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Fokus Forschung

Emotionsregulation bei ADHS – kardiovagale Kontrolle als Biomarker?

Published Online:January 17, 2018https://doi.org/10.1024/2235-0977/a000204

Abstract

Zusammenfassung. In den letzten Jahren wurden die kardiovagale Kontrolle und die damit assoziierten Indizes der vagal-mediierten Herzratenvariabilität als Biomarker der physiologischen und emotionalen Aktiviertheit sowie der Emotionsregulation herausgestellt. Gerade Patienten mit einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) weisen in diesen emotionalen Facetten häufig Schwierigkeiten auf, sodass das Ziel der vorliegenden Übersichtsarbeit ist, die physiologische Ebene der emotionalen Reaktivität und Emotionsregulation am Beispiel der vagal-mediierten Herzratenvariabilität systematisch für Patienten mit ADHS zusammenzufassen. In einer Literaturrecherche konnten sieben Arbeiten (k = 5 mit Kindern und Jugendlichen; k = 2 mit Erwachsenen) identifiziert werden. Während die Studien für das Erwachsenenalter keine eindeutigen Schlüsse zulassen, weisen die Ergebnisse für das Kindes- und Jugendalter darauf hin, dass die Psychophysiologie einen Beitrag zur Identifizierung von Mechanismen der emotionalen Reaktivität und Emotionsregulation bei ADHS leisten könnte. Die größte Studie in diesem Bereich weist unterscheidbare Patientencluster mit differentiellen kardiovaskulären Profilen der Emotionsreaktivität und -regulation aus. Diese physiologische Heterogenität birgt – wenn sie sich als robust erweist – das Potential für die Entwicklung neuer Behandlungsansätze sowie für die Verbesserung bei der Zuweisung zu bestehenden Interventionen.


Emotion regulation in ADHD: Is vagally-mediated heart rate variability a helpful biomarker?

Abstract. Within the past two decades, vagally-mediated heart rate variability (cardiovagal control) has been established as a biomarker of physiological and emotional arousal and emotion regulation. As there is increasing recognition of the importance of emotion reactivity and regulation in attention deficit/hyperactivity disorder (ADHD), the present review aims at summarizing the empirical evidence linking vagally-mediated heart rate variability, emotional reactivity, and emotion regulation in patients with ADHD. Although the association between ADHD and emotion-related dysfunction is currently a hot research topic, empirical investigations of autonomic mechanisms contributing to those alterations in emotion reactivity and regulation in ADHD are still rare, as our literature search identified only seven studies (k = 5 with children and adolescents, k = 2 with adults). While studies including adult patients do not allow drawing any firm conclusions, the studies with children and adolescents suggest alterations in autonomic functioning depending on ADHD subtypes. This physiological heterogeneity – if it proves robust – potentially allows for the development of novel treatments, as well as improvements in treatment allocation and matching.

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