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Schmengler H, Peeters M, Stevens GWJM, Hartman CA, Oldehinkel AJ, Vollebergh WAM. ADHD Symptoms and Educational Level in Adolescents: The Role of the Family, Teachers, and Peers. Res Child Adolesc Psychopathol 2023; 51:1051-1066. [PMID: 36952076 PMCID: PMC10271900 DOI: 10.1007/s10802-023-01047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/24/2023]
Abstract
Few studies have explored the contribution of family and school factors to the association between ADHD symptoms and lower education. Possibly, having more ADHD symptoms contributes to poorer family functioning and less social support, and consequently a lower educational level (i.e., mediation). Moreover, the negative effects of ADHD symptoms on education may be stronger for adolescents with poorer family functioning or less social support (i.e., interaction). Using data of the Dutch TRAILS Study (N = 2,229), we evaluated associations between ADHD symptoms around age 11 and educational level around age 14, as well as between ADHD symptoms around age 14 and 16 years and subsequent changes in educational level around age 16 and 19, respectively. We assessed the potential mediating role of family functioning, and social support by teachers and classmates, all measured around ages 11, 14, and 16, while additionally evaluating interactions between ADHD symptoms and these hypothesized mediators. ADHD symptoms were associated with poorer family functioning, less social support by teachers and classmates, and lower education throughout adolescence. No conclusive evidence of mediation was found, because unique associations between family functioning and social support by teachers and classmates and education were largely absent. Furthermore, we found no interactions between ADHD symptoms and family functioning and social support by teachers and classmates. Although social support by teachers and classmates and good family functioning may benefit the wellbeing and mental health of adolescents with high levels of ADHD symptoms, they will not necessarily improve their educational attainment.
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Affiliation(s)
- Heiko Schmengler
- Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, Utrecht, 3584 CH, The Netherlands.
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, Utrecht, 3584 CH, The Netherlands
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, Utrecht, 3584 CH, The Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center of Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center of Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
| | - Wilma A M Vollebergh
- Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, Utrecht, 3584 CH, The Netherlands
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Widmer A, Havewala M, Bowker JC, Rubin KH. Secure Attachment Relationships With Mothers, But Not Fathers, Moderate the Relation Between Attention-Deficit Hyperactivity Symptoms and Delinquency in Adolescents. J Atten Disord 2023; 27:46-56. [PMID: 36039532 DOI: 10.1177/10870547221120694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The primary aim of this study was to investigate whether secure parent-adolescent attachment relationships moderate the longitudinal relation between 9th grade (G9) ADHD symptoms and 12th grade (G12) delinquency within a community sample of adolescents. METHOD Participants included 335 9th graders, of whom 203 students completed measures again in 12th grade. Mothers reported on their adolescents' ADHD symptoms and aggressive behaviors, and adolescents completed measures of their own delinquency and their perceptions of their parent-child attachment relationships. RESULTS G9 ADHD symptoms predicted increases in G12 delinquent behaviors. Moderation effects were also found such that G9 ADHD symptoms predicted G12 delinquency for only those youth who had moderate or low levels of secure maternal attachment. Paternal secure attachment did not moderate the effects of G9 ADHD symptoms on G12 delinquency. CONCLUSION Findings underscore the importance of secure maternal attachment relationships in the development of delinquency among adolescents with ADHD symptoms.
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Thapar A, Livingston LA, Eyre O, Riglin L. Practitioner Review: Attention-deficit hyperactivity disorder and autism spectrum disorder - the importance of depression. J Child Psychol Psychiatry 2023; 64:4-15. [PMID: 35972029 PMCID: PMC10087979 DOI: 10.1111/jcpp.13678] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
Young people with neurodevelopmental disorders, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), show high rates of mental health problems, of which depression is one of the most common. Given that depression in ASD and ADHD is linked with a range of poor outcomes, knowledge of how clinicians should assess, identify and treat depression in the context of these neurodevelopmental disorders is much needed. Here, we give an overview of the latest research on depression in young people with ADHD and ASD, including possible mechanisms underlying the link between ADHD/ASD and depression, as well as the presentation, assessment and treatment of depression in these neurodevelopmental disorders. We discuss the implications for clinicians and make recommendations for critical future research in this area.
