Youth Social Functioning and Externalizing Psychopathology in Relation to Attention Deficit Hyperactivity Disorder: A Network Analysis

Abstract Social functioning impairments are common among youth with externalizing psychopathology. Yet, questions remain regarding which symptoms drive poorer social and behavioral outcomes. Baseline parent and caregiver ratings from the Adolescent Brain Cognitive Development Study (ABCD) were used to examine interconnections among social problems, attention problems, and externalizing problems (i.e., rule-breaking and aggression) using network modeling. Baseline ABCD data were collected in 2017 when youth were 9–10 years and includes a diverse sample (48% female; 52% male; 52.4% White, 13.4% Black, 24.0% Hispanic, and 5.5% Other) of n = 11,878 youth at 21 research sites across the United States. Cross-sectional findings identified four bridge symptoms, individual symptoms that connect or link different symptom clusters (or communities) within a network, of social problems with strong links to youth externalizing behaviors that were robust across sex and to attention deficit hyperactivity disorder (ADHD) clinical diagnoses. Longitudinally, these bridge symptoms were more predictive of externalizing problems rather than attention problems at year 1 follow-up. Findings indicated that social problems in those with attention problems are more likely due to comorbid externalizing behaviors than to the attentional symptoms. By contrast, attention-related social challenges may be more reflective of slower social maturity owing to close links with other neurodevelopmental disorders. Findings highlight the utility of a network model for conceptualization of social functioning and child behavior within a network system to examine bidirectional symptom influences and point toward potential intervention targets for youth.