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Child Psychiatry & Human Development

, Volume 47, Issue 3, pp 440–458 | Cite as

The Association Between Socioeconomic Disadvantage and Attention Deficit/Hyperactivity Disorder (ADHD): A Systematic Review

  • Abigail Emma RussellEmail author
  • Tamsin Ford
  • Rebecca Williams
  • Ginny Russell
Substantive/Theoretical Review

Abstract

This systematic review examines associations between parental socioeconomic disadvantage and childhood attention deficit/hyperactivity disorder (ADHD). Socioeconomic status (SES) was measured by parental income, education, occupation and marital status. Results were mixed by measure of SES with no one aspect being differentially related to ADHD. 42 studies were included in the review, of which 35 found a significant univariate association between socioeconomic disadvantage and ADHD. Meta-analyses of dimensions of SES and their association with ADHD indicate that children in families of low SES are on average 1.85–2.21 more likely to have ADHD than their peers in high SES families. In spite of substantial between-study heterogeneity, there is evidence for an association between socioeconomic disadvantage and risk of ADHD measured in different ways. This is likely mediated by factors linked to low SES such as parental mental health and maternal smoking during pregnancy.

Keywords

Attention deficit/hyperactivity disorder ADHD Socioeconomic disadvantage Socioeconomic status SES Health inequalities 

Abbreviations

ADHD

Attention deficit/hyperactivity disorder

SES

Socioeconomic status

Notes

Acknowledgments

The authors thank the Evidence Synthesis Team of the University of Exeter Medical School for their support and assistance, and Dr Obioha Ukoumunne for his advice on meta-analysis. This research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Compliance with Ethical Standards

Conflict of interest

None.

