Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD

Abstract

Objective-The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions in order to increase specificity.Method-Participants were 310 young adolescents (ages 10-14; 71% male;78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression. Parents and youth both reported on youths' social skills and perceived social acceptance.Results-Path analyses indicated that above and beyond child demographics, ADHD and oppositional defiant disorder (ODD) symptom severity, and parents' own depression, self-reported social anxiety and anhedonia were both associated with lower youth-reported social skills and both parent-and youth-reported social acceptance. Negative self-evaluation was associated with poorer parent-reported social skills. Finally, harm avoidance was positively associated with both youthand parent-reported social skills. A path analysis using comorbid diagnoses (rather than symptom dimensions) indicated that that having a comorbid disruptive behavior disorder or depression diagnosis (but not a comorbid anxiety diagnosis) was associated with poorer parent-reported social functioning.Conclusions-Results demonstrate that the relation between internalizing symptoms and social functioning among young adolescents with ADHD is nuanced, with social anxiety and anhedonia symptoms associated with lower social skills and social acceptance in contrast to harm avoidance being associated with higher ratings of social skills (and unrelated to social acceptance). In terms HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript of comorbid diagnoses, depression is more clearly related than anxiety to poorer social functioning among young adolescents with ADHD. These results point to the importance of attending to specific facets of anxiety and depression in clinical care and future research. KeywordsAdolescence; Attention-Deficit/Hyperactivity Disorder; Comorbidity; Peer Functioning; Social CompetenceYouth with attention-deficit/hyperactivity disorder (ADHD) experience significant impairments in their social relationships, including higher rates of peer rejection, less social competence, and fewer dyadic friendships than their typically developing peers (see Hoza, 2007). Extant research indicates that the social impairments experienced by children with ADHD are neither transient nor innocuous, but instead tend to be long-lasting and associated with increased impairment as children with ADHD transition to adolescence (Bagwell et al., 2001;Lee et al., 2008;Mrug et al., 2012). However, the vast majority of studies in this area have focused on elementary age children, with surprisingly few studies examining the social functioning of older youth with ADHD. As such, ver...

Factors Associated with Healthy and Impaired Social Functioning in Young Adolescents with ADHD

“…The findings regarding CD severity and depression as risk factors are partially consistent with prior findings indicating that comorbid diagnoses with ADHD have either no effect on or exacerbate the social impairment of youth with ADHD (Becker et al, 2012; Becker et al, 2015). Dissimilar from Becker et al, we found that ODD severity was not associated with social impairment.…”

Attention-Deficit/Hyperactivity Disorder and Social Skills in Youth: A Moderated Mediation Model of Emotion Dysregulation and Depression

“…For example, some results indicate that symptoms of depression, but not anxiety, exacerbate the association between symptoms of ADHD and social problems (Becker, Langberg, Evans, Girio-Herrera, & Vaughn, 2014). In addition, among youth with ADHD, MDD is associated with more severe impairments and poorer developmental outcomes than those associated with either disorder alone (Daviss, 2008).…”

“…Regarding different levels of depression corresponding to different levels of social problems, findings indicate that among the internalizing disorders that co-occur with ADHD, MDD is more often associated with problems in functioning than others. For example, some results indicate that symptoms of depression, but not anxiety, exacerbate the association between symptoms of ADHD and social problems (Becker, Langberg, Evans, Girio-Herrera, & Vaughn, 2014). In addition, among youth with ADHD, MDD is associated with more severe impairments and poorer developmental outcomes than those associated with either disorder alone (Daviss, 2008).…”

The presentation of depression symptoms in attention‐deficit/hyperactivity disorder: comparing child and parent reports

“…It is important to recognise children with ADHD who present with symptoms of depression, as its presence alongside ADHD is associated with poorer academic and social functioning (Becker, Langberg, Evans, Girio‐Herrera, & Vaughn, ; Blackman, Ostrander, & Herman, ). Additionally, depression itself is more severe when comorbid with ADHD, with evidence suggesting an earlier onset, a longer duration, greater depression‐associated impairment, a higher suicidality rate and a greater likelihood of psychiatric hospitalisation (Biederman et al., ).…”