tasks. They may also require supervision to complete a given task, thereby affecting the lives of their family and society. 3 Children with ADHD, who are difficult to nurture from childhood, are sensitive and often display unpredictable, temperamental characteristics. 4 These children may also have irregular sleeping and other habits. Moreover, children with ADHD may be difficult to control, as they are overactive and impulsive. 5 They are less compliant with parental demands and more hostile and negative toward their parents. These behaviors lead to an increased need for attention compared with typically developmental children. 6 Therefore, parents of children with ADHD experience increased stress, and severe ADHD symptoms cause even greater parental stress. 7 As parental stress increases, negative emotions increase as well, and parental satisfaction decreases. 8 Thus, parents of children with ADHD experience more stress, frustration, and depression than parents of children without ADHD. 9 While ADHD symptoms in children can affect parental stress, parental stress can also aggravate ADHD symptoms. In a pre-

Background Hyperactivity, inattention, and impulsivity of children with attention deficit hyperactivity disorder (ADHD) increase parenting stress and familial conflict. Among parent-related factors, maternal mental health has been studied in-depth, but studies on paternal factors in this context are scarce. This cross-sectional study was conducted of children with ADHD and their parents in South Korea. We investigated the relationships between ADHD symptom severity of children and the mental health of their mothers and fathers. Methods The study included 70 children with ADHD and their 140 married heterosexual parents (70 fathers and 70 mothers). Children completed the Child Depression Inventory and State-Anxiety Inventory for children, and their parents completed the Korean ADHD rating scale-IV, Adult ADHD self-report scale, State-Anxiety Inventory, Patient Health Questionnaire-9, and Parental Stress Scale. Results There was a significant positive correlation between children’s ADHD symptoms and maternal anxiety symptom severity, whereby more severe ADHD symptoms were associated with more severe maternal anxiety symptoms. There was also a significant positive correlation between maternal anxiety symptom severity and paternal parenting stress severity, whereby more severe maternal anxiety was associated with more severe paternal parenting stress. A mediation model showed that paternal parenting stress severity was not directly related to children’s ADHD symptoms, but the severity of maternal anxiety mediated this relationship. Conclusion The present study found the importance of mental health in mothers of children with ADHD and the interrelatedness of mental health within families. Future assessments and treatment of children with ADHD should include both the children and their parents.

Objectives: Although aggressive behavior in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) has previously shown correlations with hyperactivity/impulsivity, few studies have examined its association with inattention or the effect of working memory on aggressive behavior. This study aimed to assess the relationship between inattention and aggressive behavior and the effect of working memory on the relationship between inattention and aggressive behavior in children and adolescents with ADHD. Methods: Thirty-one children and 26 adolescents with ADHD were retrospectively investigated. The subjects completed the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV), the Korean Child Behavior Checklist (K-CBCL), and the Korean Children's Depression Inventory (CDI). Results: Inattention was positively correlated with aggressive behavior in children and adolescents with ADHD and working memory showed an insignificant correlation. However, working memory had a significant moderating effect on aggressive behavior by interacting with inattention. The moderating effect of working memory manifested when the working memory index score on the K-WISC-IV was 73.5 points or higher, and it had a significant effect on aggressive behavior. Conclusion: This study shows that the severity of inattention and hyperactivity/impulsivity should be addressed to provide appropriate treatment to children and adolescents with ADHD who exhibit aggressive behavior.