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Attention deficit hyperactivity disorder traits are not directly associated with mental health impairment in Brazilian adults: a network analysis

psychiatry-and-psychology
mental-health

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) has been widely associated with mental health impairments. It is a neurodevelopmental disorder diagnosed when individuals exhibit characteristic behavioral traits such as inattention, hyperactivity, and impulsivity. However, the presence of these traits alone does not determine diagnosis, as they must also cause significant functional impairment for the individual, among other criteria, to fulfill diagnosis. Therefore, this study aimed at clarifying how ADHD traits are associated with mental health in the general population, independently of meeting the full diagnostic criteria. The Adult ADHD Self-Report Scale (ASRS) was used to screen ADHD traits in an online survey that also addressed other mental health indicators. The final sample consisted of 2.159 Brazilian adult participants. Data were analyzed using network analysis. An undirected network was modelled using the Gaussian Graphical Model based on partial polychoric correlations, and regularization was applied using EBICglasso. The main network analysis was conducted for individual ADHD traits. Additional analyses were performed for the summed inattention and hyperactivity/impulsivity scores, for the total ASRS summed score, and for subgroups of participants exhibiting extreme levels of trait presentation. Results indicate that, in an adult community sample, association between ADHD traits and mental health impairment is predominantly indirect. This indirect association was commonly mediated by younger age and feelings of insecurity. The results were consistent across all analyses. Overall, our results suggest that the presence of ADHD traits alone is not sufficient to determine mental health impairment in the general population. We propose that both research and clinical practice may benefit from further exploring and addressing mediating factors—such as insecurity—that could underlie the association between ADHD traits and mental health impairment observed in previous studies.
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