Children whose mothers screened positive for ADHD symptoms had lower parent-rated quality-of-life scores at follow-up in the EPINED Spanish school cohort. The association remained after the analysis accounted for the child’s ADHD and psychological distress in both parents.
The findings do not show that maternal ADHD symptoms cause poorer quality of life. The study was observational, parents were screened rather than clinically assessed, and the quality-of-life analysis included only 179 children.
What the study found
In the fully adjusted analysis, a positive maternal ADHD screen was associated with a quality-of-life score 7.7 points lower than that of children whose mothers did not screen positive. The 95% confidence interval ranged from 14.5 points lower to 0.9 points lower.
Quality of life was measured with the KIDSCREEN-27, a 27-question parent-completed survey scored from 27 to 135. Higher scores indicate better quality of life. However, the overall fully adjusted model did not reach statistical significance, with a p-value of 0.075.
There was no significant quality-of-life difference associated with a positive paternal ADHD screen. The adjusted estimate was 1.5 points lower, with a confidence interval ranging from 7.7 points lower to 4.8 points higher.
Distress was closely tied to emotional problems
The clearest pattern involved parental psychological distress and children’s emotional difficulties. When maternal distress was included in the analysis, it was the factor most closely linked to emotional problems at follow-up. The odds ratio was 4.09, with a 95% confidence interval of 1.98 to 8.43.
For persistent emotional problems, the odds ratio associated with maternal distress was 6.51, with a confidence interval of 2.44 to 17.40. In those models, the maternal ADHD screen was no longer statistically significant.
A separate model that allowed maternal ADHD symptoms and distress to interact found independent associations with persistent emotional problems. The odds ratios were 8.15 for a positive maternal ADHD screen and 12.15 for maternal distress. The confidence interval for the ADHD-screen estimate was wide, from 1.74 to 38.24, indicating considerable uncertainty.
The researchers note that the relationship between parental distress and children’s emotional problems could run in both directions. A child’s difficulties may affect a parent’s well-being, while parental distress may also influence family life.
Child ADHD was linked to conduct problems
The child’s own ADHD diagnosis was associated with conduct problems at follow-up. The odds ratio was 2.62 for conduct problems and 6.84 for persistent conduct problems.
A positive maternal ADHD screen was associated with persistent conduct problems before adjustment, but that relationship disappeared after child-related factors were included. Fathers’ ADHD screens were not linked to children’s quality of life, emotional problems or conduct problems in any model.
Why the results need careful interpretation
EPINED included 456 children: 127 with ADHD, 59 with subthreshold ADHD symptoms, 13 with ADHD and autism, and 257 without ADHD or autism. Children were first assessed at ages 4–5 or 10–11 and reassessed later. The study included 448 mothers and 375 fathers.
Parents completed the six-question screening portion of the Adult ADHD Self-Report Scale. Reporting frequent symptoms on at least four questions counted as being at risk for ADHD in this study, but a positive screen is not a diagnosis. Parents did not receive a clinical ADHD assessment.
There are also limitations to the parent-reported measures. The same parent reported their own ADHD symptoms and distress and rated the child’s quality of life, and the study did not record which parent completed the forms. Missing baseline screening answers were filled in with later scores for 81 mothers and 63 fathers. Sample attrition and the small ADHD-plus-autism group—13 children, only 10 of whom had quality-of-life scores—also limit certainty.
Because parenting was not measured, the study cannot establish whether parenting style explains the maternal association. Earlier research summarized by the researchers found that greater parental ADHD symptoms were linked with somewhat harsher or more permissive parenting and slightly less positive parenting, but those links explained about 3% of the variation in parenting measures across 32 studies.
Practical context for families and clinicians
The researchers recommend asking about parents’ ADHD symptoms and psychological well-being during a child’s ADHD evaluation. That approach can help clinicians consider the wider family context without treating a screening result as proof of a diagnosis or assuming that a parent is responsible for a child’s difficulties.
For families, the main message is one of context rather than blame: children’s quality of life and emotional well-being may be connected with challenges affecting the wider household, and both children and parents may need appropriate attention during assessment.
AI tools were used to assist with the preparation of this article.
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