Analysis of Personal and Family Factors in the Persistence of Attention Deficit Hyperactivity Disorder: Results of a Prospective Follow-Up Study in Childhood

Abstract

ObjectivesTo study the course of ADHD during childhood and analyze possible personal and family predictor variables of the results.MethodSixty-one children with ADHD who were between 6 and 12 years old at the baseline assessment were evaluated 30 months later (mean age at baseline: 8.70 ± 1.97; mean age at follow-up: 10.98 ± 2.19). Status of ADHD in follow-up was identified as persistent (met DSM-IV-TR criteria according to parents’ and teachers’ ratings), contextually persistent (met ADHD criteria according to one informant, and there was functional impairment) and remitted ADHD (with subthreshold clinical symptomatology). Associated psychological disorders of the three groups were analyzed in the follow-up with the Conners' Rating Scales. The groups were compared on ADHD characteristics (symptoms of ADHD and impairment), child psychopathology, executive functioning (EF; inhibition, working memory) and parenting characteristics (parental stress and discipline styles) at baseline.ResultsAt the follow-up, 55.7% of the children continued to meet the DSM-IV-TR criteria for ADHD, 29.5% showed contextual persistence, and 14.8% presented remission of the disorder. The persistent and contextually persistent ADHD groups showed more associated psychological disorders. Inattention, oppositional problems, cognitive problems and impairment at baseline distinguished the remitted ADHD children from the persistent and contextually persistent ADHD children. Moreover, the persistent groups had significantly more emotional liability and higher parental stress than the group in remission, while no differences in EF where found among the groups.ConclusionsADHD children continue to present symptoms, as well as comorbid psychological problems, during adolescence and early adulthood. These findings confirm that persistence of ADHD is associated with child psychopathology, parental stress and impairment in childhood.

Childhood Factors Affecting Persistence and Desistence of Attention-Deficit/Hyperactivity Disorder Symptoms in Adulthood: Results From the MTA

“…According to a recent study, high parenting stress but not parenting/discipline style distinguished persisters and remitters. 12 In contrast to this study, we found a good parental disciplining style to protect against adult ADHD symptom persistence. However, neither marital problems nor parenting styles were associated with adult ADHD symptoms when using continuous scores as outcomes or using impairment ratings in addition to symptom count to define ‘persistence’.…”

“…Persisters are more likely than desisters to have comorbid oppositional, addiction, anxiety and depression problems as well as functioning difficulties in social, educational, emotional and cognitive domains. 8–12 It is not understood whether such differences are cause, effect, or simply associated through some third factor. More importantly, it is not known if such differences in functioning are already present at an early age and predate the divergence in ADHD symptom profiles into persistent and desistent types.…”

“…10,12,13–14 Few studies, though, have followed up children with ADHD into late adolescence and adulthood. 15–19 Of these, Biederman et al, 15 Biederman et al, 16 and Cheung et al 17 have assessed the effects of several factors on ADHD persistence, but include participants with a wide age-range at follow-up.…”

“…11–12,21–22 While these are important predictors of persistence, effects of other family and child characteristics cannot be ignored. For example, socioeconomic status (SES) and family relationships affect children’s upbringing and their coping abilities.…”

A Study on the Efficiency in the Children Suffering from Attention Deficit Hyperactivity Disorder

“…Beside chronic nature of this disease, a high rate of comorbidity is the other worrying issue that is a feature of ADHD (Miranda, Colomer, Fernández, Presentación, & Roselló, 2015).…”