ADHD and Emotional Dysregulation: Why Do You Jump from 0 to 100?

Jun 12, 2026

Psychologist & Behaviour Analyst

From 0 → 100: ‘Why Do My Emotions Jump So Quickly?’

ADHD – More Than Hyperactivity and Inattention

At first glance, it can look as if the problem for people with ADHD is ‘just’ that they are hyperactive and inattentive.

In other words, the idea is that ADHD is simply a lack of self-control and organisation and that this explains all the visible symptoms and all the differences.

Why is the person hyperactive?
Because it is hard to put the brakes on, hard to hold themselves back.
Why are they inattentive?
Because it is hard to organise themselves, and hard to keep their focus where it ‘should’ be.

And there is another important, third feature, which is there even when people are not obviously hyperactive: impulsivity, which shows up in many different ways.

This is the part that, in the context of hyperactivity, shows up as: you do not think things through, you do not consider what might be the best way to act, you do not weigh up different options, you do not really scan the situation around you.

ADHD – The Marshmallow Experiment

When we talk about impulsivity or cognitive control, a classic example is the well-known ‘marshmallow experiment’. Children were offered a simple choice: to have an appealing sweet now – for instance a marshmallow – or to wait a little and receive more later. While they were waiting, their behaviour took on a characteristic pattern: they picked at their faces, fidgeted, sat restlessly, touched the marshmallow, wriggled about – in short, they were struggling with themselves in one way or another. Roughly two thirds chose the immediate reward over the delayed one. Older children were more likely to wait. Adults generally found it easier than children to hold back.

Later research highlighted the role of socio-economic background, which also plays an important part, but the experiment still illustrates very clearly the core idea that is highly relevant to ADHD: for some brains, the ‘waiting gap’ is intensely uncomfortable.

People with ADHD find almost any delay hard to tolerate: the gap between impulse and action, the pause between feeling and doing. They tend to act straight away, without hesitation. In other words, in the ADHD brain it is not only behavioural impulsivity that is more vulnerable, but emotional impulsivity as well.

ADHD – The Many Faces of Hyperactivity and Impulsivity

When we talk about hyperactivity in children, we know what it can look like: they dash around, sprint, jump, play loudly, shout, sing – they have endless opportunities to discharge physical energy.

An adult who is hyperactive and impulsive obviously cannot just stand up in the middle of a meeting and start moving, singing or doing star-jumps.

This person may show profound impatience and may find certain formal situations almost unbearable. It can look as if they are about to jump up and run off somewhere. You can see they desperately want to do something; they are no longer really listening, they are no longer concentrating, they want to get up and leave.

The person is not fully present in the here and now – and this inner restlessness is something they themselves also feel as difficult to endure.

What happens after that?

That hyperactivity does not disappear. You swallow it down and it turns ‘inwards’: the hyperactivity becomes inner restlessness and anxiety – ‘mental restlessness’.

You may feel a chronic physical tension in your body – it is hard to relax, hard simply to sit still.

People with ADHD are often extremely sensitive to both criticism and praise. The mental chaos of what someone said, and replaying it over and over in your mind, can make it hard to fall asleep.

In ADHD, anxiety and depression are very common co-occurring conditions.

Impulsivity can show up in other ways too. There can be compulsive overeating – you simply cannot stop if something tastes good. Or, when you are in hyperfocus, you can completely forget basic bodily needs.

Impulsivity can also lead to spending money without thinking it through. Unprotected sex, multiple partners, teenage pregnancy are all somewhat more common in ADHD. In general, any kind of risk-taking behaviour is characteristic, because people with ADHD often underestimate risk and danger. To others they can look almost fearless.

There can be impulsive conflicts. In relationships, this level of impulsivity can even contribute to criminal behaviour. In US prisons, for example, when inmates were assessed, researchers found that roughly 30–40% of them had probably shown ADHD symptoms in childhood– an enormous proportion.

In ADHD the risk of traffic accidents and injuries is higher, especially if the condition is untreated.

The use of psychoactive substances and various forms of gambling are also classic expressions of raw impulsivity: ‘I want to feel good right now.’ Trauma, environmental stress, social factors and access all strongly influence why people use substances – but among people with ADHD the risk of substance use disorders (alcohol, nicotine, illegal drugs) is around two- to three-fold higher.

And linked to this are those emotional ‘swings’ where you go from 0 to 100. With one sudden, impulsive step you ‘explode’ – the infamous last straw: the emotion floods you within seconds and it is almost impossible to change direction, even if you know you are about to do something you will regret.

ADHD – Impulsivity from a Psychological Perspective

Impulsivity does not only appear as ‘I explode’. It can show up in more nuanced ways:

There is motor impulsivity – sudden movement, action, ‘I act first and think later’.
Then there is cognitive impulsivity – snap decisions, lack of thinking through the consequences, ‘I must decide right now’.
And there is emotional impulsivity – emotional outbursts, anger/anxiety/tears that are hard to rein in.

In real life this does not run in three separate boxes. In any given situation, motor, cognitive and emotional impulsivity tend to pile up on top of one another.

