A Dyadic Perspective on ADHD: Adolescent-Parent Reports of Behavioural Problems and Family Functioning

Diagnosing behavioural problems in adolescents often relies on subjective reports from parents or caregivers. Systemic theory emphasizes the need for multiple perspectives, including those of the adolescent. This study examined the alignment between adolescents' and parents' perceptions of behavioural problems in ADHD and non-ADHD groups and explored how family cohesion and flexibility explain the severity of externalizing and internalizing behaviours from both perspectives. Participants included 214 adolescents diagnosed with ADHD and their parents (adolescents: Mage = 11.24, SD = 0.91, 75.23% boys; parents: Mage = 41.92, SD = 6.43, 84.11% mothers) and 514 adolescents without ADHD and their parents (adolescents: Mage = 11.34, SD = 0.75, 51.56% boys; parents: Mage = 42.29, SD = 5.58, 87.55% mothers), from 18 cities in southern Poland. The variables were measured using the ASEBA instruments (Child Behaviour Checklist, Youth Self Report) and the Family Adaptation and Cohesion Evaluation Scales. Data were analysed using Actor-Partner Interdependence Models to examine actor and partner associations within adolescent-parent dyads. More boys were diagnosed with ADHD, showing slightly more externalizing problems than girls. Lower family flexibility predicted externalizing behaviours, with parent-rated flexibility linked to parent-rated behaviours, and adolescent-rated flexibility linked to adolescent-rated behaviours. Adolescent-rated family cohesion rated by adolescents predicted fewer externalizing behaviours as reported by parents in the ADHD group and by adolescents in the non-ADHD group. Internalizing behaviours were linked to family flexibility and cohesion, regardless of the actor (adolescent or parent). The predominance of actor effects indicates that each informant's perception of family functioning is uniquely linked to their own reports of symptoms; given only moderate parent-adolescent agreement, these perspectives appear complementary rather than redundant. Assessing behavioural problems requires data from both parents and adolescents, as family cohesion and flexibility significantly impact adolescent functioning. Trial Registration: ClinicalTrials.gov identifier: NCT04574414.