Co-Occurring Autism and ADHD as Predictors of Adolescent Psychopathological Tendencies: Basis for Psychoeducational Intervention
DOI:
https://doi.org/10.69569/jip.2026.405Keywords:
Attention-Deficit/Hyperactivity Disorder, Adolescents, Autism Spectrum Disorder, Co-occurring conditions, Psychopathological tendenciesAbstract
This study examined whether co-occurring autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) predict psychopathological tendencies among adolescents and how the findings may inform a psychoeducation and intervention program. However, limited local research has examined how co-occurring ASD and ADHD relate to a broad range of psychopathological, treatment-related, and interpersonal outcomes among Filipino adolescents, particularly in interdisciplinary settings. Guided by the Developmental Psychopathology framework, the study conceptualized adolescent psychopathological tendencies as outcomes shaped by the interaction of neurodevelopmental characteristics and psychosocial contexts. A quantitative predictive-correlational design was used with 391 adolescents diagnosed with co-occurring ASD and ADHD from an interdisciplinary institution in Sta. Maria, Bulacan. Standardized instruments were used to measure ASD traits, ADHD symptoms, and psychopathological tendencies, while descriptive statistics and multiple linear regression were used for analysis. Results showed that most respondents were classified within high ASD and ADHD probability ranges. Most psychopathological tendencies were within average or low ranges; however, mild anxiety and depression, high borderline traits, moderate stress and nonsupport, and high treatment rejection emerged as areas of concern. Regression findings indicated that ASD and ADHD were weak predictors of most clinical outcomes, suggesting that psychopathological tendencies cannot be attributed to neurodevelopmental symptoms alone. However, ASD significantly and positively predicted nonsupport and strongly predicted treatment rejection. These findings contribute to theory and practice by showing that treatment engagement and perceived support may be particularly important intervention targets among adolescents with co-occurring ASD and ADHD. The study supports the development of structured, adolescent-centered psychoeducation programs focused on emotional regulation, social support, family-school collaboration, and treatment engagement. The study's distinctive contribution is its focus on intervention readiness: instead of treating co-occurring ASD and ADHD as a broad explanation for all psychopathological tendencies, the findings identify perceived nonsupport and treatment rejection as priority targets for adolescent-centered psychoeducation and coordinated family-school support.
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References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing.
Benallie, K., Brunson McClain, M., Bakner, K.E., Roanhorse, T., & Ha, J. (2021). Executive functioning in children with ASD + ADHD and ASD + ID: A systematic review. Research in Autism Spectrum Disorders, 83, Article 101807. https://doi.org/10.1016/j.rasd.2021.101807
Canals, J., Morales-Hidalgo, P., Voltas, N., & Hernandez-Martinez, C. (2024). Prevalence of comorbidity of autism and ADHD and associated characteristics in school population: EPINED study. Autism Research, 17(6), 1276-1286. https://doi.org/10.1002/aur.3146
Casseus, M., Kim, W.J., & Horton, D. (2022). Prevalence of co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder among children in the United States. Autism, 26(6), 1591–1597. https://doi.org/10.1177/13623613221083279
Casseus, M., Kim, W.J., & Horton, D. (2023). Prevalence and treatment of mental, behavioral, and developmental disorders in children with co-occurring autism spectrum disorder and attention-deficit/hyperactivity disorder: A population-based study. Autism Research, 16(4), 855–867. https://doi.org/10.1002/aur.2894
Charles, N., Cowell, W., & Gulledge, L. (2022). Using the Personality Assessment Inventory-Adolescent in legal settings. Journal of Personality Assessment, 104(2), 192–202. https://doi.org/10.1080/00223891.2021.2019050
Cicchetti, D., & Rogosch, F.A. (2002). A developmental psychopathology perspective on adolescence. Journal of Consulting and Clinical Psychology, 70(1), 6–20. https://doi.org/10.1037/0022-006X.70.1.6
Danielson, M., Claussen, A., Bitsko, R., Katz, S., Newsome, K., Blumberg, S., Kogan, M., & Ghandour, R. (2024). ADHD prevalence among U.S. children and adolescents in 2022: Diagnosis, severity, co-occurring disorders, and treatment. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2024.2335625
Faraone, S.V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M.A., Newcorn, J.H., Gignac, M., Al Saud, N.M., Manor, I., Rohde, L.A., Yang, L., Cortese, S., Almagor, D., Stein, M.A., Albatti, T.H., Aljoudi, H.F., Alqahtani, M.M.J., Asherson, P., ... Wang, Y. (2021). Attention-deficit/hyperactivity disorder. Nature Reviews Disease Primers, 7, Article 16.
Geannopoulos, Z., Moody, C., McGregor, H., Baertschi, D., Bates, S., & Laugeson, E. (2024). Outcomes in PEERS for adolescents across neurodevelopmental disorders: ADHD, autism, and their co-occurrence. Advances in Neurodevelopmental Disorders, 8, 614–626. https://doi.org/10.1007/s41252-023-00380-z
Gilliam, J.E. (2014). Gilliam Autism Rating Scale (3rd ed.). Pro-Ed.
Gilliam, J.E. (2015). Attention-Deficit/Hyperactivity Disorder Test (2nd ed.). Pro-Ed.
