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Objective: ADHD is associated with risky sexual behavior and early pregnancy, but few studies have examined mechanisms of risk linking childhood ADHD to early pregnancy. The present study utilized data from the Multimodal Treatment Study of ADHD to examine potential mechanisms that may account for the association between childhood ADHD and becoming pregnant or causing a pregnancy by age 18. Method: Participants were 579 children with ADHD and 289 comparison peers followed over 16 years. Results: Relative to the comparison group, those with childhood ADHD were at more than two times increased risk of early pregnancy. Univariately, persistence of ADHD symptoms, delinquency/substance use, and academic performance/achievement during adolescence each mediated the association between childhood ADHD and early pregnancy. When considered together, only delinquency/substance use remained a significant mediator of this relationship. Conclusion: Findings point toward specific targets of intervention for youth with ADHD to prevent early pregnancy.

The current study aims to evaluate the effectiveness of a high-intensity (HI) versus a low-intensity (LI) skills-based summer intervention delivered to adolescents with ADHD by school staff in improving depressive symptoms, anxiety symptoms, social problems, and self-esteem. Participants were 325 ethnically diverse rising sixth and ninth graders with ADHD randomized to an HI versus an LI intervention (n = 218) or recruited into an untreated comparison group (n = 107). Group x time and group x grade x time one-year outcome trajectories were compared using linear mixed models. Across the transitional year (sixth or ninth grade), adolescents in the HI group were found to experience significantly greater decreases in depressive symptoms (p =.022, d =.25) compared to the LI group. There was no significant impact of the HI intervention (vs. LI) on anxiety symptoms (p =.070, d =.29), social problems (p =.054, d =.34), or self-esteem (p =.837, d = 0.21); however, secondary analyses of the non-randomized untreated comparison group indicated a significant effect of HI versus the untreated comparison group on social problems (p =.009, d = 43). These significant treatment effects suggest that comprehensive academic and organizational skills interventions for adolescents with ADHD may have a secondary impact of relieving adolescent depression for teens with this comorbidity. Given mixed evidence for the efficacy of the HI intervention on social skills, future work should further evaluate this effect. [ABSTRACT FROM AUTHOR]

The high school years are a challenging developmental period for adolescents with attention- deficit/hyperactivity disorder (ADHD), their families, and those who work with them in the school system. Moreover, racially minoritized families and schools in low-resource, urban settings often experience additional adverse experiences that can make access to evidence-based mental health care particularly difficult. This qualitative investigation into the experiences of Black high school students with ADHD, their caregivers, teachers, and school mental health providers (SMHPs) aimed to understand this community's experiences with ADHD across development and to explore the barriers/facilitators to adequate services. Through focus group interviews with stakeholders (i.e., 6 adolescents with a diagnosis of ADHD, 5 caregivers of adolescents with ADHD, 6 teachers, 5 school mental health providers), themes emerged related to (1) developmental changes observed in ADHD presentation in high school students and (2) contextual factors (including barriers/facilitators to optimal school and home functioning). These themes led to the development of an ecological model that show various contextual factors influencing the experiences of Black adolescents with ADHD in under-resourced urban public high schools (e.g., adolescents' coping strategies, caregiver involvement, teacher burden or lack of ADHD-knowledge, socio-economic status, access to care). This qualitative study represents the first step of a treatment development project assessing the implementation of a depression prevention intervention for Black adolescents with ADHD in urban public-school settings. Clinical implications (e.g., coordination of care between home and schools, increasing attention to social determinants of health, ensuring culturally competent discussion of ADHD and its treatment) are discussed. [ABSTRACT FROM AUTHOR]

Objective: Symptoms of ADHD place adolescents at increased risk for depression. The transition from middle to high school may magnify depression risk. This study examined whether changes in adolescents' negative relationship quality with their mothers and best friends from eighth to 12th grades mediated the longitudinal relations between ADHD and depressive symptoms. Method: 368 adolescents (48.5% male) were initially recruited. Results: Boys with elevated ADHD symptoms in the eighth grade reported steeper increases in negative relationship quality with their mothers relative to girls, and that this trajectory mediated the relation between ADHD and depressive symptoms. ADHD symptoms were also associated with increases in negative friendship quality across high school for boys; however, this did not mediate the relation between ADHD and depressive symptoms for either sex. Conclusion: Growth in mother–adolescent negative relationship quality may be one mechanism that explains the development of depressive symptoms in adolescent boys with elevated ADHD symptoms. [ABSTRACT FROM AUTHOR]

