Impact of ADHD on Family Dynamics and Relations

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent disorders in childhood (National Institute of mental health [NIMH], 2009). In 2000, the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev; DSM-IV-TR; American Psychiatric Association [APA], 2000) stated 3%-7% of school-age youngsters were stricken by this disorder. More recently, results from a parent-report enclosed within the National Survey of Children’s Health in 2007 indicated the prevalence rate of the disorder was 9.5% percent for children aged 4-17 within the United States (US).

 The disorder commonly results from physiological variations within the brain that cause people to systematically display extreme hyperactivity and impetuousness. In several cases, inattentiveness was another symptom displayed. In preschool-age youngsters, signs of impetuousness consisted of excessive distractibility and inability to follow easy directions was displayed. Impetuousness is indicated by the inability to act accordingly and reacting to even minor frustrations with physical aggression. Constant fidgeting, inability to quiet down for relaxed activities and constant motion are signs of ADHD (Hopkins-Best, 1999).

Attention deficit Hyperactivity disorder is one of the most frequently studied and complex disorders in child development. This disorder, which is present in roughly four to seven percent of the childhood population within the

United States, is characterized by behavior difficulties such as inattentiveness, impetuousness, and hyperactivity. The child or adult with ADD has problems beginning, maintaining, or finishing tasks. The result is a life that is, more often than not, chaotic (Durall, 1999). Attention Deficit Hyperactivity Disorder, one of the most customary, troubling onset childhood behavior disorders, (DuPaul, 1991) is characterized by a consistent pattern of inattentiveness and/or hyperactivity-impulsivity (American Attention-Deficit six Psychiatric Association, 1994).

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Impetuousness is characterized by impatience and is often expressed in frequent interruptions of others, issue in delaying responses, and intrusiveness on others (Rapport, 1994). Young children with ADHD typically fail to concentrate on tasks at hand, initiate conversations at inappropriate times, blunder out answers before completed queries, grab objects from others, and have issue waiting their turn (American Psychiatrical Association, 1994).

DSM-IV identifies the principle feature of Attention-Deficit/ Hyperactivity Disorder as a persistent pattern of frequent inattentiveness and/ or hyperactivity-impulsivity that is severe and usually observed in people at a comparable level of development. Some hyperactive-impulsive or inattentive symptoms that cause impairment should have been noticeable before age seven, albeit several people are diagnosed after the symptoms are portrayed for a variety of years. Some impairment from the symptoms should be conveyed in a minimum of 2 settings (e.g., abode and at school or work). There should be clear proof of interference with developmentally acceptable social, academic, or activity functioning. The disturbance doesn’t occur completely throughout the course of a Pervasive Developmental Disorder, Schizophrenia, or any other alternative Psychotic Disorder. It is not accounted for by another disorder (e.g., a Mood Disorder, Anxiety Disorder, Dissociative, or Antisocial Personality Disorder).

Inattentiveness might manifest in academic, occupational, or social settings. Individuals with this disorder might fail to provide proper attention to details or might make careless mistakes in school assignment or similar tasks. Work is usually untidy and performed carelessly without a second thought. People usually have issues sustaining attention in tasks or play activities and find it arduous to persist with tasks till completion. They usually seem as if their mind is elsewhere or as if they’re not listening or failed to hear what has been iterated. There could also be frequent shifts in one uncompleted activity to another. Individuals diagnosed with this disorder might begin a task, move on to another, turn to something completely unrelated, without ever having actually finished any tasks at all ultimately. They usually don’t follow through on requests or directions and fail to complete school assignment, chores, or miscellaneous duties. Failure to finish tasks ought to be thought of in making the diagnosis provided that it’s solely due to inattentiveness as opposed to other potential reasons (e.g. a failure to interpret instructions properly).

