Impact of Comorbidities on Self-Esteem of Children with Attention Deficit Hyperactivity Disorder

Pradeep Palaniappan Pradeep Palaniappan

doi:10.25215/0303.011

Abstract

Background: 2 decades of research had found that comorbid disorders occur in children with ADHD more than by chance. The role of comorbidities in influencing the self-esteem of children with ADHD is still less explored. Aims: To study the various domains of self-esteem in children with ADHD and to evaluate the effect of comorbidities on low self-esteem in ADHD children. Methods And Materials: 60 subjects aged 6 to 16 years who were diagnosed based on DSM IV as ADHD were recruited with informed consent, from tertiary care hospital for a period of 6 months by consecutive sampling. Based on detailed interview of subjects and parents using the Semi structured assessment schedule K- SADS – PL for comorbidities, children with ADHD were grouped as those with and without comorbidities. While severity of ADHD was assessed by Conner’s Parent’s 10 item abbreviated index, self-esteem was assessed by Culture free self-esteem inventory. Results: Parent related self-esteem was lower in ADHD children with comorbid internalizing disorders when compared to ADHD children with comorbid externalizing disorders. Higher severity of ADHD and longer duration of ADHD correlated with lower self-esteem, (especially social domain). Conclusions: Comorbidities definitely influence the level of self-esteem in children with ADHD, but other factors also need to be considered for optimal management of low self-esteem.

Highlights

2 decades of research had found that comorbid disorders occur in children with attention-deficit/hyperactivity disorder (ADHD) more than by chance
In ADHD children without comorbidities, lower social self-esteem was significantly correlated with earlier age of onset of ADHD, longer duration of ADHD and higher severity of ADHD (Table 3)
In children with comorbid externalizing disorders, higher severity of ADHD was correlated with lower social, academic and global domains of self-esteem. In these children with comorbid externalizing disorders, duration of externalizing disorders was correlated with lower general and parent related self-esteem (Table 5). In this current study, Low self-esteem was related to increasing age of the children, possibly reflecting better perception of poor self-esteem along the development trajectory[14]; earlier age of onset of ADHD, earlier age of onset of comorbid disorders, prolonged duration of ADHD & comorbid disorders probably reflecting the deranged internalization of self-concept secondary to ADHD related social, peer, academic dysfunction during the early childhood [15]; severity of ADHD, depression and anxiety [11,16]

Summary

Introduction

2 decades of research had found that comorbid disorders occur in children with ADHD more than by chance. The role of comorbidities in influencing the self-esteem of children with ADHD is still less explored. Aims: To study the various domains of self-esteem in children with ADHD and to evaluate the effect of comorbidities on low self-esteem in ADHD children. Based on detailed interview of subjects and parents using the Semi structured assessment schedule K- SADS - PL for comorbidities, children with ADHD were grouped as those with and without comorbidities. While severity of ADHD was assessed by Conner’s Parent’s 10 item abbreviated index, self-esteem was assessed by Culture free selfesteem inventory. Results: Parent related self-esteem was lower in ADHD children with comorbid internalizing disorders when compared to ADHD children with comorbid externalizing disorders. Conclusions: Comorbidities definitely influence the level of self-esteem in children with ADHD, but other factors need to be considered for optimal management of low self-esteem

Objectives

Methods

Results

Conclusion