title: Relationships between behavioral symptoms of non-medicated Chinese children with attention deficit hyperactivity disorder and parenting stress: Comparison of different subtypes and comorbidities.
abstract: BACKGROUND
  To identify the characteristics of behavior problems among children with attention deficit hyperactivity disorder (ADHD) and their relation with parenting stress.
  
  
  METHODS
  The Conners Parent Symptom Questionnaire (PSQ) and Parenting Stress Index (PSI) were used to assess the symptoms and parenting stress of 132 non-medicated children with ADHD as compared with 88 healthy controls.
  
  
  RESULTS
  Every PSQ factor of ADHD children was higher than in the control group; children with the combined subtype of ADHD had the highest scores in conduct and learning problems, impulsivity/hyperactivity, and overall hyperactivity index; the PSI total stress, child domain, and parent domain scores were all higher in the ADHD group than in the control group; children with the combined subtype of ADHD had the highest score in the competence subscale of the parent domain, whereas the PSI total stress score of parents of children with ADHD and comorbid oppositional defiant disorder (ODD) was higher than that of parents of children with only ADHD. The PSI total stress score was positively correlated with all PSQ factor scores. The PSQ factors of conduct problems and learning problems were found to be significant predictors in a regression analysis.
  
  
  CONCLUSIONS
  The children with ADHD exhibited abnormal parenting stress compared with healthy controls, which was much more pronounced when the children had comorbid ODD. Furthermore, parenting stress was related with the severity of ADHD symptoms, suggesting that children with the combined subtype of ADHD require particular attention in the future.
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Wen-Qing
authors.initials: WQ
authors.lastname: Jiang
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ya-Song
authors.initials: YS
authors.lastname: Du
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Dundee, Dundee, UK.
authors.forename: David
authors.initials: D
authors.lastname: Coghill
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000453:epidemiology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D000066553:Problem Behavior / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: attention deficit hyperactivity disorder; behavioral symptom; comorbidity; different subtype; parenting stress