Attention deficit hyperactivity disorder (ADHD) and the intersection of emotional regulation in adolescents: the theoretical basis

Attention deficit hyperactivity disorder (ADHD) is traditionally formulated in terms of executive function deficiencies and impaired attention regulation. However, recent research shows that emotional dysregulation is a central rather than peripheral feature of NGBS, especially during adolescence, when emotional demands increase. This theoretical paper is an integrated model that studies the two-way relationship between NGB symptoms and difficulties in emotional regulation in adolescents. Through a systematic review and theoretical synthesis of neurobiological, developmental, and clinical studies, we propose a rationale that positions emotional regulation as a transdiagnostic process that influences the underlying symptoms of NGD and which they affect. The proposed model reflects the common neurobiological substrates, developmental trajectories, and psychosocial effects that contribute to this intersection. In addition, we explore the implications of this theoretical integration for clinical assessment, intervention design, and future areas of research. This rationale contradicts the traditional symptom-based concept of ADHD and suggests that addressing emotional regulation may be crucial for comprehensive treatment approaches at a critical stage of adolescent development.

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