parents are divorced or one parent has died.
  • The parents are immigrants and have difficulty integrating into society.
  • The family experiences financial hardship.

There are two types of parentification: instrumental and emotional.

Alcohol use in children, and how parents can make a difference

Alcohol use in children, and how parents can make a difference

Martin was 17 when he was first introduced to alcohol.

“As a young person, there’s the world of alcohol. You go there as a way [to], I guess, get away from your problems,” he says.

“It’s a way to be social, it’s a way people perceive to have fun, you see it as something to do with your mates and if you are not doing it then … you’re different.”

But for Martin, alcohol soon became a way to cope with his anxiety.

“I think it led to experiences that weren’t necessarily the best for me,” he says.

“The decisions you make while you are under the influence essentially can increase more of that anxiety in you as a young person.”

In a culture where alcohol is prevalent, Martin says the pressure to drink can be overwhelming.

“I think just growing up in Australia in general, there’s a lot of emphasis on drinking alcohol to be social,” he says.

“At a stage of my life where I felt a bit shy or insecure, not confident in who I was, drinking alcohol was a way to cope with that social anxiety.”

Add to that research that finds people living with an anxiety disorder are 2-3 times more likely to also have an alcohol use disorder, and it becomes all the more worrying. Preventing problem drinking from the start

In a culture where alcohol is prevalent, the pressure to drink can be immense — but parents can have an impact.( Unsplash: Kelsey Chance ) It’s a familiar cause of angst for many parents — the concern that as their children grow up, they will encounter or face pressure to drink alcohol or try illicit drugs.

But while the pressure from media and peers is real, parents can make more of a difference than they think.In fact, they are more influential than peers at this stage, according to Associate Professor Nicola Newton, the Director of Prevention Research at the University of Sydney’s Matilda Centre. “The most important thing is for parents to know that they still have an influence over their children’s choices when they become adolescents,” she says. “In fact, they are the number one influence over their adolescents’ choices at this stage.”Whilst it may appear and it may seem at the time that peers are the most important influence in your life, parents still have a critical role to play in their adolescents’ health, behaviours and choices.” Dr Newton says to reduce “uptake of substances”, modelling good behaviour around alcohol is key — and that means parents need to have healthy habits themselves.”If your kids are coming home from school and you are there having a glass of […]