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Associations of Lifetime Depression with Trauma Exposure, Other Environmental Adversities, and Impairment in Adolescents with ADHD

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Abstract

Depression is a common, potentially devastating comorbidity in youth with attention-deficit/hyperactivity disorders (ADHD). Various environmental adversities are well-described as correlates of depression in general pediatric populations, but not in youth with ADHD. In 104 adolescents with ADHD, we examined potential environmental correlates of lifetime depression, including trauma exposure, recent negative life events and current parent-child conflict, along with current and past ADHD severity and current impairment. Controlling for demographic variables, comorbid disorders, and ADHD severity, we noted significant associations between lifetime depression and environmental adversities, including victimization trauma, parent-child conflict, and behaviorally-independent negative life events. Current impairment but not ADHD severity was also highly associated with lifetime depression, controlling for the same covariates. Findings from this preliminary, cross-sectional study suggest that environmental adversities and impairment in youth with ADHD should also be targeted along with the ADHD when contemplating strategies to treat or prevent comorbid depression.

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References

  • Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 40, 57–87. doi:10.1111/1469-7610.00424.

    Article  PubMed  Google Scholar 

  • Barkley, R. A., & Biederman, J. (1997). Toward a broader definition of the age-of-onset criterion for attention-deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1204–1210. doi:10.1097/00004583-199709000-00012.

    Article  PubMed  Google Scholar 

  • Bauermeister, J. J., Shrout, P. E., Ramirez, R., Bravo, M., Alegria, M., Martinez-Taboas, A., et al. (2007). ADHD correlates, comorbidity, and impairment in community and treated samples of children and adolescents. Journal of Abnormal Child Psychology, 35, 883–898. doi:10.1007/s10802-007-9141-4.

    Article  PubMed  Google Scholar 

  • Biederman, J., Faraone, S., Mick, E., & Lelon, E. (1995). Psychiatric comorbidity among referred juveniles with major depression: fact or artifact? Journal of the American Academy of Child and Adolescent Psychiatry, 34, 579–590.

    PubMed  Google Scholar 

  • Biederman, J., Faraone, S., Milberger, S., Curtis, S., Chen, L., Marrs, A., et al. (1996). Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 343–351.

    PubMed  Google Scholar 

  • Biederman, J., Mick, E., & Faraone, S. V. (1998). Depression in attention deficit hyperactivity disorder (ADHD) children: “true” depression or demoralization? Journal of Affective Disorders, 47, 113–122. doi:10.1016/S0165-0327(97)00127-4.

    Article  PubMed  Google Scholar 

  • Biederman, J., Faraone, S. V., & Monuteaux, M. C. (2002). Differential effect of environmental adversity by gender: Rutter’s index of adversity in a group of boys and girls with and without ADHD. The American Journal of Psychiatry, 159, 1556–1562. doi:10.1176/appi.ajp.159.9.1556.

    Article  PubMed  Google Scholar 

  • Biederman, J., Ball, S. W., Monuteaux, M. C., Mick, E., Spencer, T. J., McCreary, M., et al. (2008). New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 426–434. doi:10.1097/CHI.0b013e31816429d3.

    Article  PubMed  Google Scholar 

  • Bird, H. R., Shaffer, D., Fisher, P., Gould, M. S., Staghezza, B., Chen, J. Y., et al. (1993). The Columbia impairment scale (CIS): pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3, 167–176.

    Google Scholar 

  • Birmaher, B., Ryan, N. D., Williamson, D. E., Brent, D. A., Kaufman, J., Dahl, R. E., et al. (1996). Childhood and adolescent depression: a review of the past 10 years. Part I. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1427–1439. doi:10.1097/00004583-199611000-00011.

    Article  PubMed  Google Scholar 

  • Blackman, G. L., Ostrander, R., & Herman, K. C. (2005). Children with ADHD and depression: a multisource, multimethod assessment of clinical, social, and academic functioning. Journal of Attention Disorders, 8, 195–207. doi:10.1177/1087054705278777.

    Article  PubMed  Google Scholar 

  • Brand, A. H., & Johnson, J. H. (1982). Note on reliability of the life events checklist. Psychological Reports, 50(3), 1274.

    Google Scholar 

  • Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82, 217–225. doi:10.1016/j.jad.2003.12.013.

