TY - JOUR
T1 - Moderate-to-Vigorous Physical Activity and Psychiatric Symptoms in Children with ADHD
T2 - Exploring the Mediating Role of Gross Motor Performance
AU - Tao, Ruiyuan
AU - Yang, Yijian
AU - Wong, Stephen Heung-Sang
AU - Huang, Wendy Y
AU - Siu, Parco Ming-Fai
AU - Tsai, Chia-Liang
AU - Wong, Savio Wai-Ho
AU - Sit, Cindy Hui-Ping
N1 - This study was funded by the Research Grants Council of Hong Kong, General Research Fund (No.14612122).
Copyright © 2025 by the American College of Sports Medicine.
PY - 2025/7/1
Y1 - 2025/7/1
N2 - OBJECTIVE: To examine whether gross motor performance mediated the association between physical activity and psychiatric symptoms in children with Attention-Deficit/Hyperactivity Disorder (ADHD), and whether these effects would be moderated by individual characteristics.METHODS: Seventy-six children with ADHD aged 6-12 years were included in this cross-sectional study. Moderate-to-vigorous physical activity (MVPA) was assessed by a wrist-worn ActiGraph GT9X accelerometer for seven consecutive days. Parents self-reported their children's psychiatric symptoms, including both internalizing and externalizing symptoms, via the Chinese version of the parent informant Child Behavior Checklist. Gross motor performance, including object control and balance, was measured by the Movement Assessment Battery for Children Second Edition. Mediation and moderation effects were performed by Hayes PROCESS macro for R.RESULTS: MVPA was positively correlated with object control and negatively associated with withdrawn and anxious/depressed symptoms. Both object control and balance showed negative correlations with anxious/depressed symptoms. Object control was also negatively correlated with withdrawn symptoms and aggressive behavior. Through the bootstrapping method, the indirect effect of object control (indirect effect = -0.081, 95%CI = -0.171 to -0.007) was found between MVPA and anxious/depressed symptoms. Additionally, this association was more pronounced in younger children with ADHD compared to their older counterparts (index of moderated mediation = 0.055, 95% CI: 0.005 to 0.150).CONCLUSIONS: Object control mediated the association between MVPA and anxious/depressed symptoms in children with ADHD. Future physical activity interventions are suggested to emphasize the early development of gross motor skills through moderate-to-vigorous intensity activities to help reduce internalizing symptoms in this population.
AB - OBJECTIVE: To examine whether gross motor performance mediated the association between physical activity and psychiatric symptoms in children with Attention-Deficit/Hyperactivity Disorder (ADHD), and whether these effects would be moderated by individual characteristics.METHODS: Seventy-six children with ADHD aged 6-12 years were included in this cross-sectional study. Moderate-to-vigorous physical activity (MVPA) was assessed by a wrist-worn ActiGraph GT9X accelerometer for seven consecutive days. Parents self-reported their children's psychiatric symptoms, including both internalizing and externalizing symptoms, via the Chinese version of the parent informant Child Behavior Checklist. Gross motor performance, including object control and balance, was measured by the Movement Assessment Battery for Children Second Edition. Mediation and moderation effects were performed by Hayes PROCESS macro for R.RESULTS: MVPA was positively correlated with object control and negatively associated with withdrawn and anxious/depressed symptoms. Both object control and balance showed negative correlations with anxious/depressed symptoms. Object control was also negatively correlated with withdrawn symptoms and aggressive behavior. Through the bootstrapping method, the indirect effect of object control (indirect effect = -0.081, 95%CI = -0.171 to -0.007) was found between MVPA and anxious/depressed symptoms. Additionally, this association was more pronounced in younger children with ADHD compared to their older counterparts (index of moderated mediation = 0.055, 95% CI: 0.005 to 0.150).CONCLUSIONS: Object control mediated the association between MVPA and anxious/depressed symptoms in children with ADHD. Future physical activity interventions are suggested to emphasize the early development of gross motor skills through moderate-to-vigorous intensity activities to help reduce internalizing symptoms in this population.
KW - Internalizing Symptoms
KW - Neurodiverse Children
KW - Object Control
KW - Physical Activity
UR - https://www.scopus.com/pages/publications/105010351900
U2 - 10.1249/MSS.0000000000003810
DO - 10.1249/MSS.0000000000003810
M3 - Journal article
C2 - 40590676
SN - 0195-9131
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
ER -