The Differential Predictive Power of Inattention and Hyperactivity for Later Depressive Symptoms in School-Aged Children

• In Event: Poster Session 14
  In Poster Session: PS 14 Topic - Developmental Psychopathology

Abstract

Introduction
Attention Deficit/Hyperactivity Disorder (ADHD) is the most common early childhood neurodevelopmental disorder, impacting 3%-7% of school-aged children (APA, 2000). ADHD frequently co-occurs with depression (e.g., Anderson et al., 1998) and comorbid ADHD and depression are associated with greater academic and psychosocial difficulties among youth than either problem alone (Steele et al., 2000). Research focused on comorbid ADHD and depression suggests that ADHD emerges before depressive symptoms. An enhanced understanding of what aspects of ADHD best forecast later depressive symptoms, and for which children, can inform preventive intervention efforts.

An emerging literature suggests that the inattention better predicts later adjustment difficulties than hyperactivity (e.g., Pingault et al. 2011). For example, research with young children has demonstrated that inattention at age 3 predicts depressive symptoms at age 7, but early hyperactivity does not (Rajendran et al., 2013). It is not clear, however, whether this effect of early inattention on later childhood depressive symptoms extends to depressive symptoms in adolescence. Moreover, it is not clear whether the association between early hyperactivity and later depressive symptoms may depend, at least in part, upon social factors. Negative peer and parental relationships are linked to ADHD symptoms, and the likelihood of later comorbid internalizing symptoms might be greater for youth with these social difficulties (Deault, 2010; Willcutt et al., 2013). Thus, this study examined the differential association of inattention and hyperactivity in early childhood and later depressive symptoms, and whether social rejection moderated the association between hyperactivity and later depressive symptoms.

Method
Participants were 678 African American (53.8% girls) youth initially assessed as part of a universal preventive intervention delivered in grade 1. Teachers reported about inattention and hyperactivity symptoms in grade 1 and grade 6. Peer rejection and parental rejection were assessed in grades 1 and 6 via teacher and parent report, respectively. Youth reported about depressive symptoms in grades 1 and 6. Multiple regression analyses were used to examine the relative predictive power of grade 1 inattention and hyperactivity on grade 6 depressive symptoms, and the moderating role of peer rejection and parental rejection. Intervention status and grade 1 depressive symptoms were controlled in the analyses.

Results
Grade 1 inattention was positively associated with grade 6 depressive symptoms when controlling for grade 1 hyperactivity (B = .038, p = .024, 95% CI: 0.005, 0.072). However, grade 1 hyperactivity was not associated with grade 6 depressive symptoms while controlling for grade 1 inattention (B = -.004, p = .85, 95% CI: -0.041, 0.033). Neither peer nor parental rejection moderated the association between grade 1 hyperactivity and grade 6 depressive symptoms.

Conclusion
These findings replicate prior research demonstrating that inattention better predicts later depressive symptoms than hyperactivity (Rajendran et al., 2013), and extends that research to early adolescence. While intervention efforts often target children with symptoms of hyperactivity, possibly to the neglect of children with inattention only, results from this research suggest that interventions focused on inattention have the potential to reduce later depressive symptoms.

Authors

• Jacob Hadwen, George Washington University
  Presenting Author

• Kantoniony Rabemananjara, George Washington University
  Non-Presenting Author

• Sharon Lambert, George Washington University
  Non-Presenting Author

• George Howe, George Washington University
  Non-Presenting Author

• Nicholas Ialongo, Johns Hopkins University
  Non-Presenting Author