    Article  PubMed  Google Scholar 

  • Connor, D. F., Edwards, G., Fletcher, K. E., Baird, J., Barkley, R. A., Steingard, R. J., et al. (2003). Correlates of comorbid psychopathology in children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 193–200. doi:10.1097/00004583-200302000-00013.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Benjamin, R., Angold, A., & Silver, D. (1991). Mood variability in adolescents: a study of depressed, nondepressed and comorbid patients. Journal of Affective Disorders, 23, 199–212. doi:10.1016/0165-0327(91)90101-W.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Angold, A., March, J., & Fairbank, J. (1998). Life events and post-traumatic stress: the development of a new measure for children and adolescents. Psychological Medicine, 28, 1275–1288. doi:10.1017/S0033291798007569.

    Article  PubMed  Google Scholar 

  • Crystal, D. S., Ostrander, R., Chen, R. S., & August, G. J. (2001). Multimethod assessment of psychopathology among DSM-IV subtypes of children with attention-deficit/hyperactivity disorder: self-, parent, and teacher reports. Journal of Abnormal Child Psychology, 29, 189–205. doi:10.1023/A:1010325513911.

    Article  PubMed  Google Scholar 

  • Daviss, W. B. (2008). A review of co-morbid depression in pediatric ADHD: etiology, phenomenology, and treatment. Journal of Child and Adolescent Psychopharmacology, 18, 565–571. doi:10.1089/cap.2008.032.

    Article  PubMed  Google Scholar 

  • Daviss, W. B., Mooney, D., Racusin, R., Ford, J. D., Fleischer, A., & McHugo, G. J. (2000). Predicting posttraumatic stress after hospitalization for pediatric injury. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 576–583. doi:10.1097/00004583-200005000-00011.

    Article  PubMed  Google Scholar 

  • Daviss, W. B., Birmaher, B., Melhem, N. A., Axelson, D. A., Michaels, S. M., & Brent, D. A. (2006). Criterion validity of the mood and feelings questionnaire for depressive episodes in clinic and non-clinic subjects. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 927–934. doi:10.1111/j.1469-7610.2006.01646.x.

    Article  PubMed  Google Scholar 

  • Drabick, D. A., Gadow, K. D., & Sprafkin, J. (2006). Co-occurrence of conduct disorder and depression in a clinic-based sample of boys with ADHD. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 766–774. doi:10.1111/j.1469-7610.2006.01625.x.

    Article  PubMed  Google Scholar 

  • DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretation. New York City, NY: Guilford Publications.

    Google Scholar 

  • Faraone, S. V., & Biederman, J. (1997). Do attention deficit hyperactivity disorder and major depression share familial risk factors? The Journal of Nervous and Mental Disease, 185, 533–541. doi:10.1097/00005053-199709000-00001.

    Article  PubMed  Google Scholar 

  • Fishman, P. A., Stang, P. E., & Hogue, S. L. (2007). Impact of comorbid attention deficit disorder on the direct medical costs of treating adults with depression in managed care. The Journal of Clinical Psychiatry, 68, 248–253.

    Article  PubMed  Google Scholar 

  • Flament, M. F., Cohen, D., Choquet, M., Jeammet, P., & Ledoux, S. (2001). Phenomenology, psychosocial correlates, and treatment seeking in major depression and dysthymia of adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1070–1078. doi:10.1097/00004583-200109000-00016.

    Article  PubMed  Google Scholar 

  • Fleiss, J. L. (1981). Statistical methods for rates and proportions (2nd ed.). New York City: Wiley.

    Google Scholar 

  • Ford, J. D., Racusin, R., Daviss, W. B., Ellis, C. G., Thomas, J., Rogers, K., et al. (1999). Trauma exposure among children with oppositional defiant disorder and attention deficit-hyperactivity disorder. Journal of Consulting and Clinical Psychology, 67, 786–789. doi:10.1037/0022-006X.67.5.786.

    Article  PubMed  Google Scholar 

  • Happonen, M., Pulkkinen, L., Kaprio, J., Van der Meere, J., Viken, R. J., & Rose, R. J. (2002). The heritability of depressive symptoms: multiple informants and multiple measures. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 43, 471–479. doi:10.1111/1469-7610.00038.

