Psychological markers associated with ADHD symptom-risk classification among adolescents in Uzbekistan: a school-based cross-sectional study

Abstract Background School-based screening can identify adolescents who show elevated attention-deficit/hyperactivity disorder (ADHD) symptom risk and may benefit from further psychological assessment or support. However, screening studies are difficult to interpret when risk classification procedures, informant sources, and analytic workflows are not fully described. This study examined psychological markers associated with high ADHD symptom-risk classification among adolescents in Uzbekistan, an underrepresented Central Asian school context. Methods A cross-sectional school-based study was conducted in three state general education schools in Tashkent, Uzbekistan. The final analytic sample included 1,512 adolescents aged 12–14 years in grades 7–8. ADHD symptom risk was classified using a study-specific multi-informant screening procedure based on adolescent, parent/legal guardian, and teacher forms. The classification was used for research screening only and was not a clinical ADHD diagnosis. Adolescents completed self-report measures of emotional intelligence, self-regulation, coping strategies, and perceived social support. Descriptive statistics, χ² tests, transparent candidate-variable comparisons, and binary logistic regression were used. The primary regression compared adolescents currently classified as high risk with those classified as medium risk. Results Low ADHD symptom risk was identified in 1,152 adolescents (76.19%), medium risk in 255 adolescents (16.87%), and high risk in 105 adolescents (6.94%; 95% CI 5.77–8.34). Risk level was not significantly associated with sex (χ²(2) = 0.90, p = 0.636, Cramer’s V = 0.024) or age (χ²(4) = 2.04, p = 0.729, Cramer’s V = 0.026). In the high-versus-medium adjusted association model, escape–avoidance coping (OR = 4.47; 95% CI 3.25–6.14) and perceived significant-other support (OR = 2.62; 95% CI 1.81–3.80) were independently associated with high-risk classification, whereas age and sex were not. Model diagnostics are reported descriptively and should not be interpreted as external validation of a clinical prediction tool. Conclusions Among adolescents already showing elevated ADHD symptom risk, high-risk classification was mainly distinguished from medium-risk classification by greater escape–avoidance coping and greater perceived support from a significant other. The findings should be interpreted as cross-sectional associations, not as evidence of causal progression or clinical diagnosis. The results suggest possible targets for future school-based psychological support, while also highlighting the need for more detailed item-level, informant-specific, and school-context data in subsequent studies.

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