Hours, C., Recasens, C., & Baleyte, J.-M. (2022). ASD and ADHD comorbidity: What are we talking about? Frontiers in Psychiatry, 13, Article 837424. https://doi.org/10.3389/fpsyt.2022.837424
Karren, B.C. (2017). A review of the Gilliam Autism Rating Scale-Third Edition. Journal of Psychoeducational Assessment, 35(3), 342–346.
Leachman, C., Nichols, E., Al-Saoud, S., & Duerden, E. (2024). Anxiety in children and adolescents with autism spectrum disorder: Behavioural phenotypes and environmental factors. BMC Psychology, 12, Article 606. https://doi.org/10.1186/s40359-024-02044-6
Mannuzza, S., Klein, R., Abikoff, H., & Moulton, J., III. (2004). Significance of childhood conduct problems to later development of conduct disorder among children with ADHD: A prospective follow-up study. Journal of Abnormal Child Psychology, 32(5), 565–573. https://doi.org/10.1023/B:JACP.0000037784.80885.1a
Martinez, S., Stoyanov, K., & Carcache, L. (2024). Unraveling the spectrum: Overlap, distinctions, and nuances of ADHD and ASD in children. Frontiers in Psychiatry, 15, Article 1387179. https://doi.org/10.3389/fpsyt.2024.1387179
Morey, L.C. (2007). Personality Assessment Inventory-Adolescent professional manual. Psychological Assessment Resources.
Mutluer, T., Aslan Genc, H., Ozcan Morey, A., Yapici Eser, H., Ertinmaz, B., Can, M., & Munir, K. (2022). Population-based psychiatric comorbidity in children and adolescents with autism spectrum disorder: A meta-analysis. Frontiers in Psychiatry, 13, Article 856208. https://doi.org/10.3389/fpsyt.2022.856208
Orm, S., Lydersen, S., Vatne, T., Wentzel-Larsen, T., Bains, K.E.S., & Hjemdal, O. (2021). Declining trajectories of co-occurring psychopathology symptoms in attention-deficit/hyperactivity disorder and autism spectrum disorder: A 10-year longitudinal study. Frontiers in Psychiatry, 12, Article 724759. https://doi.org/10.3389/fpsyt.2021.724759
Pemovska, T., Loizou, S., Appleton, R., Spain, D., Stefanidou, T., Kular, A., Cooper, R., Greenburgh, A., Griffiths, J., Barnett, P., Foye, U., Baldwin, H., Minchin, M., Brady, G., Saunders, K.R.K., Ahmed, N., Jackson, R., Olive, R.R., Parker, J., Timmerman, A., Sapiets, S., Driskell, E., Chipp, B., Parsons, B., Totsika, V., Mandy, W., Pender, R., Clery, P., Lloyd-Evans, B., Simpson, A., & Johnson, S. (2024). Approaches to improving mental health care for autistic children and young people: A systematic review and meta-analysis. Psychological Medicine, 54(10), 2313–2343. https://doi.org/10.1017/S0033291724001089
Perdue, N.H. (2016). Review of the Attention-Deficit/Hyperactivity Disorder Test-Second Edition. Journal of Psychoeducational Assessment, 34(4), 404–406.
Rosenau, K., et al. (2024). Meta-analysis of psychotherapy for autistic youth. Child Psychiatry & Human Development. https://doi.org/10.1007/s10578-024-01686-2
Shochet, I., Saggers, B., Carrington, S., Orr, J., Duncan, B., & Smith, C.L. (2022). A school-based approach to building resilience and mental health among adolescents on the autism spectrum: A longitudinal mixed methods study. School Mental Health, 14, 753–775. https://doi.org/10.1007/s12310-022-09501-w
Sultan, R., Liu, S.-M., Hacker, K., & Olfson, M. (2021). Adolescents with attention-deficit/hyperactivity disorder: Adverse behaviors and comorbidity. Journal of Adolescent Health, 68(2), 284–291. https://doi.org/10.1016/j.jadohealth.2020.09.036
Thapar, A., Riglin, L., & Lundstrom, S. (2023). Practitioner review: Attention-deficit/hyperactivity disorder and autism spectrum disorder - the importance of depression. Journal of Child Psychology and Psychiatry, 64(1), 4–15. https://doi.org/10.1111/jcpp.13678
Viksveen, P., Bjønness, S.E., Cardenas, N.E., Game, J.R., Berg, S.H., Storm, M., & Aase, K. (2024). Adolescents' involvement in mental health treatment and service design: A systematic review. BMC Health Services Research, 24, Article 1384. https://doi.org/10.1186/s12913-024-11892-2
Wang, S., et al. (2025). Rates of depression in children and adolescents with ADHD: A systematic review and meta-analysis. Journal of Attention Disorders.
Wiggins, L., Daniels, J., Overwyk, K., Croen, L., DiGuiseppi, C., Bradley, C., Powell, P., Dichter, G., Moody, E., & Pazol, K. (2024). Depressive symptoms and activity engagement in autistic adolescents and those with other developmental disabilities. Disability and Health Journal, 17(3), Article 101633. https://doi.org/10.1016/j.dhjo.2024.101633
World Health Organization. (2025). Adolescent mental health. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
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