Objective: ADHD and depression co-occur at higher than chance levels in adolescence, but moderators of this association are not well understood. Consistent with a developmental-transactional framework, one such moderator may be maternal emotion regulation (ER) difficulties. Using latent growth curve modeling, the current study examined the independent and interactive effects of adolescent ADHD symptoms and maternal ER difficulties on the trajectory of depressive symptoms across adolescence. Method: This study included a community sample of 247 adolescents (Mage = 13.06 years) assessed annually over a 6-year period. Results: Findings suggested that youth with greater ADHD symptoms whose mothers evidenced more ER difficulties demonstrated steeper increases in depressive symptoms over time relative to their peers with lower ADHD symptoms or whose mothers reported fewer ER difficulties. Conclusion: This work highlights the importance of maternal ER difficulties in predicting the trajectory of depressive symptoms among adolescents with ADHD symptomatology. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is an unprecedented social-emotional stressor significantly impacting intervention services for at-risk college students with attention-deficit/hyperactivity disorder (ADHD). In order to succeed in the new remote learning context, students are tasked with employing strong organizational, time management, and planning skills. They must self-regulate thoughts, actions, and emotions, inhibit task-irrelevant activity, and cope with unprecedented stressors. These ingredients for success nearly completely overlap with the core dysfunctions of ADHD. Recognizing the importance of providing psychosocial services during this high-risk time and in response to social distancing and university guidelines, we initiated a telehealth version of our program for college students with ADHD (i.e., SUCCEEDS). In the current paper, we describe novel and creative clinical strategies designed to assist students with ADHD in problem solving, adaptive coping, organizational skills, and time management strategies during the COVID-19 pandemic. Specifically, we: (1) detail the initial set-up of remote delivery services and supervision, (2) describe key components of the SUCCEEDS program developed to support students' unique needs during the COVID-19 pandemic, (3) present focus group and qualitative feedback from SUCCEEDS coaches and students, (4) provide an illustrative case vignette of application, and (5) discuss future directions and "lessons learned" in moving SUCCEEDS to a remote platform. In so doing, our hope is to contribute to an ongoing dialog surrounding optimal delivery of remote services to college students with ADHD, particularly during high-risk periods. [ABSTRACT FROM AUTHOR]

College students with ADHD are at risk for a host of negative outcomes in academic, social, and emotional domains. However, the majority of college campuses do not provide comprehensive and individualized services to target the executive functioning difficulties and psychological comorbidity seen in college students with ADHD. The current manuscript describes the development of a specialized semester-long program to address the unique needs of college students with ADHD (Students Understanding College Choices: Encouraging and Executing Decisions for Success; SUCCEEDS) as well as the clinical, research, and training mission of this venture. Results from reliable change indices indicate that among the eight students in this case series, the majority reported significant improvements in organizational skills. Additionally, the majority of students with elevated rates of depression or alcohol use at baseline also reported significant improvement in these comorbid symptoms. A descriptive case study is also provided to further demonstrate the individualization and implementation of SUCCEEDS. Preliminary evidence suggests that SUCCEEDS is an effective method for addressing the personalized and wide-ranging difficulties experienced by college students with ADHD. Lessons learned and future directions for research are discussed. [ABSTRACT FROM AUTHOR]

Despite gaining admission to college, many students with attention-deficit/hyperactivity disorder (ADHD) struggle to achieve academic, social, and occupational success. Additionally, college students with ADHD experience higher rates of problem drinking and comorbid psychology (e.g., depression). This paper describes the development of the Students Understanding College Choices: Encouraging and Executing Decisions for Success (SUCCEEDS) program for college students diagnosed with ADHD who are engaging in problem drinking. SUCCEEDS combines ADHD psychoeducation, behavioral activation, and brief motivational intervention treatment elements to help college students with ADHD achieve healthier and more fulfilling lifestyles. SUCCEEDS aims to decrease problem drinking by increasing substance-free, goal-directed behavior allowing for success in college. The iterative treatment development process, two SUCCEEDS illustrative case examples, and reliable change indices are presented. Preliminary results suggest that SUCCEEDS may be effective in reducing problem drinking and functional impairment in areas relevant to college students (e.g., academics). • SUCCEEDS combines ADHD psychoeducation, BA, and MI treatment elements. • SUCCEEDS was developed with UCC and SHC input to enhance dissemination potential. • Two case examples illustrate the implementation of SUCCEEDS. • Case examples decreased total weekly drinks and impairment in various domains. • Preliminary evidence shows SUCCEEDS beneficial for college students with ADHD. [ABSTRACT FROM AUTHOR]