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Prospective prediction of developing internalizing disorders in ADHD.

Sarah L Karalunas1, Dylan Antovich2, Natalie Miller2

  • 1Psychological Sciences, Purdue University, West Lafayette, IN, USA.

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PubMed
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Childhood attention-deficit/hyperactivity disorder (ADHD) shows varied anxiety and depression trajectories. Early emotional traits, executive function, and family factors predict these divergent courses, aiding risk identification.

Keywords:
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Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Behavioral Neuroscience

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) presents a heterogeneous clinical course.
  • Comorbid anxiety and mood disorders during childhood and adolescence contribute to divergent ADHD outcomes.
  • Understanding predictors of anxiety and depression onset in ADHD is crucial for identifying at-risk children.

Purpose of the Study:

  • To characterize heterogeneity in the onset of anxiety and depression in children with ADHD.
  • To identify prospective predictors of divergent anxiety and depression trajectories in ADHD.
  • To facilitate early identification of children at higher risk for comorbid mood and anxiety disorders.

Main Methods:

  • A longitudinal study followed 849 children (aged 7-12 at baseline) with ADHD for up to six years.
  • Latent class growth curve analyses modeled trajectories of anxiety and depression.
  • Predictors included child temperament, executive function (EF), parental criticism, and child-reported self-blame.

Main Results:

  • Three distinct trajectories for anxiety and depression were identified: persistently high, persistently low, and increasing.
  • Temperamental fear/sadness and irritability interacted with family characteristics to predict trajectories.
  • Parental criticism and self-blame influenced outcomes, particularly with low temperamental risk; better working memory predicted delayed depression onset.

Conclusions:

  • Interactions between child emotional features, executive function, and family environment predict divergent anxiety and depression courses from childhood to adolescence.
  • These findings highlight modifiable risk factors influencing long-term outcomes in ADHD.
  • Early identification of risk factors can inform targeted interventions for children with ADHD.