Knowledge Bank

Background: There are currently 12.5 million children in the United States living in food insecure households, yet the psychiatric consequences of this public health crisis are not well documented. Early childhood exposure to environmental stressors related to food insecurity could be associated with predisposing or exacerbating mood dysregulation symptoms in children.

Purpose: The purpose of this cross-sectional study is to explore the relationship of food insecurity with Attention-Deficit Hyperactivity Disorder (ADHD) symptoms and co-occurring mood dysregulation symptoms in a pediatric population.

Study Design and Methodology: Data was collected as part of baseline assessments for the “Multi-nutrients for ADHD Youth” (MADDY) Study, a multi-site randomized placebo-controlled trial investigating the efficacy of a multi-nutrient supplement in reducing ADHD symptom severity among children ages 6-12 years (N=135). Household food insecurity was ascertained using the 18-Item US Household Food Security Survey Module (USHFSSM). Children’s ADHD and mood dysregulation symptoms were assessed using the Child and Adolescent Symptom Inventory-5 (CASI-5) questionnaire.

Results: Preliminary trends from baseline data (n= 45) show that the prevalence of household food insecurity is 11.1%, which is close to the national prevalence of 11.8%. Children in food insecure households scored significantly higher on measures for Oppositional Defiant Disorder (ODD) (p-value = 0.002) and Disruptive Mood Dysregulation Disorder (DMDD) symptoms (p-value = 0.013) versus children in food secure households.

Conclusions: Childhood experience of food insecurity is associated with increased severity of mood dysregulation symptoms in a pediatric ADHD population. The direction and magnitude of this relationship will be explored in additional analysis upon study completion. If these trends are maintained in the total sample, future public health interventions addressing food insecurity may be needed to help alleviate the severity of mood dysregulation symptoms in this population. Additionally, pediatric health care providers could routinely assess hunger and food insecurity status in combination with ADHD assessments.