Exploring the relationship between ADHD and childhood anxiety

Over time, the relationship between ADHD and anxiety disorders has been thoroughly explored. While ADHD is one of the most common disorders in the child and adolescent population, with a prevalence ranging from 1% to 17%, anxiety disorders appear even more frequently in this group, reaching between 2% and 24%.In this regard, an interesting fact has been observed: "The association between ADHD and anxiety in the same individual is something that has been seen in one out of every three children, regardless of their sex, socioeconomic status, or context of birth, among other things." What this information boils down to is that generally, between 15% and 30% of children simultaneously suffer from both disorders, according to data published by the CADAH Foundation.

The Impact of ADHD and Childhood Anxiety

Ok, so taking a look at the aspect we mentioned earlier, we can see that girls with inattentive presentation tend to present more separation anxiety disorder more frequently.  Meanwhile, girls with combined ADHD, tend to experience more GAD, or generalized anxiety disorder. 

According to the Foundation, kids with ADHD and anxiety suffer from lower self-esteem, overachieve and seek out positive affirmation and assurance –this was certainly true in my case. In other words, these are children who are more risk-averse.

ADHD and comorbid anxiety

So, let’s diving deeper into the comorbidity of ADHD and anxiety. Let's break this down, shall we? From the research that's been done so far, it seems there are a few key points to highlight:

Cognitive Performance in Comorbid ADHD and Anxiety

While there haven't been many studies comparing cognitive performance in ADHD and comorbid anxiety, the few suggest some interesting findings. In the case of kids with the inattentive ADHD subtype, higher levels of anxiety appear actually to improve their working memory. However, anxiety doesn't seem to have the same positive influence on working memory for children with the combined ADHD subtype.

Prognosis and Progression

The prognosis is that, in cases of anxiety co-occurring with ADHD, the ADHD tends to decrease over time, while the anxiety fluctuates through adolescence and adulthood. However, if anxiety levels increase over time, the individual may evolve into a different type of anxiety disorder than what was diagnosed in childhood.

In short, the interaction between ADHD and anxiety can have some nuanced cognitive effects, and the long-term trajectory is one of shifting symptom profiles. Fascinating stuff, really – the complexity of the human mind.



Cognitive functioning

Now for the cognitive functioning aspect. Let me summarize the key points from the CADAH Foundation's insights:

Cognitive Performance in ADHD vs ADHD with Comorbid Anxiety

When comparing ADHD alone versus ADHD with co-occurring anxiety, there don't appear to be significant differences in terms of attentional capabilities. To better understand this, we need to consider the multifactorial model of working memory, which has four main components:

  • The episodic buffer: the circuit that can hold only a few topics selected by the individual, connected to spatio-temporal events.
  • The visuospatial sketchpad: the ability to think and perceive the world in images. 
  • The verbal component.
  • The central executive: the supervisory system

Gaps in Understanding the ADHD-Anxiety Relationship

As we can see, there isn't enough information yet to fully grasp the relationship between ADHD and anxiety. However, it appears in high percentages of the population, especially from childhood to adolescence, though the developments can vary over time.

To conclude, the cognitive performance similarities between ADHD alone and ADHD with comorbid anxiety are intriguing and speak to the complex interplay of working memory subcomponents. But there's still more to uncover to understand this clinical relationship fully. 

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