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ADHD and depressive symptoms in adolescents: the role of community violence exposure

  • Andrew StickleyEmail author
  • Roman Koposov
  • Ai Koyanagi
  • Yosuke Inoue
  • Vladislav Ruchkin
Original Paper

Abstract

Purpose

Comorbid depression is common in adolescents with attention-deficit/hyperactivity disorder (ADHD). As yet, however, little is known about the factors associated with co-occurring depression in this population. To address this research gap, the current study examined the role of community violence exposure in the association between ADHD symptoms and depression.

Methods

Data came from 505 Russian adolescents [mean age 14.37 (SD = 0.96)] who had teacher-reported information on ADHD symptoms that was collected in conjunction with the Social and Health Assessment (SAHA). Adolescent self-reports of witnessing and being a victim of community violence were also obtained while depressive symptoms were self-assessed with an adapted version of the Center for Epidemiologic Studies-Depression Scale (CES-D). Logistic regression analyses were performed to examine associations.

Results

In univariable analyses, both witnessing and being a victim of violence were associated with significantly increased odds for depressive symptoms in adolescents with ADHD symptoms compared to non-ADHD adolescents who had not experienced community violence. However, in the multivariable analysis only being a victim of violence continued to be associated with significantly increased odds for depression [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.33–16.35].

Conclusion

Exposure to community violence may be associated with depression in adolescents with ADHD symptoms. Clinicians should enquire about exposure to community violence in adolescents with ADHD/ADHD symptoms. Early therapeutic interventions to address the effects of violence exposure in adolescents with ADHD may be beneficial for preventing depression in this group.

Keywords

Attention-deficit/hyperactivity disorder Depressive symptoms Witness violence Violent victimization Adolescent 

Notes

Acknowledgements

AK’s work was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII—General Branch Evaluation and Promotion of Health Research—and the European Regional Development Fund (ERDF-FEDER).

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical standards

Prior to being included in the study informed consent was obtained from all participants. The study was approved by the institutional review committee at the Northern State Medical University, Arkhangelsk, Russia. The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

