ADHD is a neurodevelopmental disorder with multifactorial origins. Several studies have shown that parent-child attachment impacts the expression of ADHD symptoms, while others have highlighted the influence of cognitive impairments on ADHD symptoms. However, few studies have simultaneously examined the respective contributions of child attachment and cognitive functions to ADHD, which is the aim of this study. We included 45 children with ADHD from a university hospital and 44 typically developing children from regular schools. Child attachment was evaluated using a self-report questionnaire, the French Attachment Security Scale (ASS-Fr), and a narrative interview, the Cartes pour l'évaluation de l'Attachement et de la Mentalisation chez l'Enfant (CAME). Cognitive assessment involved both objective and subjective measures. Perceived attachment security to both parents and disorganized attachment were significantly associated with ADHD symptoms, but these relationships were mediated by externalizing symptoms and executive function difficulties. The relationships between attachment and ADHD symptoms are indirect and mediated by the presence of externalizing symptoms and executive function impairments.
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