Skip to content
2000
Volume 4, Issue 2
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882

Abstract

Background

Attention-deficit/ hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts during childhood. It is commonly associated with elevated levels of parenting stress. This study aimed to examine parents’ stress levels, potential contributing factors, as well as changes associated with the COVID-19 pandemic.

Methods

This study was based on a cross-sectional design. The target population was parents of children with ADHD aged 6-18 years who were evaluated in a tertiary care hospital in Dubai, United Arab Emirates (UAE) from January 2018 to August 2021. Participants completed a survey, which gathered information on the child’s personal characteristics and medical history as well as the parents’ and family characteristics. Additionally, the parents stress level was evaluated using the English and Arabic-translated versions of the Perceived Stress Scale (PSS).

Results

Parents of 103 children diagnosed with ADHD participated in this study. Most children were males (74.8%), and their mean age was 10.0 ± 3.4 years. Most children had ADHD as a primary diagnosis (87.4%), with ADHD subtypes being mainly combined presentation (60.2%), followed by a predominately inattentive presentation (35.9%). Psychiatric morbidity was present in 87.4% of the children, mainly learning disorders (41.7%), conduct disorder (34%), or autism spectrum disorder (24.3%). On the other hand, physical disorders were present in 68.9% of the children. Parents’ perceived stress levels differed significantly according to their children’s ADHD subtypes (p=0.002), with the highest stress levels among parents of children with predominately hyperactive/impulsive ADHD. PSS scores were moderate in 62.1% of the sample and high in 32% of the sample. Significant associations with elevated PSS scores was found in the presence of comorbid tic disorders (p<0.001) as well as in comorbid autism spectrum disorder (p=0.029). The most frequently reported items on the PSS were: being upset because of something that happened unexpectedly; feeling nervous and stressed; being angered because of things that were outside of your control; feeling unable to control important things in life; and feeling that difficulties were piling up so high that could not be overcome. Various changes were reported during the COVID-19 pandemic, which included a significant decrease in social activities (31.1%), time spent with friends (26.2%), conflicts between the child and siblings (18.5%), and conflicts between parents (25.3%). Furthermore, a significant increase was reported in children’s average screen time (28.2%), the quality of the child’s relationship with parents (19.4%), and the overall stresses faced by the family (16.5%).

Conclusion

ADHD is commonly associated with high levels of parental stress. Factors associated with an increased level of stress include ADHD predominantly hyperactive/ impulsive subtype as well as comorbidity with tic disorders or autism spectrum disorder. Furthermore, the COVID-19 pandemic had a marked impact on children with ADHD and their families’ social functioning.

© 2023 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
Loading

Article metrics loading...

/content/journals/nemj/10.2174/04666230317110616
2023-03-29
2025-09-09
Loading full text...

Full text loading...

/deliver/fulltext/nemj/4/2/NEMJ-4-2-E170323214707.html?itemId=/content/journals/nemj/10.2174/04666230317110616&mimeType=html&fmt=ahah