    Article  PubMed  Google Scholar 

  • Herman, K. C., Lambert, S. F., Ialongo, N. S., & Ostrander, R. (2007). Academic pathways between attention problems and depressive symptoms among urban African American children. Journal of Abnormal Child Psychology, 35, 265–274. doi:10.1007/s10802-006-9083-2.

    Article  PubMed  Google Scholar 

  • Hollingshead, A. B. (1975). Four factor index of social status. New Haven, CT: Yale University Press.

    Google Scholar 

  • Johnston, C. A., Steele, R. G., Herrera, E. A., & Phipps, S. (2003). Parent and child reporting of negative life events: discrepancy and agreement across pediatric samples. Journal of Pediatric Psychology, 28, 579–588. doi:10.1093/jpepsy/jsg048.

    Article  PubMed  Google Scholar 

  • Kaufman, J. (1991). Depressive disorders in maltreated children. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 257–265. doi:10.1097/00004583-199103000-00014.

    Article  PubMed  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988. doi:10.1097/00004583-199707000-00021.

    Article  PubMed  Google Scholar 

  • Kendler, K. S., Kuhn, J. W., & Prescott, C. A. (2004). Childhood sexual abuse, stressful life events and risk for major depression in women. Psychological Medicine, 34, 1475–1482. doi:10.1017/S003329170400265X.

    Article  PubMed  Google Scholar 

  • Kovacs, M., Akiskal, H. S., Gatsonis, C., & Parrone, P. L. (1994). Childhood-onset dysthymic disorder. Clinical features and prospective naturalistic outcome. Archives of General Psychiatry, 51, 365–374.

    PubMed  Google Scholar 

  • Kovacs, M., Obrosky, D. S., Gatsonis, C., & Richards, C. (1997). First-episode major depressive and dysthymic disorder in childhood: clinical and sociodemographic factors in recovery. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 777–784. doi:10.1097/00004583-199706000-00014.

    Article  PubMed  Google Scholar 

  • Leckman, J. F., Sholomskas, D., Thompson, W. D., Belanger, A., & Weissman, M. M. (1982). Best estimate of lifetime psychiatric diagnosis: a methodological study. Archives of General Psychiatry, 39, 879–883.

    PubMed  Google Scholar 

  • Marmorstein, N. R., & Iacono, W. G. (2004). Major depression and conduct disorder in youth: associations with parental psychopathology and parent-child conflict. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45, 377–386. doi:10.1111/j.1469-7610.2004.00228.x.

    Article  PubMed  Google Scholar 

  • McCauley, E., & Myers, K. (1992). Family interactions in mood-disordered youth. Child and Adolescent Psychiatric Clinics of North America, 1, 111–127.

    Google Scholar 

  • Milberger, S., Biederman, J., Faraone, S. V., Murphy, J., & Tsuang, M. T. (1995). Attention deficit hyperactivity disorder and comorbid disorders: issues of overlapping symptoms. The American Journal of Psychiatry, 152, 1793–1799.

    PubMed  Google Scholar 

  • Ostrander, R., Crystal, D. S., & August, G. (2006). Attention deficit-hyperactivity disorder, depression, and self— and other-assessments of social competence: a developmental study. Journal of Abnormal Child Psychology, 34, 773–787. doi:10.1007/s10802-006-9051-x.

    Article  PubMed  Google Scholar 

  • Patton, G. C., Coffey, C., Posterino, M., Carlin, J. B., & Bowes, G. (2003). Life events and early onset depression: cause or consequence? Psychological Medicine, 33, 1203–1210. doi:10.1017/S0033291703008626.

    Article  PubMed  Google Scholar 

  • Power, T. J., Costigan, T. E., Eiraldi, R. B., & Leff, S. S. (2004). Variations in anxiety and depression as a function of ADHD subtypes defined by DSM-IV: do subtype differences exist or not? Journal of Abnormal Child Psychology, 32, 27–37. doi:10.1023/B:JACP.0000007578.30863.93.

    Article  PubMed  Google Scholar 

  • Poznanski, E. O., Grossman, J. A., Buchsbaum, Y., Banegas, M., Freeman, L., & Gibbons, R. (1984). Preliminary studies of the reliability and validity of the children’s depression rating scale. Journal of the American Academy of Child Psychiatry, 23, 191–197.

