Study: Emotional Dysregulation Associated with Weak, Risky Romantic Relationships Among Teens with ADHD
Severe emotional dysregulation increases the chances that an adolescent with ADHD will engage in shallow, short-lived romantic relationships and participate in unprotected sex, according to a new study that suggests negative patterns developed in adolescence may continue to harm the romantic relationships and health of adults with ADHD.
May 20, 2020
Adolescents with attention deficit hyperactivity disorder (ADHD) and severe emotional dysregulation (ED) are more likely to have many shallow, short-term romantic relationships, more romantic partners overall, engage in sexual intercourse, and participate in unprotected sex. ED was particularly associated with poor relationship quality and risky sexual behaviors, two challenges that may persist and worsen in adulthood, according to a new study published in the Journal of Attention Disorders1.
The research, which investigated the extent to which social skills and emotional regulation contribute to patterns of romantic impairment that persist into adulthood, studied the responses of 171 adolescents with ADHD (80% male; 70% white; aged 13-17) who answered questions about their emotion dysregulation and romantic and sexual relationship experiences. It also factored in parents’ ratings of participants’ ADHD symptoms, emotion dysregulation, and social skills.
Adolescents reported an average of four relationships before adulthood, which was double the national average of approximately two. It is possible that adolescents with ADHD and ED are more likely to overestimate their number of romantic relationships, or misinterpret friendships or non-romantic relationships as romantic relationships. However, only 12% of adolescents with ADHD reported participating in group or recreational activities associated with casual relationships — a stark contrast to the 86% of adolescents without ADHD who reported doing so. This insight suggests social impairment among youth with ADHD, who may not have large networks of friends.
Among adolescents with ADHD, 21% said they had never engaged in sexual relations (more than kissing but less than sexual intercourse); 12% reported experience with sexual intercourse. Though this study had no control group, a large national survey conducted by the Centers for Disease Control (CDC) revealed that 40% of high school students reported having sexual intercourse. Though fewer adolescents with ADHD reported being sexually active, those who did were more likely than their neurotypical peers to engage in unprotected sex. Sixty-two percent of sexually active teens with ADHD reported having unprotected sex, compared to 41% of sexually active teens from a normative sample.
More severe self-reported ED was linked to an increased likelihood of engaging in a higher number of romantic relationships, having more romantic partners, engaging in sexual intercourse, and engaging in unprotected sex. In contrast, symptoms of inattentive ADHD were not uniquely related to any romantic relationship or sexual behavior outcome. Likewise, symptoms of hyperactive or impulsive ADHD reported by parents were actually linked to longer relationships, fewer sexual partners, and less unprotected sex. This phenomenon may be explained, in part, by research that shows hyperactive/impulsive characteristics are more appealing to potential romantic partners than are inattentive characteristics.
These findings suggest that health professionals should focus on improving symptoms of emotional dysregulation as an effective method for changing the developmental trajectory and sexual behaviors of adolescents with ADHD. This focus, the researchers argue, could improve long-term romantic relationships and health outcomes for adults with ADHD.
1Margherio, S. M., Capps, E. R., Monopoli, J. W., Evans, S. W., Hernandez-Rodriguez, M., Owens, J. S., & DuPaul, G. J. (2020). Romantic Relationships and Sexual Behavior Among Adolescents With ADHD. Journal of Attention Disorders. https://doi.org/10.1177/1087054720914371