This study looked at emotional lability in children and teenagers who had ADHD combined type. Emotional lability means quick, strong mood swings. The researchers studied 1186 children with ADHD and 1827 of their siblings, aged 5 to 18, at 12 specialty clinics across eight countries in Europe and the Middle East, as part of the IMAGE project.
Many but not all of the children with ADHD showed emotional lability. Those with more of it tended to have more severe ADHD symptoms, especially hyperactivity and impulsivity, and more other mental health problems. Emotional lability was tied more closely to oppositional behavior than to the core ADHD symptoms. Age plus hyperactive, oppositional, and emotional symptoms together explained about a third of the differences in emotional lability (30%), and oppositional symptoms alone explained 12%.
Oppositional defiant disorder became more common as emotional lability got worse, rising across the low, mild-to-moderate, and severe groups (46%, 65.1%, and 79.1%). Parents rated emotional lability higher in the children with ADHD than in their siblings (t-scores of 68.2 versus 54.3). It also ran in families: siblings of children with severe emotional lability were more likely to have high levels themselves (odds ratio 1.63), but they did not have more ADHD or ODD.
The authors note this was a re-analysis of an existing clinical sample, which may lean toward more severe cases, and it could not show whether the family link came from genes or shared environment.
Source: Esther Sobanski, Tobias Banaschewski, Philip Asherson, et al.. Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence. Journal of Child Psychology and Psychiatry (2010). doi:10.1111/j.1469-7610.2010.02217.x