UC Berkeley

Attention-Deficit/Hyperactivity Disorder (ADHD) in females is associated with notable interpersonal difficulties during childhood and adolescence, yet little is known about the relationship quality of young women with histories of childhood ADHD. The purpose of this study was to examine the association between childhood ADHD and self-reported peer and parent relationship quality in young women, and to examine potential adolescent pathways of this association. Data were drawn from the Berkeley Girls with ADHD Longitudinal Study (BGALS, N = 228), composed of females with childhood ADHD (n = 140) and healthy comparisons (n = 88). Participants were followed prospectively from childhood (Wave 1; M age = 9.6 years) and assessed during adolescence (Wave 2; M age = 14.2 years) and young adulthood (Wave 3; M age = 19.6 years). A principal component analysis (PCA) on items from the Interview of Parent and Peer Relationships (Armsden & Greenberg, 1987), yielded a single peer and a single parent factor, with higher scores reflecting better perceived relationship quality (e.g., more trusting, accessible, and reliable) and lower scores reflecting poorer perceived relationship quality (e.g., less trusting, accessible, and reliable). Participants were compared with respect to Wave 1 ADHD status and symptom severity to their Wave 3 relationship quality. Parallel bivariate analyses were conducted according to ADHD diagnostic subtype at Wave 1 and diagnostic persistence over time. Potential pathways linking Wave 1 ADHD and Wave 3 relationship quality were explored via mediational analyses using four candidate variables assessed during adolescence (Wave 2 social skills, response inhibition, internalizing symptoms, and externalizing symptoms). Analyses were conducted with inclusion of psychiatric, cognitive, and demographic covariates. After covariate adjustment, ADHD diagnostic status was associated with significantly poorer peer and parent relationship quality, with small and medium effect sizes, respectively. There were no differences in relationship quality with respect to diagnostic subtype at Wave 1. Relative to having a lifetime non-diagnosis or transient diagnosis of ADHD, persistent ADHD was associated with significantly lower quality peer and parent relationship quality. Finally, social skills and response inhibition partially mediated the Wave 1 ADHD – Wave 3 relationship quality associations, although only the social skills variable was in the expected direction. In females, childhood ADHD, regardless of diagnostic subtype, is a specific risk factor for diminished quality of relationships with peers and parents during young adulthood. Persistent ADHD appears to be detrimental to parent relationship quality in particular. Interventions targeting adolescent social skills in girls with ADHD may help to improve the quality of their peer and parent relationships as they transition to adulthood.