A Longitudinal Study of the Relation Between Family Functioning and Preschool ADHD Symptoms

Abstract

The present study examined the bidirectional relation between family functioning and attention-deficit/hyperactivity disorder (ADHD) symptoms across the preschool years. Participants included 197 (110 boys) 3-year-old children (M = 44.14 months, SD = 3.43; 60% White) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Parenting, parent psychopathology, life stress, and child symptoms were assessed annually from ages 3 to 6. Cross-lagged models provided evidence for both parent and child effects for mothers. In particular, greater maternal overreactive parenting and life stress were predictive of more child ADHD symptoms, and greater child ADHD symptoms significantly predicted greater maternal life stress and depressive symptoms and lower warmth, controlling for child oppositional defiant disorder and parent ADHD symtoms. Child effects were evident for fathers’ depression and life stress, but these did not remain controlling for paternal ADHD symptoms. Findings suggest that targeting child ADHD symptoms, maternal overreactive parenting, and maternal stress each hold promise for attenuating the negative mutual influence of child ADHD symptoms and family functioning over time.

Notes

¹ For six of the families in the sample, parents were not biological parents. In five of these families, primary caregivers were adoptive parents, and for one family, primary caregivers were a grandmother and step-grandfather. For seven additional families, the second caregiver was a stepfather or the mother’s partner. Analyses included all caregivers to enhance generalizability of findings.

² Multigroup analyses were conducted exploring whether gender differences were present in the final models. Model comparison tests revealed that no significant gender differences were present for any of our final models; thus, all models presented are based on the combined sample of boys and girls.

³ Results held when the full sample of 258 children was used for cross-lagged models for child ADHD symptoms and parent depression, parent overreactive and lax parenting, maternal warmth, and life stress. In addition, child effects from child ADHD symptoms to maternal overreactivity (b = .02, SE = .01, p = .03) and parent effects from maternal warmth to child ADHD symptoms (b = −.32, SE = .15, p = .04) became significant when the full sample was used.

⁴ The pattern of results controlling for comorbid ODD symptoms was largely consistent with the full sample. With the full sample, parent effects from maternal life stress to child ADHD symptoms remained significant rather than being a trend. In addition, the child effects from child ADHD symptoms to maternal overreactivity that were significant for the full sample only, became nonsignificant when accounting for comorbid ODD symptoms.

⁵ All results held when the full sample was used and parent ADHD symptoms were controlled for.

Additional information

Funding

This research was supported by a grant from the National Institutes of Health (MH60132) awarded to the second author.