DOI: 10.4103/tjp.tjp_52_23 ISSN: 2772-8706

Assessment of emotional distress and regulation in specific learning disorder and with its comorbid attention-deficit/hyperactivity disorder

Devika Kosana, Rajesh Sagar, K. K. Deepak, Rachna Bhargava, Bichitra Nanda Patra, Dinu S. Chandran



Specific learning disorder (SLD) and attention-deficit/hyperactivity disorder (ADHD) commonly occur together leading to significant academic underachievement. Individuals with dyslexia not only face behavioral and emotional regulation problems but also psychiatric disorders, including anxiety and depression.

Materials and Methods:

Sixty adolescents aged 14 years to <18 years were recruited into three groups, namely, SLD-ADHD, SLD, and healthy controls. Sociodemographic and clinical variables were collected using semi-structured pro forma. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Difficulties in Emotion Regulation Scale.


The mean age of the study participants was 15.25 ± 1.29 years, 15.10 ± 1.21 years, and 15.60 ± 1.23 years in SLD-ADHD, SLD, and healthy controls, respectively. The male: female ratio was 1.73:1. Developmental delay was significant in SLD-ADHD and SLD when compared to healthy individuals. Statistically significant differences were observed in irregularity at school, academic performance, stress, and lack of clarity of emotions between the three arms. SLD arm recorded significantly lower stress and better clarity of emotions than healthy individuals. Differences recorded were insignificant between the three arms in terms of depression, anxiety, as well as overall difficulties in emotional regulation.


Compared to healthy individuals, there was a significant developmental delay, more school irregularities, and poorer academic performance in SLD-ADHD and SLD subjects. Adolescents having both SLD and ADHD experienced significantly higher scores on each of the three components of DASS-21 and a greater lack of clarity of emotions compared to individuals having only SLD suggesting the synergistic effect of these disorders on emotional deregulation.

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