View Full Version : "Ground Up" Subcortical Emotional Systems/Enviro-stresses, Shape Executive Systems

02-22-13, 09:44 PM
I do think the information below is fairly accurate, but I also think there is something missing. I think Dr.Barkley is making a big mistake by not considering,

how cortical functions develop (examples: self regulation, executive function, etc.), from the "bottom-up"/"ground-up",

when primary emotional sub-cortical systems, interact/experience, normal and abnormal environmental influences (stresses) to literally shape (or not shape) development of the higher cortical areas,

for the first time, during the first 3 years of early childhood neurodevelopment. Early environmental stresses can interfere with early cortical development, and may result in ADD.

(Another major influence/factor is the sensitivity/temperament of the individual infant, to normal and abnormal environmental stresses. (All topics open for discussion.)

EI = Emotional impulsivity.

DESR = Deficient emotional self-regulation

(I also recommend members, see the full link below for more information from Dr.Barkley about Emotions and ADD)

(All the information is well worth discussing/reviewing, as well as the information posted here, lots to discuss)


by Russell A. Barkley, Ph.D.

(see all charts at link below)


 Don’t mistake emotional impulsivity (EI) and deficient
emotional self-regulation (DESR) as being the result of
comorbidity or reactions to previous failure experiences --
they are central to ADHD itself

 Don’t mistake mood disorders as arising from EI-DESR

 EI-DESR is a “top-down” deficit in regulating rational emotional responses to events
probably via the L-PFC and ACC;

 Many mood disorders are “bottom-up” excessive expressions of emotions and probably of underlying amygdala-limbic system activities.

 Others may be an excessive enhancement of emotions by the EF system such as in cognitive rumination (over or excessive event appraisal).

 What is the difference? In ADHD, emotions are time limited (not moods), setting specific, rational (reasonable), provoked.

 Comorbid mood and other disorders may require separate
management methods targeting them directly

 Core ADHD EI-DESR problems are improved by ADHD meds –
EI is part of HI (Inhibitory) dimension; DESR overlaps with IN
(Meta-cognitive) dimension

 Drug types may differ in their effects on EI/DESR

 Secondary impairments from DESR on major life activities may
also be improved by ADHD meds

 Comorbid ODD may improve with ADHD meds given that 3 of
its 8 symptoms are related to EI-DESR
Residual ODD may require behavioral parent training

 Social ecology factors will require separate psychosocial
interventions and possibly family relocation
Some factors may be secondary to parental ADHD and related disorders
making their identification and management essential to treating their ADHD child