BMC Psychiatry (Aug 2025)
Identifying resilience promoting factors and sex differences in youth with ADHD across the transition to middle school
Abstract
Abstract Background Despite extensive research on risk factors contributing to functional impairment in youth with attention-deficit/hyperactivity disorder (ADHD), there is considerable heterogeneity in outcomes. Some youth experience significant wide-ranging impairments, others experience impairment in specific domains (e.g., academics, social relationships), and still others avoid long-term negative effects. Most existing studies focus on deficits, overlooking strength-based factors that may contribute to positive outcomes for youth with ADHD. A risk-resilience framework offers a valuable approach to identifying promotive and protective mechanisms for youth with ADHD, particularly during the critical developmental transition from elementary school to middle school. Yet research remains limited by cross-sectional methods, small samples, and a failure to consider sex differences in factors supporting well-being. Methods This study protocol describes the background and method for a prospective observational study – Resilience in Student Education (RISE) – examining individual and social-contextual resilience promoting mechanisms among youth with ADHD from fifth grade through seventh grade, with an added focus on the potentially moderating role of sex in understanding associations between resilience promotive and protective factors for functional outcomes among youth with ADHD. Discussion This study also includes formation and engagement of a Youth Advisory Board of adolescents with ADHD (8th-12th grades) to ensure lived experience is incorporated in study measurement, participant engagement/retention, and dissemination of findings with an eye towards how identified promotive and protective factors can be incorporated into interventions to support the well-being of youth with ADHD.
Keywords
