Family environment in attention deficit hyperactivity, oppositional defiant and conduct disorders

This study aims to ascertain whether there were differences in family environment among patients with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder and conduct disorder.

The records of 233 patients, selected for high or low scores on a scale that taps ADHD symptoms, were reviewed by three clinicians who made DSM-IV diagnoses and rated the family environment with the Global Family Environment Scale (GFES). Self-report data obtained from the parent and child versions of the Child Behaviour Checklist were also used. The quality of the family environment was then compared between the various diagnostic groups.

A poorer family environment was associated with conduct disorder and oppositional defiant disorder and predicted a worse outcome (e.g. admission to a non-psychiatric institution, drug and alcohol abuse). Quality of the family environment did not vary according to ADHD diagnosis or gender.

There seems to be no association between the quality of the family environment and a diagnosis of ADHD among referred adolescents. However, there is an association with conduct disorder. Interventions that improve family environment in the early years of life may prevent the development of conduct problems.