Doctor of Philosophy, Case Western Reserve University, 2020, Psychology

Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic disorder associated with functional impairments in childhood, adolescence, and adulthood. Although externalizing behavior problems are the most common reason children are referred for ADHD diagnosis, disparities exist in when parents seek treatment. Differences between children who are referred for psychological evaluations in early childhood versus adolescence are not well understood. The purpose of this study is to explore the differences between children and adolescents that are referred for ADHD diagnosis and determine whether protective factors emerge for individuals referred at later ages. Participants included 1,331 youth referred for psychological evaluation at the ADHD Center for Evaluation and Treatment at Cleveland Clinic Children's Hospital. Prior to evaluation, parents completed questionnaires about the child's history (medical history, developmental history, family history), temperament, behavior problems and assets, and previous mental health services. In addition, parents and teachers completed rating scales on ADHD symptoms, stress, and impairment. Also in-person diagnostic assessment and intellectual assessment was completed. Structural equation modeling techniques were used to explore predictors of Age of ADHD diagnosis, including number of ADHD symptoms, parent and teacher ratings of impairment, and compensatory factors related to IQ, temperament, and behavioral assets. Severe behavioral problems at school, higher numbers of referrals concerns, and lower family and caregiver quality of life contributed to younger age of ADHD diagnosis. Older age of diagnosis was predicted by parents who rated low support in their relationships with their spouse. Examination of developmental assets revealed that easy temperament, better social functioning, and greater compliance at school predicted older age of ADHD diagnosis, whereas younger age of diagnosis predicted more positive attitudes toward scho (open full item for complete abstract)

Committee: Elizabeth Short PhD (Committee Chair); Sandra Russ PhD (Committee Member); Michael Manos PhD (Committee Member); Christopher Burant PhD (Committee Member) Subjects: Clinical Psychology