ADHD – Everyday Impulsivity

1. ‘I’ll just quickly open the laptop’ – motor + cognitive impulsivity

You are impatient to open the new laptop you have been waiting for. As you slice off the packing tape, the blade slips and you scratch the front panel right across the middle. Later you manage to polish it out a bit, but the memory stays with you: your ADHD moved faster than your hands.

Here we mostly see motor impulsivity (a rushed movement, without checking where the blade is). Alongside it there is cognitive impulsivity (impatient thinking: ‘I want to see it right now; I’m not going to faff around carefully unboxing it.’).

2. ‘Where’s the money?!’ – emotional + cognitive impulsivity

Another situation: you are waiting for your rental deposit to be transferred back to you. You wind yourself up more and more, then send the person a rather nasty message: ‘Where is my money?’ A bit later the money arrives – the delay was at the bank. You feel an intense wave of shame about how you reacted, and you would love to rewind the entire scene.

Here the main driver is emotional impulsivity (anger and a sense of injustice steering your reaction), plus cognitive impulsivity (a quick, distorted conclusion: ‘They haven’t transferred the money – they must be cheating me.’).

3. ‘Short hair, big event tomorrow’ – cognitive + emotional impulsivity

One more example. You are walking down the street, spot a hairdresser’s, walk in and have your hair cut very short – the day before an important event. On the way home it suddenly hits you what you have done and you burst into tears at your own ‘brilliance’.

Here, the key element is cognitive impulsivity (a big decision – cutting your hair short right before an important event – made within a moment). This is paired with emotional impulsivity (the tears and self-reproach on the way home).

4. Self-monitoring

To identify impulsivity and define it more precisely, you need self-monitoring skills – the ability to notice, as early as possible, when you are acting impulsively.

As you read the next example, try to ‘sort’ the story into the different types of impulsivity:

‘I once set off to go for a swim at the pool, then my daughter rang and begged me to come to her in another town. On the way I popped into work, put in my leave request (don’t even ask), stayed with her for a few days to make sure she and the new baby were all right, then flew straight from there to visit my mum in another country, seeing as I was on leave anyway. I didn’t even go home in between. Later my husband sounded a bit sad on the phone and just said: I seem to remember you only went out to the pool…’

Have you got your own answers?

In this case we see classic cognitive impulsivity (a chain of major life-organisation decisions in quick succession: ‘seeing as I’m on leave anyway, I might as well…’). This blends with an emotional component – emotional impulsivity (worry for the daughter, the ‘I must go right now’ momentum).

ADHD – Emotional Dysregulation

We also need to mention something else: emotional dysregulation in ADHD.

At the moment this appears in the literature as a ‘fourth accompanying feature’, not as an official diagnostic criterion. But we already know that emotional dysregulation is a major manifestation of ADHD.

And sadly, people with ADHD have no shortage of painful stories. In children, emotional dysregulation alongside ADHD is present in around 40–50% of cases. In adults, these rates rise to around 70%. if we are honest, a sobering number.

What does emotional dysregulation in ADHD mean in practice?

First of all: anxiety.

We have already mentioned that hyperactivity can turn into this kind of internal anxiety when it goes ‘inwards’ – when the person cannot discharge it.

Someone with ADHD can be incredibly harsh on themselves, far more than other people are. From a really good mood they can suddenly plunge into self-flagellation, self-blame, guilt and shame. The anger and aggression turn inwards and get directed at themselves.

There is also heightened sensitivity to rejection – rejection sensitive dysphoria (RSD). A sudden emotional reaction, a shift in emotional tone or a sudden memory can throw the person into an emotional pit dominated by a single negative feeling.

Another direction of emotional dysregulation is an over-reactive nervous system. A more emotionally sensitive person is repeatedly exposed, throughout their development, to invalidating messages and belittling comments:

‘Stop crying.’
‘Don’t behave like that, be a good boy/girl.’
‘Nothing is ever good enough for you.’

For them, these emotional reactions often show up in social situations. Children can be overwhelmed by intense sadness at almost any moment – for instance, if at a school celebration, someone steps on their foot or some other tiny thing happens. And there is simply no way for them to switch this sadness off – they may stand in the middle of the room sobbing.

This is painful for the parents as well: first the crying child who cannot stop, and then the parent who cannot regulate themselves either and starts saying things like:

‘Why are you like this? Look, everyone else is dancing. You should dance too, everyone’s dancing.’

People with ADHD constantly try to ‘compensate’ for their neurodivergence with huge effort, with ‘good girl / good boy’ over-performance – especially when they are not yet aware of their diagnosis.

This constant over-exertion increases the frequency of emotional dysregulation.

ADHD – Mood Swings and Relationship Difficulties

There can also be multiple mood shifts during the day – the mood may change four or five times within a single day.

Crucially, emotional dysregulation often shows itself in relationships. People with ADHD may hurt others more often – emotional dysregulation can trigger aggression towards others.

And they themselves are more often hurt – these children and adults are frequently targets of bullying, because they ‘react strangely’ or ‘overreact’ to situations.

