背景:焦虑和注意力缺陷/多动障碍(ADHD)的症状从童年到青春期具有前瞻性相关。然而,ADHD的两个维度-注意力不集中和多动-冲动-是否与焦虑有差异,以及这些关系中是否存在发育和性别/性别差异尚不清楚.
方法:每两年对两个4至16岁的挪威儿童(N=1,077;49%的女孩)进行评估,并进行诊断性父母访谈,以评估焦虑和ADHD的症状。使用随机截距交叉滞后面板模型分析数据,调整所有未观察到的时不变混杂效应。
结果:在女孩中,注意力不集中,但不是多动-冲动,预测2年后所有时间点的焦虑增加,12岁和14岁时焦虑增加,预测注意力不集中而不是多动-冲动增加。在男孩中,在6岁和8岁时,多动-冲动增加,但注意力不集中,预测2年后焦虑增加,而焦虑的增加并不能预测注意力不集中或多动-冲动的增加。
结论:ADHD的两个维度与焦虑有差异,而且这种关系是有性别的.在女孩中,注意力不集中可能参与整个儿童期和青春期焦虑的发展,而焦虑可能导致女孩在青春期早期开始出现更多的注意力不集中.在男孩中,多动-冲动可能参与早期学校焦虑的发展。有效治疗女孩的注意力不集中症状可以降低所有时间点的焦虑风险,而解决焦虑可能会减少青春期的注意力不集中。同样,治疗多动-冲动可能会降低男孩在儿童后期(8-10岁)的焦虑风险。
BACKGROUND: Symptoms of anxiety and attention-deficit/hyperactivity disorder (ADHD) are prospectively related from childhood to adolescence. However, whether the two dimensions of ADHD-inattention and hyperactivity-impulsivity-are differentially related to anxiety and whether there are developmental and sex/gender differences in these relations are unknown.
METHODS: Two birth cohorts of Norwegian children were assessed biennially from ages 4 to 16 (N = 1,077; 49% girls) with diagnostic parent interviews used to assess symptoms of anxiety and ADHD. Data were analyzed using a random intercept cross-lagged panel model, adjusting for all unobserved time-invariant confounding effects.
RESULTS: In girls, increased inattention, but not hyperactivity-impulsivity, predicted increased anxiety 2 years later across all time-points and increased anxiety at ages 12 and 14 predicted increased inattention but not hyperactivity-impulsivity. In boys, increased hyperactivity-impulsivity at ages 6 and 8, but not increased inattention, predicted increased anxiety 2 years later, whereas increased anxiety did not predict increased inattention or hyperactivity-impulsivity.
CONCLUSIONS: The two ADHD dimensions were differentially related to anxiety, and the relations were sex-specific. In girls, inattention may be involved in the development of anxiety throughout childhood and adolescence and anxiety may contribute to girls developing more inattention beginning in early adolescence. In boys, hyperactivity-impulsivity may be involved in the development of anxiety during the early school years. Effective treatment of inattention symptoms in girls may reduce anxiety risk at all time-points, while addressing anxiety may decrease inattention during adolescence. Similarly, treating hyperactivity-impulsivity may reduce anxiety risk in boys during late childhood (at ages 8-10).