April 24, 2024

A longitudinal study highlights the bidirectional relationship between child maltreatment and ADHD symptoms

New research provides evidence of a bidirectional association between childhood maltreatment and ADHD symptoms. Babies who get upset more and more are more likely to have ADHD symptoms as they get older. These children are more likely to experience maltreatment, such as abuse or neglect. This poor treatment can make their ADHD symptoms worse.

The study, published in Development and Psychopathologyprovides new insights into how child temperament, maltreatment, and ADHD symptoms are linked.

“Previous research has shown that there is a complex relationship between ADHD and maltreatment. We know that children with higher symptoms of ADHD, or in other words, inattentive, impulsive or hyperactive are at a higher risk of abuse from a caretaker,” explained the author of the study Dennis Golm (@GolmDennis), lecturer in psychology at the University of Southampton. “What we don’t fully know is why. Our study adds one piece to this answer.”

“Infants who show negative emotions, such as crying a lot, have a higher risk of developing ADHD. We wanted to know if these infants were also at higher risk of maltreatment. I believe this topic is important to help parents cope with difficult situations. The first few months at home can be very challenging for parents. Even more so if they have mental health issues or their children exhibit challenging behavior that these parents may not know how to respond to.”

“Support for new parents is still limited. We want to encourage parents to seek help. From now on, we want to know what kind of help could be useful to support parents to deal with difficult situations and ultimately to reduce the risk of childhood maltreatment.”

To carry out their new study, the researchers used data from the Vulnerable Families and Child Wellbeing Study (FFCWS), which followed a birth cohort of children born between 1998 and 2000. The study included a total of 4,898 children. Data from the 1-year, 5-year and 9-year follow-ups were used for analysis.

The researchers assessed negative emotion during infancy using three items from the Mood, Activity and Sociability Survey. These items measured how often the child laughed, cried, got upset easily, and reacted strongly when upset. Mothers of children gave responses on a 5-point Likert scale.

Child maltreatment in middle childhood was assessed using selected items from the Conflict Tactics Scale, which measured psychological aggression, physical aggression, and neglect. The items referred to the past year, and the mothers provided responses indicating the frequency of each type of maltreatment.

ADHD symptoms were assessed at ages 5 and 9 using the Attention Problems subscale of the Child Behavior Checklist. The checklist included items relating to concentration difficulties and attention problems. Assessments were carried out by mothers and primary carers.

​​​​The researchers found that infant negative affectivity had an indirect effect on ADHD symptoms at age 9 through its effect on the amount of childhood maltreatment at age 5. Higher rates of maltreatment were more likely for children with higher negative emotions at 12 months at age 5. , which, in turn, increased the risk of ADHD symptoms at age 9. This shows the importance of early mood in later maltreatment and predict ADHD symptoms.

There was also evidence of a bidirectional relationship. Higher ADHD symptoms at age 5 increased the risk of maltreatment at age 9. This suggests a vicious cycle in which the severity of ADHD symptoms is maintained by continued adverse experiences, such as maltreatment.

“​​​​​​We found that negative emotions in infants, and ADHD symptoms in children, put these children at greater risk of maltreatment. However, maltreatment also increased ADHD symptoms,” Golm told PsyPost.

“A number of explanations can be given. Parents can feel overwhelmed with babies who show more negative emotions, such as crying, and with children who are impulsive and inattentive. Harsh parenting techniques are often used when parents feel helpless and overwhelmed and don’t know how else to deal with the situation.”

“It is also possible that impulsive and hyperactive children have parents who tend to react impulsively,” explained Golm. “These children may inherit the risk of developing ADHD and have parents who may have a stronger reaction in a severe situation and use a harsher parenting technique. We need to find out what the direct links are, to help parents cope with challenging situations.”

The study highlights the reciprocal relationship between maltreatment and ADHD symptoms, suggesting the importance of interventions targeting both areas. Early identification of ADHD and parenting support for maltreated children may be valuable in promoting their well-being and reducing long-term mental health burden.

But Golm said “it’s important to point out that the results of the study are not conclusive. What this means is that the presence of negative emotions or ADHD symptoms in a child does not mean they will be treated badly. It only increases the likelihood of abuse. Second, the impact of the study is small, indicating that our findings are only one piece of a much larger puzzle.”

The researchers included several covariates in their analysis, such as sex, low birth weight, physical disability, maternal age, child age, maternal depression, and family income. These variables were controlled to account for their potential influence on the results. But the study, like all research, had some limitations.

“Our study was not able to take into account whether parents had ADHD. Because of the high heritability of ADHD, parents are likely to have higher levels of ADHD symptoms and therefore a higher likelihood of maltreatment themselves. Future studies need to examine how these factors may interact with children’s different temperaments.”

The study, “The longitudinal association between infant negative emotions, child maltreatment, and ADHD symptoms: A secondary analysis of data from the Study of Fragile Families and Child Wellbeing“, written by Dennis Golm and Valerie Brandt.

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