Parent-child interaction patterns and adolescent functioning in Saudi families managing ADHD: A cross-sectional study

Parent-child interaction patterns are critical for attention-deficit/hyperactivity disorder (ADHD) outcomes but limited relevant research has been conducted in KSA. The present study examined parent-child interaction patterns, their relationships with adolescent functioning, and the influence of sociodemographic factors in Saudi families managing ADHD.

This cross-sectional study recruited 126 caregiver-adolescent dyads from specialized clinics. Caregivers completed the Alabama Parenting Questionnaire and Strengths and Difficulties Questionnaire (SDQ). Data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple linear regression with effect sizes (Cohen's f²).

Mean adolescent age was 14.6 years (69.8% male). Positive parenting (praise: 86.5%; friendly conversations: 66.6%) was common, but 60.3% reported yelling and 47.6% reported inconsistent supervision. Adolescents had strengths (57.1% kind to younger children) but also challenges (65.1% easily distracted). Correlations indicated that positive parenting was associated with fewer difficulties (r = -0.28 to -0.24), while inconsistent/harsh discipline was associated with greater impairment (r = 0.26 to 0.42). Regression analyses demonstrated that maternal guardianship was associated with higher SDQ scores (β = 12.097, p = 0.019, f² = 0.15), while higher parental education (β = -3.017, p = 0.021, f² = 0.09), better school performance (β = -3.257, p = 0.009, f² = 0.11), and access to support services (β = -3.157, p = 0.006, f² = 0.12) were protective. The full model explained 28% of the variance in adolescent functioning (f² = 0.39), indicating a moderate-to-large collective effect.

Culturally sensitive family-based interventions that strengthen positive parenting, promote consistent discipline, and improve access to school and psychosocial support services should be prioritized in ADHD care programs in KSA. These strategies may help to reduce emotional and behavioral difficulties among adolescents with ADHD and support better family functioning. However, these findings should be interpreted with caution due to the cross-sectional design and clinic-based sampling limiting causal inference and generalizability.