References

  1. Muñoz-SilvaA. Lago-UrbanoR. Sanchez-GarciaM. Carmona-MárquezJ. Child/Adolescent’s ADHD and parenting stress: The mediating role of family impact and conduct problems.Front. Psychol.20178225210.3389/fpsyg.2017.0225229312090
    [Google Scholar]
  2. Catalá-LópezF. PeiróS. RidaoM. Sanfélix-GimenoG. Gènova-MalerasR. CataláM.A. Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain: A systematic review and meta-analysis of epidemiological studies.BMC Psychiatry201212116810.1186/1471‑244X‑12‑16823057832
    [Google Scholar]
  3. EapenV. JakkaM.E. Abou-SalehM.T. Children with psychiatric disorders: The Al Ain community psychiatric survey.Can. J. Psychiatry200348640240710.1177/07067437030480060712894615
    [Google Scholar]
  4. EapenV. Ai-SabosyM. SaeedM. SabriS. Child psychiatric disorders in a primary care Arab population.Int. J. Psychiatry Med.2004341516010.2190/JW8N‑PW2D‑P63A‑F5YV15242141
    [Google Scholar]
  5. AlZabenF.N. SehloM.G. AlghamdiW.A. TayebH.O. KhalifaD.A. MiraA.T. AlshuaibiA.M. AlguthmiM.A. DerhamA.A. KoenigH.G. Prevalence of attention deficit hyperactivity disorder and comorbid psychiatric and behavioral problems among primary school students in western Saudi Arabia.Saudi Med. J.2018391525810.15537/smj.2018.1.2128829332109
    [Google Scholar]
  6. AlhraiwilN.J. AliA. HousehM.S. Al-ShehriA.M. El-MetwallyA.A. Systematic review of the epidemiology of attention deficit hyperactivity disorder in Arab countries.Neurosciences201520213714410.17712/nsj.2015.2.2014067825864066
    [Google Scholar]
  7. HaackL.M. VillodasM.T. McBurnettK. HinshawS. PfiffnerL.J. Parenting mediates symptoms and impairment in children with ADHD inattentive type.J. Clin. Child Adolesc. Psychol.201645215516610.1080/15374416.2014.95884025411896
    [Google Scholar]
  8. ChoeD.E. OlsonS.L. SameroffA.J. The interplay of externalizing problems and physical and inductive discipline during childhood.Dev. Psychol.201349112029203910.1037/a003205423458660
    [Google Scholar]
  9. TheuleJ. WienerJ. RogersM.A. MartonI. Predicting parenting stress in families of children with ADHD: parent and contextual factors.J. Child Fam. Stud.201120564064710.1007/s10826‑010‑9439‑7
    [Google Scholar]
  10. TheuleJ. WienerJ. TannockR. JenkinsJ.M. Parenting stress in families of children with ADHD: A meta-analysis.J. Emot. Behav. Disord.201321131710.1177/1063426610387433
    [Google Scholar]
  11. MacklerJ.S. KelleherR.T. ShanahanL. CalkinsS.D. KeaneS.P. O’BrienM. Parenting stress, parental reactions, and externalizing behavior from ages 4 to 10.J. Marriage Fam.201577238840610.1111/jomf.1216326778852
    [Google Scholar]
  12. WienerJ. BiondicD. GrimbosT. HerbertM. Parenting stress of parents of adolescents with attention-deficit hyperactivity disorder.J. Abnorm. Child Psychol.201644356157410.1007/s10802‑015‑0050‑726183609
    [Google Scholar]
  13. GaglianoA. LambertiM. SiracusanoR. CiuffoM. BoncoddoM. MaggioR. RosinaS. CedroC. GermanòE. A comparison between children with ADHD and children with epilepsy in self-esteem and parental stress level.Clin. Pract. Epidemiol. Ment. Health201410117618310.2174/174501790141001017625614755
    [Google Scholar]
  14. MirandaA. TárragaR. FernándezM.I. ColomerC. PastorG. Parenting stress in families of children with autism spectrum disorder and ADHD.Except. Child.2015821819510.1177/0014402915585479
    [Google Scholar]
  15. SollieH. MørchW.T. LarssonB. Parent and family characteristics and their associates in a follow-up of outpatient children with ADHD.J. Child Fam. Stud.20162582571258410.1007/s10826‑016‑0411‑z
    [Google Scholar]
  16. LiY. JiangW.Q. DuY.S. CoghillD. Relationships between behavioral symptoms of non-medicated Chinese children with attention deficit hyperactivity disorder and parenting stress: Comparison of different subtypes and comorbidities.Asia-Pac. Psychiatry20168212713510.1111/appy.1221326403485
    [Google Scholar]
  17. DelvecchioE. SciandraA. FinosL. MazzeschiC. RisoD.D. The role of co-parenting alliance as a mediator between trait anxiety, family system maladjustment, and parenting stress in a sample of non-clinical Italian parents.Front. Psychol.20156117710.3389/fpsyg.2015.0117726347674
    [Google Scholar]
  18. MartelM.M. LevinsonC.A. LangerJ.K. NiggJ.T. A network analysis of developmental change in ADHD symptom structure from preschool to adulthood.Clin. Psychol. Sci.201646988100110.1177/216770261561866428083448
    [Google Scholar]