References

  1. 1.
    Thomas R, Sanders S, Doust J, Beller E, Glasziou P (2015) Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 135(4):e994–e1001Google Scholar
  2. 2.
    Daley D, Birchwood J (2010) ADHD and academic performance: why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? Child Care Health Dev 36(4):455–464Google Scholar
  3. 3.
    Bagwell CL, Molina BS, Pelham WE Jr, Hoza B (2001) Attention-deficit hyperactivity disorder and problems in peer relations: predictions from childhood to adolescence. J Am Acad Child Adolesc Psychiatry 40(11):1285–1292Google Scholar
  4. 4.
    Scahill L, Schwab-Stone M, Merikangas KR, Leckman JF, Zhang H, Kasl S (1999) Psychosocial and clinical correlates of ADHD in a community sample of school-age children. J Am Acad Child Adolesc Psychiatry 38(8):976–984Google Scholar
  5. 5.
    Johnston C, Mash EJ (2001) Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child Fam Psychol Rev 4(3):183–207Google Scholar
  6. 6.
    Isaksson J, Stickley A, Koposov R, Ruchkin V (2018) The danger of being inattentive—ADHD symptoms and risky sexual behaviour in Russian adolescents. Eur Psychiatry 47:42–48Google Scholar
  7. 7.
    Holmberg K, Hjern A (2006) Health complaints in children with attention-deficit/hyperactivity disorder. Acta Paediatr 95(6):664–670Google Scholar
  8. 8.
    Ruchkin V, Koposov RA, Koyanagi A, Stickley A (2017) Suicidal behavior in juvenile delinquents: the role of ADHD and other comorbid psychiatric disorders. Child Psychiatry Hum Dev 48(5):691–698Google Scholar
  9. 9.
    Danckaerts M, Sonuga-Barke EJ, Banaschewski T, Buitelaar J, Dopfner M, Hollis C, Santosh P, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Zuddas A, Coghill D (2010) The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 19(2):83–105Google Scholar
  10. 10.
    Taurines R, Schmitt J, Renner T, Conner AC, Warnke A, Romanos M (2010) Developmental comorbidity in attention-deficit/hyperactivity disorder. Atten Defic Hyperact Disord 2(4):267–289Google Scholar
  11. 11.
    Larson K, Russ SA, Kahn RS, Halfon N (2011) Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics 127(3):462–470Google Scholar
  12. 12.
    Biederman J, Newcorn J, Sprich S (1991) Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am J Psychiatry 148(5):564–577Google Scholar
  13. 13.
    Busch B, Biederman J, Cohen LG, Sayer JM, Monuteaux MC, Mick E, Zallen B, Faraone SV (2002) Correlates of ADHD among children in pediatric and psychiatric clinics. Psychiatr Serv 53(9):1103–1111Google Scholar
  14. 14.
    Becker SP, Fite PJ, Vitulano ML, Rubens SL, Evans SC, Cooley JL (2014) Examining anxiety and depression as moderators of the association between ADHD symptoms and academic and social problems in Hispanic adolescents. J Psychopathol Behav Assess 36(2):265–275Google Scholar
  15. 15.
    Booster GD, Dupaul GJ, Eiraldi R, Power TJ (2012) Functional impairments in children with ADHD: unique effects of age and comorbid status. J Atten Disord 16(3):179–189Google Scholar
  16. 16.
    Biederman J, Faraone S, Mick E, Moore P, Lelon E (1996) Child Behavior Checklist findings further support comorbidity between ADHD and major depression in a referred sample. J Am Acad Child Adolesc Psychiatry 35(6):734–742Google Scholar
  17. 17.
    Angold A, Costello EJ, Erkanli A (1999) Comorbidity. J Child Psychol Psychiatry 40(1):57–87Google Scholar
  18. 18.
    Daviss WB (2008) A review of co-morbid depression in pediatric ADHD: etiologies, phenomenology, and treatment. J Child Adolesc Psychopharmacol 18(6):565–571Google Scholar
  19. 19.
    Biederman J, Ball SW, Monuteaux MC, Mick E, Spencer TJ, McCreary M, Cote M, Faraone SV (2008) New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry 47(4):426–434Google Scholar
  20. 20.
    Humphreys KL, Katz SJ, Lee SS, Hammen C, Brennan PA, Najman JM (2013) The association of ADHD and depression: mediation by peer problems and parent-child difficulties in two complementary samples. J Abnorm Psychol 122(3):854–867Google Scholar
  21. 21.
    Jerrell JM, McIntyre RS, Park YM (2015) Risk factors for incident major depressive disorder in children and adolescents with attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 24(1):65–73Google Scholar
  22. 22.