References

  1. 1.
    Polanczyk G, de Lima M, Horta B, Biederman J, Rohde L (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948CrossRefPubMedGoogle Scholar
  2. 2.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders IV, Text Revision. American Psychiatric AssociationGoogle Scholar
  3. 3.
    Cooper P (2001) Understanding AD/HD: a brief critical review of literature. Child Soc 15(5):387–395CrossRefGoogle Scholar
  4. 4.
    Galera C, Bouvard MP, Lagarde E, Michel G, Touchette E, Fombonne E et al (2012) Childhood attention problems and socioeconomic status in adulthood: 18-year follow-up. Br J Psychiatry 201(1):20–25CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Sacker A, Schoon I, Bartley M (2002) Social inequality in educational achievement and psychosocial adjustment throughout childhood: magnitude and mechanisms. Soc Sci Med 55(5):863–880CrossRefPubMedGoogle Scholar
  6. 6.
    Klein RG, Mannuzza S, Olazagasti MAR, Roizen E, Hutchison JA, Lashua EC et al (2012) Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry 69(12):1295–1303CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Bernfort L, Nordfeldt S, Persson J (2008) ADHD from a socio-economic perspective. Acta Paediatr 97(2):239–245CrossRefPubMedGoogle Scholar
  8. 8.
    Russell G, Ford T, Rosenberg R, Kelly S (2013) The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence. J Child Psychol Psychiatry 55(5):436–445CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Linnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A et al (2003) Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry 160(6):1028–1040CrossRefPubMedGoogle Scholar
  10. 10.
    Thapar A, Fowler T, Rice F, Scourfield J, van den Bree M, Thomas H et al (2003) Maternal smoking during pregnancy and attention deficit hyperactivity disorder symptoms in offspring. Am J Psychiatry 160(11):1985–1989CrossRefPubMedGoogle Scholar
  11. 11.
    Pheula GF, Rohde LA, Schmitz M (2011) Are family variables associated with ADHD, inattentive type? A case-control study in schools. Eur Child Adolesc Psychiatry 20(3):137–145CrossRefPubMedGoogle Scholar
  12. 12.
    Kreppner JM, O’Connor TG, Rutter M (2001) Can inattention/overactivity be an institutional deprivation syndrome? J Abnorm Child Psychol 29(6):513–528CrossRefPubMedGoogle Scholar
  13. 13.
    Mulligan A, Anney R, Butler L, O’Regan M, Richardson T, Tulewicz EM et al (2013) Home environment: association with hyperactivity/impulsivity in children with ADHD and their non-ADHD siblings. Child Care Health Dev 39(2):202–212CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K et al (2007) Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet 370(9598):1560–1567CrossRefPubMedGoogle Scholar
  15. 15.
    Williams NM, Zaharieva I, Martin A, Langley K, Mantripragada K, Fossdal R et al (2010) Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder: a genome-wide analysis. Lancet 376(9750):1401–1408CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Kahn RS, Khoury J, Nichols WC, Lanphear BP (2003) Role of dopamine transporter genotype and maternal prenatal smoking in childhood hyperactive-impulsive, inattentive, and oppositional behaviors. J Pediatr 143(1):104–110CrossRefPubMedGoogle Scholar
  17. 17.
    Boe T, Overland S, Lundervold AJ, Hysing M (2012) Socioeconomic status and children’s mental health: results from the Bergen Child Study. Soc Psychiatry Psychiatr Epidemiol 47(10):1557–1566CrossRefPubMedGoogle Scholar
  18. 18.
    Froehlich TE, Lanphear BP, Epstein JN, Barbaresi WJ, Katusic SK, Kahn RS (2007) Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med 161(9):857–864CrossRefPubMedGoogle Scholar
  19. 19.
    Russell G, Rodgers L, Ukoumunne O, Ford T (2013) Prevalence of parent-reported ASD and ADHD in the UK: findings from the millennium cohort study. J Autism Dev Disord 44(1):31–40CrossRefGoogle Scholar
  20. 20.
    Bradley RH, Corwyn RF (2002) Socioeconomic status and child development. Annu Rev Psychol 53(1):371–399CrossRefPubMedGoogle Scholar
  21. 21.
    Miech RA, Caspi A, Moffitt TE, Wright BRE, Silva PA (1999) Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. Am J Sociol 104(4):1096–1131CrossRefGoogle Scholar
  22. 22.
    Scahill L, Schwab-Stone M, Merikangas KR, Leckman JF, Zhang H, Kasl S (1999) Psychosocial and clinical correlates of ADHD in a community sample of school-age children. J Am Acad Child Adolesc Psychiatry 38(8):976–984CrossRefPubMedGoogle Scholar
