(PS3-100) Does Working Memory Moderate the Relation of Emotion Regulation and Children’s ADHD Symptoms?

Emotion regulation (ER) difficulties affect many children with attention-deficit/hyperactivity disorder (ADHD) and pose a risk for a variety of functional impairments. For example, children with ADHD may present with irritability, mood swings, difficulty calming down once upset, and have limited strategies for dealing with emotions (Bunford et al., 2015). Working memory (WM) assists with emotion decoding and responding (Tarle et al., 2021), and WM and ER are supported by overlapping neural networks (Groves et al., 2020). Clear evidence indicates that ADHD is associated with impairments in executive functioning, including tasks assessing WM (e.g., Kofler et al., 2018). Neurocognitive deficits in WM may underlie difficulties in ER, as suggested in theoretical models of ADHD (e.g., Barkley, 1997; Rapport et al., 2008). Recent studies have linked WM deficits to ER difficulties in children with ADHD (Groves et al., 2020; Groves et al., 2021; Tarle et al., 2021), however, the effects that the subcomponents of WM [phonological (PH) and visuospatial (VS)] have on ADHD symptoms and ER are still unknown, and many ER ratings scale items are conflated with ADHD symptoms. Thus, the current study examined the association of ADHD symptom severity and ER dysregulation, and the role WM plays in these relations. Participants were 168 children with ADHD (ages 8-12 years, M=9.8, SD=1.5; 61.9% male; 71.4% White, mostly higher socioeconomic status; 42% medicated). Parents and teachers completed the Child and Adolescent Disruptive Behavior Inventory (CADBI; Burns et al. 2014) assessing ADHD inattentive (IA) and hyperactivity-impulsivity (HI) symptoms. Children reported on their own ER dysregulation (exaggerated display of feelings) in response to sadness, anger, and worry on the Child Emotion Management Scale (Ogbaselase et al., 2022). Children were also administered computerized WM tasks (Kofler et al., 2010; Rapport et al., 2008) assessing PH and VS WM. Multivariate regression was used to evaluate whether WM factors, parent- and teacher-rated IA and HI, and their interactions were associated with emotion dysregulation for the three emotions. The three multivariate regression analyses were performed in R controlling for sex and medication status and following model-based multiple imputation in BLIMP. Results were not significant for sadness or worry dysregulation. VS (t=-2.74, p=.007), PH (t=-2.42, p=.017), and parent-rated HI (t=2.40, p=.018) significantly predicted anger dysregulation; however, the interactions for VS and parent-rated HI (t=2.22, p=.028), and PH and parent-rated IA (t=2.03, p=.045) were significant. Thus, WM was a significant moderator of the association between ADHD symptoms and anger dysregulation, such that the association with HI was strengthened at higher levels of VS, and the association with IA was attenuated at lower levels of PH. The current findings add to the literature suggesting WM plays a role in ER, specifically in the domain of anger, and that this association may be conveyed in part via the role of WM contributing to ADHD symptoms. Future studies of ER in ADHD should consider specific emotions, in addition to disaggregating VS and PH as each conveyed differential risk for IA and HI symptomatology.