Abstract

The persistent nature of attention deficit hyperactivity disorder (ADHD) and the role of behavioral factors in its continuity have been widely documented in the literature. However, less is known about the role of early family and neuropsychological factors in predicting later adaptive functioning and quality of life in individuals with ADHD. This study aimed to analyze the contribution of early family, behavioral, and neuropsychological factors to long-term functional outcomes in young adults with ADHD. Family (parental mood disorders, family risk index, parenting stress, coherence), behavioral (oppositionism, inattention, emotional lability, hyperactivity), and cognitive factors were examined at baseline. Twelve years later, daily life functioning, quality of life, and executive and behavioral functioning were also evaluated in 61 young adults with a childhood diagnosis of ADHD. Results revealed significant correlations between most of the family and behavioral factors at baseline and the long-term functional outcomes. Specifically, multiple regressions showed that mothers’ depression and laxness predicted later quality of life, executive functioning, and the hyperactivity index, and mothers’ depression and parenting stress at baseline also significantly predicted the hyperactivity index. Oppositionism behavior and inhibition were also significant predictors of the hyperactivity index. Therefore, understanding the family, behavioral, and neuropsychological factors that can contribute to later quality of life, daily functioning, and behavioral and executive functions is a particularly critical issue in detecting and planning efficacious ADHD interventions.

Highlights

  • attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inappropriate levels of inattention, impulsivity, and hyperactivity

  • The first aim of the present study was to examine the relationship between early family, cognitive, and behavioral factors and long-term outcomes of individuals with childhood

  • Maternal depression and the discipline style characterized by laxness were found to be the factors in the family context that had the most significant relationships with the functioning outcomes of children with ADHD as young adults

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Summary

Introduction

ADHD is a neurodevelopmental disorder characterized by inappropriate levels of inattention, impulsivity, and hyperactivity. 65% of clinically-referred children with ADHD continue to have symptoms as young adults [2], which adversely affects their social, academic, or occupational functioning and places a significant burden on the family and society [3]. The negative outcomes are present in various areas, including poor self-esteem [4] and increased rates of oppositional-defiant disorder [5,6], antisocial personality disorder [7], depression and anxiety [8,9], substance use disorders [10], and executive function (EF) deficits [11], among others. The studies included in the systematic review by Agarwal et al [12] showed that ADHD is associated with significant, adverse functional

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