Table 2.
Articles included in the review analysis (n = 26).
| Reference | Study design | Participant/method | Summary results |
|---|---|---|---|
| Al-Yagon et al. (40) | Case control study | 100 children, age 11–12, 50 with ADHD, 50 with TD | Children with ADHD reported higher incidents of insecure attachment to the father, and lower trust and closeness to the mother, in comparison to children with TD (Typical development). |
| Al-Yagon (41) | Case control study | 100 children, age 11–12, 50 with ADHD, 50 with TD | The child-mother attachment affected all measures for EF (executive functions) while the child-father attachment did not affect these measures. |
| Bourrat (42)* | Case study | A boy's follow-up from 6 to 24 months, with his mother | Psychotherapy unraveled a traumatic experience in the mother's own childhood (death of her younger brother) that resonated with her helplessness in front of her second child's hyperactivity (“le petit frère”). |
| Clarke et al. (32) | Case control study | 38 boys, age 5–10, 19 with ADHD, 19 with TD | The ADHD group received lower scores on all tests associated with attachment (Separation Anxiety, Self- Interview, Family Drawing). |
| Dalaire and Lafortune (43)* | Review study | 23 studies (family factors) based on DSM diagnosis | Additional burdens in parents of children with ADHD (alcoholism, drug dependency, anti-social personality, mood disorder, divorce, low income) are associated with coercive discipline and less efficient coping strategies in family conflicts. |
| Duc Marwood (44)* | Case study | A 6-year-old boy diagnosed with ADHD | Tales in psychotherapy helped the child identify with the characters and their emotions (fear, courage, anger), which unraveled conflictual relationships within the family that was behind hyperactive and inattentive conducts (father's abuse and domestic violence). |
| Edel et al. (45) | Retrospective case control | 73 adults with ADHD | Adults who subjectively remembered their own mother's ADHD symptoms from growing up, had to a greater extent attachment problems and difficulties with emotion regulation in the present. |
| Eyuboglu and Eyuboglu (46) | Case control study | 48 newly diagnosed untreated adolescents with ADHD, 51 in a control group | Adolescents with ADHD had a higher degree of avoidant attachment. Affiliation scores correlated with ADHD severity. |
| Finzi-Dottan et al. (47) | Correlational study | 65 children with ADHD, age 7–15 | The child's temperament in combination with different parenting styles gave rise to different attachment styles in the child. Some parenting styles parenting style can aggravate the child's difficulties with self-regulation, and lead to insecure attachment. |
| Guinard (48)* | Multiple case study | Clinical assessment with drawings and projective tests (36 childrens, aged 6–11, 31 boys). | Exclusive attention from the mother, rigid control over the clinician's presence and explosive conducts characterizes children who turn out to be highly sensitive to the evocation of family conflicts. |
| Hornstra et al. (49) | Case control study | Children age 8–12, 45 with ADHD, 57 with TD | There were no significant differences between the ADHD group and the TD group regarding attachment or trust in parents. Attachment might be linked to ODD (oppositional defiant disorder) and CD (conduct disorder) symptoms. |
| Hurt et al. (50) | Correlational study | 110 children with ADHD, 108 mothers, 53 fathers | Higher warmth from fathers was associated with higher peer acceptance, and higher exercise of power from the father was related to lower peer acceptance, but both correlations applied only at low levels of family loneliness. The mother's warmth and exercise of power were not related to either. |
| Latimer et al. (51) | Review study | 47 studies on DBD (umbrella concept for ADHD, ODD and CD. | Risk factors for DBDs (Disruptive Behavior Disorders) were prenatal smoking and alcohol use, prenatal viral disease, stress and anxiety in the mother, low birth weight, complications associated with birth, parental stress and parental style during infancy, early neglect, adoption, and separation. In the field, there has been a disproportionate focus on certain risks at the expense of others. |
