Child Psychiatry & Human Development

, Volume 46, Issue 5, pp 736–748 | Cite as

Longitudinal Associations Between Internalizing and Externalizing Comorbidities and Functional Outcomes for Children with ADHD

  • Daniel Armstrong
  • Kate Lycett
  • Harriet Hiscock
  • Esther Care
  • Emma SciberrasEmail author
Original Article


This study examined functional outcomes for children with ADHD by comorbidity status. Children with ADHD (5–13 years) were recruited from 21 pediatric practices and followed up 12 months later (n = 199). Parent and teacher-reported baseline and 12 month surveys measured peer problems, daily functioning, quality of life (QoL), parent mental health, and family QoL. The Anxiety Disorders Interview Schedule for Children IV assessed mental health comorbidities at baseline. Linear regression models were conducted, adjusting for socio-demographics, ADHD severity, and baseline functioning (where possible). In adjusted analyses, children with ADHD and co-occurring internalizing and externalizing comorbidities had poorer QoL, greater peer problems, and poorer family QoL, compared to children with ADHD alone. The parents of children with ADHD and internalizing and externalizing comorbidities alone, also reported poorer family QoL, compared to children with ADHD alone. Children with ADHD and co-occurring internalizing and externalizing comorbidities appear particularly vulnerable to poorer functioning.


Attention-deficit/hyperactivity disorder Internalizing Externalizing Longitudinal Comorbidity 



We thank all families and pediatricians for taking part in the study. We would also like to thank the investigators on the broader Sleeping Sound with ADHD study for their support: Daryl Efron, Frank Oberklaid, and Fiona Mensah. This study has been funded by a Project Grant from the Australian National Health and Medical Research Council (NHMRC) (No. 607362). Dr. Sciberras is funded by an NHMRC Early Career Fellowship in Population Health (No. 1037159). Ms. Lycett is funded by a Murdoch Childrens Research Institute (MCRI) Postgraduate Health Scholarship. A/Prof. Hiscock’s position is funded by an NHMRC Career Development Award (No. 607351). This research was supported by the Victorian Government’s Operational Infrastructure Support Program to the MCRI.

Conflict of interest

The authors declared that they had no conflict of interest with respect to their authorship or the publication of this article.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Daniel Armstrong
    • 1
    • 2
  • Kate Lycett
    • 1
    • 4
  • Harriet Hiscock
    • 1
    • 4
    • 5
  • Esther Care
    • 2
    • 3
  • Emma Sciberras
    • 1
    • 4
    • 5
    • 6
    Email author
  1. 1.Murdoch Childrens Research InstituteMelbourneAustralia
  2. 2.Graduate School of EducationUniversity of MelbourneParkvilleAustralia
  3. 3.Assessment Research CentreUniversity of MelbourneParkvilleAustralia
  4. 4.Department of PaediatricsUniversity of MelbourneParkvilleAustralia
  5. 5.Centre for Community Child HealthThe Royal Children’s HospitalMelbourneAustralia
  6. 6.The Royal Children’s HospitalMurdoch Childrens Research InstituteParkvilleAustralia

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