Another expression of emotional dysregulation is rapid frustration when something does not work out. The sense that ‘I must have missed something, I must be overlooking something’ – and this anxiety reflects the ongoing attempt to keep everything under tight control.

Children with ADHD may hear messages like these from teachers, parents and other adults:

‘Sit still.’
‘Calm down.’
‘Just concentrate.’
‘Why can’t you be like Tom, who sits quietly and writes?’

Over time, this invalidation becomes internalised. As a result, many people with ADHD do not even start tasks where they expect this kind of frustration.

Black-and-white thinking is also very typical here: categorical ‘all-or-nothing’ thinking. If something does not work perfectly, if one small detail is off, then: ‘That’s it, I’m done!’

ADHD – Rapid Activation and Burnout

Irritability and a labile nervous system mean that a person can ‘catch fire’ extremely quickly.

For example, they go to some event, see something or start an activity that ‘lights them up’, and their energy level can rocket from zero to a hundred in no time. They become highly active, throw themselves into it, pour out energy very fast – and then the sense of overload arrives.

After a few hours of this kind of mode, the person may feel utterly exhausted and need a whole day just to recover and get back to their own ‘resourced’ level.

People who struggle with self-control and self-organisation tend to change jobs more frequently and earn less. Which is understandable: work demands patience, willpower, self-control and self-organisation – all of it.

ADHD – Intolerance of Delay

Where does all this lead?

If you have ADHD, your relationships are more at risk of breaking down and it is harder to ‘please’ others – in everyday life all the minor collisions add up.

Waiting for your partner to call you back can feel almost unbearable. It can feel easier to text them ‘go to hell, you never loved me anyway’ and then cry, than to sit with the waiting and uncertainty. You may do this regularly, without fully understanding why. A few hours later you regret it – but by then many relationships are already over. In that moment no one could have stopped you.

Intolerance of delay also shows up in frustrations and conflicts: something feels off, tension appears – and you feel you must discharge it immediately, in the first moment, through irritability, a sudden burst of anger or rage.

This often plays out in relationships – anger and aggression breaking outwards. At home, blazing rows can erupt ‘out of nowhere’, with intense scenes that could be from a soap opera: objects thrown, doors slammed.

If you are in a leadership role at work and something does not go to plan, you can, within a second, say something or take an action in anger that you later sit and feel deeply ashamed about. It is very hard to live with this – you want to be a good manager, and at the same time your impulses keep getting to the finish line before your better judgement.

You react instantly to the smallest thing: someone writes ‘you’re wrong’ under your post online, and you rush to pour out your entire opinion on the spot.

It is easy to get into conflict, even into a physical fight, in completely mundane situations – queueing at a supermarket till, in traffic.

At parents’ evening in school, when you have to wait your turn and you cannot bear it, you may repeatedly interrupt others, speak when everyone else is listening quietly – and then feel terrible about it afterwards.

ADHD – Shopping

Difficulties with executive functions and impulsivity are closely linked to problems with financial decision-making.

Anything where you make impulsive, poorly thought-through moves – you see something and instantly must have it – is likely to feature. That is how you end up with a mountain of unnecessary purchases. In the rush you may even buy the wrong product.

You might be told: ‘Try the shoes properly first.’ You try one on, think: ‘The size is fine, I’ll take them.’ At home you put both on… and realise you brought home two left shoes. The best part is that you had checked them more than once in the changing area – and still did not notice.

Another example: in one week you manage to ‘sort out’ two coach tickets.

First you quickly buy a ticket – and only later realise it is for a coach leaving from the wrong station. Then you buy another one and only afterwards notice that this one is for the wrong date. The punchline is that the first ticket was also for the wrong date, in a slightly different way.

With ADHD, there is always a spare disaster in reserve.

ADHD – The Neurobiological Background

So, what explains hyperactivity and impulsivity at a biological level?

There is nothing ‘mystical’ here – it is entirely natural that these symptoms are linked to differences in how certain brain areas function.

Most of the inattention, hyperactivity and impulsivity is related to the functioning of the prefrontal cortex – the area just behind the forehead. There are also widespread differences in networks responsible for movement, emotions and habits.

Put in very simple terms: at the front of the brain, behind the forehead, sits the prefrontal cortex. This is the area that:

sets goals,
makes plans,
monitors whether we are doing what we decided to do,
and inhibits impulses.

This region allows us to think ahead, adapt, learn from mistakes and collaborate with others.

In ADHD it is not that this part is ‘missing’. Rather:

it often matures more slowly – in childhood it may not stabilise fully until late adolescence (because of this slower maturation, younger children with ADHD often find it particularly hard to tolerate delay or to ‘wait their turn’ – as in the classic ‘marshmallow experiment’);
as a result, braking, planning and working memory fall apart more easily, especially under fatigue, stress or boredom (by adulthood many people with ADHD notice some improvement – the brain has had more time to catch up – but their self-control often remains more fragile);
and communication between nerve cells – particularly via the messenger chemicals dopamine and noradrenaline – is more uneven.

In a brain without ADHD, these chemicals flow relatively steadily – like a tap that has been opened, and the water is running smoothly.

