Longitudinal bidirectional effects between ADHD and education performance: a new RI-CLPM model with instrumental variables

Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder with significant implications for educational attainment. Previous research has established a bidirectional relationship between ADHD symptoms and academic outcomes, but the underlying mechanisms remain poorly understood. This study employs a novel Random Intercept Cross-Lagged Panel Model (RI-CLPM) incorporating instrumental variables to improve precision of bidirectional effects estimation between ADHD and educational performance. Utilizing a large, longitudinal dataset from the Adolescent Brain and Cognitive Development Study (ABCD Study ® ), we examine the reciprocal influences between ADHD symptoms and academic achievement across multiple time points. Our findings reveal significant within-wave bidirectional effects, with ADHD symptoms negatively impacting subsequent academic attainment, and poor academic outcomes exacerbating ADHD symptoms over time. These results underscore the need for integrated interventions targeting both ADHD symptoms and academic support.