Prospective Associations Between ADHD Symptom Dimensions and Forms of Aggression During Elementary School

• In Event: 1-152 - Executive Functioning and Relational Aggression/Victimization: Longitudinal Findings from Childhood to Adolescence

Integrative Statement

Introduction: Symptoms of attention-deficit/hyperactivity disorder (ADHD) are associated with a range of executive functioning deficits as well as higher levels of aggressive behavior across developmental periods. Less is known, however, regarding the relations between ADHD symptom dimensions (i.e., inattention and hyperactivity-impulsivity) and specific forms of aggression. Although previous research has demonstrated that symptoms of oppositional defiant disorder (ODD) are more strongly linked to relational and physical aggression than ADHD symptoms, to our knowledge, these unique associations have not yet been examined longitudinally. The central aim of the current study was therefore to evaluate whether ADHD symptom dimensions were prospectively associated with relational and physical aggression over a 1-year period during elementary school.

Hypotheses: We hypothesized that, after controlling for ODD symptom dimensions, ADHD symptom dimensions would be associated with lower levels of relational aggression and higher levels of physical aggression over time.

Study Population: Participants included 961 kindergarten through fourth-grade students (52.2% boys) and their homeroom teachers, who were recruited from an elementary school located in a rural Midwestern community in the United States. According to school records, the student body was predominantly comprised of Caucasian youth (> 90%), and approximately 40% of students were eligible for free or reduced-price lunch.

Methods: Teachers provided ratings of ADHD and ODD symptoms at Time 1. Forms of aggression were also assessed at each time point using teacher-reports. The first round of data collection occurred approximately 2 months into the fall semester (Time 1); data collection took place again approximately 6 months later during the spring semester (Time 2) in addition to 6 months after that during the subsequent fall semester (Time 3). Note that the informants changed between Time 2 and Time 3 when children transitioned into the next grade level.

Results: Data in the current study had a multilevel structure due to the clustering of children into classrooms that changed between Time 2 and Time 3. Accordingly, prospective associations were examined using a series of cross-classified multilevel cross-lagged models within Mplus statistical software; these analyses were performed using a Bayesian estimator with noninformative priors. Results indicated that symptoms of hyperactivity-impulsivity predicted residualized increases in relational and physical aggression both within and across academic years after controlling for prior levels of both forms of aggression along with gender, grade level, and baseline levels of ODD symptom dimensions (see Table 1). Further, symptoms of inattention predicted residualized decreases in physical aggression across academic years.

Discussion: It appears that symptoms of hyperactivity-impulsivity, but not inattention, may heighten children’s risk for engaging in both relational and physical forms of aggression within an academic year, and these effects persist even when students transition into the next grade level. Contrary to previous research, these associations were significant after controlling for ODD symptom dimensions. Thus, youth exhibiting these behaviors (e.g., fidgeting, difficulty awaiting turn, interrupting or intruding on others) may benefit from evidence-based interventions (e.g., token reinforcement, response cost) in order to prevent escalating aggression and promote prosocial behavior within the elementary school context.

Authors

• John L. Cooley, University of Colorado Denver
  Presenting Author

• Spencer C. Evans, Harvard University
  Non-Presenting Author

• Paula Fite, University of Kansas
  Non-Presenting Author