Emotional dysregulation

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Emotional dysregulation is characterized by an inability to flexibly respond to and manage emotional states, resulting in intense and prolonged emotional reactions that deviate from social norms, given the nature of the environmental stimuli encountered. Such reactions not only deviate from accepted social norms but also surpass what is informally deemed appropriate or proportional to the encountered stimuli.^[1][2][3][4]

It is often linked to physical factors such as brain injury, or psychological factors such as adverse childhood experiences, and ongoing maltreatment, including child abuse, neglect, or institutional abuse.^[5]

Emotional dysregulation may be present in people with psychiatric and neurodevelopmental disorders such as attention deficit hyperactivity disorder,^[6] autism spectrum disorder, bipolar disorder, borderline personality disorder, complex post-traumatic stress disorder, and fetal alcohol spectrum disorders.^[7][8][9] In such cases as borderline personality disorder and complex post-traumatic stress disorder,^[10] hypersensitivity to emotional stimuli causes a slower return to a normal emotional state, and may reflect deficits in prefrontal regulatory regions. Damage to the frontal cortices of the brain can cause deficits in behavior that can severely impact an individual's ability to manage their daily life.^[11] As such, the period after a traumatic brain injury such as a frontal lobe disorder can be marked by emotional dysregulation. This is also true of neurodegenerative diseases.^[12]

Possible manifestations of emotion dysregulation include extreme tearfulness, angry outbursts or behavioral outbursts such as destroying or throwing objects, aggression towards self or others, and threats to kill oneself. Emotion dysregulation can lead to behavioral problems and can interfere with a person's social interactions and relationships at home, in school, or at their place of employment.^[13]