Severity of children's ADHD symptoms and parenting stress: a multiple mediation model of self-regulation

The goal of the current study was to determine the extent to which the perceived self-regulation deficits across behavioral, cognitive, and emotional domains seen in children with ADHD explain the association between the severity of ADHD symptoms and parenting stress. Participants for this study included 80 children (mean age = 10 years, 9 months) with a DSM-IV diagnosis of ADHD confirmed by a comprehensive clinical diagnostic assessment. Parents reported their own stress levels as well as the severity of their children's ADHD symptoms, aggression, emotional lability, and executive functioning difficulties. Results indicated that the severity of children's hyperactivity/impulsivity symptoms but not their inattention related to parenting stress. Multiple mediational analyses indicated that the association between hyperactivity/impulsivity and parenting stress was explained by children's perceived comorbid aggression levels, emotional lability, and executive functioning difficulties. No significant differences in the strength of the mediators were found. The current study provides initial data showing that the perceived impairments in children's self-regulation across emotional, cognitive, and behavioral domains are what parents report as stressful, not simply the severity of ADHD symptoms. Due to the cross-sectional nature of this study and shared variance from relying solely on parent report, it will be critical for future research to replicate our findings using longitudinal and multi-informant data such as teacher reports and standardized assessments.