The relationship between financial difficulty and childhood symptoms of attention deficit/hyperactivity disorder: a UK longitudinal cohort study

Abigail Emma Russell,Tamsin Ford,Ginny Russell

doi:10.1007/s00127-017-1453-2

Abigail Emma Russell, Tamsin Ford + Show 1 more

Open Access

https://doi.org/10.1007/s00127-017-1453-2

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Abstract

PurposeAttention deficit/hyperactivity disorder (ADHD) is associated with socioeconomic status (SES), in that children who grow up in low SES families are at an increased risk of ADHD symptoms and diagnosis. The current study explores whether different levels of ADHD symptoms are associated with prior changes in the SES facet of financial difficulty.MethodsUsing the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined symptoms of ADHD measured by the Strengths and Difficulties Questionnaire (SDQ) hyperactivity subscale in relation to parent-reported changes in financial difficulty, grouped into four repeated measures at four time points across childhood; (n = 6416). A multilevel mixed-effects linear regression model with an unstructured covariance matrix was used to test whether different patterns of financial difficulty were associated with subsequent changes in ADHD symptoms.ResultsFamilies who had no financial difficulty had children with a lower average ADHD symptom score than groups who experienced financial difficulty. Children whose families stayed in financial difficulty had higher mean ADHD symptom scores than all other groups (No difficulty mean SDQ hyperactivity 3.14, 95% CI 3.07, 3.21, In difficulty mean SDQ hyperactivity 3.39, 95% CI 3.28, 3.45, p < 0.001). Increasing or decreasing financial difficulty predicted mean symptom scores lower than those of the in difficulty group and higher than the no difficulty group.ConclusionsOur findings contribute to the building evidence that SES may influence the severity and/or impairment associated with the symptoms of ADHD, however the effects of SES are small and have limited clinical significance.

Highlights

The aetiology of attention deficit/hyperactivity disorder (ADHD) is complex and multifaceted
Our results suggest that the experience of any financial difficulty at any time is associated with higher levels of subsequent ADHD symptoms
Our aim was to identify the conceptual relationship between financial difficulty (FD) change and ADHD symptoms, and we found that this association was robust even adjusting for more material measures of socioeconomic status (SES)

Summary

Introduction

The aetiology of attention deficit/hyperactivity disorder (ADHD) is complex and multifaceted. Evidence around environmental factors that may influence vulnerability to ADHD often centres on prenatal exposures to toxins, such as those associated with smoking and alcohol consumption [2]. It has been accepted that social factors, such as socioeconomic status (SES), throughout the life-course may have a role in the aetiology of inattentive and impulsive behaviour that characterises ADHD [1, 3]. Relatively little is known about its association with social and environmental factors early in life, such as SES [3]. We found that children whose mothers reported financial difficulty (FD) were over twice as likely to receive a research diagnosis of ADHD when the child was age seven [6]. The measure concerned asks directly about ability to afford basic necessities, such as food and housing, in a manner that considers the difficulty or burden this may cause the family

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