In someone with ADHD, however, noradrenaline and dopamine release may be:

too low – not enough signal, lots of ‘noise’, like a radio that is not tuned properly; or
disrupted in another way: for instance, when the person is told ‘Stop fidgeting, just concentrate, pull yourself together, don’t be so scatter-brained’ – this stress can trigger excessive release of noradrenaline and dopamine.

Unfortunately, this overshoot has a similar effect: the signal again becomes less clear, and dopamine signalling becomes more ‘noisy’. And precisely in these stressful situations emotional dysregulation kicks in, as we described earlier.

This is why ADHD has such high rates of comorbid conditions: conduct problems, impulsivity, a tendency to conflict, certain rigidities, as well as mood disorders – anxiety, mood swings, depression – plus problems with anger control and aggression.

ADHD – Cyclical Variations in Women

For women with ADHD, one more point is important. Oestrogens can modulate certain aspects of dopamine function, which may contribute to some of the sex differences we see in ADHD.

This is one reason why we see explicit hyperactivity less often in women.

At the same time, there are cyclical fluctuations. Modern studies suggest that almost half of all women experience significant premenstrual mood symptoms, and among those with ADHD this is even more frequent. Naturally, genetic, neurobiological, social and diagnostic biases all interact in the sex differences we see.

ADHD – Managing Impulsivity

To make these emotional swings more bearable, it is not enough simply to know about them – you also need concrete tools.
In ADHD there are basically two main approaches.

One approach focuses mainly on helping the person adapt to the surrounding world – which can include medication.

The second is the reverse: we adjust the surrounding world to the person.

If we choose the second approach – the non-medication route – the question becomes: how can we develop cognitive control, in other words train the brain?

This can be done through lifestyle changes and psychotherapeutic interventions.

ADHD – Lifestyle

If you struggle with impulsivity, it is crucial to get enough sleep. You have probably noticed: when you are sleep-deprived, you are more irritable and less patient.

The second pillar is physical activity. Sport gives both children and adults a way to discharge energy – and to supply the ‘fuel’ that the brain needs to function.

Nutrition also matters. If food is one of your main sources of reward, and you have impulsive eating tendencies – for instance while dieting – then it is very important not to be constantly hungry. The aim is not for you to starve, but to be full on different types of food; otherwise, it is easy to fall back into compulsive overeating. In ADHD, extreme restrictions do not always work – if the brain is trying to control too many things at once, it gets exhausted, and impulsive eating breaks through the barrier.

If your internal self-regulation is not strong enough, you can build external regulation – reactive behaviours: external control, accountability, promises made to others. Humans are social beings; it matters what others think of us. Shame, conscience and guilt are deeply human feelings. If you promise something to someone else, you are more likely to stick to it.

It is useful to divide symptoms into two groups:

those where you are genuinely willing and able to compromise and adapt a bit;
and those you are not obliged to change in your temperament – instead, you create the right conditions for yourself: personal arrangements, your own ‘life hacks’.

As adults, many people with ADHD choose self-employment, and in that they can finally do something they truly want, in a schedule that actually suits them.

If sitting still in a meeting is hard, you can walk while on a call. You can move around the room. You can study and memorise while pacing. Try to keep only a tiny fraction of situations where you must sit motionless – and shift everything else into movement, as long as it harms no one.

The fact that many people with ADHD talk a lot can also be an advantage in certain roles. You can choose a profession where talking is central – business, creative work, hosting, TV, blogging – where this is valued.

If your impatience, your urge to correct others or to give advice is strong, many people with ADHD gravitate towards the business world or education – places where lots of ideas, creativity and different directions are welcome.

ADHD – Psychotherapy

When it comes to specific guidelines, there is no magic pill ‘for impulsivity’. There is no single treatment that has been proven to fix it.

If the goal is specifically to reduce impulsivity, the main tool is psychotherapy.

Mindfulness-based therapies

Mindfulness is the skill of deliberately focusing attention on what is happening inside you right now – noticing your current inner processes.

As you are reading this article, you are probably not aware of how your clothes feel against your body, how the chair touches you, or what the room smells like – you have adapted and these sensations have faded into the background.

The moment I draw your attention to them, you suddenly notice them.

That returning to the present moment – that is the core of mindfulness.

ACT – Acceptance and Commitment Therapy

The goal of ACT is to increase psychological flexibility.

Its role is not to ‘get rid of’ or suppress thoughts and feelings, but to help you notice and accept them, even when they are uncomfortable. At the same time, you practise taking up an observer position: ‘I notice that I feel afraid’, ‘I notice that I feel angry’ – while shaping your behaviour according to your own values.

CBT – Cognitive Behavioural Therapy

CBT is not about simply ‘teaching someone to sit still’. It is about helping the person adapt their work routines, activities and movement to their own neurocognitive profile.

When automatic thoughts are incorrect or irrational, we try to bring them into awareness and re-work them – so that behaviour can change as well.

DBT – Dialectical Behaviour Therapy

To regulate emotions, you first need to notice that ‘something is not right’.

