Dissertations and Theses
Date of Award
2023
Document Type
Thesis
Department
Psychology
First Advisor
Sarah O’Neill
Second Advisor
Henry Bulley
Third Advisor
Steven Tuber
Keywords
ADHD severity, neighborhood-level Socioeconomic status (SES), Preschoolers’ Risk for Obesity, School-Age
Abstract
Background: Attention-Deficit/Hyperactivity Disorder (ADHD) oftentimes emerges during the preschool years. School-age children with ADHD are at an increased risk for obesity as compared to their non-ADHD peers, but it is unknown if this risk is observed in younger children. Socioeconomic status (SES) is negatively related to both ADHD and obesity, but how SES interacts with ADHD to affect later obesity is unknown. This study aimed to examine if preschool ADHD diagnosis and severity interacted with neighborhood-level SES to increase risk for overweight/obesity and greater growth in BMI at school-age. We hypothesized that ADHD severity/diagnosis would be associated with greater growth in BMI/increase risk for overweight/obesity from preschool to school-age (age 7 years). Second, we hypothesized that children with higher ADHD severity/ADHD diagnosis in combination with lower neighborhood SES would report greater increase in BMI/increased risk for overweight or obesity from preschool to school-age. Third, this study aimed to depict associations among these variables visually using geospatial mapping. Method: Preschoolers aged 3-4 years at High and Low risk for hyperactive/impulsive and/or inattentive (H/I) behaviors were recruited into a longitudinal study through local preschools and direct referrals from clinics in metropolitan New York. During the baseline (T1) and at the follow up at 7-years (T2), the child’s teachers and parents completed the ADHD-RS (DuPaul et al. 1998), and these responses were integrated with parents’ reports on the K- SADS-PL to determine ADHD diagnosis. K-SADS-PL items were summed to yield severity scores. At each evaluation, children were weighed and their height was measured, and these values were used to calculate age- and sex-specific BMI z scores, based on CDC growth charts. Zipcode of the family home at T1 was used to obtain neighborhood-level data on multidimensional child health and welfare variables, from which two neighborhood SES factors, Child Health and Wellbeing and Child Welfare, were derived.
Results: Both ADHD diagnosis/severity and BMI severity/classification were highly stable over time. There was no significant association of ADHD diagnosis and increase in risk for overweight/obesity from preschool to school-age (age 7 years). After controlling for ADHD medication use over the follow-up period, ADHD severity at age 4 was marginally significantly related to greater increase in BMI from age 4 to age 7 years. There was no significant interaction between ADHD (diagnosis or severity) and neighborhood SES on BMI outcomes (severity or classification of overweight/obesity). Lower Child Health and Wellbeing neighborhood SES was associated with greater increase in ADHD severity from preschool to school-age. This study was able to depict associations among variables visually using geospatial mapping.
Conclusions: Given the stability of ADHD and obesity overtime, there is a need for further research to understand factors that amplify risk, particularly among families and neighborhoods of lower socioeconomic status. Emerging evidence suggests risk for change in BMI over time may be related to preschool ADHD severity, although this needs to be replicated in larger samples.
Keywords: Attention-deficit/hyperactivity disorder; obesity; BMI; neighborhood-level socioeconomic status; geospatial mapping; preschool.
Recommended Citation
Jayanthi, Ramya V., "Interaction of ADHD severity and neighborhood-level SES on Preschoolers’ Risk for Obesity at School-Age" (2023). CUNY Academic Works.
https://academicworks.cuny.edu/cc_etds_theses/1100