The Influence of ADHD and Adolescent Romantic Relationships on
Early Adult Psychopathology in Females
Andrea Lynne Stier
Doctor of Philosophy in Psychology
University of California, Berkeley
Professor Stephen P. Hinshaw, Chair
Attention-Deficit/Hyperactivity Disorder (ADHD) is a significantly impairing disorder of childhood that affects functioning across numerous domains, including academic, behavioral, and emotional functioning, through adolescence and into adulthood (Barkley, Murphy, & Fischer, 2007; Hinshaw, Owens, Sami, & Fargeon, 2006). Girls and women with ADHD have been understudied in past research. The current study uses a longitudinal design to investigate the romantic relationships of girls with and without ADHD during late adolescence and early adulthood in order to gain a deeper understanding of underlying relationship factors that may be detrimental or protective to their well-being. A large sample of girls with the Inattentive type of ADHD (ADHD/I; n = 47), the Combined type of ADHD (ADHD/C; n = 93), plus a matched comparison group of girls without ADHD (n = 88), were studied when they were 6-12 years of age. In a 10-year prospective follow-up, the sample (age 17-22, n = 187) self-reported on the stability, onset, and quality of their romantic relationships, attachment style, relationship aggression, and risky sexual behavior. Girls' relationships were also assessed via information posted on girls' pages on networking websites (Facebook, MySpace), including comments from peers and partners, photographs, and girls' reports about themselves and their relationships. Self-concept, friendship quality and support, and quality and stability of family relationships were examined as potential mechanisms underlying positive or negative relationship effects. Results indicated that girls with ADHD continue to be quite impaired in adulthood relative to their non-ADHD peers with respect to internalizing and externalizing symptoms and that ADHD type (i.e., ADHD/I vs. ADHD/C) does not appear to moderate any such effects. Relative to comparison girls, girls with ADHD initiated dating behavior significantly earlier and showed a significant and sizably larger number of lifetime dating partners. Girls with ADHD also showed a marginally significant effect with regard to increased likelihood of engagement in early sexual intercourse (before age 15). There was also a marginally significant effect with regard to more severe and frequent victimization by relationship aggression and more severe relationship aggression perpetration in girls with ADHD relative to the comparison sample. For all girls, regardless of ADHD diagnosis, there were mixed findings with respect to the impact of romantic relationships: excessive engagement in romantic relationships in adolescence was a risk factor for later adult externalizing problems, but engagement in a positive romantic relationship in early adulthood was associated with lower levels of concurrent externalizing and internalizing symptoms. Finally, after controlling for childhood externalizing symptoms, childhood peer rejection (but not ADHD diagnosis) also contributed significantly to early adult externalizing behavior, but this association was not mediated by number of romantic relationships in adolescence.