Interventions for Emotional Dysregulation and Associated Factors in Neurodevelopmental Disorders: A Comprehensive Review

Emotional dysregulation (ED), characterized by difficulties in modulating emotional responses, is a pervasive and transdiagnostic challenge in neurodevelopmental disorders (NDDs) such as Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and Intellectual Disability (ID). It is a primary contributor to functional impairment, poor long-term outcomes, and reduced quality of life.This comprehensive systematic integrative review aims to synthesize the extensive literature published between January 2000 and December 2025 on the multifactorial etiology of ED in NDDs and provide a critical evaluation of evidence-based interventions, moving from theoretical models to practical, real-world application while addressing controversies and limitations in the evidence base. A systematic integrative review methodology was employed. A systematic search of PubMed, PsycINFO, Web of Science, and Scopus databases was conducted for literature published between 2000-2025. The search strategy incorporated a comprehensive set of keywords including "emotional dysregulation," "emotion regulation," "autism," "ADHD," "intellectual disability," "intervention," and associated terms. The process followed PRISMA guidelines, with a detailed flow diagram illustrating study selection. Data from included studies were extracted into a structured master table documenting study characteristics, interventions, outcomes, effect sizes, and risk of bias assessments using standardized tools (RoB 2, ROBINS-I, JBI). ED in NDDs arises from a complex interplay of neurological vulnerabilities (e.g., amygdala hyperactivity, prefrontal cortex dysfunction, altered connectivity patterns), cognitive deficits (e.g., executive functions, theory of mind, alexithymia), and environmental factors (e.g., sensory processing differences, family climate, social challenges). The evidence supports multi-modal interventions including adapted cognitive-behavioral therapies (CBT, DBT), mindfulness-based practices, pharmacological management (e.g., stimulants, atypical antipsychotics, alpha-2 agonists), parent-mediated approaches, and emerging technologies like biofeedback and virtual reality. However, significant heterogeneity in outcomes, modest effect sizes in many studies, and concerns about generalizability and publication bias necessitate cautious interpretation of findings.Addressing ED requires personalized assessment of underlying mechanisms and multi-modal treatment approaches. While substantial evidence supports various interventions, future research must address significant gaps including transdiagnostic protocols, lifespan perspectives, implementation science, biomarker-guided personalization, and more rigorous methodological approaches. The evidence suggests a need for more critical appraisal of intervention effects and acknowledgment of both positive and negative findings in the literature.