Emotional Impulsivity in Children with ADHD Associated with Comorbid—Not ADHD—Symptomatology Perry I. Factor & Rachel A. Reyes & Paul J. Rosen Published online: 15 May 2014 # Springer Science+Business Media New York 2014 Abstract Children with ADHD often demonstrate sudden and intense shifts in both positive and negative affect. This study examined the role of diagnostic status on emotional impulsivity in children utilizing ecological momentary assessment (EMA). Parents of 64 8–12 year old children (15 ADHD-only; 27 ADHD-comorbid; 22 control) completed a diagnostic structured interview and then an EMA protocol, rating the child’ s affect thrice daily for 28 days. Analysis of covariance (ANCOVA) suggested that children with ADHD and a comorbid disorder demonstrated significantly more EMA-derived emotional im- pulsivity than children with ADHD only and control children. No difference was found between children with ADHD only and control children. This study suggested that children with ADHD demonstrate significantly higher levels of emotional impulsivity than control children only in the presence of a comorbid disorder. Keywords ADHD . Internalizing . Externalizing . Comorbidities . Ecological momentary assessment . Emotion . Emotional impulsivity . Emotional lability Impaired emotional functioning has been recognized as a central feature of ADHD in children (Barkley 2010). Studies have found higher rates of emotional instability (Skirrow et al. 2009), intense reactions to emotional stimuli (Jensen and Rosen 2004), and disinhibition of negative emotional reactions (Crundwell 2005) in children with ADHD relative to healthy controls. A pattern of sudden, intense shifts in emotion has been identified in children with ADHD. Barkley (2010) and others have used the term “emotional impulsivity” to describe this phenomenon. Emotional impulsivity has been characterized by impatience, low frustration tolerance, quick- ness to anger, irritability, and emotional excitability (Barkley and Fischer 2010). Individuals with ADHD display quicker and more dramatic shifts when presented with an emotionally evocative stimulus, whether positive or negative (Musser et al. 2011; Barkley and Fischer 2010). All children—regardless of ADHD status—are capable of demonstrating impulsive emotional reactions. However, a subset of children has been identified as frequently engaging in emotionally impulsive behaviors, and this subset is strongly associated with the presence of ADHD (Anastopoulos et al. 2011). Indeed, Anastopolous and colleagues (2011) found that approximately 47 % of children with ADHD demonstrated this pattern, as compared to 15 % of non-ADHD children. Emotional impulsivity is more likely to occur in conjunction with the combined subtype of ADHD (Wheeler Maedgen and Carlson 2000; Martel 2009), and in children with more severe ADHD symptomatology (Banaschewski et al. 2012). Barkley (2010) and others have speculated that this finding stems from executive functioning difficulties at the neurolog- ical level. Specifically, the inability to inhibit responses causes the difficulties with selective attention, hyperactivity, and impulsivity inherent in ADHD, as well as an impaired ability to inhibit strong emotional responses. Furthermore, children with ADHD display heterogeneous physiological responses to emotionally arousing stimuli, suggesting that there is variabil- ity within this population at the neurobiological level regard- ing emotional responses (Musser et al. 2013). Such physio- logical heterogeneity may explain the reasons why only a certain subset of children with ADHD displays significant problems with emotional impulsivity. P. I. Factor (*) : R. A. Reyes : P. J. Rosen University of Louisville, 317 Life Sciences Building, Louisville, KY, USA 40292 e-mail: perry.factor@louisville.edu R. A. Reyes e-mail: rachel.reyes@louisville.edu P. J. Rosen e-mail: paul.rosen@louisville.edu J Psychopathol Behav Assess (2014) 36:530–541 DOI 10.1007/s10862-014-9428-z