Here, mindful awareness and crisis-management skills are key: how to stop yourself in the spiral of emotional dysregulation, how to bring yourself back to the present, how not to make the situation worse. The aim of crisis skills is not to solve the problem, but to avoid making it worse – to ‘ride out’ the moment.

DBT is a multi-component therapy, not just one-to-one work. It also includes skills training in groups, where participants learn emotion regulation, crisis-management and mindfulness skills.

The whole therapy is essentially a large toolbox of extremely useful techniques.

ADHD – A Quick Tool in Crisis

One simple and fast tool that does not require deep prior knowledge is Jacobson’s progressive muscle relaxation: you tense a muscle group very strongly and then relax it as you breathe out.

Classically you go through the whole body: fists, forearms, upper arms, shoulders, back, neck, face and so on.

But in sudden emotional dysregulation you do not have time for full protocols. In those moments you focus quickly on one large muscle group – for example the muscles in the feet or legs.

It is important not to try this for the first time in a full-blown crisis. If the skill has never been ‘trained’, it will not work in the heat of the moment – just as no one runs a marathon without ever training. That is why it is so important to practise beforehand in calmer situations: cold water on the face at home, progressive tensing and releasing of muscles, and observing what effect it has.

Biology shifts here too: blood flow changes, sympathetic activity decreases (the ‘fight-or-flight’ branch eases off), parasympathetic activity increases (the ‘rest-and-digest’ system comes to the fore). You can often feel this as yawning, a sense of relief and relaxation after just a few minutes.

If the stress level is not extremely high, even a simple walk can help.

There is a wide range of methods, and they would deserve a whole chapter of their own.

ADHD – Medication

We need to say straight away that medication for ADHD is not compulsory. It is an option that doctor and patient discuss and decide on together.

Doctors start medication when they see that despite everyone’s efforts – the environment is informed, parents have read about ADHD, people have set up supports, reward systems are being used, a suitable school or workplace has been found – there is still clear maladaptation. In such cases, medication can complement these supports – not replace them.

Doctors always consider the individual, select medicines case by case and do not reach for ‘heavy artillery’ straight away. They consider comorbid conditions, age and which side effects would be particularly unacceptable.

Any medication for ADHD is always agreed jointly by doctor and patient. This is not a condition where medication is automatically essential, as in some other psychiatric diagnoses. The aim of medication here is purely to improve quality of life.

ADHD – What to Do If You Recognise Yourself?

If there are many impulsive people in your family, you are more likely to have stronger impulsivity yourself. This does not mean ‘that’s it, nothing can be done’ – but it does mean that developing self-control will be harder work for you.

One starting point can be identifying your difficulties with a quick, free online self-screening test (this is not a diagnosis, only a quick self-check): Free ADHD test → https://adhdtest.co.uk/free-test

This can be the moment when you move from self-blame to a different sentence: ‘My nervous system is ADHD-type – and I need to learn how to live with it.’

ADHD is a ‘good diagnosis’.

In what sense is it good?

It can bring a sense of relief.

It helps because once the diagnosis is made, things cannot really get worse – only better. You start taking your own condition into your own hands and working with it in a targeted way.

How much better everything becomes after that is, ultimately, up to you.

Last updated February 2026
Written by Olga Karolyi for ADHD Test

Important: This article is for information only. Diagnosis and treatment are determined and overseen by a qualified clinician. If you feel affected, contact your GP.

References:

Key UK guidance

National Institute for Health and Care Excellence. (2018, last reviewed 2025). Attention deficit hyperactivity disorder: Diagnosis and management (NG87). https://www.nice.org.uk/guidance/ng87
National Health Service. (2025). ADHD in adults. https://www.nhs.uk/conditions/adhd-adults/
Royal College of Psychiatrists in Scotland. (2022). ADHD in adults: Good practice guidance (CR235). https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/cr235-adhd-in-adults---good-practice-guidance.pdf

Further reading

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Association
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
(A DSM-5 is the core psychiatric classification manual; for adults it explicitly notes that hyperactivity often appears as an inner sense of restlessness rather than obvious running around.)

Arnsten, A. F. T. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience, 10(6), 410–422.
(This review explains how stress chemistry temporarily degrades prefrontal cortex performance and shifts control towards more emotional, reactive brain systems.)

Bangma, D. F., Tucha, L., Fuermaier, A. B. M., Tucha, O., & Koerts, J. (2020). Financial decision-making in a community sample of adults with and without current symptoms of ADHD. PLOS ONE, 15(10), e0239343.
(This empirical study shows that adults with ADHD symptoms are more prone to impulsive purchases, use more avoidant or spontaneous decision styles, and find it harder to save money than controls.)

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94.
(This classic theoretical paper frames ADHD as a disorder rooted in impaired inhibition, hyperactivity, and impulsivity, organised around executive function deficits.)

Barkley, R. A. (2015). Emotional dysregulation is a core component of ADHD. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed., pp. 81–115). The Guilford Press.
(Barkley argues that emotional dysregulation is not a side issue but a core component of ADHD, tightly linked to executive dysfunction and everyday social and occupational problems.)