    Ostrander R, Herman KC (2006) Potential cognitive, parenting, and developmental mediators of the relationship between ADHD and depression. J Consult Clin Psychol 74(1):89–98Google Scholar
  23. 23.
    Brown NM, Brown SN, Briggs RD, German M, Belamarich PF, Oyeku SO (2017) Associations between adverse childhood experiences and ADHD diagnosis and severity. Acad Pediatr 17(4):349–355Google Scholar
  24. 24.
    Lewis T, Schwebel DC, Elliott MN, Visser SN, Toomey SL, McLaughlin KA, Cuccaro P, Tortolero Emery S, Banspach SW, Schuster MA (2015) The association between youth violence exposure and attention-deficit/hyperactivity disorder (ADHD) symptoms in a sample of fifth-graders. Am J Orthopsychiatry 85(5):504–513Google Scholar
  25. 25.
    Daviss WB, Diler RS, Birmaher B (2009) Associations of lifetime depression with trauma exposure, other environmental adversities, and impairment in adolescents with ADHD. J Abnorm Child Psychol 37(6):857–871Google Scholar
  26. 26.
    Foster JD, Kuperminc GP, Price AW (2004) Gender differences in posttraumatic stress and related symptoms among inner-city minority youth exposed to community violence. J Youth Adolesc 33(1):59–69Google Scholar
  27. 27.
    Gorman-Smith D, Tolan P (1998) The role of exposure to community violence and developmental problems among inner-city youth. Dev Psychopathol 10(1):101–116Google Scholar
  28. 28.
    Lambert SF, Boyd RC, Cammack NL, Ialongo NS (2012) Relationship proximity to victims of witnessed community violence: associations with adolescent internalizing and externalizing behaviors. Am J Orthopsychiatry 82(1):1–9Google Scholar
  29. 29.
    Ruchkin V, Lorberg B, Koposov R, Schwab-Stone M, Sukhodolsky DG (2008) ADHD symptoms and associated psychopathology in a community sample of adolescents from the European north of Russia. J Atten Disord 12(1):54–63Google Scholar
  30. 30.
    Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401Google Scholar
  31. 31.
    Stickley A, Koyanagi A, Koposov R, Schwab-Stone M, Ruchkin V (2014) Loneliness and health risk behaviours among Russian and U.S. adolescents: a cross-sectional study. BMC Public Health 14:366Google Scholar
  32. 32.
    DuPaul GJ, Power TJ, Anastopoulos AD, Reid R (1998) ADHD Rating Scale-IV: checklists, norms, and clinical interpretation. Guilford, New YorkGoogle Scholar
  33. 33.
    Power TJ, Costigan TE, Leff SS, Eiraldi RB, Landau S (2001) Assessing ADHD across settings: contributions of behavioral assessment to categorical decision making. J Clin Child Psychol 30(3):399–412Google Scholar
  34. 34.
    Pineda D, Ardila A, Rosselli M, Arias BE, Henao GC, Gomez LF, Mejia SE, Miranda ML (1999) Prevalence of attention-deficit/hyperactivity disorder symptoms in 4- to 17-year-old children in the general population. J Abnorm Child Psychol 27(6):455–462Google Scholar
  35. 35.
    Richters JE, Martinez P (1993) The NIMH community violence project: I. Children as victims of and witnesses to violence. Psychiatry 56(1):7–21Google Scholar
  36. 36.
    Pynoos RS, Frederick C, Nader K, Arroyo W, Steinberg A, Eth S, Nunez F, Fairbanks L (1987) Life threat and posttraumatic stress in school-age children. Arch Gen Psychiatry 44(12):1057–1063Google Scholar
  37. 37.
    Wozniak J, Crawford MH, Biederman J, Faraone SV, Spencer TJ, Taylor A, Blier HK (1999) Antecedents and complications of trauma in boys with ADHD: findings from a longitudinal study. J Am Acad Child Adolesc Psychiatry 38(1):48–55Google Scholar
  38. 38.
    Aguado-Gracia J, Mundo-Cid P, Lopez-Seco F, Acosta-Garcia S, Cortes-Ruiz MJ, Vilella E, Masana-Marín A (2018) Lifetime victimization in children and adolescents With ADHD. J Interpers Violence.  https://doi.org/10.1177/0886260518771680 Google Scholar
  39. 39.
    Razani N, Hilton JF, Halpern-Felsher BL, Okumura MJ, Morrell HE, Yen IH (2015) Neighborhood characteristics and ADHD: results of a national study. J Atten Disord 19(9):731–740Google Scholar
  40. 40.
    King S, Waschbusch DA (2010) Aggression in children with attention-deficit/hyperactivity disorder. Expert Rev Neurother 10(10):1581–1594Google Scholar
  41. 41.
    Gudjonsson GH, Sigurdsson JF, Sigfusdottir ID, Young S (2014) A national epidemiological study of offending and its relationship with ADHD symptoms and associated risk factors. J Atten Disord 18(1):3–13Google Scholar
  42. 42.
