Brandeis University, Waltham, MA, USA.
J Atten Disord. 2021 Oct;25(12):1676-1686. doi: 10.1177/1087054720925900. Epub 2020 Jun 4.
Depression and attention-deficit hyperactivity disorder (ADHD) are prevalent and highly comorbid. ADHD symptoms are associated with specific dependent (i.e., self-generated) stressors in children, and there is a strong link between dependent stress and depression. Despite continued comorbidity of ADHD and depressive symptoms into adulthood, it is unknown whether stress generation mediates the relation between ADHD and subsequent depressive symptoms in emerging adulthood, a period of heightened stress. We tested this mediation model in a semester-long longitudinal study of 224 college students (aged 18-23 years). We additionally tested whether this model differed between inattentive versus hyperactive/impulsive ADHD symptoms given evidence that they vary in their relations to stress and depression. Dependent stress mediated the association between total ADHD symptoms at baseline and later depressive symptoms; these effects were equivalent for inattentive versus hyperactive/impulsive ADHD symptoms. These findings suggest stress generation as a mechanism for increased depression in individuals with ADHD symptoms.
抑郁和注意缺陷多动障碍（ADHD）较为普遍且高度共病。ADHD 症状与儿童特定的依赖性（即自我产生的）应激源有关，依赖性应激与抑郁之间存在很强的联系。尽管 ADHD 和抑郁症状在成年后持续共病，但尚不清楚依赖性应激是否在成年早期（压力较高的时期）调节 ADHD 与随后抑郁症状之间的关系。我们在一项为期一学期的 224 名大学生（年龄 18-23 岁）的纵向研究中测试了这种中介模型。我们还测试了这个模型是否在注意力不集中与多动/冲动 ADHD 症状之间存在差异，因为有证据表明它们与应激和抑郁的关系不同。依赖性应激中介了基线时总 ADHD 症状与随后抑郁症状之间的关联；对于注意力不集中与多动/冲动 ADHD 症状，这些影响是等效的。这些发现表明，应激产生是 ADHD 症状个体抑郁加重的一种机制。