Baumeister, R. F., & Heatherton, T. F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7(1), 1–15.
(This target article models typical processes in self-regulation failure—stress, temptation, depletion and self-justification—and shows how chronic self-control problems have long-term physical, psychological and social costs.)

Beheshti, A., Chavanon, M. L., & Christiansen, H. (2020). Emotion dysregulation in adults with attention deficit hyperactivity disorder: A meta-analysis. BMC Psychiatry, 20(1), 120. https://doi.org/10.1186/s12888-020-2442-7
(This meta-analysis finds that emotional dysregulation is a substantial and robust additional burden in adult ADHD, closely associated with everyday functional impairment.)

Bitsakou, P., Psychogiou, L., Thompson, M., & Sonuga-Barke, E. J. (2009). Delay aversion in Attention Deficit/Hyperactivity Disorder: An empirical investigation of the broader phenotype. Neuropsychologia, 47(2), 446–456. https://doi.org/10.1016/j.neuropsychologia.2008.09.015
(This experimental study shows that children with ADHD systematically avoid waiting, even when it reduces rewards, supporting the idea of “delay aversion” as a key feature.)

Bunford, N., Evans, S. W., & Wymbs, F. (2015). ADHD and emotion dysregulation among children and adolescents. Clinical Child and Family Psychology Review, 18(3), 185–217. https://doi.org/10.1007/s10567-015-0187-5
(This review summarises how ADHD-related emotional dysregulation links to anxiety, depression, anger outbursts, interpersonal conflict and school difficulties in young people.)

Chang, Z., Lichtenstein, P., D’Onofrio, B. M., Sjölander, A., & Larsson, H. (2014). Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: A population-based study. JAMA Psychiatry, 71(3), 319–325. https://doi.org/10.1001/jamapsychiatry.2013.4174
(This large population study shows that adults with ADHD have an elevated risk of serious traffic accidents, and that this risk is reduced during periods when they are receiving medication.)

Clark, K. L., & Noudoost, B. (2014). The role of prefrontal catecholamines in attention and working memory. Frontiers in Neural Circuits, 8, 33.
(This article reviews how prefrontal dopamine and noradrenaline systems regulate attention and working memory, and what happens when their levels are too low or too high.)

Cortese, S., Moreira-Maia, C. R., St Fleur, D., Morcillo-Peñalver, C., Rohde, L. A., & Faraone, S. V. (2016). Association between ADHD and obesity: A systematic review and meta-analysis. The American Journal of Psychiatry, 173(1), 34–43. https://doi.org/10.1176/appi.ajp.2015.15020266
(This meta-analysis finds a significant association between ADHD and obesity, with suggested mechanisms including reward seeking, impulsive eating and emotional regulation difficulties.)

Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327–1343.
(This classic paper on rejection sensitivity shows how expecting rejection can trigger intense emotional reactions, conflict and shame in close relationships.)

Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146(4), 348–361. https://doi.org/10.1007/PL00005481
(This review argues that impulsivity consists of several partly independent dimensions—such as motor impulses, decision-making and delay intolerance—rather than a single homogeneous trait.)

Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD international consensus statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022
(This international consensus statement summarises current evidence on ADHD in 208 conclusions covering epidemiology, neurobiology, course, comorbidities, emotional dysregulation and treatment, and emphasises multimodal, life-span care.)

Filiz Kulacaoglu, F., Solmaz, M., Ardic, F. C., Akin, E., & Kose, S. (2017). The relationship between childhood traumas, dissociation, and impulsivity in patients with borderline personality disorder comorbid with ADHD. Psychiatry and Clinical Psychopharmacology, 27(4), 393–402. https://doi.org/10.1080/24750573.2017.1380347
(Working with a comorbid BPD + ADHD sample, this study shows that attentional and motor impulsiveness are closely linked to ADHD symptoms and treats impulsivity as a multidimensional construct with motor and cognitive components.)

Fogleman, N. D. (2019). Emotion regulation is associated with peer victimization among children with attention-deficit/hyperactivity disorder (Doctoral dissertation). University of Louisville. ThinkIR Institutional Repository.
(This dissertation demonstrates that the link between ADHD symptoms and greater peer victimisation is partly mediated by emotion regulation problems, highlighting how difficulties managing feelings increase vulnerability.)

Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1–26.
(This overview sets out a widely used model of emotion regulation processes—attentional deployment, reappraisal and response modulation—on which CBT, mindfulness, ACT and DBT approaches build.)

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The process and practice of mindful change (2nd ed.). Guilford Press.
(This core ACT text explains how psychological flexibility can be increased by combining acceptance, values-based action and mindful awareness.)

Hirsch, O., Chavanon, M. L., Christiansen, H., & Philipsen, A. (2018). Emotional dysregulation is a key symptom in adult attention-deficit/hyperactivity disorder. Journal of Affective Disorders, 232, 41–47.
(Using adult ADHD samples, this study finds very high rates of emotional dysregulation (around 40–70% depending on the measure) and shows strong links with functional impairment.)

