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Abstract

Introduction: Attention-deficit/ hyperactivity-disorder (ADHD) is a neurodevelopmental disorder with a lifetime prevalence rate of 8.7% (Centers for Disease Control and Prevention, 2022). Numerous previous studies have exhibited how ADHD can be debilitating with both symptoms and impairments, but Black youth remain understudied (Green et al., 2024). To add, ADHD may present differently depending on one’s gender (Young et al. 2020), and bias has been shown to influence ratings of someone’s ADHD symptoms (Fairman et al., 2020). To combat these health disparities seen within the literature, this study aimed to describe attention problems in Black youth and to investigate whether attention problems or gender were a predictor of internalizing or externalizing comorbidities.

Methods: Participants were 299 Black youth (Mage = 10.76 years, SDage = 3.70, 51.3% female, 81.6% receiving Medicaid) who presented with their caregivers to the Southeastern United States integrated pediatric primary care clinic for mental health concerns. Participants’ caregivers completed the Pediatric Symptom Checklist-17 (PSC-17; Gardner et al., 1999) and demographic information at the clinic. The PSC-17 collects caregiver concerns about youth mental health symptoms across three subscales: attention, internalizing, and externalizing problems. This study is a secondary data analysis of a larger study on the treatment of mental health problems in youth presenting to integrated pediatric primary care.

Results: In the total sample, the mean attention problems score was 6.28 (SD = 2.56), with 52.8% of the sample being rated above the clinical cut-off for the subscale (i.e., in need of treatment for attention problems). Additionally, in the total sample of Black youth, attention problems significantly predicted externalizing problems (B = .559, p.05). Finally, there were gender differences in severity, such that Black males were more likely to have been rated above the clinical cut-off for attention problems than females Χ2 (2, N = 297) = 17.29, p

Discussion: In the current sample of Black youth, boys scored higher on the PSC-17 for externalizing and attention problems, aligning with previous research. However, the girls in the sample scored higher than what was found in the literature on the PSC-17 across all domains, which contradicts previous research stating that girls are more likely to only experience internalizing comorbidities. Limitations of the study included the lack of diagnostic data. For future directions, prevention programs should be set in place with this study’s findings in mind to help mediate symptoms and impairments.

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