Dissecting daily distress in mothers of children with ADHD: an electronic diary study

It is well known that parents of children with attention-deficit/hyperactivity disorder (ADHD) experience elevated levels of caregiver stress, but little is known about the ebb and flow of parental distress as it happens, or the degree of synchrony between short-term oscillations in child behaviors and maternal distress. Electronic diaries (eDiaries) were used to dissect daily distress in natural settings. Across 7 days during nonschool hours, half-hourly eDiaries were completed independently by mothers and their 8- to 12-year-old children (51 receiving medication for ADHD and 58 comparison peers). Diary items tapped behaviors, moods, and contexts, with children reporting their own behaviors and mothers reporting on themselves and their children. Maternal distress and child ADHD-type behaviors exhibited moderate to strong associations "in the moment," whether child behaviors were reported by mothers or children. This mother-child synchrony emerged for the comparison as well as the ADHD group, although the associations were stronger when the dyad included a child with ADHD. Because fixed-effects analyses were conducted, these patterns are not attributable to levels of psychopathology or other stable individual differences in mothers or children. Further moderation analyses revealed that the links between child behaviors and maternal distress were strengthened by maternal risk and attenuated by child behavioral self-esteem; these effects were modest but detectable. These findings can help guide not only interventions targeted on improving quality of life in families of children with ADHD, but also programs designed to help all parents identify and manage their own parenting stressors.