Differential impacts of parental attention deficit/hyperactivity disorder on early maternal-infant attachment

Parental attention deficit/hyperactivity disorder (ADHD) is associated with increased postpartum depressive symptoms and impaired daily functioning, potentially impacting early maternal-infant attachment (MIA).

78 mothers, half with ADHD, were enrolled during pregnancy or postpartum. Participants completed questionnaires regarding social support, home chaos, postpartum depressive symptoms, and postnatal MIA. Pregnant participants (n = 45) also reported antenatal MIA. ANOVA compared mothers without ADHD (n = 44), mothers with ADHD (n = 21), and mothers with ADHD coparents (infants' fathers; n = 13), and Benjamini-Hochberg correction was applied to account for multiple testing. Multilevel linear regression examined predictors of MIA.

Mothers with ADHD reported greater postpartum depressive symptoms and home chaos than mothers with ADHD coparents or those without parental ADHD; mothers with ADHD coparents reported the poorest overall MIA and quality of attachment and greatest hostility toward their infants (Benjamini-Hochberg false discovery rate q < 0.05). In the final model for MIA, postpartum depressive symptoms (B = -0.85, p < 0.001) and coparent ADHD (B = -4.70, p = 0.051) were associated with poorer MIA (R ²  = 0.40, p < 0.001). When examining MIA subscales, postpartum depressive symptoms were negatively correlated with subscales measuring quality of attachment and absence of hostility but not pleasure in mother-child interaction. When antenatal attachment was included, it (B = 0.65, p = 0.002), along with postpartum depressive symptoms (B = -0.60, p = 0.032), predicted postnatal MIA (R ²  = 0.50, p < 0.001).

Given parental ADHD (mother or father) was associated with increased maternal postpartum depressive symptoms and less optimal MIA in this study, additional support for families with ADHD in the perinatal period may improve maternal and infant mental health outcomes. Future work incorporating observational data and additional investigation of the coparenting relationship is needed to further clarify determinants of MIA in early childhood.