European Journal of Pediatrics

, Volume 171, Issue 2, pp 271–280 | Cite as

Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study

  • Alexandra Cussen
  • Emma SciberrasEmail author
  • Obioha C. Ukoumunne
  • Daryl Efron
Original Paper


This study examined the relationship between family functioning and attention-deficit/hyperactivity disorder (ADHD) symptoms in an Australian community-based sample. Children were screened for ADHD in their second year of formal schooling. Two hundred and two (202) primary caregivers completed validated measures of family quality of life (QoL), parent mental health, parenting styles and parental relationship quality. Compared with controls, parents of children screening positive for ADHD reported poorer family QoL in the domains of emotional impact (mean difference [MD] −20.1; 95% CI −38.2 to −1.9, p = 0.03) and impact on family activities (MD −17.2; 95% CI −27.9 to −6.5, p = 0.002), less parental warmth (MD −3.4; 95% CI −6.0 to −0.9, p = 0.01) and higher parental depression (MD 6.8; 95% CI 1.8 to 11.7, p = 0.009) and anxiety (MD 6.2; 95% CI 1.7 to 10.6, p = 0.008) after adjusting for socio-demographic characteristics and child conduct symptoms. Parents of children screening positive for ADHD reported higher stress (MD 4.5; 95% CI 1.2 to 7.1, p = 0.007) and more inconsistent (MD 3.0; 95% CI 1.2 to 4.8, p = 0.002) and hostile (MD = 2.2; 95% CI 1.0 to 3.4, p = 0.001) parenting after adjusting for socio-demographic factors only. No difference in parental relationship quality and parental inductive reasoning was identified. Conclusion: These findings suggest a strong association between poor family functioning and ADHD symptoms and carry implications for comprehensive ADHD management and the importance of seeing the child within the family context.


Attention-deficit/hyperactivity disorder Family functioning Parenting Quality of life Parent mental health 


Conflict of interest

The authors declare that they have no conflict of interest, nor a financial relationship, with the organisation that sponsored the research.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Alexandra Cussen
    • 1
    • 2
  • Emma Sciberras
    • 2
    • 3
    Email author
  • Obioha C. Ukoumunne
    • 5
  • Daryl Efron
    • 2
    • 3
    • 4
  1. 1.Department of Medicine, Dentistry and Health SciencesUniversity of MelbourneMelbourneAustralia
  2. 2.Centre for Community Child HealthRoyal Children’s HospitalParkvilleAustralia
  3. 3.Murdoch Childrens Research InstituteMelbourneAustralia
  4. 4.Department of PaediatricsUniversity of MelbourneMelbourneAustralia
  5. 5.PenCLAHRC, Peninsula College of Medicine and DentistryUniversity of ExeterExeterUK

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