Abstract:
Parenting and family environment have significant impact on child development, including development of executive function, attention, and self-regulation, and may affect the risk of developmental disorders including attention-deficit/hyperactivity disorder (ADHD). This paper examines the relationship of parenting and family environment factors with ADHD. A systematic review of the literature was conducted in 2014 and identified 52 longitudinal studies. A follow-up search in 2021 identified 7 additional articles, for a total of 59 studies that examined the association of parenting factors with ADHD outcomes: ADHD overall (diagnosis or symptoms), ADHD diagnosis specifically, or presence of the specific ADHD symptoms of inattention and hyperactivity/impulsivity. For parenting factors that were present in three or more studies, pooled effect sizes were calculated separately for dichotomous or continuous ADHD outcomes, accounting for each study\'s conditional variance. Factors with sufficient information for analysis were parenting interaction quality (sensitivity/warmth, intrusiveness/reactivity, and negativity/harsh discipline), maltreatment (general maltreatment and physical abuse), parental relationship status (divorce, single parenting), parental incarceration, and child media exposure. All factors showed a significant direct association with ADHD outcomes, except sensitivity/warmth which had an inverse association. Parenting factors predicted diagnosis and overall symptoms as well as inattentive and hyperactive symptoms when measured, but multiple factors showed significant heterogeneity across studies. These findings support the possibility that parenting and family environment influences ADHD symptoms and may affect a child\'s likelihood of being diagnosed with ADHD. Prevention strategies that support parents, such as decreasing parenting challenges and increasing access to parent training in behavior management, may improve children\'s long-term developmental health.
摘要:
父母教养方式和家庭环境对儿童发展有重大影响,包括执行功能的发展,注意,和自我调节,并可能影响发育障碍的风险,包括注意力缺陷/多动障碍(ADHD)。本文研究了父母教养和家庭环境因素与ADHD的关系。2014年对文献进行了系统回顾,确定了52项纵向研究。2021年的后续搜索发现了另外7篇文章,共有59项研究检查了育儿因素与ADHD结局的关系:ADHD总体(诊断或症状),特别是多动症诊断,或存在注意力不集中和多动/冲动的特定ADHD症状。对于三个或更多研究中存在的育儿因素,对于二分性或连续性ADHD结局,分别计算合并效应大小,考虑每个研究的条件方差。具有足够分析信息的因素是父母的互动质量(敏感性/温暖,侵入性/反应性,和消极/苛刻的纪律),虐待(一般虐待和身体虐待),父母关系状况(离婚,单身父母),父母被监禁,和儿童媒体曝光。所有因素都显示出与ADHD结果有显著的直接关联,除了敏感度/温暖有逆关联。育儿因素可预测诊断和总体症状以及测量时的注意力不集中和过度活跃症状,但多个因素在研究中显示出显著的异质性。这些发现支持育儿和家庭环境影响ADHD症状的可能性,并可能影响儿童被诊断为ADHD的可能性。支持父母的预防策略,例如减少育儿挑战,增加父母在行为管理方面的培训,可以改善儿童的长期发育健康。