Depression and anxiety in attention-deficit/hyperactivity disorder : moderating and mediation effects of self-esteem and social support

Abstract

It is well established that individuals with attention-deficit hyperactivity disorder (ADHD) have higher levels of depression and anxiety than individuals without ADHD but less is known about the mechanisms whereby ADHD is related to depression and anxiety or which individuals with ADHD are at most risk for depression and anxiety. There is evidence that individuals with ADHD have lower self-esteem and lower social support than individuals without ADHD but both of these factors have been associated with depression and anxiety. Therefore, the aim of this study was to examine if self-esteem and social support buffered to effects of ADHD on depression and anxiety or if it mediated the relationship between ADHD and anxiety and depression. A total of 2051 students aged 14-24 participated in this study and completed measures of ADHD, depression, anxiety, social support and self-esteem. The results showed that adolescents with ADHD reported higher levels of anxiety and depression and lower levels of self-esteem and social support. Girls with ADHD reported more anxiety and depression than boys with ADHD. Neither self-esteem nor social support was found to moderate the effects of ADHD on depression and anxiety. Self-esteem was found to partially mediate the relationship between ADHD and depression, however, self-esteem was not found to mediate the relationship between ADHD and anxiety. Furthermore, social support was not found to mediate the relationship between ADHD and depression and anxiety. These result suggest that only self-esteem explained the nature of the relationship between ADHD and depression. Further research is needed to examine what factors do play a role in the relationship between ADHD and depression and anxiety and what measure can be taken to alleviate this relationship.