Symposia
ADHD - Child
Julia D. McQuade, Ph.D.
Amherst College
Amherst, Massachusetts
Background. There is a strong co-occurrence of attention-deficit/ hyperactivity disorder (ADHD) and borderline personality (BP) disorder in adolescence (Matthies & Philipsen 2014). Although ADHD symptoms are a robust predictor of BP features (Stepp et al., 2012), other impairments, including emotion dysregulation and peer problems, also characterize adolescents with either ADHD (Graziano & Garcia, 2016; McQuade, 2020) or BPD (Putnam & Silk, 2005; Runion et al., 2020). Yet to date, limited research has examined emotion dysregulation and peer problems as vulnerabilities for BP features in samples that include children with ADHD. The present study sought to address this gap in the literature and examined both longitudinal child and concurrent adolescent predictors of adolescent BP elevations within a sample that included youth with and without ADHD.
Methods. Participants were 125 youth, 47% with full or subthreshold childhood ADHD, 52% female. In childhood (8-13 years), predictors included parent/teacher-rated ADHD symptoms, child and teacher-rated social impairments (peer victimization, aggression, social acceptance) and parent-rated emotion dysregulation (negativity/lability and emotion regualtion skills). In adolescence (13-18 years) predictors included parent-rated ADHD symptoms, adolescent-rated social impairment (peer victimization, aggression, close relationships), and adolescent and parent-rated emotion dysregulation. Parent/adolescent-rated BP features were also measured in adolescence; 15.3% had clinically elevated adolescent BP features (Chang et al., 2011).
Results. MPLUS regression models examined youth sex, ADHD symptoms, and youth vulnerabilities as predictors of adolescent BP features; social and emotional vulnerabilities assessed in childhood or adolescence by each reporter were considered in separate models. Above and beyond the significant effect of ADHD symptoms, greater childhood and adolescent peer victimization, poorer adolescent close friendships, and greater adolescent-reported emotion dysregulation significantly predicted elevated adolescent BP features. Greater parent-rated child and adolescent emotion dysregulation also significantly predicted greater BP features, with ADHD symptoms no longer a significant predictor.
Conclusion. Results suggest that even for youth with ADHD, peer and emotional vulnerabilities in childhood and adolescence may serve as important markers of risk for adolescent BP features; these may be important targets for intervention.