(PS1-74) Benevolent Childhood Experiences as a Buffer for ADHD and Comorbidities Among College Students

Abstract Text: Attention-deficit/hyperactivity disorder (ADHD) is associated with increased rates of comorbid mental disorders (e.g., substance misuse, depression, anxiety), as well as overall impairment in functioning. These associations may be mediated by risk factors associated with ADHD, including deficits in emotion regulation and executive functioning. Further, previous research indicates that childhood adversity experienced by individuals with ADHD can further worsen comorbidities and impairment. In contrast, Benevolent Childhood Experiences (BCEs; high-quality relationships or consistent home environments) may serve as a protective factor, weakening the negative effects of ADHD symptoms on later development and improving health outcomes. However, no studies have investigated the potentially protective role of BCEs in the association between ADHD and comorbid disorders and impairment. The present study seeks to determine if BCEs may moderate the association between ADHD symptom severity, anxiety, depression, substance use, and impairment among college students.

Data from the multisite Undergraduate Learning, Emotion, and Attention Research Network (U-LEARN) study (mean age= 19.12; SD= 1.33) was analyzed, utilizing online self-report questionnaires to report on BCEs, functional impairment, depression and anxiety symptoms, alcohol and marijuana consumption, and ADHD symptom severity. Participants (n = 4,952; 68.38% female; 54.87% White; 18.36% Asian; 7.33% Black; 11.52% Multiracial; 6.17% Other) across eight US universities completed this study. To evaluate the associations between ADHD symptoms, anxiety, depression, substance use, impairment, and BCES, bivariate correlations were examined and linear regression models were fit. Analyses were conducted in R (R version 4.3.1; R Core Team, 2023) and all models were adjusted for socioeconomic status and gender.

Preliminary investigations revealed that BCEs moderated the association between ADHD symptom severity and impairment in self-concept (B = 0.001, F(4,298) = 349.6, p = 0.003, ΔR2 = 0.33); work (B = -0.002, F(1,822) = 97.08, p = 0.001, ΔR2 = 0.24); social skills (B= -0.001, F(4,306) = 317, p < 0.001, ΔR2 = 0.31); and risk behaviors (B = -0.001, F(4,281) = 183.00, p< 0.001, ΔR2 = 0.20). High levels of BCEs weaken the association between ADHD symptom severity and social, work, and risk-behavior related impairment at high levels of ADHD severity. High levels of BCEs are also protective against self-concept-related impairment at low levels of ADHD symptom severity, but not high. BCEs did not moderate the association between other domains of impairment, nor depression, anxiety, or substance use.

Findings could have implications for clinical practice and community interventions and elucidate potential protective factors that may promote positive long-term well-being for individuals with ADHD. Further, they highlight that BCEs may be particularly important in buffering against impairment in social skills, risk, and work among college students with high levels of ADHD symptom severity. However, due to small effect sizes, more research is warranted to understand more powerful protective factors against ADHD-related impairment.