The Effects of Child and Adolescent Attention Deficit / Hyperactivity Disorder and Associated Executive Function Deficits on Family Functioning

U. Savcı, A. Tufan, Y. Ozturk, M. Cansız
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Abstract

Objective: In this study, we aimed to investigate the effects of ADHD and associated executive dysfunctions on family functioning and enrolled children aged between 8- 17 years old diagnosed with ADHD at the study center. The control group was formed of children attending well-child visits at the study center. Method: Executive functions were measured via the Stroop test- TBAG form while the Family Assessment Device (FAD) was used to assess family functioning. Diagnoses were ascertained with K-SADS-PL and symptom severity was reported by parents via the Turgay DSM-IV–Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Descriptive, bivariate, and multivariate methods were used in analyses. P was set at 0.05 (Holm-Bonferroni procedure was used to control for family-wise error rate). Results: Families of children with ADHD performed significantly worse compared to controls in communication, affective responses, affective involvement, behavior control and general functioning. FAD- affective involvement scores of families of girls with ADHD were significantly elevated compared to males. ADHD subtypes, comorbidity and their interaction did not display significant effects on family functioning. Correlation analyses revealed that severity of oppositional and conduct disorder symptoms affected family functioning in various domains. In regression analyses, selective and focused attention and resistance to interference domains of Stroop-TBAG test did not significantly predict family functioning, although there was a signal that processing speed in resistance to interference domain may be important. Conclusion: ADHD diagnosis in children may affect multiple domains of family functioning. Parents of female children with ADHD may experience greater family dysfunction, especially in affective involvement. Severity of oppositionality and behavior problems rather than subtypes and comorbidity seem to affect family functioning in ADHD. Contributions of different facets of executive functions to family functioning in ADHD should be evaluated with different neuropsychological tasks.
儿童和青少年注意缺陷/多动障碍及相关执行功能缺陷对家庭功能的影响
目的:在本研究中,我们旨在探讨ADHD和相关执行功能障碍对家庭功能的影响,并在研究中心招募了年龄在8- 17岁之间诊断为ADHD的儿童。对照组由在研究中心参加健康儿童探访的儿童组成。方法:采用Stroop测试- TBAG表格测量执行功能,采用家庭功能评估仪(FAD)评估家庭功能。通过k - ssad - pl确定诊断,家长通过Turgay基于dsm - iv的儿童和青少年行为障碍筛查和评定量表报告症状严重程度。在分析中使用了描述性、双变量和多变量方法。P设为0.05(采用Holm-Bonferroni程序控制家庭误差率)。结果:ADHD患儿家庭在沟通、情感反应、情感参与、行为控制和一般功能方面的表现明显差于对照组。ADHD女孩家庭的FAD-情感介入得分显著高于男性家庭。ADHD亚型、合并症及其相互作用对家庭功能没有显著影响。相关分析显示,对立性和品行障碍症状的严重程度在多个领域影响家庭功能。在回归分析中,Stroop-TBAG测试的选择性和集中注意力以及对干扰域的抵抗并不能显著预测家庭功能,尽管有信号表明抵抗干扰域的处理速度可能很重要。结论:儿童ADHD诊断可能影响家庭功能的多个领域。患有ADHD的女性儿童的父母可能会经历更大的家庭功能障碍,特别是在情感参与方面。对立性和行为问题的严重程度似乎比亚型和共病更能影响ADHD患者的家庭功能。执行功能的不同方面对ADHD家庭功能的贡献应通过不同的神经心理学任务进行评估。
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