Childhood ADHD With and Without Co-occurring Internalizing/Externalizing Problems: Prospective Predictions of Change in Adolescent Academic and Social Functioning

J Atten Disord. 2023 Nov;27(13):1520-1531. doi: 10.1177/10870547231187146. Epub 2023 Jul 27.

Abstract

Objective: Internalizing and externalizing problems predict poor academic and social outcomes. However, ADHD co-occurs with internalizing and externalizing problems and is itself a risk factor, thus preventing precise inferences. This study evaluated childhood anxiety, depression, and aggression as predictors of change in adolescent academic and social outcomes, including moderation by childhood ADHD.

Methods: 182 ethnically-diverse 5- to 11-year-old youth with (54.7%) and without (45.3%) ADHD completed a separate baseline and 6- to 7-year prospective follow-up assessment, consisting of parallel measures across youth psychopathology, academic functioning (i.e., academic achievement, school competence), and friendship quality domains.

Results: Whereas childhood ADHD inversely predicted academic competence, depression and aggression uniquely predicted worsening friendship quality. Interestingly, anxiety was unrelated to change in academic and friendship outcomes; similarly, neither ADHD, depression, nor aggression predicted change in objectively-measured academic achievement from a standardized assessment.

Conclusion: Implications for intervention and prevention are considered, including school-based approaches, within a developmental psychopathology framework.

Keywords: ADHD; academic achievement; friendship quality; school competence; youth psychopathology.

MeSH terms

  • Adolescent
  • Anxiety / epidemiology
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Child
  • Child, Preschool
  • Humans
  • Prospective Studies
  • Social Adjustment
  • Social Interaction