  19. AdamsE.L. SmithD. CaccavaleL.J. BeanM.K. Parents are stressed! patterns of parent stress across COVID-19.Front. Psychiatry20211262645610.3389/fpsyt.2021.62645633897489
    [Google Scholar]
  20. Van BortelT. BasnayakeA. WurieF. JambaiM. KoromaA.S. MuanaA.T. HannK. EatonJ. MartinS. NellumsL.B. Psychosocial effects of an Ebola outbreak at individual, community and international levels.Bull. World Health Organ.201694321021410.2471/BLT.15.15854326966332
    [Google Scholar]
  21. a RamakrishnanV.K. Efficacious psychological resilience for COVID-19 pandemic.Purakala20203144253267
    [Google Scholar]
  22. b WangC. PanR. WanX. TanY. XuL. HoC.S. HoR.C. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China.Int. J. Environ. Res. Public Health2020175172910.3390/ijerph1705172932155789
    [Google Scholar]
  23. YousefA.M. SehloM.G. MohamedA.E. The negative psychological impact of COVID-19 pandemic on mothers of children with attention deficit hyperactivity disorder (ADHD): a cross-section study.Middle East Current Psychiatry20212815710.1186/s43045‑021‑00139‑z
    [Google Scholar]
  24. WangG. ZhangY. ZhaoJ. ZhangJ. JiangF. Mitigate the effects of home confinement on children during the COVID-19 outbreak.Lancet20203951022894594710.1016/S0140‑6736(20)30547‑X32145186
    [Google Scholar]
  25. AlmadiT. CathersI. Hamdan MansourA.M. ChowC.M. An Arabic version of the perceived stress scale: Translation and validation study.Int. J. Nurs. Stud.2012491848910.1016/j.ijnurstu.2011.07.01221851941
    [Google Scholar]
  26. NarkunamN. HashimA.H. SachdevM.K. PillaiS.K. NgC.G. Stress among parents of children with attention deficit hyperactivity disorder, a Malaysian experience.Asia-Pac. Psychiatry20146220721610.1111/j.1758‑5872.2012.00216.x23857633
    [Google Scholar]
  27. SpinelliM. LionettiF. PastoreM. FasoloM. Parents’ stress and children’s psychological problems in families facing the COVID-19 outbreak in Italy.Front. Psychol.202011171310.3389/fpsyg.2020.0171332719646
    [Google Scholar]
  28. İpÇİM. İncİ İzmİrS.B. TÜrkÇaparM.H. ÖzdelK. ArdiÇÜ.A. ErcanE.S. Psychiatric comorbidity in the subtypes of ADHD in children and adolescents with ADHD according to DSM-IV.Noro Psikiyatri Arsivi202057428328933354119
    [Google Scholar]
  29. MattinglyG. WeislerR. DirksB. BabcockT. AdeyiB. SchecknerB. LasserR. Attention deficit hyperactivity disorder subtypes and symptom response in adults treated with lisdexamfetamine dimesylate.Innov. Clin. Neurosci.201295-6223022808446
    [Google Scholar]
  30. FeltB.T. BiermannB. ChristnerJ.G. KochharP. HarrisonR.V. Diagnosis and management of ADHD in children.Am. Fam. Physician201490745646425369623
    [Google Scholar]
  31. JogiaJ SharifAH NawazFA Comorbidities associated with attention-deficit/hyperactivity disorder in children and adolescents at a tertiary care setting.Glob Pediatr Health202292333794X22107660710.1177/2333794X22107660735224143
    [Google Scholar]
  32. LeitchS. SciberrasE. PostB. GernerB. RinehartN. NicholsonJ.M. EvansS. Experience of stress in parents of children with ADHD: A qualitative study.Int. J. Qual. Stud. Health Well-being2019141169009110.1080/17482631.2019.169009131713473
    [Google Scholar]
  33. SegenreichD. The impact of the COVID-19 pandemic on diagnosing and treating attention deficit hyperactivity disorder: New challenges on initializing and optimizing pharmacological treatment.Front. Psychiatry20221385266410.3389/fpsyt.2022.85266435463503
    [Google Scholar]
  34. ShahR. RajuV.V. SharmaA. GroverS. Impact of COVID-19 and lockdown on children with ADHD and their families—an online survey and a continuity care model.J. Neurosci. Rural Pract.2020121717910.1055/s‑0040‑171864533531763
    [Google Scholar]
  35. WolraichM BrownL BrownRT Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents.Pediatrics.2011128510071022.10.
    [Google Scholar]
  36. TzangR.F. ChangY.C. LiuS.I. The association between children’s ADHD subtype and parenting stress and parental symptoms.Int. J. Psychiatry Clin. Pract.200913431832510.3109/1365150090309456724916944
    [Google Scholar]
  37. BellomoR. WarrillowS.J. ReadeM.C. Why we should be wary of single-center trials.Crit. Care Med.200937123114311910.1097/CCM.0b013e3181bc7bd519789447
    [Google Scholar]
/content/journals/nemj/10.2174/04666230317110616
Loading
/content/journals/nemj/10.2174/04666230317110616
Loading

Data & Media loading...


  • Article Type:
    Research Article
Keyword(s): ADHD; Adolescents; Children; COVID-19 pandemic; Parents; Stress
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test