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

Abstract

BackgroundThe objective of this study was to investigate relationships among family environmental characteristics, behavior problems, and social function impairments in children with ADHD.MethodsAmong children from four primary schools in Shantou city of China, 132 who were diagnosed with ADHD were selected and 138 typically developing children were recruited from the same schools. These children were evaluated using the self-designed questionnaire, FES-CV, CPRS, CTRS, and WFIRS-P for familial environment, behavioral problems, and social function impairment measures. In addition, children’s behavioral problems and functional impairments were evaluated using self-established field behavior observation method. Logistic regression model was used to estimate ORs and 95% CIs for ADHD risk with family environmental factors.ResultsIn the unconditional logistic model, ADHD risk in children was increased with parents’ worse educational level, occupational status, and emotional stability with trend. Children with ADHD had lower scores on most subscales of FES-CV (P<0.01) but higher scores on Conflict subscale (P<0.001). Children with ADHD showed impairments on all the six WFIRS-P subscales tests (all P<0.001), and higher scores on the CPRS and CTRS scale subscales representing behavioral symptoms (all P<0.001 except Somatic Complaints), and more behavioral problems and functional impairments.ConclusionCompared with typically developing children, children with ADHD had worse family environment. Family characteristics especially parents’ emotional unstability, lower education levels, and worse occupation status may increase ADHD risk in children. In addition, the behavioral problems and social functional impairments may interact with adverse family environmental factors in children with ADHD. Therefore, early interventions with focus onto the compromising factors can be useful for improving the social-behavioral functions of children with ADHD.

Predicting the Adult Clinical and Academic Outcomes in Boys With ADHD: A 7- to 10-Year Follow-Up Study in China

“…Family characteristics have a profound impact on the experiences and life trajectories of offspring, playing an important role in emotional and behavioral development during childhood ( 31 ). Thus, the family environment may be relevant for the course of various mental and psychological diseases and ultimately clinical outcomes, including major depressive disorder ( 32 ), trichotillomania, obsessive–compulsive disorder ( 33 ), and ADHD ( 23 ). Character profiles are correlated with individual differences in goals and values, which are based on learning and the perceptions of self and others ( 34 ).…”

“…Each item was answered as “Yes = 1” or “No = 2” by one of the parents who spent more time with family and became involved in more family affairs. The FES-CV has good validity and reliability in Chinese people and works well in evaluating different kinds of families and testing the family relationships and family environment in China ( 23 ).…”

“…It has become one of the most important and practical tools for assessing family atmosphere and function. A recent study showed that the ADHD group had lower cohesion, expressiveness, independence, achievement, intellectual–cultural, moral–religious, organizational, and control scores but higher conflict scores than the non-ADHD group ( 23 ). To our knowledge, no study has explored which family environmental factors predict adult clinical and academic outcomes based on the FES.…”

Prevalence of ADHD symptoms and their correlations with mental health-related variables among medical student

“…Children with ADHD experienced worse family environment. Parents obtaining lower education levels may increase ADHD risk among children [17]. ADHD symptoms were found to be signi cantly associated with alcohol use, depression, suicidal behavior [8,18], internet misuse [19][20][21][22] and bipolar disorders [13].…”

Paging Dr. Google: Availability and Reliability of Online Evidence-Based Treatment Information about ADHD

“…ADHD is characterized by developmentally inappropriate symptoms of inattention and/or hyperactivity/impulsivity, symptom onset prior to age 12, and impairment in at least two settings (American Psychiatric Association, 2013). Research has consistently indicated that children and adolescents with ADHD often experience academic difficulties (e.g., Altszuler et al, 2017;Arnold et al, 2020;Kent et al, 2011), peer relationship/ social difficulties (e.g., Aduen et al, 2018;de Boo & Prins, 2007;McQuade & Hoza, 2008Mikami et al, 2007;Ros & Graziano, 2018), and increased levels of conflict with parents and family (e.g., Altszuler et al, 2017;Churchill et al, 2018;Haydicky et al, 2015;Huang et al, 2018;Johnston & Lee-Flynn, 2011). Given the potential for poor long-term outcomes for children with ADHD, effective evidence-based treatment is essential to ensure the best possible outcomes for this group.…”