Author ORCID Identifier

Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Arts and Sciences



First Advisor

Dr. Richard Milich


Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent and impairing childhood disorders (5%; American Psychiatric Association, 2013), yet it is often studied in isolation. Such an approach is at odds with the clinical reality, where ADHD has a high comorbidity with oppositional defiant disorder, anxiety, and depression (Jensen, Martin, & Cantwell, 1997). Based on the possible presentations of ADHD with both externalizing and internalizing symptoms, there may be differences in associated characteristics, areas of impairment, and resulting assessment interventions. Therefore, the present study investigated how ADHD comorbidities manifested in a population of 233 elementary age children and how these profiles varied in already established characteristics (i.e., traits, social behaviors) and areas of deficit for children with ADHD (i.e., social functioning, academics, narrative comprehension). Characteristics and outcomes were examined using rating scales, behavior observations, laboratory tasks, and grades. Based on latent profile analyses, different patterns of comorbidity were identified using both parent and teacher ratings of ADHD. Based on parent and teacher report, those with high ADHD/ODD symptoms had more negative characteristics and outcomes. Network analyses corroborated these results, showing that internalizing symptoms were less relevant for associated characteristics and outcomes compared to ADHD and ODD symptoms. Overall, these results suggest that ADHD comorbidities may be primarily driven by ADHD and ODD symptoms, with this profile displaying more severe negative characteristics and outcomes.

Digital Object Identifier (DOI)