Poster #15 - Examining outcomes for Black youth with ADHD: impact of experiences with microaggressions

• In Event: Poster Session 08

Abstract

Motivation: Based on the 2016 National Survey for Children’s Health, approximately 9.4% of American youth aged 2-17 have ever received an ADHD diagnosis (Danielson, 2018). The DSM-5 reported that prevalence of ADHD is lower among Black people in the general population; however, Black and other non-white people are often underrepresented in studies evaluating ADHD (Knopf, 2021). A review of 21 ADHD studies published between 1979-2020 found a prevalence of 14.54%, contrary to the DSM-5’s reporting (Knopf, 2021). Research suggests that risk factors for ADHD include race, socioeconomic status, and discrimination (Cénat et al., 2020). ADHD research should include participants of marginalized communities to ensure culturally relevant data and to better understand how intersectional identities affect people’s experiences with psychopathology. Specifically, it is important to understand how race-related factors, such as experiencing microaggressions, affect the psychological outcomes of Black youth with ADHD.
Microaggressions are forms of discrimination defined as “brief, everyday exchanges that send denigrating messages to people of color because they belong to a racial minority group” (Williams, 2021; Sue et al., 2007). Members of other marginalized groups (e.g., LGBTQ+ individuals) experience microaggressions as well. Persistent, ongoing microaggressions have been linked to mental health problems. They have been identified as predictors of increased mental health symptoms in Black women (Loyd et al., 2021) and the cumulative effect of ongoing microaggressions is related to increased mood and adjustment issues among transracially adopted youth (Baden et al., 2022). Children with ADHD are likely to receive more negative feedback than their peers (Furukawa et al., 2019). Persistent negative feedback in response to ADHD symptoms has additionally been linked to higher levels of self-reported rejection sensitivity in children (Babinski et al., 2019). Consequently, negative feedback might in turn be compounded by simultaneously experiencing microaggressions, leading to unique mental health challenges. While research examining the relationship between microagressions and mental health exists, the link between microaggressions and ADHD in adolescents is an area that could benefit from further research.

Methods: Using data from the Duke Preschool Anxiety Study (DPAS) (Franz et al., 2013) and the Study of Toddler to Teenage Anxiety and Resilience (STTAR), we will examine differential outcomes for adolescents who met criteria for ADHD diagnoses either when they were in preschool or in adolescence and explore the moderating effect of experiencing microaggressions. 917 children, aged 2-5, and their caregivers participated in DPAS. The same 917 are being invited to participate again at ages 12-20 in STTAR. Data collection in STTAR is ongoing. ADHD diagnoses were determined using diagnostic interviews: the Preschool Age Psychiatric Assessment (PAPA) (Egger & Angold, 2004) in DPAS and the Childhood Age Psychiatric Assessment (CAPA) (Egger & Angold, 2004) in STTAR. Experiences with microagressions are being obtained via the Racial and Ethnic Microaggressions Scale (REMS), a self-report measure of perceived microagressions.

Hypothesis: We hypothesize that Black children with ADHD will report experiencing more microaggressions than Black children without ADHD. Additionally, we predict that children with ADHD who experienced more microaggressions will exhibit more mental health symptoms at adolescence.

Authors

• Adjoa T Ewool, Duke Univeristy
  Presenting Author

• Sarah Maren Lempres, Duke Univeristy

• William Copeland, University of Vermont

• Helen Egger, New York University Langone, Child Study Center

• Margaret A. Sheridan, University of North Carolina at Chapel Hill

• Kimberly Carpenter, Duke Univeristy