Linking ADHD to Depression in Adolescents: the Mediating Role of Social Skills

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at a higher risk for developing depression than their peers. One potential explanation for this increased risk is that adolescents with ADHD often have impaired social skills, which may interfere with successful social interactions and connections, and subsequently lead to low self-worth and depression. We hypothesized that global social skills and social skill factors most related to friendships (communication, cooperation, engagement, and empathy) would mediate the positive relation between ADHD symptom severity and depression. Additionally, we investigated whether global social skills would mediate the relations between ADHD symptom severity and four facets of depression (negative self-evaluation, anhedonia, dysphoric mood, and somatic complaints). Our sample included 335 adolescents with ADHD in grades 6–11 who participated in an intervention study. Parent-reported ADHD symptoms were measured at or before baseline, parent-reported social skills (global and several subscales) were measured one year later, and self-reported depression was measured 1.5 years after baseline. Global social skills mediated (1) the relation between ADHD and depression and (2) the relation between ADHD and negative self-evaluation. Cooperation, communication, empathy, and responsibility individually mediated the relation between ADHD and depression, and assertion, self-control, and engagement did not.