ADHD and Family Stress

Meghan Miller

 Attention Magazine October 2018

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THIS RESEARCH UPDATE focuses on the impact of ADHD on parenting and family stress. The reviewed studies also examined whether reductions in parenting stress follow ADHD treatment.

How are early ADHD symptoms associated with family stress?

Prior studies have documented higher levels of stress among parents and families of children with ADHD. This study sought to better understand how a child’s ADHD symptoms are related to family functioning in early childhood. Just over one hundred three-year-olds and their parents participated in this longitudinal study over the course of three years, with annual assessments each year until the children turned six.

The researchers found that greater over-reactive responding to children’s ADHD symptoms, along with more stress among mothers, predicted more ADHD symptoms in the children. They also found that more ADHD symptoms in the children predicted more stress, greater depression, and lower warmth among mothers.

The researchers concluded that treatments addressing early emerging ADHD symptoms in children as young as age three may help reduce the development of parenting stress and enhance family functioning over time.

Breaux, R.P. & Harvey, E.A. (2018). A longitudinal study of the relation between family functioning and preschool ADHD symptoms. Journal of Clinical Child & Adolescent Psychology, epub ahead of print.

Does ADHD treatment improve parenting stress?

In this meta-analysis, researchers examined the effect of ADHD treatment on parenting stress across numerous studies between 1993 and 2016. Meta-analyses contrast and combine results from different studies in order to identify patterns in results, sources of disagreement among results, or other interesting associations that may emerge in the context of multiple studies.

After conducting a comprehensive literature search, the meta-analysis identified 43 studies examining parenting stress, either before and after ADHD treatment (33 studies) or between those receiving an ADHD treatment versus a control group (9 studies). Overall, ADHD treatment produced meaningful improvement in parenting stress across studies.

Improvements were similar regardless of the child age or gender. Improvements also were similar regardless of treatment factors, such as medication versus psychosocial treatment, length and frequency of the treatment, type of treatment provider, and whether or not parents participated in the treatment. The only difference across studies was that samples with a higher proportion of mothers showed greater parenting stress improvements, although this may be due to fathers reporting lower levels of parenting stress before treatment than mothers.

Researchers concluded that getting help for a child’s ADHD can improve stress related to parenting, even if the treatment does not involve parents or target parenting stress.

Theule, J., Cheung, K., & Aberdeen, K. (2018). Children’s ADHD Interventions and Parenting Stress: A Meta-Analysis. Journal of Child and Family Studies, 1–13.

Lauren Haack, PhD, is an assistant professor and attending psychologist in the department of psychiatry at the University of California San Francisco. Her research and clinical practice focus on accessible and culturally attuned evidence-based services for vulnerable youth and families, with a particular specialty in ADHD services for children of Spanish-speaking, Latinx families.

Meghan Miller, PhD, is an assistant professor in the department of psychiatry and behavioral sciences and the MIND Institute at the University of California, Davis. Her research focuses on identifying the earliest behavioral manifestations of ADHD and autism spectrum disorder.