Hirvikoski, T., Waaler, E., Alfredsson, J., Pihlgren, C., Holmström, A., Johnson, A., Rück, J., Wiwe, C., Bothén, P., & Nordström, A.-L. (2011). Reduced ADHD symptoms in adults with ADHD after structured skills training group: Results from a randomized controlled trial. Behaviour Research and Therapy, 49(3), 175–185. https://doi.org/10.1016/j.brat.2011.01.001
(This randomised controlled trial compares a DBT-informed structured skills group with a loose discussion control group and shows significant reductions in adult ADHD symptoms in the skills-training arm.)

Jacobs, E., & D’Esposito, M. (2011). Estrogen shapes dopamine-dependent cognitive processes: Implications for women’s health. The Journal of Neuroscience, 31(14), 5286–5293. https://doi.org/10.1523/JNEUROSCI.6394-10.2011
(This paper details how oestrogen modulates dopamine-dependent cognitive functions such as working memory and executive processes, with implications for women’s brain health.)

Jacobson, E. (1938). Progressive relaxation (2nd ed.). University of Chicago Press.
(This is the original source for progressive muscle relaxation, using cycles of tensing and relaxing muscles to reduce bodily tension and sympathetic arousal.)

Katzman, M. A., Bilkey, T. S., Chokka, P., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: Clinical implications of a dimensional approach. BMC Psychiatry, 17, 302.
(This paper shows how common anxiety and depressive disorders are in adult ADHD and argues that these comorbidities worsen impulsive “0-to-100” reactions and overall impairment.)

Kretschmer, C. R., Göz Tebrizcik, B., & Dommett, E. J. (2022). Mindfulness interventions for attention deficit hyperactivity disorder: A systematic review and meta-analysis. Psychiatry International, 3(4), 363–399. https://doi.org/10.3390/psychiatryint3040031
(This systematic review and meta-analysis finds small but statistically significant benefits of mindfulness programmes on attention, impulsivity and emotion regulation in ADHD, especially when delivered as structured, multi-week courses with home practice.)

Lichtenstein, P., Halldner, L., Zetterqvist, J., Sjölander, A., Serlachius, E., Fazel, S., … Larsson, H. (2012). Medication for attention deficit–hyperactivity disorder and criminality. New England Journal of Medicine, 367(21), 2006–2014.
(This Swedish population study shows that people with ADHD have higher rates of criminal offending, and that this risk decreases during periods when they are on ADHD medication.)

Mitchell, J. T., McIntyre, E. M., English, J. S., Dennis, M. F., Beckham, J. C., & Kollins, S. H. (2013). A pilot trial of mindfulness meditation training for attention-deficit/hyperactivity disorder in adulthood: Impact on core symptoms, executive functioning, and emotion dysregulation. Journal of Attention Disorders. Advance online publication. https://doi.org/10.1177/1087054713513328
(This pilot trial reports that a structured mindfulness programme improved core ADHD symptoms, executive functioning and emotion regulation in adults.)

Mitchell, J. T., Zylowska, L., & Kollins, S. H. (2015). Mindfulness meditation training for attention-deficit/hyperactivity disorder in adulthood: Current empirical support, treatment overview, and future directions. Cognitive and Behavioral Practice, 22(2), 172–191. https://doi.org/10.1016/j.cbpra.2014.10.002
(This review summarises the evidence base for mindfulness programmes in adult ADHD and outlines a specific protocol (MAPs for ADHD) with practical guidance.)

Mischel, W., Ebbesen, E. B., & Zeiss, A. R. (1972). Cognitive and attentional mechanisms in delay of gratification. Journal of Personality and Social Psychology, 21(2), 204–218.
(This classic marshmallow-test paper describes in detail how children struggle with waiting and which cognitive and attentional strategies help or hinder delaying gratification.)
Moffitt, T. E., Arseneault, L., Belsky, D., Dickson, N., Hancox, R. J., Harrington, H., Houts, R., Poulton, R., Roberts, B. W., Ross, S., Sears, M. R., Thomson, W. M., & Caspi, A. (2011). A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences, 108(7), 2693–2698. https://doi.org/10.1073/pnas.1010076108
(This long-term longitudinal study shows that childhood self-control levels—impulsivity, persistence and tolerance of frustration—predict adult financial status, health and criminality.)

Müller, V., Mellor, D., & Pikó, B. F. (2024). Associations between ADHD symptoms and rejection sensitivity in college students: Exploring a path model with indicators of mental well-being. Learning Disabilities Research & Practice, 39(4), 223–236.
(This path-analysis study finds that well-being, creative/executive proficiency, self-regulation and resilience partly mediate the link between ADHD symptoms and rejection sensitivity, while “savouring” positive experiences moderates it.)

Paulus, F. W., Ohmann, S., Möhler, E., Plener, P., & Popow, C. (2021). Emotional dysregulation in children and adolescents with psychiatric disorders. A narrative review. Frontiers in Psychiatry, 12, 628252. https://doi.org/10.3389/fpsyt.2021.628252
(This narrative review surveys emotional dysregulation across child and adolescent psychiatric disorders and shows that significant emotion-regulation problems are very common in young people with ADHD.)

