ADHD in Children
Visual Abstract
Characteristics of Children With ADHD and Comorbid Anxiety
What does ADHD + Anxiety look like in children?
Matthew A Jarrett , Jennifer C Wolff , Thompson E Davis rd , Maria J Cowart , Thomas H Ollendick
Summarized by:
March 3, 2023
study source
J Atten Disord.
Jul 2016
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What they studied
How does having ADHD with anxiety affect symptoms and cognition compared to having just ADHD or anxiety alone?
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What they found
Both anxiety and ADHD can affect working memory. Those with both disorders have the most significant challenges on working memory tests.
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What this means
Parents and doctors should consider anxiety when evaluating children for ADHD. These conditions occur together quite often and can affect the symptoms we experience.
What does ADHD + Anxiety look like in children?
Objective
ADHD often occurs with anxiety disorder:
However, there are still unanswered questions on the link between ADHD and anxiety.
Researchers conducted a study to evaluate differences between those with ADHD only, anxiety only, and those with ADHD and anxiety together.
Study Quote
The following comorbid subgroups of ADHD have been proposed: ADHD Only, ADHD + anxiety disorders (ANX), ADHD + oppositional defiant disorder/conduct disorder (ODD/CD), and ADHD + ODD/CD + ANX.The current study examined a subset of these groups.
Method
Researchers used standardized interviews to group children based on whether they had ADHD, anxiety, or both.
They assessed the children’s behavior, intelligence, anxiety, depressive symptoms, and attention.
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The ADIS-C/P (Silverman & Albano, 1996) versions are semistructured interviews for diagnosis of most
child psychiatric disorders .... symptoms and ratings are used to identify diagnostic criteria and create a clinician’s severity rating (CSR).
Study Quote
A total of 134 children and adolescents (M age = 9.92; range = 6-17) from a clinic-referred sample (n = 407) were grouped based on a semistructured diagnostic interview: ADHD only (n = 41), ADHD + ANX (n = 31), and ANX Only (n = 62).
Results
Researchers were surprised to find that ADHD, and anxiety together had significant impacts on working memory.
The digit span backward test, a standard working memory test, showed that the three groups below had significant differences. Those with ADHD and no anxiety disorder performed well, though still below average.
Those with both ADHD and anxiety had the most significant difficulty with this test.
A small study found that those with ADHD and anxiety have significantly more challenges with their working memory than those with either anxiety or ADHD alone.
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It should be noted, though, that mean scores were well below average for all three of the groups, suggesting that working memory impairments may be present in ADHD and anxiety disorders.
Other results were generally as expected.
Those with anxiety and ADHD showed more physical symptoms of anxiety than other groups.
Those with ADHD, or ADHD and anxiety, had the most difficulty with a test of attention.
Study Quote
Findings supported greater parent-reported anxiety symptoms in anxiety groups, and greater parent- and teacher-reported attention problems in ADHD groups. ADHD groups performed worse on a continuous performance test, whereas ADHD + ANX performed worse on working memory than ADHD Only. AD...
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Conclusions
In general, among the tests that the researchers ran, there weren’t huge differences between those with ADHD and those with ADHD and anxiety.
However, one interesting, finding is the link between having ADHD and anxiety and having greater difficulties with working memory.
Because anxiety can be pretty common among those with ADHD and because having both conditions can impact how someone thinks, the study's authors recommend that those with ADHD should also be screened for anxiety.
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Overall, our results indicate that children with ADHD + ANX do not appear to differ from children with ADHD....we did find evidence that children with ADHD + ANX exhibited greater working memory deficits than did children with ADHD Only. It appears that children with ADHD + ANX are a particularly impaired group of children in terms of cognitive functioning with additional deficits in working memory
Study Quote
Comorbid anxiety should be considered in ADHD assessment and treatment