Attention deficit hyperactivity disorder is an independent risk factor for lower resilience in adolescents: a pilot study

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) is associated with impaired daily functioning in a wide range of domains. Resilience, the ability to overcome and recover from challenges, has been scarcely investigated in ADHD and could potentially provide novel strategies for treatment. However, since ADHD is often comorbid with other clinical conditions, it is necessary to better understand if it impairs resilience levels when controlled for other variables. This pilot study is the first to investigate the correlation between quantitative measures of resilience and ADHD using strict diagnostic criteria by controlling this correlation for comorbid conditions. Methods: Twelve adolescents diagnosed with ADHD via semi--structured interview using Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) were compared to 12 adolescents exhibiting typical development, regarding resilience, in an analysis controlled for anxiety and depression levels, socioeconomic status, and intelligence quotient (IQ). Results: The ADHD group was less resilient than the control group (p < 0.01). Importantly, resilience in the ADHD group was not correlated with depression or anxiety, age, intelligence level, and socioeconomic status. Conclusions: ADHD seems to be associated with lower resilience, which cannot be explained by depression, anxiety, intelligence level, age, or socioeconomic status. Keywords: Attention deficit hyperactivity disorder, resilience, adolescents. ResumoObjetivo: O transtorno de déficit de atenção com hiperatividade (TDAH) se associa a comprometimento funcional em diferentes domínios. Resiliência, o modo como indivíduos enfrentam e superam dificuldades, não foi investigada de modo suficiente no TDAH e poderia sugerir potenciais novas estratégias terapêuti-cas. Entretanto, sendo o TDAH frequentemente comórbido com outras condições clinicas, é necessário entender se ele compromete a resiliência de modo independente de outras variáveis. Este estudo piloto é o primeiro a investigar a correlação entre medidas quantitativas de resiliência e TDAH diagnosticado de modo estrito controlando-a por variáveis clínicas. Método: Os níveis de resiliência de 12 adolescentes diagnosticados com TDAH de acordo com os critérios do sistema Manual Diagnóstico e Estatístico de Transtornos Mentais, 4ª edição (DSM-IV) através de entrevista semiestruturada foram comparados aos de 12 adolescentes com desenvolvimento típico, em uma análise controlada por níveis de ansiedade e depressão, status socioeconômico e inteligência. Resultados: O grupo TDAH apresentou menor resiliência do que o grupo controle (p < 0,01). Não houve correlação entre resiliência e depressão ou ansiedade, idade, inteligência ou nível socioeconômico. Conclusões: TDAH parece estar associado a baixos níveis de resiliência que não podem ser justificados por depressão, ansiedade, inteligência, idade ou condição socioeconômica. Descritores: Transtorno de déficit de atenção com hiperatividade, resiliência, adolescentes.

Associations between symptoms of attention-deficit/ hyperactivity disorder and life satisfaction in medical students: the mediating effect of resilience

“…A systematic review has shown that without treatment, people with ADHD have poorer long-term outcomes in almost every aspect of life, such as self-esteem, social behaviors and occupational attainment, relative to those without ADHD [ 36 ]. Compared with non-symptomatic ones, the symptomatic medical students showed significantly lower level of resilience, which was consistent with other prior research [ 21 ]. One explanation is that ADHD is often comorbid with other psychiatric disorders, including depression and anxiety [ 3 , 37 ], which are negatively related to resilience [ 38 ].…”

“…The study by Wilmshurst et al demonstrated that college students with a diagnosis of ADHD reported higher level of parental supports than controls and might represent an especially resilient group [ 20 ]. However, ADHD was shown to be associated with lower resilience in adolescents [ 21 ]. Meanwhile, resilience was found to be positively related to life satisfaction among medical students, accounting for up to 18% of its variance [ 22 ].…”

The role of self‐compassion in the mental health of adults with ADHD

“…Self‐compassion also has commonalities with many of the individual differences that are known to contribute to the mental health of people with ADHD. For example, emotion dysregulation (Bodalski et al, 2019 ), maladaptive self‐schemata (Miklósi et al, 2016 ), and limited resilience (Regalla et al, 2015 ) are factors that have been implicated in the mental health of people with ADHD (Knouse et al, 2008 ; Oddo et al, 2018 ). These factors also reflect low self‐compassion.…”

Posttraumatic Stress Disorder Is Highly Comorbid With Adult ADHD in Alcohol Use Disorder Inpatients

“…This may in turn increase the risk of developing PTSD (Jakob et al, 2017). Another factor that could explain the relationship between ADHD and PTSD is the low resilience that has been observed in ADHD patients (Regalla et al, 2015), and which is associated with adverse clinical outcomes such as drug use (Dvorsky & Langberg, 2016); it would be interesting to explore this factor in future studies.…”