The Effects of Child and Adolescent Attention Deficit / Hyperactivity Disorder and Associated Executive Function Deficits on Family Functioning

Objective: In this study, we aimed to investigate the effects of ADHD and associated executive dysfunctions on family functioning and enrolled children aged between 8 - 17 years old diagnosed with ADHD at the study center. The control group was formed of children attending well-child visits at the study center. Methods: Executive functions were measured via the Stroop test - TBAG form while the Family Assessment Device (FAD) was used to assess family functioning. Diagnoses were ascertained with K-SADS-PL and symptom severity was reported by parents via the Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Descriptive, bivariate, and multivariate methods were used in analyses. P was set at 0.05 (Holm-Bonferroni procedure was used to control for family-wise error rate). Results: Families of children with ADHD performed significantly worse compared to controls in communication, affective responses, affective involvement, behavior control and general functioning. FAD - affective involvement scores of families of girls with ADHD were significantly elevated compared to males. ADHD subtypes, comorbidity and their interaction did not display significant effects on family functioning. Correlation analyses revealed that severity of oppositional and conduct disorder symptoms affected family functioning in various domains. In regression analyses, selective and focused attention and resistance to interference domains of Stroop-TBAG test did not significantly predict family functioning, although there was a signal that processing speed in resistance to interference domain may be important. Conclusion: ADHD diagnosis in children may affect multiple domains of family functioning. Parents of female children with ADHD may experience greater family dysfunction, especially in affective involvement. Severity of oppositionality and behavior problems rather than subtypes and comorbidity seem to affect family functioning in ADHD. Contributions of different facets of executive functions to family functioning in ADHD should be evaluated with different neuropsychological tasks.