New Review Shows Links Between Bullying and Depression in Youth with ADHD

Simmons, J. A., & Antshel, K. M. (2020). Bullying and depression in youth with ADHD: A systematic review. Child & Youth Care Forum, 50(3), 379–414.

Introduction

Youth bullying, declared a public health issue by the CDC, has a prevalence rate of 19%, with depression affecting over 11% of youth in the United States. ADHD, a neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity, is independently linked to increased risks for both bullying involvement and depression. Despite these overlaps, the tripartite relationship among ADHD, bullying, and depression has remained underexplored. Simmons and Antshel (2024) review and synthesize findings across these three constructs, evaluate methodological robustness, and propose future research directions.

Methods

This systematic review included 13 studies published between 2007 and 2020, selected through a rigorous screening of peer-reviewed literature. Eligible studies assessed bullying involvement and depressive symptoms among youth diagnosed with ADHD, considering quantitative designs that measured ADHD using validated instruments and accounted for comorbidities like Oppositional Defiant Disorder (ODD).

Data extraction focused on sample characteristics, study design, ADHD assessment, and metrics for bullying and depression.

Results

The review revealed consistent positive associations between ADHD, bullying involvement, and depression across studies. Bullying served as both a mediator and moderator, depending on the theoretical lens applied. ADHD traits such as impulsivity and poor emotion regulation predisposed youth to victimization or perpetration, amplifying their risk for depression. Notably, bullying involvement increased depressive symptoms more prominently in adolescents than in children, underscoring developmental variations.

Longitudinal findings indicated that among female adolescents, bullying victimization mediated the ADHD-depression link. For males, relational victimization was the primary predictor of depressive outcomes. Protective factors, such as social acceptance, attenuated these risks, highlighting the need for relational supports.

Methodological inconsistencies included diverse bullying definitions and measures, insufficient consideration of bully-victim dynamics, and a lack of nuanced gender analyses. These gaps limited the generalizability and strength of conclusions.

Discussion

This review underscores the dual role of bullying as both a consequence and amplifier of ADHD-related vulnerabilities, situating it within the diathesis-stress model. Youth with ADHD experience compounded risks due to social impairments and heightened emotional sensitivity, creating a feedback loop of victimization and depressive symptoms. Interventions targeting these pathways could disrupt the progression to comorbid depression.

The findings also validate the mediational role of bullying in ADHD-depression relationships, particularly for relational victimization during adolescence. However, the limited longitudinal data necessitate further exploration of causality.

Implications for Mentoring Programs

Mentoring programs for youth with ADHD must integrate strategies to reduce bullying involvement and enhance emotional resilience. Training mentors to recognize signs of victimization and foster social skills can mitigate relational conflicts. Mentors can also model emotion regulation and coping strategies, addressing core ADHD vulnerabilities.

Furthermore, programs should prioritize relational continuity, matching youth with mentors who provide consistent support. Incorporating psychoeducation on ADHD-related challenges and leveraging peer mentorship models can create protective networks, reducing isolation and stigma. Research-informed practices, emphasizing social acceptance and bullying prevention, hold promise for addressing the interconnected challenges of ADHD, bullying, and depression.

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