(PS11-A20) ADHD and Resilience

Background: Decades of critical research have identified risk factors (e.g., Becker et al., 2012) and deficit reduction strategies (e.g., evidence-based treatments; Evans et al., 2018) for children with ADHD. In contrast, there is limited research that adopts strength-based approaches to the study and treatment of ADHD. Thus, while ADHD is one of the most studied childhood disorders, our understanding of positive adaptation among children with ADHD remains in its nascent stage (Lee, Sibley, & Epstein, 2016).

Aims: The present study utilizes a strength-based theoretical perspective to examine predictors of resilience or positive adaptation in children with ADHD. Specifically, the study (a) identifies individual (e.g., emotion regulation, academic competence, social skills), family (e.g., parent-child attachment, positive parenting, parental mental health), and social-community (e.g., peer acceptance, school/community involvement) assets associated with resilience in children with ADHD, and (b) examine whether these assets promote resilience similarly for children with versus without ADHD. Predictors were selected from a core set of assets consistently associated with resilience in the developmental literature (Masten, 2014).

Hypotheses: Based on the extant ADHD and resilience literature (see Dvorsky & Langberg, 2016), we predicted family and social-community assets, particularly social acceptance and positive parent-child relationships, would be associated with resilience in children with ADHD. While there is a paucity of literature on individual assets and resilience in ADHD, we also predict better developed child cognitive abilities, self-regulation skills, and peer acceptance would predict resilience for these children.

Methods: The study included a well-characterized, clinically evaluated sample of 206 children with (n=108) and without ADHD (n=98) ages 8-13 years (M=10.31, SD=1.41; 85 girls; 66.5% White/Non-Hispanic) who were included in our first study on resilience in ADHD (REFS REMOVED FOR MASKED REVIEW). In the initial study, reliable change analyses (Jacobson & Truax, 1991) based on parent/teacher BASC-3 Resiliency subscales were used to classify the ADHD and Non-ADHD groups into low and average/high resilience subgroups. In the current study, the same groups are used for a series of ADHD (Yes/No) x Resilience (Low vs Avg/High) ANOVAs and χ2 tests to examine whether assets predict resilience similarly for children with/without ADHD. Dominance analysis will then be used to examine the relative importance of 15 individual, family, and social-community assets as predictors of parent/teacher perceived resilience; separate models will be run per informant. Data collection/screening/cleaning is complete.

Conclusion: Looking ahead, this study aims to provide an empirical basis for a precision medicine treatment approach for ADHD that moves beyond deficit reduction towards incorporating a child’s individual, family, and social-community assets to facilitate more positive outcomes. We additionally hope that identifying community/individual resilience factors among children with ADHD will contribute to proactive emergency preparedness and effective support for this high-risk population.