| Lemelin et al. (52)* | Review study | Number of studies not indicated (focus on parenting and family interactions, from 1985 to 2005) | Additional burdens in parents of children with ADHD (marital conflicts, psychopathology, drug abuse, coercive discipline, low self-esteem) threatens the consistency and attentiveness of their attitude toward their children. |
| Maguire et al. (53) | Review study | 30 studies on school-aged children (of which 4 focused on ADHD) | Children with difficulties at school, ADHD symptoms or deviant behavior, are overrepresented in having a background of neglect or emotional abuse. |
| Metz and Thévenot (54)* | Multiple case study | Projective tests of 17 children diagnosed with ADHD, 14 boys, age 8–12. Focus on two cases: a boy of 8 and a girl of 9, and their parents | Psychotherapy helped parents to identify the power in the relationship to their child with ADHD, as they struggled to distant themselves from their own familial history of trauma (violence, abuse, bereavement of children in their own parents' life). |
| Nahas et al. (55)* | Correlational study | 110 children with ADHD | The parent's attachment style and educational technique was a risk factor for the development (or worsening) of ADHD-like symptoms. The less parental involvement in the child-parent interaction, the more hyperactivity in the child. |
| Petot (56)* | Case study | A 6-year-old boy diagnosed with ADHD, met again at 13 | The child's hyperactivity functioned as a defense against anxiety separation and led to mutual hold with his mother through constant attention to him; oppositional defiant behavior resulted from the escalating of mutual frustration between the boy and the adults over the years (at schools and family). |
| Rasmussen et al. (57) | Correlational study | 67 children, ages 7–12, and their mothers | ADHD symptoms in the mother and high RSA (Resilience in Adults) in the mother correlated with a positive treatment outcome for the child. There was no correlation between the mother's attachment style and treatment outcome for the child. |
| Rasmussen et al. (58) | Correlational study | 64 mothers of children with ADHD | Self-reported ECR (insecure attachment style) correlated negatively with self-reported RSA (Resilience in adults). Self-reported ADHD correlated with self-reported RSA. A secure attachment in the mother may contribute to the development of maternal resilience, which may in turn be an important factor in parenting. |
| Scharf et al. (59) | Correlational study | 508 adolescents in 'junior high' | Adolescents with an insecure-ambivalent attachment had a higher degree of ADHD. Insecure-ambivalent and insecure-avoidant attachment correlated to the same extent with social adjustment difficulties. |
| Sempio et al. (60) | Case control study | 72 children: 36, age 4–5, of which 24 in the risk zone for ADHD. 36, age 7, of which 24 in the risk zone for ADHD | Children with a higher degree of ADHD received lower scores on attachment security, based on F-SAT (Family Separation Anxiety) and S-SAT (School Separation Anxiety). Attachment deficit may be an underestimated factor in the diagnosis of ADHD. |
| Sochos and Yahya (61) | Case control study | 98 parents of children and adolescents with ADHD, 153 parents in the control group | Parents of children with ADHD had more difficulties in their partner relationships, but the parental groups differed only when attachment style was controlled for. Parents of children with less severe ADHD were more likely to experience relationship problems. |
| Sourgen (62)* | Case study | An 8-year-old boy, with his mother | Psychodynamic psychotherapy (drawings and free associations) helped the mother and her child in dealing with the anxiety separation that sustained the mutual hold behind inattentive and hyperactivity conducts. |
| Storeboe et al. (63) | Review study | 29 studies on the association between attachment and ADHD | There is a clear association between ADHD and insecure attachment. Parental involvement in combination with environmental factors was associated with ADHD in children. Adults with ADHD have to a greater extent a more insecure attachment style. |
| Özyurt et al. (64) | Case control study | 61 children, ages 8–12 with ADHD. 87 children in the control group. | Children with ADHD had more difficulties with emotion regulation and empathic ability. Mothers of children with ADHD had a higher degree of insecure attachment and more difficulties with emotion regulation (DERS). |
ADHD, Attachment and the child-parent relationship.
*
Indicates French article.