  23. 23.
    Larsson H, Sariaslan A, Langstrom N, D’Onofrio B, Lichtenstein P (2013) Family income in early childhood and subsequent attention deficit/hyperactivity disorder: a quasi-experimental study. J Child Psychol Psychiatry 55(5):428–435CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi KS, Metzler M et al (2005) Socioeconomic status in health research: one size does not fit all. JAMA 294(22):2879–2888CrossRefPubMedGoogle Scholar
  25. 25.
    Shavers VL (2007) Measurement of socioeconomic status in health disparities research. J Natl Med Assoc 99(9):1013PubMedPubMedCentralGoogle Scholar
  26. 26.
    Conger RD, Donnellan MB (2007) An interactionist perspective on the socioeconomic context of human development. Annu Rev Psychol 58:175–199CrossRefPubMedGoogle Scholar
  27. 27.
    Galobardes B, Lynch J, Smith GD (2007) Measuring socioeconomic position in health research. Br Med Bull 81(1):21–37CrossRefPubMedGoogle Scholar
  28. 28.
    Miech RA, Hauser RM (2001) Socioeconomic status and health at midlife: a comparison of educational attainment with occupation-based indicators. Ann Epidemiol 11(2):75–84CrossRefPubMedGoogle Scholar
  29. 29.
    Mackenbach JP (2012) The persistence of health inequalities in modern welfare states: the explanation of a paradox. Soc Sci Med 75(4):761–769CrossRefPubMedGoogle Scholar
  30. 30.
    Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31CrossRefPubMedGoogle Scholar
  31. 31.
    Graham H (2002) Building an inter-disciplinary science of health inequalities: the example of lifecourse research. Soc Sci Med 55(11):2005–2016CrossRefPubMedGoogle Scholar
  32. 32.
    Taylor E, Rogers JW (2005) Practitioner review: early adversity and developmental disorders. J Child Psychol Psychiatry 46(5):451–467CrossRefPubMedGoogle Scholar
  33. 33.
    von Stumm S, Deary IJ, Kivimaki M, Jokela M, Clark H, Batty GD (2011) Childhood behavior problems and health at midlife: 35-year follow-up of a Scottish birth cohort. J Child Psychol Psychiatry 52(9):992–1001CrossRefGoogle Scholar
  34. 34.
    Kiernan KE, Mensah FK (2009) Poverty, maternal depression, family status and children’s cognitive and behavioural development in early childhood: a longitudinal study. J Social Policy 38(04):569–588CrossRefGoogle Scholar
  35. 35.
    Hausner E, Waffenschmidt S, Kaiser T, Simon M (2012) Routine development of objectively derived search strategies. Syst Rev 1(1):1–10CrossRefGoogle Scholar
  36. 36.
    Koster J (2004) PubMed PubReMiner: a tool for PubMed query building and literature mining. http://hgserver2.amc.nl/cgi-bin/miner/miner2.cgi
  37. 37.
    Reuters Thomson (2011) Endnote X5. Thomson Reuters, New YorkGoogle Scholar
  38. 38.
    StataCorp (2013) Stata statistical software: release 13. StataCorp LP, College StationGoogle Scholar
  39. 39.
    de Oliveira Pires T, da Silva CMFP, de Assis SG (2013) Association between family environment and attention deficit hyperactivity disorder in children–mothers’ and teachers’ views. BMC Psychiatry 13(1):1–9CrossRefGoogle Scholar
  40. 40.
    Li S, Jin X, Yan C, Wu S, Jiang F, Shen X (2009) Sleep problems in chinese school-aged children with a parent-reported history of ADHD. J Atten Disord 13(1):18–26CrossRefPubMedGoogle Scholar
  41. 41.
    Lingineni RK, Biswas S, Ahmad N, Jackson BE, Bae S, Singh KP (2012) Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey. BMC Pediatr 12(1):50CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Graetz BW, Sawyer MG, Hazell PL, Arney F, Baghurst P (2001) Validity of DSM-IV ADHD subtypes in a nationally representative sample of Australian Children and Adolescents. J Am Acad Child Adolesc Psychiatry 40(12):1410–1417CrossRefPubMedGoogle Scholar
  43. 43.
    Khamis V (2006) Family environment and parenting as predictors of attention-deficit and hyperactivity among Palestinian Children. Journal of Social Service Research 32(4):99–116CrossRefGoogle Scholar
  44. 44.
    Duric NS, Elgen I (2011) Characteristics of Norwegian children suffering from ADHD symptoms: ADHD and primary health care. Psychiatry Res 188(3):402–405CrossRefPubMedGoogle Scholar
  45. 45.
    Franz M, Lensche H, Schmitz N (2003) Psychological distress and socioeconomic status in single mothers and their children in a German city. Soc Psychiatry Psychiatr Epidemiol 38(2):59–68CrossRefPubMedGoogle Scholar
