Helpful family climate moderates the relationship between perceived family support of ADHD symptoms and depression: a conditional process model.

BACKGROUND: Symptoms of attention deficit hyperactivity disorder (ADHD) are commonly comorbid with depression This study aimed to examine the relationship between ADHD symptoms and depression through perceived family support and to explore whether the magnitude of the relationship depended on the type of family climate of medical students. METHODS: This cross-sectional study was conducted among 124 first year medical students in Thailand. Participants completed questionnaires on ADHD symptoms, depression, perceived family support, and 9 types of family climate. The questionnaires included the Adult ADHD Self-Report Scale Screener, Patient Health Questionnaire-9, and revised Thai Multidimensional Scale of Perceived Social Support. Mediational analysis was adopted to examine the mediating role of perceived family support in the relationship between ADHD symptoms and depression, while moderation analysis was applied to examine the extent of the relationship depending on family climate. RESULTS: The relationship between ADHD symptoms and depression was moderate. Perceived family support partially mediated this relationship after controlling for age and sex. Among the types of family climate, only helpful family climate was a significant moderator of perceived family support and depression. The moderated mediation model increased the variance in depression from 17% by the mediation model to 21%. However, follow-up conditional mediational analysis showed that the indirect effect of ADHD symptoms on depression via perceived family support was not significant and that this effect did not vary linearly as a function of helpful family climate. CONCLUSION: The findings of the study revealed that poor family support might be one risk of developing depression in the context of ADHD symptoms. Further study on providing intervention concerning family support among those with ADHD symptoms should be warranted. In addition, a study on helpful family climate in a larger sample size, in other populations, and in a longitudinal fashion for a more robust conclusion is encouraged.

Impact of Perceived Social Support on the Relationship between ADHD and Depressive Symptoms among First Year Medical Students: A Structural Equation Model Approach.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is associated with depression among college students, while perceived social support is also associated with depression, especially among young adults. This study aimed to examine to what extent perceived social support mediated the relationship between ADHD symptoms and depressive symptoms. METHODS: In total, 124 first year medical students completed the Adult ADHD Self-Report Scale Screener (ASRS), the Patient Health questionnaire-9 and the revised Thai Multidimensional scale of perceived social support reflecting ADHD symptoms, depressive symptoms, and perceive social support, i.e., family members, friends and other significant people, respectively. Structural equation modeling was used to investigate the hypothesized mediation model. RESULTS: ADHD symptoms exhibited a significant indirect effect on depressive symptoms via perceived social support. ADHD symptoms initially had a direct effect on depression; thereafter, it reduced to a non-significance effect after perceived social support was added. The total variance explained by this model was 35.2%. The mediation model with family support as a mediator showed the highest effect size. CONCLUSIONS: The study highlighted the importance of perceived social support, particularly family support, on depressive symptoms among young medical students experiencing ADHD symptoms. The model suggests promising relationships for further research on ADHD-related depression and potential treatment in the future.

Changes in character strengths after watching movies: when to use rasch analysis.

OBJECTIVE: Professionalism is a critical part of a medical education, and various activities have been proposed to enhance professionalism among medical students. Watching films is an activity to promote character related to professionalism. Limitation of such is a single group pre-posttest design raising concerns about the errors of measurement. The study aimed to demonstrate a method to deal with this design using Rasch analysis. RESULTS: This study used a pre-posttest design with 40 first year medical students. All participated in a 3-day activity that involved watching four selected movies: Twilight, Gandhi, The Shawshank Redemption and Amélie. These films offer compelling illustrations of the themes of self-regulation, humility, prudence and gratitude, respectively. All participants completed a 10-item composite scale (PHuSeG) addressing these themes before and after watching the movies. When determining who benefitted from the intervention, paired t-tests on the results of a Rasch analysis were used to evaluate changes between pre- and posttest. Using Rasch analyses, we could document the stability of the items from pre- to posttest, and significant changes at both the individual and group levels, which is a useful and practical approach for pre- and posttest design. Moreover, it helps validate the psychometric property of the instrument used.