Impairment and Internalizing Comobidity in Adolescent ADHD: Gender Considerations, Risk Factors, and Response to Treatment

Thesis (Ph.D.)--University of Washington, 2021The literature on attention-deficit/hyperactivity disorder (ADHD) has historically concentrated on externalizing symptoms in elementary-aged males. This paper investigates gender differences in ADHD-related impairment, relationships between ADHD and comorbid internalizing problems, and response to intervention for adolescents with ADHD. Participants are 325 ethnically diverse rising 6th and 9th graders randomized to a high intensity (412 hour) Summer Treatment Program for Adolescents (HI; n=109) vs. low intensity (24 hour) organizational skills intervention (LI; n=109) and an untreated comparison group (n=107). Multiple regression of baseline data was used to evaluate differences in patterns of impairment by gender and grade as well as the relationship between three common areas of ADHD-related impairment (social problems, academic impairment, and family conflict) and teen-reported depressive and anxious symptoms. Results showed few differences in parent- or teacher-reported impairment by gender or grade. Notably, participants identifying as female were found to have fewer parent-reported academic problems (b=-0.09, p=0.017). Rising 9th graders were found to have higher levels of family conflict (b=0.18; p