Remarkable high frequency of insecure attachment in children with ADHD persists in a three-year follow-up

Abstract

Background

Studies have pointed to a complicated and mutual relationship between attention deficit hyperactivity disorder (ADHD) and attachment. In an observational follow-up study conducted in 2015 60 children from 7 years to 12 years recently diagnosed with ADHD were included and assessed according to attachment representation showing 85% of the children to be insecurely attached.

Aim

The aim of this study was to investigate the stability of this remarkably high frequency of insecure attachment in the same cohort of children.

Methods

Children previously assessed using the child attachment interview (CAI) when diagnosed with ADHD were contacted three years later for a follow-up CAI assessment.

Results

At follow-up, 31 children participated in the CAI-interviews. Since their diagnosis with ADHD, the children had received treatment as usual. The CAI-interviews showed a continued high rate of insecure attachment with 90% of the children classifying as insecurely attached compared to expected 38% in the normal population. Of these, the majority of children (77%) were classified as dismissing.

Conclusion

Our findings suggest that targeting ADHD-symptoms with our current treatment strategies does not in itself improve attachment security. Attachment security may in turn be a factor of importance when evaluating general functioning and prognosis.

Keywords:

• Attention deficit hyperactivity disorder
• ADHD
• insecure attachment
• follow-up
• child attachment interview

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

PD was the primary investigator in this study and wrote the first draft of the manuscript, GL and AM participated in the collection of data. RK analyzed and interpreted the data. ME was a major contributor in writing the manuscript. JPR edited and revised the manuscript. OJS supervised the process. All authors read and approved the final manuscript.

Data availability statement

Data analyzed in this study are available on request from the corresponding author.

Additional information

Funding

This research was supported by a research grant from The Unit for Production, Research and Innovation, Region Zealand.