Does frustration intolerance worsen ADHD impulsivity? 

Frustration intolerance is a common challenge for adults with attention deficit hyperactivity disorder (ADHD). It can contribute to impulsive reactions, quick temper, and difficulty staying calm under pressure. When frustration builds, many individuals with ADHD find it hard to manage their emotional responses, leading to impulsive decisions or actions that may feel hard to control. This emotional volatility often results from emotional dysregulation and impulsivity, two core features of ADHD. 

According to NICE guideline NG87, frustration intolerance and impulsivity are interrelated and frequently observed in ADHD. Emotional dysregulation, including difficulty managing frustration, can significantly impact decision-making, often leading to impulsive behaviours such as snapping, quitting tasks early, or making hasty decisions. NICE recommends combining pharmacological treatments with Cognitive Behavioural Therapy (CBT) and mindfulness-based strategies to manage frustration and reduce impulsivity. These interventions help individuals recognise frustration triggers, reframe negative thought patterns, and develop coping strategies to manage emotional reactivity. 

The Royal College of Psychiatrists further emphasises that low frustration tolerance directly impacts emotional control in ADHD, especially when under stress. This poor emotional control can overwhelm the brain’s ability to inhibit impulsive actions, leading to rash decisions or outbursts. To manage these reactions, structured therapies that teach self-soothing techniques and cognitive control are essential. 

How frustration intolerance worsens impulsivity 

Frustration intolerance can worsen impulsivity in ADHD by impairing cognitive resilience and task persistence. When frustration builds, it depletes a person’s ability to focus, solve problems, or regulate emotions. As found in a 2024 study published in the Journal of Attention Disorders, adults with ADHD exhibit increased irritability and reduced persistence under frustration-inducing conditions, which often leads to risky behaviours or poor decision-making (Montgomery, 2024). The study suggests that emotional overload exacerbates impulsivity, impairing self-control and task endurance. 

The NHS highlights that emotional overload due to frustration may result in impulsive reactions like quitting, arguing, or taking unnecessary risks. To address this, mindfulness and CBT have been shown to reduce frustration-induced impulsivity by enhancing emotional awareness and cognitive endurance. Techniques like mindful breathing, positive reframing, and emotion-regulation skills are integral to improving emotional control and reducing impulsive responses. 

Key takeaway 

Frustration intolerance is a significant factor in exacerbating impulsivity in ADHD. By combining CBT, mindfulness, medication, and lifestyle changes such as consistent routines, individuals with ADHD can improve their ability to manage frustration and make more thoughtful decisions. Understanding frustration intolerance as a core ADHD symptom, not a personal flaw, helps individuals build healthier emotional responses, ultimately reducing impulsivity and improving overall emotional regulation. 

Harriet Winslow, BSc

Author

Harriet Winslow is a clinical psychologist with a Bachelor’s in Clinical Psychology and extensive experience in behaviour therapy and developmental disorders. She has worked with children and adolescents with ADHD, autism spectrum disorder (ASD), learning disabilities, and behavioural challenges, providing individual and group therapy using evidence-based approaches such as CBT and DBT. Dr. Winslow has developed and implemented personalised treatment plans, conducted formal and informal assessments, and delivered crisis intervention for clients in need of urgent mental health care. Her expertise spans assessment, treatment planning, and behavioural intervention for both neurodevelopmental and mental health conditions.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.