The Impact of Oppositional Defiant Disorder and Cognitive Disengagement on Emotional Instability and Family Functioning in ADHD Cases

Background Children with Attention-deficit/hyperactivity disorder (ADHD) often exhibit emotional dysregulation and family dysfunction, especially when comorbid with Oppositional Defiant Disorder (ODD) or Cognitive Disengagement Syndrome (CDS). This study aims to compare emotional and familial functioning across ADHD, ADHD + ODD, ADHD + CDS, and control groups to guide prognosis and intervention. Methods The study involved 155 children aged 7–12, categorized into ADHD (n = 40), ADHD + ODD (n = 40), ADHD + CDS (n = 40), and control (n = 35) groups. Diagnoses were based on DSM-5 criteria and structured interviews. Data were collected using parent- and child-report measures, including the CBCL, Barkley Scale, DBDRS, PARQ, FAD, Emotion Regulation Checklist, CDI, and DERS. Results The ADHD + ODD group consistently showed the highest impairments across all domains. They had the highest total scores on the Family Assessment Device (2.16), Parental Acceptance-Rejection Questionnaire (88.08), Difficulties in Emotion Regulation Scale (96.68), Emotion Regulation Scale (55.90), and Children’s Sleep Habits Questionnaire (54.35), significantly exceeding scores of the ADHD, ADHD + CDS, and control groups (all p < .001). Conclusions Emotion regulation difficulties in ADHD vary by comorbidity, with ADHD + ODD linked to greater impairments across emotional, family, and sleep domains, and ADHD + CDS showing internalized challenges and delays. Results support emotion dysregulation as a core ADHD feature and highlight the need for tailored, family-focused interventions.