Impact of adversity on functioning and comorbidity in children with attention-deficit hyperactivity disorder.
OBJECTIVE
Prior research on risk factors for attention-deficit hyperactivity disorder (ADHD) has shown that familial risk factors play a role in the disorder's etiology. This study investigated whether features of the family environment were associated with ADHD.


METHODS
One hundred forty children with ADHD and 120 normal control probands were studied. Subjects were Caucasian, non-Hispanic males between the ages of 6 and 17 years. Exposure to parental psychopathology and exposure to parental conflict were used as indicators of adversity, and their impact on ADHD and ADHD-related psychopathology and dysfunction in children was assessed.


RESULTS
Increased levels of environmental adversity were found among ADHD compared with control probands. The analyses showed significant associations between the index of parental conflict and several of the measures of psychopathology and psychosocial functioning in the children. In contrast, the index of exposure to parental psychopathology had a much narrower impact, affecting primarily the child's use of leisure time and externalizing symptoms.


CONCLUSIONS
A relationship appears to exist between adversity indicators and the risk for ADHD as well as for its associated impairments in multiple domains. These findings confirm previous work and stress the importance of adverse family-environment variables as risk factors for children who have ADHD.
Pediatric Psychopharmacology Unit in Psychiatry, Massachusetts General Hospital, Boston 02114, USA.
J
J
Biederman
S
S
Milberger
S V
SV
Faraone
K
K
Kiely
J
J
Guite
E
E
Mick
J S
JS
Ablon
R
R
Warburton
E
E
Reed
S G
SG
Davis
D000124:Achievement; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000235:genetics*; D002648:Child; D005190:Family / Q000523:psychology; D006801:Humans; D007859:Learning Disabilities; D008297:Male; D008425:Maternal Behavior / Q000523:psychology; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment