Parenting Stress as a Mediator Between Childhood ADHD and Early Adult Female Outcomes

Abstract

The purpose of this study is to examine the mediating role of parenting stress (both parental distress and stress due to dysfunctional interactions in the mother–daughter relationship [PSDI]) in the link between childhood attention-deficit/hyperactivity disorder (ADHD) status and several important young adult outcomes. The diverse sample comprised 140 girls with ADHD and 88 age- and ethnicity-matched comparisons, evaluated at ages 6–12 years and followed prospectively for five years (M age = 14.2) and 10 years (M age = 19.6). The PSDI experienced by a mother during her daughter's adolescence mediated the link between her daughter's childhood ADHD status and adult externalizing and internalizing symptoms. PSDI also mediated the link between ADHD status and young adult nonsuicidal self-injury and had an indirect effect in the relation between childhood ADHD and young adult depressive symptoms. The mediating role of PSDI with respect to internalizing symptoms and depressive symptoms remained in place even when covarying adolescent internalizing/depressive symptoms. Parenting stress, particularly related to maternal perceptions of dysfunctional interactions with adolescent daughters, serves as a key mediator in the association between childhood ADHD status and important domains of young adult functioning. Minimizing parenting stress and dysfunctional mother–daughter interactions during adolescence might reduce the risk of adverse adult outcomes for girls with ADHD.

Notes

¹The internal consistency for this measure is not extremely high, because this score reflects the sum of six methods endorsed. Participants tend to only endorse one method (e.g., “cutting”) and not others (e.g., “burning”).

²Some investigators argue that significant total effects are not required to test the indirect effects, suggesting quantification of the indirect the effects instead of inferring them from the significance testing of the direct and total effects (see Hayes, 2009, for a more detailed explanation).