The Influence of ADHD Traits on School Maladjustment in Middle School Students: Focusing on the Serial Mediation Effect of Daily Life Stress and Self-Esteem

Background: This study examined the influence of attention-deficit/hyperactivity disorder (ADHD) traits on school maladjustment among middle school students and investigated the mediating effects of daily life stress and self-esteem on this relationship.Methods: Data were drawn from the Korean Teenager Mental Health Survey. A total of 1,948 middle school students were analyzed using PROCESS Macro Model 6.Results: A positive association between ADHD traits and school maladjustment was observed. Self-esteem significantly mediated the relationship between ADHD traits and school maladjustment. In addition, a significant serial mediation pathway was identified: higher ADHD traits were associated with increased daily life stress, which, in turn, was associated with to lower self-esteem, ultimately leading to greater school maladjustment.Conclusions: The findings suggest that ADHD traits contribute to school maladjustment both directly and indirectly through psychological processes. In particular, the sequential pathway involving daily life stress and self-esteem highlights the importance of considering both stress experiences and self-evaluation mechanisms. Interventions aimed at reducing school maladjustment among middle school students should therefore address not only ADHD-related characteristics but also promote stress management and the enhancement of self-esteem.