Association of externalizing behavior disorder symptoms and injury among fifth graders.

Academic Article

Abstract

  • OBJECTIVE: Injury is the leading cause of death among American youth, killing more 11-year-olds than all other causes combined. Children with symptoms of externalizing behavior disorders such as attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) may have increased risk. Our aims were to determine: (1) whether increasing symptoms of ADHD and CD associate positively with injuries among a community sample of fifth graders; and (2) whether symptoms of ADHD and CD have a multiplicative rather than additive association with injuries among the sample. METHODS: Data were collected from 4745 fifth graders and their primary caregivers participating in Healthy Passages, a multisite, community-based study of pediatric health risk behaviors and health outcomes. The primary outcome was injury frequency. Primary independent variables were ADHD and CD symptoms. Additional covariates included gender, race/ethnicity, and household income. Ordinal logistic regression examined correlates of injury frequency. The interaction between ADHD and CD symptoms also was examined. RESULTS: In bivariate analyses, the odds of injury increased as ADHD symptoms (odds ratio [OR] 1.29; 95% confidence interval [95% CI] 1.18-1.41) and CD symptoms (OR 1.18; 95% CI 1.07-1.31) increased. However, in multivariate analysis, only ADHD symptoms were significantly associated with injury (OR 1.22; 95% CI 1.10-1.35). There was no statistically significant interaction between ADHD and CD symptoms. CONCLUSIONS: ADHD symptoms are associated with increased odds of injury in fifth graders. Findings have implications for potential injury prevention strategies for mental health practitioners (for example, cognitive training with at-risk youth), pediatricians (ADHD screening), and parents (improved supervision).
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    Published In

    Keywords

  • Age Factors, Attention Deficit Disorder with Hyperactivity, Case-Control Studies, Child, Conduct Disorder, Female, Humans, Male, Risk Factors, Wounds and Injuries
  • Digital Object Identifier (doi)

    Author List

  • Schwebel DC; Roth DL; Elliott MN; Visser SN; Toomey SL; Shipp EM; Grunbaum JA; Schuster MA
  • Start Page

  • 427
  • End Page

  • 431
  • Volume

  • 11
  • Issue

  • 5