Abstract
BackgroundStudies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link.MethodSecondary analysis of a UK birth cohort (the Millennium Cohort Study, N = 19,519) was used to model the association of ADHD with socioeconomic disadvantage and assess evidence for several potential explanatory pathways. The case definition of ADHD was a parent-report of whether ADHD had been identified by a medical doctor or health professional when children were 7 years old.ResultsADHD was associated with a range of indicators of social and economic disadvantage including poverty, housing tenure, maternal education, income, lone parenthood and younger motherhood. There was no evidence to suggest childhood ADHD was a causal factor of socioeconomic disadvantage: income did not decrease for parents of children with ADHD compared to controls over the 7-year study period. No clinical bias towards labelling ADHD in low SES groups was detected. There was evidence to suggest that parent attachment/family conflict mediated the relationship between ADHD and SES.ConclusionAlthough genetic and neurological determinants may be the primary predictors of difficulties with activity level and attention, aetiology appears to be influenced by socioeconomic situation.
Highlights
Childhood attention deficit hyperactivity disorder (ADHD) has been reported to be more prevalent among socioeconomically disadvantaged groups in many regions of the developed world
We excluded children who had a statement of special needs (n = 318) as a proxy for other disorders because being diagnosed with alternative problems could confound the relationship between ADHD and socioeconomic status (SES)
This study detected a higher prevalence of ADHD among socioeconomically disadvantaged groups, a finding that concurs with results from a wide range of other studies (Akinbami et al, 2011; Do€pfner et al, 2008; Ford et al, 2007; Froehlich et al, 2007; Pastor & Rueben, 2008; Sciberras et al, 2011; St Sauver et al, 2004)
Summary
Childhood attention deficit hyperactivity disorder (ADHD) has been reported to be more prevalent among socioeconomically disadvantaged groups in many regions of the developed world. Studies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link. Method: Secondary analysis of a UK birth cohort (the Millennium Cohort Study, N = 19,519) was used to model the association of ADHD with socioeconomic disadvantage and assess evidence for several potential explanatory pathways. There was no evidence to suggest childhood ADHD was a causal factor of socioeconomic disadvantage: income did not decrease for parents of children with ADHD compared to controls over the 7-year study period.
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