These individuals usually have difficulties organizing tasks and activities. Tasks that require sustained mental effort are commonly associated and seen as difficult and boring. Consequently, they generally avoid or have a strong dislike for activities that demand sustained self-application and mental effort that needs full concentration (e.g. homework or paperwork). This avoidance can easily be attributed to the individual’s difficulties paying attention and simply not to being lazy. Work habits are usually disordered and, therefore, the materials necessary for doing the task are usually scattered, lost, or carelessly handled and broken. Individuals with this disorder are simply distracted by irrespective stimuli and frequently interrupt current tasks to attend to trivial noises (e.g. a vehicle honking, a background conversation).

Often, they are forgetful in daily activities (e.g. missing appointments, forgetting to bring lunch). In social settings, inattentiveness might be expressed as frequent shifts in spoken language, not being attentive to others, not keeping one’s mind on conversations, and not following details or games or activities. Hyperactivity could also be manifested by agitation or jitteriness in one’s seat (i.e. not remaining seated once expected to try to or by excessive running or climbing in settings where it’s highly inappropriate). Another example would be having issues enjoying or quietly engaging in leisure activities. Hyperactivity might vary with the individual’s age and level of development, and therefore, the identification ought to be made cautiously in young children. Toddlers and preschoolers with this disorder vary from their fellow peers by being perpetually on the go and into everything. They dart back and forth, are “out of the door before their coat is on,” jump or hop on articles of furniture, run through the abode, and have difficulty collaborating in relaxed group activities in the class setting (e.g., listening to a story).

The associated symptoms and behaviors of the disorder has proven to heavily impact the child’s life and conjointly cause dysfunction for the child’s parental figures and siblings (Harpin, 2007). In a qualitative study conducted by Counts, Nigg, Stawicki, Rappley, & Von Eye (2005), the degree of family adversity in attention deficit disorder subtypes and behavioral problems was explored and compared to families who did not have a child with ADHD. The authors hypothesized that levels of family adversity would be increased among children with adhd combined kind (ADHD-C), which is defined as inattention and hyperactivity/impulsivity both being present, versus a comparison group. It has been highly hypothesized that there would be a definite correlation between the behavioral issues of attention deficit disorder and comorbid disorders, together with conduct disorder (CD). Symptoms of attention deficit disorder in association with maternal psychopathology and marital status conflict was conjointly explored (Counts, Nigg, Stawicki, Rappley, & Von Eye, 2005). The study sample enclosed 206 boys and girls, whom ranged in age from 7-13 years of age.

A total of 337 parental figures (206 mothers, 131 fathers) were enclosed. They were put into groups determined by attention deficit disorder diagnosis, or lack thereof. Ninety-six children were placed within the attention deficit disorder-C cluster, thirty eight within the ADHD primarily inattentive sort (ADHDPI) and the remaining seventy two children within the control group. The family adversity index was created for the study and one point on a scale of zero to five was given for every display of adversity. The impact of attention deficit disorder on the family dynamic categories for adversity included low socioeconomic standing, parental figures psychiatric disorders, marital conflict, and traumatic events. Socioeconomic factors included education level of parental figures, occupation, and salary. Parental psychopathology consisted of deciding the presence of lifetime psychiatric disorders, with the exclusion of any adhd diagnosis for the parent. Marital status conflict was evaluated through the child’s perception of many factors, together with the frequency, intensity, resolution, and content of arguments between the child’s parental figures. Instances of stressful events included the death of a relative or loss of employment over the last one year (Counts et al., 2005).

Results of the study ultimately stated that children with attention deficit disorder had larger family adversity than children who simply did not have such. An association of larger family adversity was conjointly noted in children with ADHD-C versus children with ADHD-PI or the comparison group cluster. Evidently, the results indicated the largest rates of family adversity was discovered in the younger females with ADHD-C. Greater adversity was noted once when children conduct issues were related to ADHD. However, results with higher adversity scores were seen in attention deficit disorder when the CD symptoms were controlled. Results conjointly indicated the child’s perception of marital status conflict and maternal mental disease were associated with a better degree of attention deficit disorder symptoms. This study provided support for the requirement of a comprehensive psychosocial assessment of adversity and family problems for the adhd kid. If compelling proof of parental mental illness or marital status conflict is found within the assessment then psychosocial interventions ought to be performed (Counts et al., 2005). This study provides support to this research paper by evidently conveying greater family adversity is found in families once there’s a baby with attention deficit disorder. It also contributed the fascinating finding that rates of family adversity were highest among young females with combined adhd (ADHD-C).

