Attention-Deficit/Hyperactivity Disorder and Unhealthy Lifestyle in Adolescence: Unforeseen Role of Allostatic Overload and Psychological Well-Being

Abstract

Unhealthy lifestyle behaviors (ULBs) are common in early adolescence and could be worsened by Attention-Deficit/Hyperactivity Disorder (ADHD), as well as by specific psychosocial factors, such as stress and unbalanced (i.e., too high or low scores of) psychological well-being (PWB) dimensions. This multi-center study aimed to evaluate how interactions between ADHD symptoms and psychosocial factors associated with ULBs (i.e., Allostatic Overload and multidimensional Psychological Well-Being), considered as moderators, could affect the adoption of ULBs during adolescence. A total of 440 fourteen-year-old adolescents were recruited from six upper secondary schools in Bologna and Rome (Italy) and completed self-report questionnaires on ULBs, ADHD, and psychosocial factors. Relations between ADHD symptomatology and specific ULBs (i.e., impaired sleep, problematic Internet use) were moderated by variables deemed as "negative" (i.e., Allostatic Overload) or "positive" (i.e., PWB dimensions of Self-Acceptance, Personal Growth, Positive Relations, Purpose in Life, Environmental Mastery): when the "negative" moderator is absent and the levels of the "positive" moderators are higher, ULBs decrease among students with lower ADHD symptomatology but increase among students with more severe ADHD. Based on ADHD severity, interventions should aim at promoting a state of euthymia, which consists in balanced PWB dimensions and reflects the optimal level of well-being to fulfill one's own potential and self-realization.

Keywords: ADHD; adolescence; allostatic overload; moderation analysis; psychological well-being; unhealthy behaviors.

Figure A1

Flow chart of study phases.

Figure 1

Graphs representing ASRS total score × PWB Positive Relations and ASRS total score × Allostatic Overload interactions, concerning hours of sleep. Note: ASRS = Adult ADHD Self-Report Scale; PWB = Psychological Well-Being scales; SD = Standard Deviation.

Figure 2

Graph representing ASRS total score × PWB Environmental Mastery interaction, concerning daily hours spent using technological devices instead of sleeping. Note: ASRS = Adult ADHD Self-Report Scale; PWB = Psychological Well-Being scales; SD = Standard Deviation.

Figure 3

Graphs representing ASRS total score × PWB Personal Growth and ASRS total score×PWB Purpose in Life interactions, concerning daily hours spent using smartphone. Note: ASRS = Adult ADHD Self-Report Scale; PWB = Psychological Well-Being scales; SD = Standard Deviation.

Figure 4

Graphs representing ASRS total score × PWB Self-Acceptance, ASRS total score × PWB Personal Growth and ASRS total score × PWB Purpose in Life interactions, concerning daily hours spent using personal computers. Note: ASRS = Adult ADHD Self-Report Scale; PWB = Psychological Well-Being scales; SD = Standard Deviation.

Figure 5

Graph representing ASRS total score × PWB Positive Relations interaction, concerning IAT Compromised Time Control (CTC). Note: ASRS = Adult ADHD Self-Report Scale; IAT = Internet Addiction Test; PWB = Psychological Well-Being scales; SD = Standard Deviation.