Trait Anxiety as a Mediator of the Association between Attention Deficit Hyperactivity Disorder Symptom Severity and Functional Impairment

Abstract

ObjectiveAnxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined.MethodsThe sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners’ Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson’s correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses.ResultsAdult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales.ConclusionPatients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

The Psychological Burden of Attention-Deficit/Hyperactivity Disorder Traits on Medical Workers Under the COVID-19 Outbreak: A Cross-Sectional Web-Based Questionnaire Survey (Preprint)

“…Results indicated that ADHD traits might have a strong influence on depression and anxiety symptoms even after controlling for physical and psychological burden and fear of COVID-19, with its effect possibly being greater than other factors, including autistic traits. In general, and not only during a pandemic, the relationship between ADHD and depression or anxiety has already been addressed [34][35][36][37][38][39]. Additionally, in general, ASD patients are more prone to develop depression and anxiety [40].…”

Effects of Methylphenidate on Somatic Symptoms and Brain Functional Connectivity in Adolescents with Attention Deficit Hyperactivity Disorder: A Pilot Study

“…Attention deficit hyperactivity disorder (ADHD) is a developmental disorder characterized by symptoms of inattention, distraction, hyperactivity, and impulsivity [ 1 ]. In addition, ADHD is mostly associated with poor health outcomes including hypertension, diabetes mellitus, obesity, smoking, substance abuse, injury due to accidents, insomnia, suicidality [ 2 ], and increased medical costs [ 3 ]. Although somatic symptoms are not included in the core symptoms of ADHD, subjective health (psychological and somatic) complaints and somatic symptoms are more frequently reported in children with ADHD [ 4 - 7 ].…”