Involvement of family environmental, behavioral, and social functional factors in children with attention-deficit/hyperactivity disorder

Figures & data

Table 1 Family characteristics between the ADHD (n=132) and the control (n=138) groups

Characteristics	ADHD, N (%)	Control, N (%)	t/χ^2	P-value
Age (mean ± SD)	9.28 ± 1.39	9.26 ± 1.52	0.11	0.910
Sex			0.78	0.380
Male	100 (75.8)	98 (71.0)
Female	32 (24.2)	40 (29.0)
Father’s education level			40.92	<0.001
Bachelor degree or above	37 (28)	74 (53.6)
Junior college	26 (19.7)	37 (26.8)
High school	44 (33.3)	26 (18.8)
Junior high school or below	25 (19)	1 (0.7)
Father’s occupation			35.70	<0.001
Technical personnel	17 (12.9)	37 (26.8)
Civil servants	12 (9.1)	38 (27.5)
Business/service industries	32 (24.2)	19 (13.8)
Company employees	26 (19.7)	26 (18.8)
Unemployed	45 (34.1)	18 (13.0)
Father’s emotional stability			11.70	0.001
Stable	111 (84.1)	133 (96.4)
Unstable	21 (15.9)	5 (3.6)
Mother’s education level			36.40	<0.001
Bachelor degree or above	27 (20.5)	40 (29.0)
Junior college	37 (28)	72 (52.2)
High school	38 (28.8)	21 (15.2)
Junior high school or below	30 (22.8)	5 (3.6)
Mother’s occupation			48.35	<0.001
Technical personnel	14 (10.6)	64 (46.4)
Civil servants	8 (6.1)	12 (8.7)
Business/service industries	23 (17.4)	12 (8.7)
Company employees	27 (20.5)	22 (15.9)
Unemployed	60 (45.5)	28 (20.3)
Mother’s emotional stability			5.24	0.020
Stable	112 (84.8)	129 (93.5)
Unstable	20 (15.2)	9 (6.5)
Family type			3.80a	0.16
Core family	68 (51.5)	60 (43.5)
Big family of multi-generation	59 (44.7)	76 (55.1)
Other (single parent, reorganization)	5 (3.8)	2 (1.4)
Family history
Poor intelligence and poor living ability	2 (1.5)	0
Hyperactivity/impulsivity	15 (11.4)	4 (2.9)	7.39a	0.007
Learning difficulty	23 (17.4)	1 (0.7)	23.23a	<0.001
Short fuse/oddball/impulsivity	14 (10.6)	1 (0.7)	12.56a	<0.001
Substance abuse	2 (1.5)	0 (0.0)

Note:

a Fisher’s exact test.

Abbreviation: ADHD, attention-deficit/hyperactivity disorder.

Table 2 Multivariate logistic regression analyses of family environmental factors associated with ADHD risk

Variables	B	Wald	P-value	OR (95% CI)	P for trend
Mother’s occupation
Technical personnel				1.00 (Ref)	<0.001
Civil servants	−0.105	0.032	0.857	0.90 (0.29–2.82)
Business/service industries	0.807	3.459	0.063	2.24 (0.96–5.24)
Company employees	1.207	7.343	0.007	2.34 (1.40–8.01)
Unemployed	1.777	11.969	0.001	5.91 (2.16–16.17)
Mother’s education level
Bachelor degree or above				1.00 (Ref)	<0.001
Junior college	0.157	0.123	0.726	1.17 (0.49–2.83)
High school	2.18	9.629	0.002	8.81 (2.23–34.83)
Junior high school or below	2.22	4.764	0.029	9.21 (1.25–67.62)
Father’s occupation
Technical personnel				1.00 (Ref)	<0.001
Civil servants	−0.345	0.145	0.601	0.71 (0.17–2.12)
Business/service industries	1.241	8.459	0.003	3.46 (1.52–7.95)
Company employees	0.912	4.443	0.074	2.49 (0.98–4.33)
Unemployed	1.873	13.141	<0.001	7.19 (3.24–17.83)
Father’s education level
Bachelor degree or above				1.00 (Ref)	<0.001
Junior college	0.131	0.126	0.173	1.14 (0.89–1.45)
High school	0.588	2.463	<0.001	1.80 (1.29–2.50)
Junior high school or below	2.852	7.629	0.005	17.33 (2.53–118.99)
Mother’s emotional stability
Unstable vs stable	0.545	2.124	0.020	1.73 (1.01–3.01)	0.022
Father’s emotional stability
Unstable vs stable	1.042	6.109	0.001	1.83 (1.28–6.28)	0.001
Family type
Core family				1.00 (Ref)	0.393
Big family of multi-generation	−0.186	0.115	0.161	0.83 (0.66–1.06)
Other (single parent, reorganization)	0.495	1.352	0.323	0.64 (0.50–5.37)

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; OR, odds ratio; CI, confidence interval; Ref, reference.

Figure 1 FES-CV scores of the ADHD and the control groups (mean ± SD).

Notes: **P<0.01; ***P<0.001.
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; FES-CV, Family Environment Scale Chinese Versions.

Figure 2 Conners’ Children Behavior Scale scores between the ADHD and the control groups (mean ± SD).

Notes: (A) CPRS; (B) CTRS. ***P<0.001.
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; CIH, Conners’ Index of Hyperactivity; CPRS, Conners’ Parent Rating Scale; CTRS, Conners’ Teacher Rating Scale.

Figure 3 WFIRS-P scores of the ADHD and the control groups (mean ± SD).

Note: *** P<0.001.
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; WFIRS-P, Weiss Functional Impairment Scale-Parent.

Table 3 Observed behaviors between the ADHD (n=132) and the control (n=138) groups

Observed behaviors	ADHD, n (%)	Control, n (%)	χ^2	P-value
Careless mistakes or sloppy writing	122 (92.4)	39 (28.3)	115.38	<0.001
Missing the examination questions	105 (79.5)	17 (12.3)	132.11	<0.001
Fugue states, procrastination	58 (43.9)	9 (6.5)	50.63	<0.001
Cannot follow instructions, cannot complete according to regulations	39 (29.5)	2 (1.4)	41.35	<0.001
Loss of tools or learning supplies	27 (20.5)	2 (1.4)	25.42	<0.001
Easily distracted by external stimuli	130 (98.5)	29 (21.0)	167.25	<0.001
Move around in their seats	121 (91.7)	17 (12.3)	169.99	<0.001
Leave the seat at will	77 (58.3)	4 (2.9)	98.73	<0.001
Random fiddle with the indoor objects	35 (26.5)	9 (6.5)	19.77	<0.001
Unable to wait for alternate or difficult to complete quietly	21 (15.9)	2 (1.4)	18.10	<0.001
Talkative, and disturb others	81 (61.4)	4 (2.9)	106.91	<0.001
Impatient	51 (38.6)	11 (8.0)	35.86	<0.001

Abbreviation: ADHD, attention-deficit/hyperactivity disorder.

Figure S1 Flowchart of the two-stage procedures of sampling participants and diagnosis of ADHD.

Abbreviation: ADHD, attention-deficit/hyperactivity disorder.

Table S1 Correlation analyses between selected dimensions’ score between CPRS and CTRS (n=270)

Similar dimensions of CPRS and CTRS	Pearson correlation coefficient	P-value
Conduct Problem	0.834	<0.001
Hyperactivity	0.803	<0.001
CIH	0.872	<0.001

Abbreviations: CIH, Conners’ Index of Hyperactivity; CPRS, Conners’ Parent Rating Scale; CTRS, Conners’ Teacher Rating Scale.