Mediating Role of Emotional Symptoms in the Association Between Core ADHD Symptoms and Social Impairment in Children
Abstract
Yue Ma,1,2 Yonghua Cui,3 Nan Song,4 Hairong Liu,2 Jiajia Gao,2 Hongmei Duan1 1School of Nursing, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 2Department of Nursing, Shunyi Maternal and Children’s Hospital of Beijing Children’s Hospital, Beijing, 101300, People’s Republic of China; 3Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Healthy, Beijing, 100101, People’s Republic of China; 4Department of Nursing, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Healthy, Beijing, 100101, People’s Republic of ChinaCorrespondence: Hongmei Duan, School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuan East Road Chaoyang District, Beijing, 100029, People’s Republic of China, Tel +86 10 53912281, Email [email protected]: This study aimed to examine whether emotional symptoms mediate the association between core symptoms of attention-deficit/hyperactivity disorder (ADHD) and social impairment in children.Methods: In this cross-sectional study, 403 children diagnosed with ADHD were recruited through convenience sampling from the psychiatry and psychology outpatient clinics of a tertiary Grade A hospital in Beijing between January and November 2024. Data were collected using a general demographic questionnaire, the Swanson, Nolan and Pelham, Version IV Scale–Parent Form Parent Rating Scale, the Strengths and Difficulties Questionnaire Emotional Symptoms Subscale (Parent Version), and the Weiss Functional Impairment Rating Scale–Parent Report. After adjustment for relevant covariates, structural equation modeling combined with bootstrapping procedures was applied to evaluate the mediating effect of emotional symptoms.Results: Core behavioral symptoms of ADHD, emotional symptoms, and social impairment demonstrated significant positive correlations (all p < 0.01). Emotional symptoms partially mediated the association between core behavioral symptoms and social impairment. The indirect effect was 0.25 (95% CI: 0.19– 0.33), accounting for 22.69% of the total effect.Conclusion: Emotional symptoms represent a significant mediating factor in the social impairment experienced by children with ADHD, suggesting a pathway linking ADHD symptoms, emotional difficulties, and functional outcomes. These findings contribute to a more precise understanding of whether improvements in behavioral symptoms correspond to functional recovery. The results indicate that clinical nursing practice should extend beyond behavior-focused management to incorporate assessment and intervention addressing both behavioral and emotional symptoms. Integrating structured emotional symptom management into comprehensive nursing care may improve social functioning in children with ADHD.Keywords: attention deficit hyperactivity disorder, children, emotional symptoms, mediating effect, nursing management research, social functioning
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BibTeX
@article{ma2026mediating,
title = {{Mediating Role of Emotional Symptoms in the Association Between Core ADHD Symptoms and Social Impairment in Children}},
author = {Ma Y and Cui Y and Song N and Liu H and Gao J and Duan H},
journal = {Neuropsychiatric Disease and Treatment},
year = {2026},
month = nov,
url = {https://www.dovepress.com/mediating-role-of-emotional-symptoms-in-the-association-between-core-a-peer-reviewed-fulltext-article-NDT},
note = {CC BY},
}
RIS
TY - JOUR
TI - Mediating Role of Emotional Symptoms in the Association Between Core ADHD Symptoms and Social Impairment in Children
AU - Ma Y
AU - Cui Y
AU - Song N
AU - Liu H
AU - Gao J
AU - Duan H
PY - 2026
DA - 2026/11/08
JO - Neuropsychiatric Disease and Treatment
UR - https://www.dovepress.com/mediating-role-of-emotional-symptoms-in-the-association-between-core-a-peer-reviewed-fulltext-article-NDT
AB - Yue Ma,1,2 Yonghua Cui,3 Nan Song,4 Hairong Liu,2 Jiajia Gao,2 Hongmei Duan1 1School of Nursing, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 2Department of Nursing, Shunyi Maternal and Children’s Hospital of Beijing Children’s Hospital, Beijing, 101300, People’s Republic of China; 3Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Healthy, Beijing, 100101, People’s Republic of China; 4Department of Nursing, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Healthy, Beijing, 100101, People’s Republic of ChinaCorrespondence: Hongmei Duan, School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuan East Road Chaoyang District, Beijing, 100029, People’s Republic of China, Tel +86 10 53912281, Email [email protected]: This study aimed to examine whether emotional symptoms mediate the association between core symptoms of attention-deficit/hyperactivity disorder (ADHD) and social impairment in children.Methods: In this cross-sectional study, 403 children diagnosed with ADHD were recruited through convenience sampling from the psychiatry and psychology outpatient clinics of a tertiary Grade A hospital in Beijing between January and November 2024. Data were collected using a general demographic questionnaire, the Swanson, Nolan and Pelham, Version IV Scale–Parent Form Parent Rating Scale, the Strengths and Difficulties Questionnaire Emotional Symptoms Subscale (Parent Version), and the Weiss Functional Impairment Rating Scale–Parent Report. After adjustment for relevant covariates, structural equation modeling combined with bootstrapping procedures was applied to evaluate the mediating effect of emotional symptoms.Results: Core behavioral symptoms of ADHD, emotional symptoms, and social impairment demonstrated significant positive correlations (all p < 0.01). Emotional symptoms partially mediated the association between core behavioral symptoms and social impairment. The indirect effect was 0.25 (95% CI: 0.19– 0.33), accounting for 22.69% of the total effect.Conclusion: Emotional symptoms represent a significant mediating factor in the social impairment experienced by children with ADHD, suggesting a pathway linking ADHD symptoms, emotional difficulties, and functional outcomes. These findings contribute to a more precise understanding of whether improvements in behavioral symptoms correspond to functional recovery. The results indicate that clinical nursing practice should extend beyond behavior-focused management to incorporate assessment and intervention addressing both behavioral and emotional symptoms. Integrating structured emotional symptom management into comprehensive nursing care may improve social functioning in children with ADHD.Keywords: attention deficit hyperactivity disorder, children, emotional symptoms, mediating effect, nursing management research, social functioning
SN - 1178-2021
ER -