Behavioral and mental health problems in adolescents with ADHD: Exploring the role of family resilience

Abstract

BackgroundFamily resilience and its role in behavioral and mental health problems has not been well documented among U.S. adolescents, especially those with ADHD. MethodsUsing data from the 2016 and 2017 National Survey of Children's Health (NSCH), we examined associations between family resilience connection index (FRCI) and conduct problems, depression, anxiety, and substance abuse in adolescents with ADHD aged 11–17 (n=4,169). Data were analyzed using multivariate logistic regression and chi-square tests. ResultsAdolescents with ADHD who had a lower FRCI score were more likely to have conduct problems (OR:1.64, CI:1.13–2.38) and depression (OR: 3.08, CI: 2.12–4.49). There were small differences between adjusted and unadjusted odds after controlling for adverse childhood experience and other covariates. LimitationWe could not assert prediction or causation, only associations among variables, due to the cross-sectional design of the 2016–2017 NSCH; however, a major advantage of the NSCH is that it includes a nationally representative sample of children and allows inferences to be made for understanding of the adolescents with ADHD in the U.S. ConclusionFindings suggest that family resilience may serve as a protective factor that leads to decreasing conduct problems, despite experiencing adversity in childhood. Targeting family resilience, in terms of teaching families ways to cope with adversities such as: a child's diagnosis of ADHD; behavioral problems, and/or other adverse experiences in children's environments, has great potential to reduce adolescents’ conduct and mental health problems.