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Aging and Pubertal Development Differentially Predict Symptoms of ADHD, Depression, and Impairment in Children and Adolescents: An Eight-Year Longitudinal Study

Research on Child and Adolescent Psychopathology volume 51, pages 819–832 (2023)Cite this article

Abstract

Activational effects of the reproductive neuroendocrine system may explain why some youths with ADHD are at greater risk for exacerbated ADHD symptoms (hyperactivity, inattention, impulsivity) during adolescence. For youths diagnosed with ADHD, first signs of ADHD symptoms become noticeable by multiple reporters (e.g., teachers, parents) when children enter schools, typically around kindergarten. The current study examined possible sex differences in ADHD, impairment, and comorbidity due to pubertal effects, as the role of pubertal development in ADHD is understudied. ADHD symptoms, depressive symptoms, impairment, and pubertal stage were assessed annually by multiple reporters in a well-characterized community sample of 849 children over-recruited for ADHD over eight years. Ages ranged from 7 to 13 years (38.16% female) at wave 1. Multilevel models indicated that males had higher levels of hyperactivity, impulsivity, and inattention than females, but that females had higher levels of impairment than males. Inattention symptoms did not show marked maturation changes. Hyperactivity and impulsivity declined as youth aged and impairment increased as youth aged. Lastly, depressive symptoms largely increased as youth aged and were higher amongst youth at later pubertal stages. Put together, aging and pubertal development are associated with improved ADHD symptoms but not for youth with high impairment. Findings from this study contributes to understanding the role that aging, pubertal status, and pubertal development plays in ADHD, impairment, and comorbidity in children and adolescents.

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Notes

  1. For simplicity, we designate “males” as youth who were assigned male at birth and are presumed to have testicular maturation throughout puberty, whereas we designate “females” as youth who were assigned female at birth and are presumed to have ovarian maturation throughout puberty. Although, there are many instances in which this presumption is erroneous (e.g., intersex youth; trans* youth; youth with delayed or precocious puberty).

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Acknowledgements

The authors thank all participants for making this work possible. This study’s design, hypotheses, and analysis plan were preregistered; see https://osf.io/vtxej. The datasets generated and analyzed for the current study are not publicly available but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Psychology, University of Kentucky, 171 Funkhouser Drive, 40506-0044, Lexington, KY,, USA

    Ashley G. Eng & Michelle M. Martel

  2. Children’s National Hospital, Center for Autism Spectrum Disorders, Center for Neuroscience Research, Washington, D.C., USA

    Jenny M. Phan

  3. University of Oregon, Eugene, OR, USA

    Elizabeth A. Shirtcliff

  4. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

    Tory A. Eisenlohr-Moul

  5. Department of Psychology, University of Hawai’i at Mānoa, Honolulu, HI, USA

    Patrick K. Goh

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Correspondence to Ashley G. Eng.

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Ethical Standards and Informed Consent

The authors complied with APA ethical standards in the treatment of their participants and ethics approval was obtained from the Institutional Review Board at Oregon Health & Science University. A parent/legal guardian provided written informed consent and children provided written assent.

This research was supported by R01-MH119119, R01-MH122446, RF1-MH120843, T32 NIAAA AA027488, T32 NICHD HD007489, and T32 NINDS T32NS115656. Infrastructure support was provided by NICHD P50HD105353, P50HD105328-01, and U54HD090256. The authors have no relevant financial or non-financial interests to disclose.

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Eng, A.G., Phan, J.M., Shirtcliff, E.A. et al. Aging and Pubertal Development Differentially Predict Symptoms of ADHD, Depression, and Impairment in Children and Adolescents: An Eight-Year Longitudinal Study. Res Child Adolesc Psychopathol 51, 819–832 (2023). https://doi.org/10.1007/s10802-023-01030-7

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