The Stigmatization of Caregivers of Children With Attention-Deficit/Hyperactivity Disorder: A Systematic Review

Research on Attention-Deficit/Hyperactivity Disorder (ADHD)-related stigma has centered on individuals with the diagnosis. Evidence concerning caregivers exists but has not been brought together in a way that clarifies its scope, correlates, and implications, despite caregivers' central role in navigating services, supporting daily functioning, and treatment engagement. The present study therefore to systematically review the empirical literature on the stigmatization of caregivers of children with ADHD. Following PRISMA guidelines, we searched PubMed and PsycINFO for studies between 2013 and 2024. Of the 4136 articles, 15 studies examining affiliate and courtesy stigma met criteria. Across studies, affiliate stigma was consistently linked to higher levels of caregiver depression, anxiety, and distress, as well as coping strategies and parenting styles. Higher education levels among caregivers were associated with lower affiliate stigma. The severity of the child's ADHD symptoms and internalizing/externalizing problems significantly associated with the level of stigma experienced by caregivers. Courtesy stigma was associated with several factors, including negative attitudes (e.g., anger or blame directed at children with ADHD) among members of the general public. These findings highlight the multifaceted associations of stigma on caregivers. The association between affiliate stigma and caregiver psychological distress underscores the need for targeted interventions, however only one intervention study met inclusion criteria for this review. The association between negative attitudes and courtesy stigma indicates the importance of addressing public perceptions. Future research should focus on developing and testing interventions that aim to reduce stigma and improve the well-being of caregivers and their families. Trial Registration: Prospero registration number: CRD42024527305.