Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Kevin Antshel



Subject Categories

Clinical Psychology | Psychology | Social and Behavioral Sciences


Abstract Background: Youth with attention deficit / hyperactivity disorder (ADHD) are at increased independent risk for bullying involvement or depression yet the topic of bullying involvement and depression in ADHD is poorly understood and largely considered without a guiding theoretical framework. Research on the relation between ADHD and bullying is still in its early stages and less is known about the risk and protective factors that may contribute to the development or buffering of depression in these youth. Family factors such as positive parenting promote resilience in children with ADHD, help reduce the risk for youth depression and help to protect youth from bullying involvement. However, to date, no research has considered how positive parenting might be associated with depression and bullying involvement in youth who have ADHD. The current study investigated associations between bullying frequency and depression severity among youth with and without ADHD and the influence of positive parenting. Method: Thirty eight thousand two hundred twenty-one surveys of children and adolescents between the ages of 6 and 18 completed by parents and caregivers as part of the 2018 and 2019 National Survey of Children’s Health (NSCH) administrations were included in the current study. The NSCH is a large cross-sectional survey of children and adolescents living in the United States and provides yearly nationally representative estimates of key indicators of child health and well-being. Households were randomly sampled and contacted by mail to identify those with children under 18 years old. For the purpose of this study, information regarding children’s mental health (including child ADHD and depression status), bullying involvement, parenting factors, and demographics of youth aged 6 – 17 were examined. Results: Chi-square tests of independence were conducted to establish external validity of the NSCH sample (Aim 1). Results suggested that youth with ADHD were more likely to be engaged in bullying, particularly as victims and bully-victims, than youth without ADHD. External validity was also established as adolescents with ADHD were more likely to have depression than youth without ADHD, and independent of ADHD, adolescents had higher rates of depression and bully perpetration than children. Children had higher rates of victimization and bully-victimization. Multinomial logistic regressions were conducted to determine if there were positive associations between bullying frequency and depression severity in ADHD and non-ADHD groups (Aim 2). Analyses revealed general trends of positive associations between bully perpetration frequency, bullied frequency and bully-victims and depression severity. ADHD youth generally had increased risk for depression, especially bully-victims with ADHD. Aim 3 examined whether bullying frequency and positive parenting were associated with depression severity. Multinomial logistic regressions revealed an overall trend of positive associations between bullying frequency and depression severity and positive parenting as protective. Ordinal logistic regressions were conducted to assess for positive associations between bully involvement, positive parenting, ADHD and depression severity and protective effects of positive parenting. ADHD moderated the effect of depression most for victim youth. Positive parenting was generally protective across bullying roles, though not significantly more protective for ADHD youth compared to non-ADHD youth. Discussion: Results largely supported positive associations between all roles of bullying involvement and depression severity for non-ADHD youth. While it was hypothesized that ADHD would moderate associations between bullying frequency and depression severity, our findings did not entirely support this. Infrequent bully perpetrating youth with ADHD were less likely to have mild depression than their non-ADHD peers. Victim youth with ADHD were more likely to have mild and moderate-to-severe depression than their non-ADHD peers, suggesting that victim youth with ADHD are especially vulnerable to depression. Bully-victim youth with ADHD were at increased risk of having mild and moderate-to-severe depression relative to non-bully-victim youth without ADHD. Results on positive parenting were difficult to interpret due to small cell sizes and lack of variability across data. Among ADHD and non-ADHD youth, positive parenting was protective. Findings largely revealed negative associations between bullying involvement x positive parenting and depression severity. Positive parenting did not appear to be more protective among youth with ADHD than youth without ADHD, however ADHD did moderate the risk of depression among bully perpetrators, victim youth, and bully-victims.


Open Access