Associations of Lifetime Depression with Trauma Exposure, Other Environmental Adversities, and Impairment in Adolescents with ADHD

Abstract

Depression is a common, potentially devastating comorbidity in youth with attention-deficit/hyperactivity disorders (ADHD). Various environmental adversities are well-described as correlates of depression in general pediatric populations, but not in youth with ADHD. In 104 adolescents with ADHD, we examined potential environmental correlates of lifetime depression, including trauma exposure, recent negative life events and current parent-child conflict, along with current and past ADHD severity and current impairment. Controlling for demographic variables, comorbid disorders, and ADHD severity, we noted significant associations between lifetime depression and environmental adversities, including victimization trauma, parent-child conflict, and behaviorally-independent negative life events. Current impairment but not ADHD severity was also highly associated with lifetime depression, controlling for the same covariates. Findings from this preliminary, cross-sectional study suggest that environmental adversities and impairment in youth with ADHD should also be targeted along with the ADHD when contemplating strategies to treat or prevent comorbid depression.

Emotion Regulation Mediates the Relationship between ADHD and Depressive Symptoms in Youth

“…Moderate to high rates of comorbid ADHD and mood disorders, ranging up to 75%, have been found in youth (Bauermister et al, 2007Biederman, Newcorn, Spirch, 1991Daviss, 2009;Elia, Ambrosini & Wade, 2008 research suggests increased rates of mood disorders (Biederman, et al, 2008;Green et al, 1997;Fisher, et al, 2002;Biederman, et al, 2006;Monuteaux, et al, 2007) as well as depressive symptoms (Hinshaw et al, 2006;Lahey et al, 2007;Lee et al, 2008) in youth diagnosed with ADHD in comparison to non-ADHD youth.…”

“…Moderate to high rates of comorbidity between ADHD and mood disorders in youth have been established in cross-sectional studies including both community (Anderson, Williams, McGee & Silva, 1987;Angold, Costello & Erkanli, 1999;Bauermeister et al, 2007;Bird, Canino, Rubio-Stipec, Gould, Ribera, Sesman et al, 1988;Blackman, Ostrander & Herman, 2005) and clinical samples (Daviss, 2009;Elia, Ambrosini & Wade, 2008;Milberger, Biederman, Faroane, Murphy & Tsuang, 1995;Souza, Pinheiro, Denardin, Mattos, & Rohde, 2004). Cross-sectional studies of community-based samples suggest that the co-occurrence rates of Attention Deficit Disorder (ADD, DSM-III-R, American Psychological Association, 1987) and/or Attention Deficit/Hyperactivity Disorder (ADHD, DSM-IV, American Psychological Association, 2000) and mood disorders range from 0% (McGee et al, 1990) to 75% (Biederman, Newcorn, Spirch,1991) (for reviews see Angold & Costello, 1993Jensen, Martin & Cantwell, 1997).…”

“…Specifically, in clinical samples of youth between the ages of 5 to 18 years, comorbidity rates of ADHD and depression range from 29%-39% (Daviss, 2009;Elia, et al, 2008;Milberger, et al, 1995;Souza, et al, 2004). In a large clinical sample of youth ages 6 to 18 years, Elia and colleagues (2008) found a comorbidity rate of 21.6% for ADHD and Depression/Dysthymia.…”

Does Comorbid Depression Predict Subsequent Adverse Life Events in Youth with Attention-Deficit/Hyperactivity Disorders?

“…The earlier study found that youth with ADHD had significantly more total, child-dependent, and child-independent ALEs than healthy controls, adjusting for age, gender, and pubertal status (Tillman et al 2003). The second, which was exclusively in a sample of youth with ADHD, reported that there were significant univariate correlations between lifetime depression and both child-dependent and child-independent ALEs, but only child-independent ALEs remained a significant correlate of lifetime depression after controlling for the effects of ADHD severity, comorbid externalizing disorders, age, and female gender (Daviss et al 2009). Two longitudinal studies have examined environmental adversities as predictors of the subsequent course of ADHD (Biederman et al 1996;Kessler et al 2005), but only the earlier study suggested that ALEs contribute to the persistence of ADHD diagnosis.…”

“…This study's findings suggest the need to control for the effects of other comorbidity when assessing the relationship between a particular psychiatric diagnosis and ALEs. Only two studies have examined the associations of ADHD diagnosis or ADHD severity with ALEs, taking into consideration whether such events were likely dependent on the child's behaviors (Tillman et al 2003;Daviss et al 2009). The earlier study found that youth with ADHD had significantly more total, child-dependent, and child-independent ALEs than healthy controls, adjusting for age, gender, and pubertal status (Tillman et al 2003).…”