Date of Award
College of Arts Humanities and Social Sciences, Psychology
Angela J. Narayan
Julia O. Dmitrieva
Attention deficit hyperactivity disorder (ADHD), Anxiety, Cognition, Compensation, Executive functioning
Higher ADHD symptoms have been associated with reduced executive functioning (EF) performance in children. However, an emerging body of research has suggested that in children with higher ADHD symptoms, higher levels of anxiety symptoms may contribute to buffered executive functioning (EF) performance, termed a compensatory interaction. However, results investigating this hypothesis have been mixed, possibly due to the use of smaller sample sizes, cross-sectional datasets, and infrequent testing of compensatory interaction effects between ADHD and anxiety symptoms. The current study expands upon the previous literature by testing for compensatory interactions between anxiety symptoms and ADHD symptoms (e.g., inattention and hyperactive-impulsive [H-I]) on EF abilities (e.g., working memory [WM] and inhibition) both cross-sectionally and longitudinally in a large, well-validated sample. This study also investigated whether compensatory interactions between Time 1 ADHD and symptoms contributed to a reduction in Time 2 ADHD symptoms. The sample included 547 children and adolescents recruited for the Colorado Learning Disabilities Research Center twins study, who then participated in a second time point five years later. Results revealed no significant interactions for cross-sectional analyses, but significant longitudinal interactions were identified for Time 1 Inattention symptoms x Anxiety symptoms (Beta=0.149, p= 0.002) and Time 1 H-I symptoms x anxiety symptoms (Beta= 0.159, p=0.016) on Time 2 inhibition abilities. Simple slope investigations revealed similar compensatory interactions where higher Time 1 anxiety symptoms buffered against both higher Time 1 inattention and H-I symptoms on Time 2 inhibition abilities. Both interactions remained significant when controlling for Time 1 inhibition abilities. Simple slope investigations of the Inattention symptoms x Anxiety symptoms and H-I symptoms x Anxiety symptoms interactions confirmed a consistent compensatory form, where higher ADHD and higher anxiety symptoms contributed to improvements in Time 2 inhibition relative to Time 1. No significant longitudinal interactions were identified between Time 1 ADHD and anxiety symptoms on Time 2 ADHD symptoms. Results suggested that anxiety symptoms function as compensatory factors for inhibition abilities longitudinally for children with higher ADHD symptoms. This is one of the first studies to provide evidence for compensatory effects of anxiety symptoms on EF functioning for children with higher ADHD symptoms. Nuanced considerations of this compensatory effect are discussed, given how this effect may promote compensation in EF abilities but could confer negative effects for broader aspects of functioning.
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Received from ProQuest
Slomowitz, Rebecca, "Anxiety as a Compensatory Factor for Executive Functioning Abilities and Later ADHD Symptoms in Youth with ADHD" (2023). Electronic Theses and Dissertations. 2325.
Available for download on Friday, September 12, 2025