BHCS is very lucky to have Kenzie share her work on our blog. Kenzie is seeking her master's in counseling at Montana State University and will be joining our team as a counseling intern in September. In this article Kenzie explores the impact ADHD has on parental stress. We are excited for her to join our team and share her work with you.
Attention Deficit Hyperactivity Disorder (ADHD) is commonly researched regarding children; how and when it develops, signs and symptoms, how it is genetically passed on, how ADHD effects the child and their development across the life span, particularly regarding learning and education, and how ADHD can be managed and treated. There is less research looking into adult ADHD and how it impacts the lives of adults and their children (Joseph et al. 2022). This paper seeks to gather information on how adult ADHD impacts parenting behaviors and child rearing.
Overall, parenting stress is correlated with negative outcomes for children and adults. Parent's physical and emotional well-being is directly connected to parenting behaviors and increased stress is correlated with harsher parenting (Joseph et al. 2022). Some challenges of living with adult ADHD may present as difficulties with time management, organization, memory, emotional regulation, and sleep disturbances, especially if ADHD is undiagnosed or untreated (Joseph et al. 2022). These symptoms may exacerbate stress in any individual's life leading to a hypothesis that adults with ADHD may experience higher levels of parental stress, therefore affecting their parenting.
One study found that parents with ADHD did experience higher levels of overall stress than parents without ADHD, with the primary contributing factor being sleep disturbances. When the variable for sleep was taken out of the analysis, there was not a statistically significant difference between the group with ADHD and the group without (Joseph et al 2022). A history of depression was also noted as a predictor of parenting stress as well as a comorbidity to ADHD.
Another study that looked at inhibitory control in mothers with ADHD found aspects of ADHD to be helpful in parenting. Mothers with ADHD showed higher levels of interpersonal openness, curiosity, need for variety and lack of dogmatic attitudes (Shilo and Zaidman-Zait, 2021). As with all mental health diagnosis, it may be helpful to seek how a diagnosis can be helpful for individuals and families. This may play a role in treatment goals and outcomes as the diagnosis can be viewed through a strengths-based lens as opposed to a pathology.
An additional finding in the research is the correlation between child behavior and parenting outcomes. Across both studies, parents with children who exhibited more challenging behaviors, regardless of the presence of ADHD in the child or parent, were more likely to exhibit harsh parenting behaviors and higher levels of stress. Child behavior was among the more significant indicators of parent behavior (Shilo and Zaidman-Zait, 2021).
Both articles fall within level two evidence. Both studies are quasi-experimental using qualitative research to gather the lived experiences and perceptions of parents through self-administered questionnaires. The study that looked at inhibitory control is a mixed methods study as it employed observation and a direct neurocognitive assessment of mothers to reduce bias from self-reported data (Shilo and Zaidman-Zait, 2021).
The study that looked at ADHD and the first year postpartum had a sample size of 146 participants and their infants adding to the credibility of this study. The participants were screened for ADHD and co-morbidities by masters or PhD level clinicians using the Conners' Adult ADHD Diagnostic Interview to determine presence of ADHD symptoms across the lifespan. The study used established questionnaires and indices to measure parenting distress, parent sleep, depression, social support, infant sleep, and temperament (Joseph et al 2022). Participants completed demographics questionnaires to gather additional data about Socioeconomic status (SES), stress, sleep, and infant behavior. Families with and without ADHD were compared on all study variables. All participants completed informed consent forms and were compensated for their participation (Joseph et al 2022).
All participants of this study were from Western Pennsylvania, mostly college educated, identify as white and from a higher SES standing. The study states that additional research is needed to accurately capture a wider geographic and SES demographic to be more representative of the American public (Joseph et al 2022).
The study that looked at ADHD symptoms and inhibitory control of mothers used a sample size of 141 mothers and their 8-12-year-old children adding credibility to this study. This mixed method study gathered self-reported data through questionnaires, observations of parenting behavior from clinicians, and a neurocognitive test to check for inhibitory control. Hierarchical multiple regressions were used to analyze variables (Shilo and Zaidman-Zait, 2021).
Limitations of this study include how data was gathered about maternal ADHD symptoms. The research team relied on self-reported ADHD symptoms and did not clinically assess for ADHD or co-morbidities. The study states it may be helpful to gather data about parenting behavior from other observers such as the child, spouses, or other caregivers to reduce bias. As ADHD symptoms and their effects on parenting are not often studied and this was not a longitudinal study, more data is needed to see if the results are repeatable (Shilo and Zaidman-Zait, 2021).
Across both studies, sleep quality emerged as a primary indicator in parenting behavior regardless of ADHD symptoms or diagnosis. Treating sleep related issues may be helpful in supporting clients improve their parenting behaviors. As individuals with ADHD often report difficulties with sleep, it may be helpful to treat ADHD symptoms in conjunction with sleep via sleep hygiene recommendations and appropriate timing and dosage of ADHD medications.
Both studies correlated parent social support with improved parenting behaviors. Providing resources to parents for local supports and advocating for the needs of the family may help reduce stress in the family system or individual parents (Shilo and Zaidman-Zait, 2021).
Accurate diagnosis of ADHD and co-morbidities as well as pharmacological interventions may greatly reduce parental stress and increase positive parenting behaviors. One study noted that some of the participants were unmedicated for their ADHD symptoms, so it is difficult to determine how much of their parenting stress is directly connected to untreated symptoms. Co-morbidities such as anxiety and depression were common amongst participants as well. Treating these symptoms will be helpful in bolstering parent well-being (Joseph et al 2022).
Psychoeducation in managing ADHD symptoms may also be helpful for parents as they navigate the stressors of life, family, raising children and understanding their own unique qualities and gifts of living with ADHD. As parents become aware and learn more about themselves, how their brains work and what environments support their emotional and cognitive well-being, this will inevitably translate to the family system, their partnerships, and their children.
Joseph, H. M., Khetarpal, S. K., Wilson, M. A., & Molina, B. S. G. (2022). Parent ADHD Is Associated With Greater Parenting Distress in the First Year Postpartum. Journal of Attention Disorders, 26(9), 1257–1268. Link
Zaidman-Zait, A., & Shilo, I. (2021). Parental ADHD Symptoms and Inhibitory Control in Relation to Parenting Among Mothers of Children With and Without ADHD. Journal of Attention Disorders, 25(3), 389–402. Link