  46. 46.
    Sagiv SK, Epstein JN, Bellinger DC, Korrick SA (2013) Pre- and postnatal risk factors for ADHD in a nonclinical pediatric population. J Atten Disord 17(1):47–57CrossRefPubMedGoogle Scholar
  47. 47.
    Yoshimasu K, Kiyohara C, Minami T, Yoshikawa N, Kihira S, Toyonaga K et al (2009) Maternal smoking during pregnancy and offspring attention-deficit/hyperactivity disorder: a case-control study in Japan. Atten Defic Hyperact Disord 1(2):223–231CrossRefPubMedGoogle Scholar
  48. 48.
    De Ridder A, De Graeve D (2007) Children with ADHD in Flanders: profile of consumption of health care, school attainments and impact on the household. [Dutch]Kinderen met ADHD in Vlaanderen: Profiel van zorgconsumptie, schoolresultaten en impact op het gezin. Tijdschrift voor Geneeskunde 63(11):525–531CrossRefGoogle Scholar
  49. 49.
    Schneider H, Eisenberg D (2006) Who receives a diagnosis of attention-deficit/hyperactivity disorder in the United States elementary school population? Pediatrics 117(4):e601–e609CrossRefPubMedGoogle Scholar
  50. 50.
    Dopfner M, Breuer D, Wille DPN, Erhart M, Ravens-Sieberer U (2008) How often do children meet ICD-10/DSM-IV criteria of attention deficit-/hyperactivity disorder and hyperkinetic disorder? Parent-based prevalence rates in a national sample—results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl 1):59–70CrossRefPubMedGoogle Scholar
  51. 51.
    Cornejo JW, Osio O, Sanchez Y, Carrizosa J, Sanchez G, Grisales H et al (2005) Prevalence of attention deficit hyperactivity disorder in Colombian children and teenagers. Rev Neurol 40(12):716–722PubMedGoogle Scholar
  52. 52.
    Ornoy A (2003) The impact of intrauterine exposure versus postnatal environment in neurodevelopmental toxicity: long-term neurobehavioral studies in children at risk for developmental disorders. Toxicol Lett 140–141:171–181CrossRefPubMedGoogle Scholar
  53. 53.
    Counts CA, Nigg JT, Stawicki JA, Rappley MD, Von Eye A (2005) Family adversity in DSM-IV ADHD combined and inattentive subtypes and associated disruptive behavior problems. J Am Acad Child Adolesc Psychiatry 44(7):690–698CrossRefPubMedGoogle Scholar
  54. 54.
    Flouri E, Buchanan A, Tan JP, Griggs J, Attar-Schwartz S (2010) Adverse life events, area socio-economic disadvantage, and adolescent psychopathology: the role of closeness to grandparents in moderating the effect of contextual stress. Stress 13(5):402–412CrossRefPubMedGoogle Scholar
  55. 55.
    Biederman J, Faraone SV, Monuteaux MC (2002) Differential effect of environmental adversity by gender: Rutter’s index of adversity in a group of boys and girls with and without ADHD. Am J Psychiatry 159(9):1556–1562CrossRefPubMedGoogle Scholar
  56. 56.
    Andres MA, Catala MA, Gomez-Beneyto M (1999) Prevalence, comorbidity, risk factors and service utilisation of disruptive behaviour disorders in a community sample of children in Valencia (Spain). Soc Psychiatry Psychiatr Epidemiol 34(4):175–179CrossRefPubMedGoogle Scholar
  57. 57.
    Ford T, Goodman R, Meltzer H (2004) The relative importance of child, family, school and neighbourhood correlates of childhood psychiatric disorder. Soc Psychiatry Psychiatr Epidemiol 39(6):487–496CrossRefPubMedGoogle Scholar
  58. 58.
    Al Hamed JH, Taha AZ, Sabra AA, Bella H (2009) Attention deficit hyperactivity disorder (ADHD): is it a health problem among male primary school children. Bahrain Med Bull 30(2):67–71Google Scholar
  59. 59.
    Kotimaa AJ, Moilanen I, Taanila A, Ebeling H, Smalley SL, Mcgough J et al (2003) Maternal smoking and hyperactivity in 8-year-old children. J Am Acad Child Adolesc Psychiatry 42(7):826–833CrossRefPubMedGoogle Scholar
  60. 60.
    Bener A, Al Qahtani R, Teebi AS, Bessisso M (2008) The prevalence of attention deficit hyperactivity symptoms in schoolchildren in a highly consanguineous community. Med Princ Pract 17(6):440–446CrossRefPubMedGoogle Scholar
  61. 61.
    Wagner AI, Schmidt NL, Lemery-Chalfant K, Leavitt LA, Goldsmith HH (2009) The limited effects of obstetrical and neonatal complications on conduct and attention-deficit hyperactivity disorder symptoms in middle childhood. J Dev Behav Pediatr 30(3):217–225CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Anselmi L, Menezes A, Barros FC, Hallal PC, Araújo CL, Domingues MR et al (2010) Early determinants of attention and hyperactivity problems in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study. Cad Saude Publica 26(10):1954–1962CrossRefPubMedGoogle Scholar
