ADHD and Co-occurring Psychological Symptoms: Emotion Regulation and Parenting as Potential Moderators

Abstract

A multitude of research demonstrates that ADHD is associated with negative psychological correlates and outcomes among children, such as academic difficulties and peer relationship problems. Youth with ADHD also experience high rates of comorbidity or co-occurring conditions, including mood, anxiety, oppositional defiant, and conduct disorders. However, few studies have investigated the development of co-occurring psychological symptoms among youth with ADHD over time and across different developmental periods. Shared risk factors likely contribute to the development of ODD, CD, anxiety, and depression among youth with ADHD. Emotion regulation and parenting style may confer risk or resilience for the development of co-occurring symptoms, but research is wanting. The current study examined an existing sample of youth who were recruited at age 10-12 and were followed at age 12-14 and 16. Analyses aimed to (a) identify subgroups of youth varying in type and levels of ADHD and co-occurring symptoms at three different time points using latent class analyses, (b) examine stability of membership and transitions to classes that differ in levels of ADHD and co-occurring symptoms using latent transition analyses, and (c) investigate emotion regulation and parenting style as predictors of stability and transitions among classes. Results revealed different patterns of ADHD and co-occurring symptoms, including a Low Symptoms class at each time point. Classes of youth with ADHD+Externalizing problems and ADHD+Internalizing problems emerged at ages 10-12 and 12-14. At age 16, two classes with qualitatively and quantitatively different externalizing and internalizing symptoms were identified. Latent transition analyses revealed transitions into the Low Symptoms class from each time point, but also stability and transitions to other symptomatic classes. Predictor analyses indicated that emotion regulation and parenting style were associated with transitions among and stability within classes, but findings were dependent on whether classes were defined primarily by co-occurring externalizing or internalizing symptoms. Results of the present study indicate that children with ADHD are likely to exhibit a range of psychological symptoms, but the frequency and quality of co-occurring symptoms may change over time. Emotion regulation and parenting may be potential targets for enhanced interventions among youth with ADHD with and without co-occurring symptoms.