Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD)

Abstract

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with attention-deficit/hyperactivity disorder (ADHD) during childhood, in the context of 3 potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data came from 140 participants in the Berkeley Girls With ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood, F(1, 118) change = 9.00, p = .003, R2 change = .069, and adolescent, F(1, 109) change = 10.41, p = .002, R2 change = .083, conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations.

Figure 1

Figure 1a. Indirect effect of adolescent school failure and disciplinary problems. I.E. = indirect effect (a * b), se = standard error, CI = bias-corrected confidence interval, c′ = direct effect. Figure 1b. Indirect effect of adolescent internalizing problems and peer rejection. I.E. = indirect effect (a * b), se = standard error, CI = bias-corrected confidence interval, c′ = direct effect.

Figure 1

Figure 1a. Indirect effect of adolescent school failure and disciplinary problems. I.E. = indirect effect (a * b), se = standard error, CI = bias-corrected confidence interval, c′ = direct effect. Figure 1b. Indirect effect of adolescent internalizing problems and peer rejection. I.E. = indirect effect (a * b), se = standard error, CI = bias-corrected confidence interval, c′ = direct effect.