title: Parental strain, parental health, and community characteristics among children with attention deficit-hyperactivity disorder.
abstract: OBJECTIVE
  It has been documented that parenting a child with attention deficit-hyperactivity disorder (ADHD) can cause family strain, but less is known about the added stress of additional child health diagnoses on levels of strain. This study explores the relationship between family stressors (such as child comorbid conditions) and family resources (such as social support, community characteristics, and parental health) on parental strain.
  
  
  METHODS
  We used the 2007 National Survey of Children's Health (NSCH) to identify children with ADHD and other comorbid mental and physical health conditions (n = 5473). Descriptive, bivariate, and multivariate analyses were conducted to explore the association between parental strain, social support, mother's mental health, and neighborhood amenities within groups of children with ADHD and comorbid conditions.
  
  
  RESULTS
  Parental strain was greatest when ADHD was paired with a conduct disorder, physical disorder, or other mental health disorder. Specifically, parental strain was greatest for children with ADHD plus a comorbid conduct disorder compared with ADHD alone. It was also greater for children with other mental and physical health diagnoses compared with children with ADHD alone. Better mental health of mothers in the sample is related to reduced parental strain. Greater access to social support and neighborhood amenities also are related to reduced parental strain.
  
  
  CONCLUSIONS
  Greater levels of social support and better mental health of parents is associated with decreased strain. Interventions aimed at relieving stress and building strategies to improve mental health can be beneficial for families with children with ADHD and comorbid conditions.
authors.affiliation: Institute for Child Health Policy, Department of Health Outcomes and Policy, University of Florida, Gainesville, USA.
authors.forename: Melanie Sberna
authors.initials: MS
authors.lastname: Hinojosa
authors.forename: Ramon
authors.initials: R
authors.lastname: Hinojosa
authors.forename: Daniel
authors.initials: D
authors.lastname: Fernandez-Baca
authors.forename: Caprice
authors.initials: C
authors.lastname: Knapp
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications; D002675:Child, Preschool; D019955:Conduct Disorder / Q000150:complications; D005260:Female; D006295:Health Resources; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000150:complications; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D012111:Residence Characteristics; D012944:Social Support; D014481:United States