The functioning and behaviour of biological parents of children diagnosed with attention-deficit/hyperactivity disorder, attending the outpatient department at Weskoppies Hospital, Pretoria

Abstract

BackgroundADHD (attention-deficit/hyperactivity disorder) is gradually being acknowledged as a functionally impairing disorder across the lifespan, underscored by heritability. Nonetheless, lack of ADHD (adult attention-deficit/hyperactivity disorder) data from South Africa is alarming which could be due to either the unawareness of ADHD symptoms or underutilisation of available screening measures. Undiagnosed ADHD may influence family- and working lives unpleasantly. Parenting a child with ADHD may intensify parental stress through functional impairment notwithstanding the diagnosis of ADHD.MethodsEighty-one biological parents of children diagnosed with attention-deficit/hyperactivity disorder were screened using self-reporting measurements. ADHD self-report scale (ASRS-V 1.1) identified either positive or negative subgroups; the Weiss functional impairment rating scale (WFIR-S) for functional impairment and the Jerome driving questionnaire (JDQ) for risk-taking behaviour specifically driving.ResultsOf the 39 (48%) parents who experienced impairment in all seven areas of functioning, 23 (59%) screened negative for ADHD, while 16 (41%) screened positive. A significant association was found between parents who screened either positive or negative for ADHD and functional impairment across five of the seven individual categories namely family, work, self-concept, life-skills and social functioning.ConclusionThis study emphasised the high incidence of functional impairment in parents of ADHD children. Although a substantial number of parents screened negative for ADHD, they still reported impairment in functioning; probably due to undiagnosed ADHD with comorbid psychiatric disorders, and/or parental stress due to the complex behaviour of the child. Parents of children diagnosed with ADHD should be screened for functional impairment followed by referral for psychiatric assessment and parent management training to achieve better clinical outcomes.

Prevalence of mental illness among parents of children receiving treatment within child and adolescent mental health services (CAMHS): a scoping review

“…The flowchart in Figure 1 illustrates the process of screening and data extraction undertaken in the review. Overall, 18 studies [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] were identified to have reported on the prevalence of mental illness among parents of children receiving treatment in CAMHS.…”

“…Other studies had a focus on prevalence rates in relation to specific mental illnesses, either in the parent [40] (see Table 4) or the child [41][42][43] (see Table 5). Finally, some studies reported the number of parents with a specific mental illness who had children attending CAMHS with a specific mental illness [44][45][46][47][48][49] (see Table 6).…”

“…Sundarlall et al [48] found that parents who had ADHD experienced impairments that impeded their work performance, self-concept, life-skills, and social functioning. The impacts of mental illness on parenting behaviours and capacity to support a child with mental illness was a particular focus.…”

“…Many papers stressed the need for CAMHS to identify cases where parents experienced mental illness and advocated for screening the mental health of both mothers and fathers upon a child's presentation at the service, for the benefit of both child and parent. Naughton et al [32], Robson and Gingell [39], and Sundarlall et al [48] suggested that parent mental health screening should be an integrated part of assessment procedures to identify family risk factors and support needs. Schwartz et al [40] concluded that, although many depressed parents will seek services to provide care for their children experiencing mental illness, they often do not seek mental health services for themselves.…”

“…Robson and Gingell [39] and Agha et al [44] took the position that whole-of-family interventions may be most appropriate when multiple family members experience mental illness. Dentz et al [45] and Sundarlall et al [48] suggested that interventions focused on developing and supporting parents' capacities to carry out their parental role should be provided, which would then confer benefit to the child. However, as asserted by Wesseldijk et al [33], there is presently a need for research to determine the most effective response in these circumstances and whether intervention should be focused primarily on the parent, the child, or should otherwise address parent's and children's conditions independently.…”