Deficient Emotional Self-Regulation (DESR) and ADHD

By Fatima Malik


DESR (Deficient Emotional Self-Regulation) is a term that ADHD expert Russell Barkley, Ph.D., coined to explain the emotional dysregulation kids with ADHD experience. 


Even though emotional impulsivity is one of the fundamental components of ADHD (Attention Deficit Hyperactivity Disorder), it does not show up in the DSM-5.


It is important to note that these emotional dysregulation symptoms shape the experiences and lifelong challenges of someone with ADHD.


According to an article, DESR refers to the following four aspects of emotional regulation:

  • The ability to inhibit inappropriate responses triggered by strong emotions
  • The ability to self-soothe to reduce the severity of an intense emotion
  • The ability to refocus attention from emotionally provocative events
  • The ability to substitute healthier responses in the interest of long-term welfare

Even though Emotional Impulsivity (EI) is more of an issue in kids with ADHD, it changes into DESR as they grow older. Unable to moderate the emotional responses to regular day-to-day annoyances.


Can DESR be improved?


As with all ADHD symptoms, severity and degree of impairment vary between individuals and their response to treatment. So, in theory, DESR can be improved over time. However, it is difficult with kids with ADHD. Kids have not developed the self-regulation required for DESR to improve drastically, although controlling environmental triggers would be helpful. Additionally, CBT (Cognitive Behavioural Therapy) may be beneficial in teenagers.


Each individual is different when it comes to treatments and symptoms, so it is essential to have a child psychologist and a family doctor actively involved in treating a child with ADHD.


Can DESR lead to other disorders?


Yes. It is difficult to diagnose a very young child with DESR. Although symptoms begin showing themselves in kids between the ages of 3 -5, most of these symptoms are written off as kids being kids, e.g. the terrible twos.

No one expects a 4-year-old to have control over their emotions as well as an adult, only to find out later that the kid is quite emotionally explosive compared to his peers. 

Some of these children will develop the oppositional defiant disorder (ODD). If we accept DESR as one of the core features of ADHD, we can see why the disorder poses such a significant risk for ODD and related disorders.


Although DESR is not in the DSM-5 (yet, you know how official documents are slow to catch up), it is one of the most significant features of ADHD. It requires regular monitoring and individualized treatment plans by your child’s doctor. 


At Positive Kids, we provide professional help to kids with ADHD and their families. Please contact us at 1-866-503-7454

We have professionals all over Canada. 

Montreal, Quebec

Toronto, Ontario

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Positive Kids
Author: Positive Kids

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