    Article  PubMed  Google Scholar 

  • Poznanski, E. O., Freman, L. N., & Mokros, H. B. (1985). Children’s depression rating scale-revised. Psychopharmacology Bulletin, 21, 979–989.

    Google Scholar 

  • Reinke, W. M., & Ostrander, R. (2008). Heterotyic and homotypic continuity: the moderating effects of age and gender. Journal of Abnormal Child Psychology, 36, 1109–1121. doi:10.1007/s10802-008-9236-6.

    Article  PubMed  Google Scholar 

  • Rice, F., Harold, G. T., & Thapar, A. (2003). Negative life events as an account of age-related differences in the genetic aetiology of depression in childhood and adolescence. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 44, 977–987. doi:10.1111/1469-7610.00182.

    Article  PubMed  Google Scholar 

  • Robin, A. L., & Weiss, G. (1980). Criterion-related validity of behavioral and self-report measures of problem-solving communication skills in distressed and non-distressed parent-adolescent dyads. Behavioral Assessment, 2, 339–352.

    Google Scholar 

  • Rohde, P., Clarke, G. N., Lewinsohn, P. M., Seeley, J. R., & Kaufman, N. K. (2001). Impact of comorbidity on a cognitive-behavioral group treatment for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 795–802. doi:10.1097/00004583-200107000-00014.

    Article  PubMed  Google Scholar 

  • Rucklidge, J. J., Brown, D. L., Crawford, S., & Kaplan, B. J. (2006). Retrospective reports of childhood trauma in adults with ADHD. Journal of Attention Disorders, 9, 631–641. doi:10.1177/1087054705283892.

    Article  PubMed  Google Scholar 

  • Storr, C. L., Ialongo, N. S., Anthony, J. C., & Breslau, N. (2007). Childhood antecedents of exposure to traumatic events and posttraumatic stress disorder. The American Journal of Psychiatry, 164, 119–125. doi:10.1176/appi.ajp.164.1.119.

    Article  PubMed  Google Scholar 

  • Weissman, M. M., Sholomskas, D., & John, K. (1981). The assessment of social adjustment. An update. Archives of General Psychiatry, 38, 1250–1258.

    PubMed  Google Scholar 

  • Widom, C. S., DuMont, K., & Czaja, S. J. (2007). A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Archives of General Psychiatry, 64, 49–56. doi:10.1001/archpsyc.64.1.49.

    Article  PubMed  Google Scholar 

  • Williamson, D. E., Birmaher, B., Anderson, B. P., al-Shabbout, M., & Ryan, N. D. (1995). Stressful life events in depressed adolescents: the role of dependent events during the depressive episode. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 591–598.

    Article  PubMed  Google Scholar 

  • Williamson, D. E., Birmaher, B., Dahl, R. E., & Ryan, N. D. (2005). Stressful life events in anxious and depressed children. Journal of Child and Adolescent Psychopharmacology, 15, 571–580. doi:10.1089/cap.2005.15.571.

    Article  PubMed  Google Scholar 

  • Wozniak, J., Crawford, M. H., Biederman, J., Faraone, S. V., Spencer, T. J., Taylor, A., et al. (1999). Antecedents and complications of trauma in boys with ADHD: findings from a longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 48–55. doi:10.1097/00004583-199901000-00019.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a National Alliance for Research on Schizophrenia and Depression Young Investigator’s Award (to Dr. Daviss), and National Institute of Mental Health grants K23 MH 065375 (PI: Dr. Daviss) and P30 MH066371 (PI: Dr. David Brent). Findings from this study were previously been presented October, 2006 at the 53rd Annual Meeting of the American Academy of Child and Adolescent Psychiatry, San Diego, CA. We thank Dr. Jim Mintz for his advice regarding statistical analysis of this project. We also gratefully acknowledge Diane Holland and Renee’ Weinman for their help coordinating this project, Aaron Jennings and Kim Dever for their help as interviewers, and Deena Battista, Giovanna Porta, Rebecca Munnell, Ellie Kanal, and Travis Brewer for their help with data entry.

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Daviss, W.B., Diler, R.S. & Birmaher, B. Associations of Lifetime Depression with Trauma Exposure, Other Environmental Adversities, and Impairment in Adolescents with ADHD. J Abnorm Child Psychol 37, 857–871 (2009). https://doi.org/10.1007/s10802-009-9318-0

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