Examination of comorbid anxiety as a moderator of the relationship between ADHD and impaired peer relations
Abstract
Attention deficit hyperactivity disorder (ADHD) is often associated with poor peer relations in affected children. Studies also indicate a link between anxiety, which has been found to be highly comorbid with ADHD, and peer difficulties. The current study examines the relationship between ADHD and peer relations, in addition to the potential moderating effects of comorbid anxiety. Children's ADHD and anxiety symptoms were rated based on a comprehensive assessment that includes psychosocial and clinical interviews, and broad-band and narrow-band standardized rating scales of emotional and behavioral functioning completed by parents, teachers, and parents. Anxiety was separated into four subcategories: total anxiety, physical anxiety, worry, social anxiety. The sample includes 171 children ages 7 to 13 years. Collectively, total anxiety and worry significantly moderated the relationship between teacher ratings of ADHD symptoms and peer problems. These findings suggest that comorbid internalizing anxiety disorders, and specifically worry, convey increased risk of poor peer relations in children with ADHD.