Can Disturbance in Attachment Contribute to Attention Deficit Hyperactivity Disorder? A Case Discussion

Abstract

Three cases are presented in which the emergence of Attention Deficit Hyperactivity Disorder (ADHD) is linked to a lack in sustained parental attention during the first years of the child's life. The deficit in sustained parental attention resulted from different stressors which compromised the early parent-child relationship, leading to adverse and escalating cycles of negative interaction and affecting the attachment relationship. It is argued that family stress and attachment difficulties between parents and infants may play an important role in the development of ADHD in a subgroup of children. It is also argued that this model does not explain all ADHD and that it is not implicitly critical of parents. However by delineating the different possible pathways to ADHD, clinicians may be able to offer subtype specific multimodal treatment programmes which address aetiological components more adequately. Further, ADHD in a subgroup of children may be preventable if early antecedents and risk factors are understood and appropriate intervention is provided.

Inattention/Overactivity Following Early Severe Institutional Deprivation: Presentation and Associations in Early Adolescence

“…However, attachment theory holds that a secure and responsive early parent child relationship is an integral part of the development of effective selfregulation in the child and self-regulation is linked to impulse control, perseverance and inhibition, which make up important features of the nondeprivation-related I/O and ADHD phenotype. Most studies have focused on insecure attachment with parents, rather than disinhibition with strangers, and are mainly based on small clinical case studies (Stiefel 1997;Clarke et al 2002). Nevertheless, in combination with the striking pattern of disinhibited attachment observed in our sample and pattern of overlap noted by Kreppner et al (2001), these studies highlight this as an important area of investigation when considering the phenotypic characteristics of I/O in adolescence.…”

Supportive and Controlling Parental Involvement as Predictors of Children’s Academic Achievement: Relations to Children’s ADHD Symptoms and Parenting Stress

“…Negative parenting practices, including the use of control, have been linked to problems in attachment security (Grolnick, 2003), and attachment difficulties in children with ADHD have been identified by some researchers (Gerrard & Anastopoulos, 2005;Stiefel, 1997). Due to the severe academic difficulties experienced by children with ADHD, school issues likely represent a source of frequent and stressful interaction in these families, possibly further disrupting the parent-child relationship.…”

Quantifying the Relationship between Attention‐Deficit/Hyperactivity Disorder and Experiences of Child Maltreatment: A Meta‐Analysis

“…If the ADHD symptoms do not improve over the course of child maltreatment‐related therapy or intervention, it may be worthwhile to pursue assessment and potentially additional treatment for ADHD. There is evidence that ADHD treatment can be beneficial regardless of the aetiology of ADHD (Stiefel, ).…”