Mental Health and Physical Activity in Canadian Adolescents with Attention Deficit Hyperactivity Disorder
Background: Adolescents with attention deficit hyperactivity disorder (ADHD) are at a heightened risk for poor mental health. Limitations of medication use for the treatment of ADHD include non-response and adverse side effects. Physical activity has shown promise for such treatments through the alleviation of the direct symptoms of ADHD, as well as the fostering of positive mental health. However, the contexts in which physical activity occurs in youth with ADHD and impacts upon their mental health have not been thoroughly explored. Objectives: The objectives of this thesis are to: 1) describe the prevalence of positive and negative mental health indicators in Canadian youth with ADHD and compare the prevalence of these indicators to Canadian youth without ADHD, 2) estimate the strength and statistical significance of associations between different types of physical activity and mental health indicators in adolescents with ADHD, and; 3) examine the potential influence of biological sex and age in these relationships. Methods: Data from the 7th cycle of the Health Behaviour in School-aged Children (HBSC) study was used. Prevalence estimates were calculated for each mental health indicator by ADHD status. Rao-Scott chi-square tests were conducted to examine group differences. Multi-level log binomial regression models were developed to explore the associations of interest. Results: Canadian adolescents with ADHD reported poorer mental health than Canadian adolescents without ADHD. Within the ADHD population, females reported a higher prevalence of negative mental health indicators than males. Inconsistent patterns were found between engagement in different types of physical activities and mental health in youth with ADHD. The main potential etiological finding was that engagement in physical activity in certain contexts was associated with high prosocial behaviour in adolescents with ADHD. Conclusions: Identification of different mental health patterns in males and females in the ADHD population suggests the possibility of differential diagnoses of ADHD by biological sex. Physical activity in different contexts may have differential effects on the mental health of young people with ADHD. Understanding of these relationships could help inform public health to develop physical activity interventions that are the most effective in this subpopulation of youth.