Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Dr. Joshua Langberg


Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) are at risk for developing clinically significant sleep problems and comorbid internalizing symptoms. Physical activity (PA) has significant positive associations with a variety of health outcomes, including sleep and aspects of mental health. As such, the US Department of Health and Human Services recommends adolescents receive at least 60 minutes of moderate-to-vigorous PA (MVPA) per day. However, it is unknown whether adolescents with ADHD have different patterns of physical activity compared to their peers. Importantly, it may be that PA can serve as a buffer between ADHD symptoms and development of comorbid difficulties with sleep or internalizing symptoms. Accordingly, the first aim of the present study was to evaluate whether the PA behaviors of adolescents with ADHD differ compared to non-ADHD peers. The second aim was to evaluate whether there are bidirectional relationships between ADHD symptoms, PA, and sleep and internalizing symptoms, and explore whether PA serves as a protective factor. Results indicate that adolescents with ADHD engage in significantly less PA than their non-ADHD peers in middle school, but these differences become less pronounced following the transition to high school. There were notable presentation and sex differences in levels of adolescent PA. Adolescents with ADHD-I engaged in significantly less PA at T1 than adolescents in the comparison group, whereas adolescents with ADHD-C did not. Boys with ADHD engaged in less PA than boys without ADHD at T1 and T2, whereas sex differences largely did not emerge between girls with and without ADHD. Autoregressive cross-lagged panel models demonstrated significant associations between parent-reported sleep difficulties and symptoms of ADHD; ADHD symptoms and adolescent-reported sleep; PA and adolescent-reported sleep difficulties, symptoms of depression, and symptoms of anxiety; and symptoms of anxiety and symptoms of ADHD. Moderation analyses were not significant in the present study. Future research should examine samples of youth with higher levels and more variability of PA, greater demographic and socioeconomic diversity, and explore PA from a multidimensional perspective.


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