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Impact of exposure to parental attention-deficit hyperactivity disorder on clinical features and dysfunction in the
J Biederman1, S V Faraone, M C Monuteaux
1Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
Insights
Parental attention-deficit/hyperactivity disorder (ADHD) exposure impacts family dynamics, increasing conflict and reducing cohesion, but does not elevate ADHD risk in offspring beyond genetic factors. Treating parental ADHD is crucial for affected youth.
Area of Science:
- Neurodevelopmental disorders
- Genetics and epigenetics
- Child and adolescent psychiatry
Background:
- Genetic factors are known contributors to Attention-Deficit/Hyperactivity Disorder (ADHD) etiology.
- The specific impact of parental ADHD exposure on offspring clinical features and dysfunction requires further investigation.
Purpose of the Study:
- To investigate the impact of parental ADHD on clinical features and dysfunction in offspring.
- To compare offspring of non-ADHD, remitted ADHD, and persistent ADHD parents.
Main Methods:
- A cohort of 1099 offspring (mean age 12.4 years) from parents with and without ADHD was studied.
- Structured diagnostic interviews and cognitive/psychosocial measures were employed.
- Analyses adjusted for parental psychopathology, offspring ADHD status, and social class.
Main Results:
- Parental ADHD exposure was linked to increased family conflict and decreased family cohesion, irrespective of other parental psychopathology or offspring ADHD status.
- Parental ADHD did not significantly differentiate offspring ADHD risk between remitted versus persistent ADHD parents.
- Parental ADHD detrimentally affected school performance in offspring without ADHD, but not in those with ADHD.
Conclusions:
- The study found no evidence that parental ADHD exposure increases offspring ADHD risk beyond the inherent genetic liability.
- Exposure to parental ADHD negatively impacts family environment, highlighting the importance of identifying and treating adult ADHD.
- Addressing parental ADHD may be a vital part of treatment plans for children with ADHD.
Background:
Although genes are known to influence the aetiology of ADHD, the impact of exposure to parental ADHD has received limited scientific scrutiny. This study investigated the impact of exposure to parental ADHD on clinical features and dysfunction in offspring.
Methods:
We studied 1099 offspring (53% male, mean age 12.4 years) of non-ADHD, remitted ADHD, and persistent ADHD parents, using structured diagnostic interviews and a battery of cognitive and psychosocial measures. Offspring across these three groups were compared on clinical, cognitive and psychosocial outcomes, adjusting for exposure to other parental psychopathology, offspring ADHD status and social class.
Results:
Parental ADHD was associated with an increased risk for ADHD in offspring relative to no parental ADHD, but no significant differences were found between children of remitted versus persistent ADHD parents. Exposure to parental ADHD predicted higher levels of family conflict and lesser levels of family cohesion relative to families without parental ADHD, independent of other psychopathological conditions in parents or ADHD status. Significant interactions were detected in which parental ADHD had a deleterious impact on measures of school performance in offspring without ADHD but not in those with the disorder.
Conclusions:
These results find no support for the hypothesis that exposure to parental ADHD increases the risk for ADHD in children beyond that conveyed by the liability associated with the diagnosis in the parent. However, since exposure to parental ADHD was associated with a disruptive family environment, the identification and treatment of adults with ADHD may be an important component of the treatment plan of youth with ADHD.