Remarkable high frequency of insecure attachment in children with ADHD persists in a three-year follow-up

Nord J Psychiatry. 2022 Jul;76(5):323-329. doi: 10.1080/08039488.2021.1969428. Epub 2021 Oct 10.

Abstract

Background: Studies have pointed to a complicated and mutual relationship between attention deficit hyperactivity disorder (ADHD) and attachment. In an observational follow-up study conducted in 2015 60 children from 7 years to 12 years recently diagnosed with ADHD were included and assessed according to attachment representation showing 85% of the children to be insecurely attached.

Aim: The aim of this study was to investigate the stability of this remarkably high frequency of insecure attachment in the same cohort of children.

Methods: Children previously assessed using the child attachment interview (CAI) when diagnosed with ADHD were contacted three years later for a follow-up CAI assessment.

Results: At follow-up, 31 children participated in the CAI-interviews. Since their diagnosis with ADHD, the children had received treatment as usual. The CAI-interviews showed a continued high rate of insecure attachment with 90% of the children classifying as insecurely attached compared to expected 38% in the normal population. Of these, the majority of children (77%) were classified as dismissing.

Conclusion: Our findings suggest that targeting ADHD-symptoms with our current treatment strategies does not in itself improve attachment security. Attachment security may in turn be a factor of importance when evaluating general functioning and prognosis.

Keywords: ADHD; Attention deficit hyperactivity disorder; child attachment interview; follow-up; insecure attachment.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Child
  • Follow-Up Studies
  • Humans
  • Object Attachment