Behavioral and mental health problems in adolescents with ADHD: Exploring the role of family resilience

J Affect Disord. 2021 Nov 1:294:450-458. doi: 10.1016/j.jad.2021.07.073. Epub 2021 Jul 22.

Abstract

Background: Family resilience and its role in behavioral and mental health problems has not been well documented among U.S. adolescents, especially those with ADHD.

Methods: Using data from the 2016 and 2017 National Survey of Children's Health (NSCH), we examined associations between family resilience connection index (FRCI) and conduct problems, depression, anxiety, and substance abuse in adolescents with ADHD aged 11-17 (n=4,169). Data were analyzed using multivariate logistic regression and chi-square tests.

Results: Adolescents with ADHD who had a lower FRCI score were more likely to have conduct problems (OR:1.64, CI:1.13-2.38) and depression (OR: 3.08, CI: 2.12-4.49). There were small differences between adjusted and unadjusted odds after controlling for adverse childhood experience and other covariates.

Limitation: We could not assert prediction or causation, only associations among variables, due to the cross-sectional design of the 2016-2017 NSCH; however, a major advantage of the NSCH is that it includes a nationally representative sample of children and allows inferences to be made for understanding of the adolescents with ADHD in the U.S.

Conclusion: Findings suggest that family resilience may serve as a protective factor that leads to decreasing conduct problems, despite experiencing adversity in childhood. Targeting family resilience, in terms of teaching families ways to cope with adversities such as: a child's diagnosis of ADHD; behavioral problems, and/or other adverse experiences in children's environments, has great potential to reduce adolescents' conduct and mental health problems.

Keywords: Adolescent; Adverse Childhood Experiences (ACEs); Attention-deficit/hyperactivity disorder (ADHD); Behavioral and mental health problems; Family resilience.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Child
  • Cross-Sectional Studies
  • Family Health
  • Humans
  • Mental Health
  • Resilience, Psychological*