Do you overreact to pressure, blow things out of proportion?: An ADHD-Centered Critical Review of Emotional Dysregulation Measures
Deepak Giri, Júlia Hellín López, Celeste Campos-Castillo, Megh Marathe · 2025 · ASSETS 2025: 27th International ACM SIGACCESS Conference on Computers and Accessibility · doi:10.1145/3663547.3746378
Summary
This paper presents a critical review of 27 self-report emotional dysregulation measures used in research with adults who have Attention-Deficit/Hyperactivity Disorder (ADHD). Emotional dysregulation—difficulty managing emotions leading to intense, rapid, and often disproportionate emotional responses—is a core yet frequently overlooked aspect of adult ADHD, excluded from formal DSM-5 diagnostic criteria despite its pervasive impact on work, relationships, and quality of life. The authors conducted a systematic literature search across PubMed, PsycInfo, and CINAHL databases, screening 7,809 studies down to 90 empirical papers that used self-report measures of emotional dysregulation with ADHD adults. They identified 27 distinct measures and analyzed them through two complementary frameworks: the process model of emotion regulation (which conceptualizes regulation as four stages—identification, selection, implementation, and monitoring) and the social model of disability (which challenges normative assumptions and highlights how language can marginalize disabled individuals). The interdisciplinary research team included expertise in HCI, accessibility, disability studies, neuroscience, and sociology, with one author clinically diagnosed with ADHD, providing both personal and professional insight into the biases and linguistic impacts that might go unnoticed from a neurotypical standpoint.
Key findings
The analysis revealed several critical problems with existing measures. First, 20 out of 27 measures use normative language—loaded adjectives like "excessively," "too," and "overwhelmed" that frame ADHD emotional responses as deviations from a neurotypical standard, and comparative phrases like "as most people" or "more than others" that establish implicit social benchmarks. Second, 13 out of 27 measures use judgmental language with words like "irritable," "touchy," "sensitive," and "foolish" that frame emotional reactivity as personality flaws rather than neurodevelopmental traits, and phrases like "cannot control" that center blame on the individual. Third, 3 measures use infantilizing terms like "tantrums," "clingy," and "silly" that conflate adult emotional experiences with child behavior. Fourth, no measure fully aligns with the process model of emotion regulation—none assess the monitoring stage (evaluating whether regulation strategies are working), and 8 out of 27 do not align with any stage. Fifth, only a subset of measures have been validated specifically with ADHD populations; many were designed for different clinical groups like bipolar disorder or brain injury. The authors also identified linguistic complexity issues in 8 measures that could disadvantage respondents for whom English is a second language.
Relevance
This research has direct implications for HCI and assistive technology designers building emotion regulation tools for ADHD adults. If the underlying assessment instruments carry normative bias, technologies built on their findings risk perpetuating stigma and developing interventions misaligned with ADHD users' actual experiences. The paper recommends that researchers use cognitive interviewing with ADHD adults to understand how they interpret measure questions, combine multiple measures to achieve comprehensive coverage of the emotion regulation process, and adopt a longitudinal socio-technical perspective that accounts for historical social processes like gendered socialization. For accessibility practitioners, this work demonstrates how language in assessment tools can function as a barrier—subtly pathologizing neurodivergent experiences and reinforcing deficit narratives that undermine user agency and self-perception.
Tags: ADHD · neurodiversity · emotional dysregulation · self-report measures · critical disability studies · normative language · assessment tools · cognitive accessibility
Standards referenced: DSM-5