    Fowler PJ, Tompsett CJ, Braciszewski JM, Jacques-Tiura AJ, Baltes BB (2009) Community violence: a meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Dev Psychopathol 21(1):227–259Google Scholar
  43. 43.
    Lynch M, Cicchetti D (1998) An ecological-transactional analysis of children and contexts: the longitudinal interplay among child maltreatment, community violence, and children’s symptomatology. Dev Psychopathol 10(2):235–257Google Scholar
  44. 44.
    Fitzpatrick KM (1993) Exposure to violence and presence of depression among low-income, African–American youth. J Consult Clin Psychol 61(3):528–531Google Scholar
  45. 45.
    Martinez P, Richters JE (1993) The NIMH community violence project: II. Children’s distress symptoms associated with violence exposure. Psychiatry 56(1):22–35Google Scholar
  46. 46.
    Mazza JJ, Reynolds WM (1999) Exposure to violence in young inner-city adolescents: relationships with suicidal ideation, depression, and PTSD symptomatology. J Abnorm Child Psychol 27(3):203–213Google Scholar
  47. 47.
    Ruchkin V, Henrich CC, Jones SM, Vermeiren R, Schwab-Stone M (2007) Violence exposure and psychopathology in urban youth: the mediating role of posttraumatic stress. J Abnorm Child Psychol 35(4):578–593Google Scholar
  48. 48.
    Schwab-Stone M, Koposov R, Vermeiren R, Ruchkin V (2013) Cross-cultural findings on community violence exposure and internalizing psychopathology: comparing adolescents in the United States, Russia, and Belgium. Child Psychiatry Hum Dev 44(4):516–524Google Scholar
  49. 49.
    Overstreet S, Braun S (2000) Exposure to community violence and post-traumatic stress symptoms: mediating factors. Am J Orthopsychiatry 70(2):263–271Google Scholar
  50. 50.
    Schwab-Stone ME, Ayers TS, Kasprow W, Voyce C, Barone C, Shriver T, Weissberg RP (1995) No safe haven: a study of violence exposure in an urban community. J Am Acad Child Adolesc Psychiatry 34(10):1343–1352Google Scholar
  51. 51.
    McLaughlin KA, Lambert HK (2017) Child trauma exposure and psychopathology: mechanisms of risk and resilience. Curr Opin Psychol 14:29–34Google Scholar
  52. 52.
    Cooley-Quille M, Lorion M (1999) Adolescents’ exposure to community violence: sleep and psychophysiological functioning. J Community Psychol 27(4):367–375Google Scholar
  53. 53.
    Wang CC, Wu YY, Yang YH, Hu HF, Yen CF (2018) Relationships of subjective insomnia and sleep duration with depression, anxiety, and pain problems in children and adolescents with attention-deficit/hyperactivity disorder. Neuropsychiatry 8(1):138–145Google Scholar
  54. 54.
    Nolen-Hoeksema S (2001) Gender differences in depression. Curr Dir Psychol Sci 10(5):173–176Google Scholar
  55. 55.
    Rosario M, Salzinger S, Feldman RS, Ng-Mak DS (2008) Intervening processes between youths’ exposure to community violence and internalizing symptoms over time: the roles of social support and coping. Am J Community Psychol 41(1–2):43–62Google Scholar
  56. 56.
    Osofsky JD, Wewers S, Hann DM, Fick AC (1993) Chronic community violence: what is happening to our children? Psychiatry 56(1):36–45Google Scholar
  57. 57.
    Stein BD, Jaycox LH, Kataoka S, Rhodes HJ, Vestal KD (2003) Prevalence of child and adolescent exposure to community violence. Clin Child Fam Psychol Rev 6(4):247–264Google Scholar
  58. 58.
    Schwab-Stone M, Chen C, Greenberger E, Silver D, Lichtman J, Voyce C (1999) No safe haven. II: the effects of violence exposure on urban youth. J Am Acad Child Adolesc Psychiatry 38(4):359–367Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Preventive Intervention for Psychiatric DisordersNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
  2. 2.Stockholm Center for Health and Social Change (SCOHOST)Södertörn UniversityHuddingeSweden
  3. 3.Regional Center for Child and Youth Mental Health and Child WelfareUiT The Arctic University of NorwayTromsöNorway
  4. 4.Parc Sanitari Sant Joan de Déu, Universitat de BarcelonaBarcelonaSpain
  5. 5.Instituto de Salud Carlos IIICentro de Investigación Biomédica en Red de Salud Mental, CIBERSAMMadridSpain
  6. 6.Carolina Population CenterThe University of North Carolina at Chapel HillChapel HillUSA
  7. 7.Child and Adolescent Psychiatry Unit, Department of NeuroscienceUppsala UniversityUppsalaSweden
  8. 8.Child Study CentreYale University Medical SchoolNew HavenUSA

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