Attachment and ADHD

Abstract

In recent years, attachment research has increasingly begun to look into questions of developmental psycho-pathology. Although Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequent child and adolescent psychiatric disorders, to date, very few studies exist that have investigated the attachment quality of hyperactive children. The aim of this research, therefore, was to examine the manifestations of attachment quality in children with ADHD. Thirty children with symptoms of ADHD were compared to 29 children without ADHD symptoms. The children were recruited from among first and second graders in primary schools in Cologne. One third of the children studied came from immigrant families. As expected, the ADHD group contained more male subjects than the control group. Intellectual ability, as measured by the HAWIK-III inventory, was shown to be significantly inferior in children from the ADHD group as compared to children from the control group. The results of the Clinical Assessment Scale of Child and Adolescent Psychopathology (CASCAP-D) and the Child Behavior Checklist (CBCL 4-18) showed that the hyperactive children exhibited significantly stronger psychopathological symptoms than the children in the control group. The results of the diagnostic system used to measure mental disorders of children and adolescents (DISYPS-KJ) showed that the children with ADHD exhibited significantly stronger core ADHD symptoms. In fact, in 28 of the 30 children in the ADHD group the provisional diagnosis of ADHD was confirmed. An investigation of the childrens attachment quality, using the German adaptation of the Attachment Story Completion Tasks (GEV), revealed that, compared to the children in the control group, the ADHD children tended to exhibit insecure attachment patterns more frequently and also had disorganized attachment patterns significantly more often. An attempt to classify parental attachment style via the Adult Attachment Projective (AAP) did not result in definitive findings. The parents of the children with ADHD did exhibit insecure-avoiding and insecure-ambivalent patterns of attachment more often than did the parents of the children in the control group. The differences were, however, not statistically significant. Difficulties with data gathering, data handling, and differences in the command of the German language of some of the parents may possibly have impaired data analysis. Further research to assess the quality of parental attachment to their hyperactive children is needed to determine whether insecure parental attachment quality is a risk factor for the development of ADHD in children. The results of this study argue for the relevance of early intervention for restless babies and toddlers. Further studies, especially in the area of prenatal research, are also important to identify early risk factors.