B-27: The Impact of Codiagnostic Status on Adaptive Functioning in a Transdiagnostic Sample of Rural Youth

Abstract

Objective: Psychiatric comorbidity is prevalent within pediatric presentations and is associated with poorer functional outcomes. However, the impact of comorbid status on adaptive functioning in rural pediatric samples remains under-studied. It was anticipated that youth experiencing codiagnostic challenges would demonstrate higher rates of adaptive impairment than those with a single diagnosis. Method/Data Selection: Archival data were analyzed from a sample of 88 rural schoolchildren (M = 13.14 years; 30.7% Female; 71.6% White) who completed psychoeducational evaluations between 2015 and 2024. Participants presented with a range of diagnoses, including specific learning disabilities, ADHD, mood disorders, anxiety disorders, and trauma/stressor related disorders. Evaluations included the completion of the Behavior Assessment System for Children, Third Edition (BASC-3) Parent Rating Scale. An independent samples t-test was performed to compare the mean Adaptive Skill Composite (ASC) between participants with one diagnosis (n = 42) and participants with codiagnostic status (n = 40). Results/Data Synthesis: Assumptions of normality and homogeneity of variance were met. As expected, the codiagnostic group demonstrated significantly lower mean adaptive functioning scores (M = 40.09, SD = 8.89) compared to those in the single diagnosis group (M = 46.23, SD = 9.51). This difference was statistically significant, t(64) = 2.71, p = .009. Conclusions: Within the study, on average, youth with one diagnosis demonstrated adaptive functioning within the average range, while youth with codiagnostic status indicated adaptive skills within the at-risk range. These findings highlight the vulnerability of codiagnostic youth to functional impairments and extend research regarding psychiatric comorbidity to a transdiagnostic rural pediatric sample.