Mediation models were developed to examine the influence of ADHD symptom severity on functional impairment. Separate model were estimated for each independent variable (subscales from CAARS) and dependent variable (SDS scores). Mediation models estimate the indirect effects of an independent variable (in this case, ADHD symptom severity) on a dependent variable (functional impairment) after accounting for a mediator (anxiety). We used 5,000 bootstrap resamples to provide stable estimates of direct, indirect, and total effects. Confidence intervals were established using the bias-corrected and accelerated method. Mediation was tested using the Hayes40) PROCESS modeling approach in model 4 of IBM SPSS Statistics software version 21.0 (IBM Co., Armonk, NY, USA). This analytic approach permitted the examination of both direct and indirect effects of ADHD symptom severity and anxiety on functional impairment in subjects with adult ADHD.
All tests were two-tailed, and alpha level was set at 0.05 for all analyses. We calculated all statistics using IBM SPSS Statistics software version 21.0.