Rodgers, A. L. (2025, June 23). We demand attention on how hormonal changes impact ADHD symptoms in women. ADDitude. https://www.additudemag.com/hormonal-fluctuations-adhd-symptoms-pmdd-pregnancy-menopause/
(This accessible article explains how fluctuations in oestrogen and progesterone across the menstrual cycle, pregnancy, postpartum, perimenopause and menopause affect dopamine and noradrenaline, and thereby ADHD symptoms, mood and emotional reactivity in women.)
Safren, S. A., Sprich, S., Mimiaga, M. J., Surman, C., Knouse, L., Groves, M., & Otto, M. W. (2010). Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: A randomized controlled trial. JAMA, 304(8), 875–880. https://doi.org/10.1001/jama.2010.1192
(This RCT shows that CBT plus skills training significantly reduces residual ADHD symptoms and functional problems in medicated adults compared with relaxation and education alone.)
Schoenfelder, E. N., & Kollins, S. H. (2016). Topical review: ADHD and health-risk behaviors: Toward prevention and health promotion. Journal of Pediatric Psychology, 41(7), 735–740. https://doi.org/10.1093/jpepsy/jsv162
(This short topical review summarises evidence that ADHD is linked across the life span to elevated rates of health-risk behaviours, such as substance use, risky sex, unhealthy eating and inactivity, and discusses prevention and health-promotion strategies for children and youth with ADHD.)
Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. The American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966
(This review concludes that emotion dysregulation in ADHD is present across the life span, contributes substantially to impairment and likely reflects dysfunction in networks processing emotional salience, particularly striato-amygdalo-medial prefrontal circuits.)
Shen, Y., Chan, B. S. M., Huang, C., Cui, X., Liu, J., Lu, J., Patel, M., Verrico, C. D., Luo, X., & Zhang, X. Y. (2021). Suicidal behaviors and attention deficit hyperactivity disorder (ADHD): A cross-sectional study among Chinese medical college students. BMC Psychiatry, 21(1), 258. https://doi.org/10.1186/s12888-021-03247-6
(This large student study shows that young people with ADHD have more frequent bullying experiences and higher rates of suicidal behaviour and psychological distress.)

Shin, D. W., Lee, S., Kim, H., Kim, S. Y., Yoo, J. W., & Park, S. M. (2016). Association between attention-deficit/hyperactivity disorder and injuries: A systematic review and meta-analysis. Safety Science, 82, 70–79.
(This meta-analysis consistently finds higher injury and accident risk in both children and adults with ADHD.)

Skirrow, C., & Asherson, P. (2013). Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. Journal of Affective Disorders, 147(1–3), 80–86.
(This paper shows that mood lability and emotional swings in adult ADHD are strongly associated with poorer quality of life and higher comorbidity.)

Sonuga-Barke, E. J. S. (2005). Causal models of attention-deficit/hyperactivity disorder: From common simple deficits to multiple developmental pathways. Biological Psychiatry, 57(11), 1231–1238. https://doi.org/10.1016/j.biopsych.2004.09.008
(This influential paper proposes multiple developmental pathways for ADHD, supporting the idea that impulsivity and emotional dysregulation are integral elements of different ADHD trajectories, not just add-on symptoms.)

Therapeutics Initiative. (2023). ADHD in adults. Therapeutics Letter, 144.
(This evidence-based letter offers a critical overview of adult ADHD diagnosis and medication, warning about over-diagnosis and over-treatment, highlighting the limits of stimulants—especially long-term—and stressing the importance of non-drug psychosocial interventions and environmental and lifestyle adaptations.)
Toffoletto, S., Lanzenberger, R., Gingnell, M., Sundström-Poromaa, I., & Comasco, E. (2014). Emotional and cognitive functional imaging of estrogen and progesterone effects in the female human brain: A systematic review. Psychoneuroendocrinology, 50, 28–52. https://doi.org/10.1016/j.psyneuen.2014.07.025
(This systematic review of functional imaging studies examines how oestrogen and progesterone influence emotional and cognitive brain networks in women.)
Watts, T. W., Duncan, G. J., & Quan, H. (2018). Revisiting the marshmallow test: A conceptual replication investigating links between early delay of gratification and later outcomes. Psychological Science, 29(7), 1159–1177.
(This large, more recent replication partly reinterprets the marshmallow test findings and emphasises the role of socioeconomic context in links between early delay of gratification and later outcomes.)
Wilens, T. E. (2006). Attention-deficit/hyperactivity disorder and substance use disorders. American Journal of Psychiatry, 163(12), 2059–2063. https://doi.org/10.1176/appi.ajp.163.12.2059
(This review shows that ADHD is associated with a markedly increased (about two- to three-fold) risk of substance use disorders and discusses shared neurobiological and behavioural mechanisms.)

Young, S., Moss, D., Sedgwick, O., Fridman, M., & Hodgkins, P. (2015). A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. Psychological Medicine, 45(2), 247–258.
(This meta-analysis finds that ADHD prevalence in prison populations is much higher (on average around 25% and up to 30–40% in some samples) than in the general population.)

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