Potential Overshadowing of Anxiety in School-Aged Students Diagnosed with Attention-Deficit/Hyperactivity Disorder

Leeann Trimarchi, Fordham University


ADHD and anxiety disorders are two of the most prevalent psychiatric diagnoses reported in childhood (CDC, 2016), and their notable overlap in symptom presentation makes them vulnerable to diagnostic overshadowing. Diagnostic overshadowing is a clinician bias made in response to more obvious client characteristics, leading to overlooked diagnoses. Ensuring proper diagnosis of childhood mental health disorders is key, as misdiagnosis has been seen to negatively impact students’ functioning. The current study explored potential diagnostic overshadowing of anxiety among students (N = 80) diagnosed with ADHD but not an anxiety disorder. Student self-reported anxiety levels (on the MASC 2-SR), and self- and parent- reports of treatments received by the student, were used to evaluate (a) potential evidence of clinical overshadowing and (b) the treatment experiences among students in this population. Results indicated that a significant percentage of students (40%) reported symptoms that met criteria for an anxiety disorder. No significant gender difference was found in self-reported anxiety classifications. A comparison of parent and student reports of treatments suggested considerable overlap; all students and parents reported at least one non-pharmacological treatment associated with ADHD. Parent reports of anxiety treatments were not statistically related to the student’s current anxiety level. The relationship between student reports of anxiety treatments and their current anxiety level was not significant; however, results warrant further investigation.

Subject Area

Psychology|School counseling|Clinical psychology

Recommended Citation

Trimarchi, Leeann, "Potential Overshadowing of Anxiety in School-Aged Students Diagnosed with Attention-Deficit/Hyperactivity Disorder" (2021). ETD Collection for Fordham University. AAI28495467.