Differential family and peer environmental factors are related to severity and comorbidity in children with ADHD

Abstract

Summary. Behavioral genetic studies imply that salient environmental influences operate within families, making siblings in a family different rather than similar. This study is the first one to examine differential sibling experiences (as measured with the Sibling Inventory of Differential Experience) and its effect on behavioral outcomes within ADHD families. Subjects were 45 Dutch ADHD probands and their unaffected siblings (n ¼ 45) aged 10-18 years. ADHD probands and their unaffected siblings reported differences in sibling interaction, parental treatment, and peer characteristics. These nonshared environmental influences were related to both the severity of ADHD symptoms as well as to comorbid problem behaviors. These findings suggest that environmental influences that operate within ADHD families appear relevant to the severity of problem behaviors of ADHD children and their siblings.

Family Difficulties in Children with ADHD, the Role of Integrated Psychopharmacology Psychotherapy Treatment

“…It is not easy to parent a child with ADHD. Lower quality of life has been reported in families with ADHD children [79,115,127], complicated by the presence of adversities, conflicts [23,[128][129][130][131], and psychological difficulties [88,89]. These factors significantly impact family functioning which may precipitate and/or aggravate the child parent relationship and parenting difficulties [131].…”

“…and their impact on children. A significant number of researches have recognized the family environment plays an important role in the development, outcomes, and manifestation of difficulties in children with ADHD [37,50,128]. Both parental psychopathology and parenting behavior have been identified as important environmental risk and/or protective factors in children with ADHD [37,133].…”

ADHD Children’s Emotion Regulation in FACE© – Perspective (Facilitating Adjustment of Cognition and Emotion): Theory, Research and Practice

“…Programs destined at helping children with ADHD typically focus on alleviating the behavioural components that contribute to such difficulties in order to facilitate their school and subsequent professional curriculum. Less extensively investigated yet widely documented is ADHD children's often complicated social, relational and family functioning [7][8][9]. Children with ADHD are known, for example, to have more negative peer relationships [10], be subject to bullying [11], engage in risk-taking and antisocial behaviour [12], and experience family difficulties [4,13,14].…”

“…Several fields of study, such as developmental psychopathology, trauma and stress-related as well as neurobiological investigations, converge to demonstrate that children's dysfunctional behaviour, cognition and emotion do not occur in isolation but relative to an immediate and larger environment [7,31,53]. Children's direct and long-term outcomes are determined by a dynamic balance of risks versus resources across several domains throughout their development, as illustrated in Figure 1 [6].…”

“…ER disruptions also involve less direct effects, such as ADHD children's observational, modelled learning of emotion expression through their parents and possibly siblings. Moreover, structural and functional contextual risks and resources are known to operate through cumulative and relative principles, also described as psychological allostatic load [7,13,30,35,53]. For example, an accumulation of family members with ADHD, internalising or externalising comorbidity, family conflict and an adverse school climate would expectedly culminate in mutually undermining effects on the ADHD child's ER skills.…”