OHSU School of Nursing September Scholar
Judith Kendall, Ph.D. Professor
From Grounded Theory to Phase III Clinical Trial: A Program of Research to Support Families with Children with ADHD
Attention deficit hyperactivity disorder (ADHD) is the most common mental health disorder of childhood, affecting approximately 3%-7% of children and adolescents in the U.S. and internationally. ADHD is a chronic and stigmatizing neurological disorder with deficits in dopamine transport systems that effect executive functioning. People with ADHD have impairments in adaptive functioning which is often manifested in difficult behaviors such as aggression, poor rule-regulated behavior, inability to delay gratification, behavioral disinhibition, learning difficulties, poor impulse control, and low motivation. Children and adolescents with ADHD are at significant risk for numerous emotional and social problems, including academic and occupational under achievement, increased suicide and risk-taking behavior, depression, addiction, interpersonal difficulties and family disruption.
Family difficulties are common in families with children and adolescents with ADHD. Compared to families without ADHD, families with children with ADHD have more interpersonal conflict, higher levels of depression, increased social isolation, increased marital discord and divorce, higher rates of alcoholism, and more negativity in their family and social life. Fathers and siblings of children with ADHD are at increased risk for anxiety and depression and ADHD predicts depression in mothers. Mothers hold a pivotal position in families as we found that the degree of maternal distress mediates the relationship between child behavior problems and family functioning. Intervening on behalf of these families, particularly by implementing strategies to reduce maternal distress, is hypothesized to minimize the negative emotional impact ADHD has on the mother's well-being while improving the overall functioning of individual members and families as a whole.
This 15 year program of research has aimed to support all members of the family; to understand the experience of living in a family with a child with ADHD and to offer a home-based family intervention tailored to each family's needs in order to increase family functioning, decrease maternal distress, and improve child behaviors.