Attention-deficit/hyperactivity disorder and callous-unemotional traits as moderators of conduct problems when examining impairment in emerging adults

Abstract

This study examines attention-deficit/hyperactivity disorder (ADHD) and callous-unemotional (CU) traits as moderators of the association between conduct problems (CP) and young adult functioning. Young adults (n = 283; M_age = 20.82 years; 53.4% female), oversampled for attention and behavior problems, provided self-ratings of ADHD, CP, and CU, and adaptive functioning and psychopathology. ADHD and CU simultaneously moderated relationships between CP and family functioning, tobacco use, and internalizing symptoms. In addition, ADHD moderated the relation between CP and job functioning, and main effects of ADHD in the expected direction were found for educational performance and drug use. CU was associated with poorer educational outcomes. Interestingly, no ADHD, CU, or CP effects were observed for reported alcohol use. Our results highlight the importance of considering ADHD and CU in understanding the impact of CP on young adult functioning and psychopathology, and point to the importance of continued work on this topic.

Figure 1. Peer functioning as a function of the two-way interaction between CP and CU

Note. Higher peer functioning scores indicate more adaptive functioning. **p<0.01, *p<0.05, ⁺p<0.10

Figure 2. Family impairment as a function of the three-way interaction between CP, ADHD, and CU

Note. Higher family functioning scores indicate more adaptive functioning. **p<0.01, *p<0.05, ⁺p<0.10

Figure 3. Job performance impairment as a function of the two-way interaction between ADHD and CP

Note. High job functioning scores indicate more adaptive functioning. **p<0.01, *p<0.05, ⁺p<0.10

Figure 4. Tobacco use as a function of the three-way interaction between CP, ADHD, and CU

Note. Higher tobacco use scores indicate greater use. **p<0.01, *p<0.05, ⁺p<0.10

Figure 5. Internalizing symptoms as a function of the three-way interaction between CP, ADHD, and CU

Note. Higher internalizing symptom scores indicate greater symptom severity. Simple slopes tests were all significantly different than zero: (High CU, High ADHD): b=0.76**; (High CU, Low ADHD): b=0.71**; (Low CU, High ADHD): b=0.95**; (Low CU, Low ADHD): b=1.34**. **p<0.01, *p<0.05, ⁺p<0.10