This study differed from the subsequent studies in that the child was allowed to describe their perception of marital status conflict and was associated with a better degree of attention deficit disorder symptoms. It’s unclear whether there was a clearly increased marital status conflict or if the ADHD child’s perception of conflict was simply larger. Foley (2010) used a descriptive comparative experiment to analyze disfunction and adversity among families whom had a toddler/child with attention deficit hyperactivity disorder and compared findings to families whom did not have a toddler with adhd. In total, fifty-five youngsters (36 boys and nineteen girls) were chosen. Their ages ranged from six to eleven years. And of those fifty-five youngsters, thirty-two had an ADHD diagnosis. The remaining twenty-three youngsters were chosen because they were the comparison/control group. In addition, primary caregivers/parental figures (52 biological mothers, three adoptive mothers, and a pair of biological fathers) were included. Family adversity variables were explored, together with socioeconomic standing, family size, history of criminality on paternal aspect, history of maternal mental disturbance, and foster-care placement.

Family adversity variables were measured through a form developed for this study that included open-ended queries in addition to close ended questions. Examples of these queries consisted of asking the child’s parent if the father figure had ever been in jail and how they acted in their abode. Family disfunction variables were measured by utilizing the General Functioning subscale of the McMaster Family Assessment Device. The subscale was a 12-item self-report instrument completed by the child’s parental figure, that measures variables including communication, relationships, and analytic abilities (Foley, 2010). Results of the study conducted by Foley (2010) indicated higher levels of family dysfunction in families whom had a child with attention deficit disorder identification. Foley (2010) came to the conclusion that there was poorer family performance in homes in which there was a toddler diagnosed with attention deficit disorder. Parental figures in these homes might have a lot of issues with the organization and cohesiveness of the family. Foley (2010) states that because of the participants throughout this study being primarily Caucasian, middle class kids, there wasn’t a major distinction in family adversity variables. It was recommended that solutions for ADHD ought to be geared toward enlightening the family on potential difficulties they will have among the family setting.

Another recommendation would be to conjointly provide support services to the family and kid, like classes geared toward managing anger, building social skills, management of particular behaviors, and general parenting courses. Family intervention strategies, like family and couples therapy were highly recommended (Foley, 2010). The results of this study differed from the previous study in that the degree of family adversity wasn’t considerably different between the ADHD and comparison groups/teams. However, the participants during this study were primarily Caucasian and upper middle class and well off. This study contributed to the results of the previous study by serving to spot intervention ways for the family. Hurtig et al. (2007) used a population sample (n = 457) from an oversized birth cohort study (n = 6622) in 1986 to gauge the link of comorbid disorders to adolescent attention deficit disorder, severity of symptoms, and family characteristics.

The connection of symptoms severity to family characteristics was conjointly investigated. Results of the study revealed that adolescents with attention deficit disorder adolescents were a lot more likely to have comorbid disorders, such as conduct disorder or oppositional resistive disorder, than adolescents who did not have adhd. Moreover, the severity of attention deficit disorder symptoms was directly associated with the presence of at least one comorbidities. Family environmental characteristics observed were seen by Hurtig et al. (2007) to be contributive factors to increased risk of comorbid adhd with non-intact or low-income families, parental inattentiveness to adolescent activities, and parental stress and discontentment. Hurtig et al. (2007) recommended an evaluation of the family atmosphere be conducted once adolescents with ADHD symptoms was discovered, due to the increased risk for comorbid disorders.

Conclusion

Though the aim of this study wasn’t to explore the impact of family interventions, it did establish a foundation for further analysis on evidenced-based treatments for families within which there’s an adolescent with ADHD. Although the aim of this study differed from the previous studies, the clinical implication of conducting an assessment of the family atmosphere was similar. This study conjointly added the component of comorbid disorders seen in adhd.