Caregiver Strain and Girls' ADHD, ODD, and Personality Pathology Symptoms: A One-Year Prospective Study

Caregiver strain influences service utilization and engagement. Prior work-largely centered on boys-shows that attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) strongly contribute to strain; however, less is known about these relations in girls. This study examined associations between youth psychopathology symptom dimensions (ADHD, ODD, borderline personality features [BPF], a problem more commonly identified in girls) and caregiver strain facets (objective, subjective internalized, subjective externalized, total strain) among caregivers of 10- to 15-year-old girls (N = 197, M_age = 12.06), and whether these associations changed over one year. ADHD, ODD, BPF, and subjective externalized strain increased over time (ΔM_range = 0.03-0.36, 95% CIs [0.02, 0.50], p ≤ .007, d = 0.06-0.15), whereas total and subjective internalized strain decreased (ΔM_range = - 0.19 to - 0.05, 95% CIs [-0.21, - 0.03], p < .001, d = 0.08-0.24). All psychopathology dimensions were positively associated with each caregiver strain facet, concurrently and longitudinally. Linear mixed models revealed positive, facet-specific main effects: ADHD, ODD, and BPF on total and subjective internalized strain; ADHD and BPF on objective strain; and ODD and BPF on subjective externalized strain. A Time × ADHD interaction indicated a weakening association between ADHD and objective strain over time (b = - 0.24, 95% CI [-0.43, - 0.05], p_FDR = 0.022), whereas Time × ODD interactions indicated strengthening associations with total, objective, and subjective externalized strain (b_range = 0.25-0.27, 95% CIs [0.05, 0.48], p_FDR ≤ 0.032). Findings underscore domain-specific and developmentally dynamic associations between youth psychopathology and caregiver strain in families of adolescent girls.