(PS13-100) Examining Self-esteem as a Moderator of the Relationship Between ADHD Symptomology and Internalizing Symptoms in Youth

Abstract Text: Attention-deficit hyperactivity disorder (ADHD) symptoms have been shown to predict depression and anxiety amongst youth with ADHD. This relationship may be explained by the social and academic impairments associated with an ADHD diagnosis. If self-esteem truly effects internalizing symptomology in youth with ADHD, we should expect self-esteem to have a moderating effect on said relationship. We are looking to extend the findings of Nadeau et al., (2015) which found that life-satisfaction mediated the relationship between ADHD symptom severity and depressive symptoms. The current cross-sectional study examined self-esteem, a single variable within the construct of life satisfaction, and its potential effect on the relationship of ADHD symptom severity and internalizing symptoms (i.e. depression and anxiety). We utilized data from a previous study conducted by Hacker and colleagues (2012) which investigated hoarding behaviors in children with ADHD. Data for the present study included 99 youth, aged 7-17 years old (Mage = 11.54) with a primary or co-primary diagnosis of ADHD. The following measures were used: Vanderbilt ADHD Diagnostic Rating Scale-Parent Version (VAND) to measure combined ADHD symptomology; select subscales of the self-reported Revised Child Anxiety and Depression Scale (RCADS) to measure depression and anxiety symptomology; and the Rosenberg Self-Esteem Scale (SES) to measure self-esteem. Findings from correlational analyses revealed that ADHD symptomology was generally not associated with depression and anxiety symptomology, nor self-esteem (rrange = - .13 - .09). Conversely, self-esteem was negatively associated with depression and anxiety symptomology (rrange = - .42 - - .48). Results of moderation models did not reveal any significant evidence of self-esteem as a moderator of the relation between ADHD symptomology and depression and anxiety symptomology, respectively. Findings from the present study highlight the complexity of the relationship between ADHD and internalizing symptomology, suggesting that the role of self-esteem might not be as straightforward as previously hypothesized. The necessity for a nuanced understanding of ADHD and its associated impairments is underscored given our findings contradict much of the current literature. Further work is needed in this area to elucidate potential measurement-related issues (e.g., sole reliance on parent-report) and to uncover relevant strengths-based factors that may buffer the pernicious link between neurodevelopmental-based ADHD vulnerability factors and negative behavioral health outcomes, such as internalizing psychopathology. By identifying such factors, more holistic approaches to diagnosing and treating individuals with ADHD can be revealed to promote their resilience and overall well-being.