Child attachment and ADHD: a systematic review

Wylock, Jean François; Borghini, Ayala; Slama, Hichem; Delvenne, Véronique

doi:10.1007/s00787-021-01773-y

Cited by 10 publications

(11 citation statements)

References 84 publications

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“…However, children with an insecure attachment style often respond maladaptively to stressful situations as they do not have responsive caregivers to help foster the resilience required during hardship. There has been extensive work highlighting how children with ADHD often exhibit insecure attachment styles [62][63][64][65]. The genesis of this relational interaction is a chicken-and-egg problem.…”

Section: Study Rationale and Theoretical Frameworkmentioning

confidence: 99%

The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder

2023

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Background The COVID-19 pandemic uprooted regular routines forcing many children to learn from home, requiring many adults to work from home, and cutting families off from support outside the home. Public health restrictions associated with the pandemic caused widespread psychological distress including depression and anxiety, increased fear, panic, and stress. These trends are particularly concerning for families raising neuroatypical children such as those with Attention-Deficit Hyperactivity Disorder (ADHD), as these children are already more likely than their typically developing peers to experience comorbid mental health issues, and to experience greater distress when required to stay indoors. Families with children who have ADHD are also at greater risk for experiencing heightened familial stress due to the challenges associated with managing ADHD behavioural symptoms, greater parental discord and divorce, and greater financial difficulties compared to other families. The current study engaged families comprised of at least one child diagnosed with ADHD to elucidate 1) the unique ways that the COVID-19 pandemic affected their mental health and 2) the specific barriers these families faced to maintaining optimal mental wellbeing. Methods and findings A total of 33 participants (15 parent-child dyads) engaged in virtual interviews. Content analysis revealed that the most frequently identified mental health effects for families were increased child anxiety and disconnectedness, as well as deteriorating parental mental health. The most frequently identified barriers to maintaining optimal mental wellbeing were lack of routine, lack of social interaction and social supports, and uncertainty and fear. Conclusions Findings underscore areas of need during times of large-scale social isolation, specifically for families with children who have ADHD. This work contributes to a growing body of research aimed at creating safeguards to support mental wellbeing for vulnerable families during times of crisis.

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Section: Study Rationale and Theoretical Frameworkmentioning

confidence: 99%

The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder

2023

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“…Also, motivational problems, such as altered reward and punishment sensitivity, can complicate learning from parenting behaviors. Indeed, an increasing number of studies demonstrate an association between insecure or disorganized attachment styles and ADHD (Wylock et al, 2021), differences between children with ADHD and typically developing children in attachment representations (ADHD less secure/ more disorganized) (Dekkers et al, 2021b), and a recent meta-analysis reported a significant link between attention problems and insecure and disorganized attachment styles (Pallini et al, 2019). Taken together, it could be that children with ADHD respond differently to (changes in) parenting, due to neurobiological difficulties related to (safety) conditioning (Tripp & Wickens, 2008).…”

Section: Introductionmentioning

confidence: 99%

Attachment Representation Moderates the Effectiveness of Behavioral Parent Training Techniques for Children with ADHD: Evidence from a Randomized Controlled Microtrial

Hornstra

Dekkers

Bosmans

et al. 2022

Res Child Adolesc Psychopathol

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Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but knowledge on the differential effects of behavioral techniques for specific subgroups of children is very limited. Attachment representations of children with ADHD may affect how receptive children are to changes in parenting. In this study, we investigated whether specific behavioral techniques were more or less effective for children with ADHD in relation to their attachment representations. We included parents of 74 children with ADHD (4–11 years, M = 8.15) who took part in a larger randomized controlled microtrial in which they were randomized to a two session training in antecedent-based techniques (i.e., stimulus control techniques: rules, instructions; n = 26), a two session training in consequent-based techniques (i.e., contingency management techniques: praise, rewards, ignoring; n = 25) or a waitlist control condition (n = 23). We examined whether attachment representation moderated the effectiveness of a) training versus waitlist, and b) antecedent- versus consequent-based techniques. Attachment representations were measured with a story stem task, the intervention outcome was daily parent-rated problem behaviors of the children. Attachment representation did not moderate the effects of the training compared to the waitlist. However, compared to antecedent-based techniques, consequent-based techniques were less effective for more securely and less disorganized attached children, and particularly effective for more disorganized attached children. This was the first study examining attachment as a moderator of behavioral techniques for ADHD. If replicated, the findings of this study can be used for treatment development and tailoring.

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“…Many authors [cf. ( 10 – 12 )] argue that ADHD is a heterogeneous, multifactorial problem and often with comorbidities, why the search for one explanatory factor must be abandoned. Such a view is not new, however.…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, Murdock and Fagundes ( 29 ) have illustrated how attachment can work as a mediator between socioeconomic disadvantage during childhood and negative health outcomes in adulthood. Wylock et al ( 12 ) conducted a systematic literature review aimed to clarify the nature of the relationship between ADHD and child attachment and the results showed that the link still seems to remain unclear. One explanation was that many studies tend to consider ADHD as a homogeneous disorder, but the observed differences among studies could also be a matter of the methodology used to measure attachment.…”

Section: Introductionmentioning

confidence: 99%

Is ADHD a way of conceptualizing long-term emotional stress and social disadvantage?

Erlandsson

Hornborg

Sorbring

et al. 2022

Front. Public Health

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BackgroundThe prevalent, neuropsychiatric, deficit perspective on children and youth diagnosed with ADHD prohibits a multidimensional approach where socio-economic status, family stress and relationships within the families are relevant factors to examine. Assessments of ADHD through the use of rating scales and short-term interventions may lead not only to overdiagnosis but also to a reductionistic approach in the psychiatric field. This literature review aims to address research outside the prevailing discourse on ADHD as an organic brain dysfunction and broaden the perspectives on children's behavioral difficulties.MethodsThe articles included in this applied, mixed-method, systematic review includes 26 peer-reviewed articles, both English and French, with a search focus on ADHD in children and youth related to Attachment styles and relationships.ResultsIn the studies reported, researchers approached correlations between ADHD and attachment in different ways, and in most cases, there was a caution to address causality. The role of parents was found to be both buffering and aggravating for the appearance of ADHD. In the French case studies, the diagnosis was conceptualized as a relational phenomenon where the child's behavior was inseparable from family member's suffering.DiscussionThis review article illustrates how children's difficulties in terms of ADHD symptoms can be addressed through a paradigm where emotional and cognitive dysregulation is understood through psychosocial factors rather than as a neurological condition. In our view, to avoid an overly reductionistic and medicalized approach to children's behavioral difficulties, it is time to reiterate the value of the biopsychosocial perspective.ConclusionProfessionals and researchers need to acknowledge that becoming diagnosed with ADHD has a strong connection to economic disadvantage, social status, and familial care. The academic discourse of addressing brain dysfunctions might serve the unintended purpose of masking emotional stress and social disadvantage that manifests across generations. A biopsychosocial approach to ADHD including family, emotional history, and socio-economic issues could imply a lesser focus on medical treatment as a first choice.

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Child attachment and ADHD: a systematic review

Cited by 10 publications

References 84 publications

The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder

The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder

Attachment Representation Moderates the Effectiveness of Behavioral Parent Training Techniques for Children with ADHD: Evidence from a Randomized Controlled Microtrial

Is ADHD a way of conceptualizing long-term emotional stress and social disadvantage?

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