  63. 63.
    Sciberras E, Ukoumunne OC, Efron D (2011) Predictors of parent-reported attention-deficit/hyperactivity disorder in children aged 6–7 years: a national longitudinal study. J Abnorm Child Psychol 39(7):1025–1034CrossRefPubMedGoogle Scholar
  64. 64.
    Getahun D, Jacobsen SJ, Fassett MJ, Chen W, Demissie K, Rhoads GG (2013) Recent trends in childhood attention-deficit/hyperactivity disorder. JAMA Pediatr 167(3):282–288CrossRefPubMedGoogle Scholar
  65. 65.
    McLaughlin KA, Sheridan MA, Winter W, Fox NA, Zeanah CH, Nelson CA (2014) Widespread reductions in cortical thickness following severe early-life deprivation: a neurodevelopmental pathway to attention-deficit/hyperactivity disorder. Biol Psychiatry 76(8):629–638CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Evans GW, Li D, Whipple SS (2013) Cumulative risk and child development. Psychol Bull 139(6):1342CrossRefPubMedGoogle Scholar
  67. 67.
    Lemstra M, Neudorf C, D’arcy C, Kunst A, Warren LM, Bennett NR (2008) A systematic review of depressed mood and anxiety by SES in youth aged 10–15 years. Can J Public Health 99(2):125–129 Google Scholar
  68. 68.
    Piotrowska PJ, Stride CB, Croft SE, Rowe R (2015) Socioeconomic status and antisocial behaviour among children and adolescents: a systematic review and meta-analysis. Clin Psychol Rev 35:47–55CrossRefPubMedGoogle Scholar
  69. 69.
    Durkin MS, Maenner MJ, Meaney FJ, Levy SE, DiGuiseppi C, Nicholas JS et al (2010) Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS ONE 5(7):e11551CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Thapar A, Rice F, Hay D, Boivin J, Langley K, van den Bree M et al (2009) Prenatal smoking might not cause attention-deficit/hyperactivity disorder: evidence from a novel design. Biol Psychiatry 66(8):722–727CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Lindblad F, Hjern A (2010) ADHD after fetal exposure to maternal smoking. Nicotine Tob Res 12(4):408–415CrossRefPubMedGoogle Scholar
  72. 72.
    Ellis B, Nigg J (2009) Parenting practices and attention-deficit/hyperactivity disorder: new findings suggest partial specificity of effects. J Am Acad Child Adolesc Psychiatry 48(2):146–154CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Kiernan KE, Huerta MC (2008) Economic deprivation, maternal depression, parenting and children’s cognitive and emotional development in early childhood. Br J Sociol 59(4):783–806CrossRefPubMedGoogle Scholar
  74. 74.
    Tippett N, Wolke D (2014) Socioeconomic status and bullying: a meta-analysis. Am J Public Health 104(6):e48–e59CrossRefPubMedGoogle Scholar
  75. 75.
    Holmberg K, Hjern A (2008) Bullying and attention-deficit–hyperactivity disorder in 10-year-olds in a Swedish community. Dev Med Child Neurol 50(2):134–138CrossRefPubMedGoogle Scholar
  76. 76.
    Webb E (2013) Poverty, maltreatment and attention deficit hyperactivity disorder. Arch Dis Child 98(6):397–400CrossRefPubMedGoogle Scholar
  77. 77.
    Rutter M, Andersen-Wood L, Beckett C, Bredenkamp D, Castle J, Groothues C et al (1999) Quasi-autistic patterns following severe early global privation. J Child Psychol Psychiatry 40(4):537–549CrossRefPubMedGoogle Scholar
  78. 78.
    Young S (2000) ADHD children grown up: an empirical review. Couns Psychol Q 13(2):191–200CrossRefGoogle Scholar
  79. 79.
    Skoglund C, Chen Q, Lichtenstein P, Larsson H (2014) Familial confounding of the association between maternal smoking during pregnancy and ADHD in offspring. J Child Psychol Psychiatry 55(1):61–68CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Hjern A, Weitoft GR, Lindblad F (2010) Social adversity predicts ADHD-medication in school children—a national cohort study. Acta Paediatr 99(6):920–924CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Institute of Health ResearchUniversity of Exeter Medical SchoolExeterUK
  2. 2.Department of Psychology, College of Life and Environmental SciencesUniversity of ExeterExeterUK
  3. 3.ESRC Centre for Genomics in Society (Egenis) and Institute of Health ResearchUniversity of Exeter Medical SchoolExeterUK

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