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Affiliation(s)
- Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy A Livingston
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olga Eyre
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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Longitudinal Association of Sluggish Cognitive Tempo with Depression in Adolescents and the Possible Role of Peer Victimization. Res Child Adolesc Psychopathol 2022; 50:809-822. [PMID: 35420391 DOI: 10.1007/s10802-022-00923-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
It is unknown whether sluggish cognitive tempo (SCT) is prospectively associated with depression in adolescence, and possible processes linking SCT to depression remain unexamined. Using a longitudinal study with three timepoints over a two-year period, the current study tested the indirect effects of SCT on depression via peer victimization, specifically physical, relational, and verbal victimization. Participants were 302 adolescents (Mage = 13.17 years; 44.7% female participants; 81.8% White; 52% with ADHD). In the fall of 8th grade, adolescents and parents completed measures of adolescents' SCT and ADHD symptoms. Adolescents completed a measure of peer victimization in spring of 8th grade and a measure of depressive symptoms in 10th grade. Models examining indirect effects were conducted with and without control of baseline ADHD and/or depressive symptoms. Across analyses, adolescent and parent ratings of SCT symptoms uniquely predicted greater depressive symptoms two years later when controlling for adolescent sex, study site, and either 8th grade depressive or ADHD symptoms. Further, adolescents' self-reported 8th grade SCT symptoms predicted 10th grade depressive symptoms via verbal victimization when controlling for 8th grade ADHD symptoms, but not in analyses incorporating 8th grade depressive symptoms. Findings underscore the predictive association of SCT on depressive symptoms, the possible role of adverse peer relationships as a mechanism linking SCT to depression, and the importance of considering ADHD and depressive symptoms in research on longitudinal correlates of SCT.
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Powell V, Riglin L, Ng-Knight T, Frederickson N, Woolf K, McManus C, Collishaw S, Shelton K, Thapar A, Rice F. Investigating Friendship Difficulties in the Pathway from ADHD to Depressive Symptoms. Can Parent-Child Relationships Compensate? Res Child Adolesc Psychopathol 2021; 49:1031-1041. [PMID: 33655375 PMCID: PMC8222013 DOI: 10.1007/s10802-021-00798-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 01/13/2023]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is associated with friendship difficulties. This may partly account for the increasingly recognised association between ADHD and subsequent depression. Little is known about the types of friendship difficulties that could contribute to the association between ADHD and depressive symptoms and whether other relationships, such as parent-child relationships, can mitigate against potential adverse effects of friendship difficulties. In a representative UK school sample (n = 1712), three main features of friendship (presence of friends, friendship quality and characteristics of the individual's classroom friendship group) were assessed in a longitudinal study with two assessment waves (W1, W2) during the first year of secondary school (children aged 11-12 years). These friendship features (W1) were investigated as potential mediators of the prospective association between teacher-rated ADHD symptoms (W1) and self-rated depressive symptoms (W2) seven months later. Parent-child relationship quality (W1) was tested as a moderator of any indirect effects of ADHD on depression via friendship. ADHD symptoms were inversely associated with friendship presence, friendship quality and positive characteristics of classroom friendship groups. Depressive symptoms were inversely associated with presence and quality of friendships. Friendship quality had indirect effects in the association between ADHD and subsequent depressive symptoms. There was some evidence of moderated mediation, whereby indirect effects via friendship quality attenuated slightly as children reported warmer parent-child relationships. This highlights the importance of considering the quality of friendships and parent-child relationships in children with ADHD symptoms. Fostering good quality relationships may help disrupt the link between ADHD symptomology and subsequent depression risk.
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Karawekpanyawong N, Wongpakaran T, Wongpakaran N, Boonnag C, Siritikul S, Chalanunt S, Kuntawong P. Impact of Perceived Social Support on the Relationship between ADHD and Depressive Symptoms among First Year Medical Students: A Structural Equation Model Approach. CHILDREN (BASEL, SWITZERLAND) 2021; 8:401. [PMID: 34065767 PMCID: PMC8156751 DOI: 10.3390/children8050401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is associated with depression among college students, while perceived social support is also associated with depression, especially among young adults. This study aimed to examine to what extent perceived social support mediated the relationship between ADHD symptoms and depressive symptoms. METHODS In total, 124 first year medical students completed the Adult ADHD Self-Report Scale Screener (ASRS), the Patient Health questionnaire-9 and the revised Thai Multidimensional scale of perceived social support reflecting ADHD symptoms, depressive symptoms, and perceive social support, i.e., family members, friends and other significant people, respectively. Structural equation modeling was used to investigate the hypothesized mediation model. RESULTS ADHD symptoms exhibited a significant indirect effect on depressive symptoms via perceived social support. ADHD symptoms initially had a direct effect on depression; thereafter, it reduced to a non-significance effect after perceived social support was added. The total variance explained by this model was 35.2%. The mediation model with family support as a mediator showed the highest effect size. CONCLUSIONS The study highlighted the importance of perceived social support, particularly family support, on depressive symptoms among young medical students experiencing ADHD symptoms. The model suggests promising relationships for further research on ADHD-related depression and potential treatment in the future.
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Affiliation(s)
- Nuntaporn Karawekpanyawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.); (N.W.); (P.K.)
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.); (N.W.); (P.K.)
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.); (N.W.); (P.K.)
| | - Chiraphat Boonnag
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (C.B.); (S.S.); (S.C.)
| | - Sirinut Siritikul
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (C.B.); (S.S.); (S.C.)
| | - Sirikorn Chalanunt
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (C.B.); (S.S.); (S.C.)
| | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.); (N.W.); (P.K.)
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