Top

BMC Psychiatry

Published in:

Open Access 01-12-2015 | Research article

Improved quality of life among adolescents with attention-deficit/hyperactivity disorder is mediated by protective factors: a cross sectional survey

Authors: Jorun Schei, Torunn Stene Nøvik, Per Hove Thomsen, Marit S Indredavik, Thomas Jozefiak

Published in: BMC Psychiatry | Issue 1/2015

Abstract

Background

The aim of this study was to assess the role of protective factors as mediators and/or moderators of the relationship between coexisting emotional and conduct problems and quality of life (QoL) among adolescents with attention-deficit/hyperactivity disorder (ADHD).

Methods

The sample consisted of 194 adolescents with ADHD. Participants completed measures of individual competencies, family cohesion and social support, and QoL. Coexisting emotional and conduct problems were assessed using the Strength and Difficulties Questionnaire.

Results

Individual competencies and social support mediated the association between emotional and conduct problems and QoL. Family cohesion was associated with both emotional and conduct problems. No moderating effects of protective factors and coexisting problems were found.

Conclusions

The assessment of individual competencies, social resources, and family cohesion may identify potential treatment goals for adolescents with ADHD and coexisting problems, and may contribute to improvements in QoL.

Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry. 2006;45(2):192–202.PubMedCrossRef

Mrug S, Molina BS, Hoza B, Gerdes AC, Hinshaw SP, Hechtman L, et al. Peer rejection and friendships in children with attention-deficit/hyperactivity disorder: contributions to long-term outcomes. J Abnorm Child Psychol. 2012;40(6):1013–26.PubMedPubMedCentralCrossRef

Booster GD, Dupaul GJ, Eiraldi R, Power TJ. Functional impairments in children with ADHD: unique effects of age and comorbid status. J Atten Disord. 2012;16(3):179–89.PubMedCrossRef

Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH. Long-term criminal outcome of children with attention deficit hyperactivity disorder. Crim Behav Ment Health. 2013;23(2):86–98.PubMedCrossRef

Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH. ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood – a naturalistic long-term follow-up study. Addict Behav. 2014;39(1):325–28.PubMedCrossRef

Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH. Conduct problems, gender and adult psychiatric outcome of children with attention-deficit hyperactivity disorder. Br J Psychiatry. 2002;181:416–21.PubMedCrossRef

Dalsgaard S, Østergaard SD, Leckman JF, Mortensen PB, Pedersen MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015. doi:10.1016/S0140-6736(14)61684-6.

Biederman J, Martelon M, Faraone SV, Woodworth KY, Spencer TJ, Wozniak JR. Personal and familial correlates of bipolar (BP)-I disorder in children with a diagnosis of BP-I disorder with a positive child behavior checklist (CBCL)-severe dysregulation profile: a controlled study. J Affect Disord. 2013;147(1–3):164–70.PubMedCrossRef

Danckaerts M, Sonuga-Barke EJ, Banaschewski T, Buitelaar J, Dopfner M, Hollis C, et al. The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry. 2010;19(2):83–105.PubMedCrossRef

10.

Gjone H, Stevenson J, Sundet JM. Genetic influence on parent-reported attention-related problems in a Norwegian general population twin sample. J Am Acad Child Adolesc Psychiatry. 1996;35(5):588–96. discussion 596–88.PubMedCrossRef

11.

Nigg J. What causes ADHD? New York: The Guilford Press New York; 2006.

12.

Modesto-Lowe V, Yelunina L, Hanjan K. Attention-deficit/hyperactivity disorder: a shift toward resilience? Clin Pediatr (Phila). 2011;50(6):518–24.CrossRef

13.

Riley AW, Spiel G, Coghill D, Dopfner M, Falissard B, Lorenzo MJ, et al. Factors related to health-related quality of life (HRQoL) among children with ADHD in Europe at entry into treatment. Eur Child Adolesc Psychiatry. 2006;15 Suppl 1:I38–45.PubMedCrossRef

14.

von Soest T, Mossige S, Stefansen K, Hjemdal O. A validation study of the Resilience Scale for Adolescents (READ). J Psychopathol Behav Assess. 2010;32:215–25.CrossRef

15.

Rutter M. Resilience reconsidered: conceptual considerations, empirical findings, and policy implications. In: Shonkoff JP, Meisels SJ, editors. Handbook of early childhood intervention. 2nd ed. New York: Cambridge University Press; 2000. p. 651–82.CrossRef

16.

Roberts BA, Martel MM, Nigg JT. Are there executive dysfunction subtypes within ADHD? J Atten Disord. 2013. doi:10.1177/1087054713510349

17.

Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH. Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ? J Child Psychol Psychiatry. 2010;51(8):895–904.PubMedCrossRef

18.

Harpin V, Mazzone L, Raynaud JP, Kahle J, Hodgkins P. Long-term outcomes of ADHD: a systematic review of self-esteem and social function. J Atten Disord. 2013. doi:10.1177/1087054713486516

19.

Burt KB, Roisman GI. Competence and psychopathology: cascade effects in the NICHD Study of Early Child Care and Youth Development. Dev Psychopathol. 2010;22(3):557–67.PubMedCrossRef

20.

Murray-Close D, Hoza B, Hinshaw SP, Arnold LE, Swanson J, Jensen PS, et al. Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in the Multimodal Treatment Study of Children With ADHD: developmental cascades and vicious cycles. Dev Psychopathol. 2010;22(4):785–802.PubMedPubMedCentralCrossRef

21.

Vaananen JM, Isomaa R, Kaltiala-Heino R, Frojd S, Helminen M, Marttunen M. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study. BMC Psychiatry. 2014;14:79.PubMedPubMedCentralCrossRef

22.

Biederman J, Petty CR, Clarke A, Lomedico A, Faraone SV. Predictors of persistent ADHD: an 11-year follow-up study. J Psychiatr Res. 2011;45(2):150–55.PubMedCrossRef

23.

Schei J, Jozefiak T, Novik TS, Lydersen S, Indredavik MS. The impact of coexisting emotional and conduct problems on family functioning and quality of life among adolescents with ADHD. J Atten Disord. 2013. doi:10.1177/108705713507976

24.

Rinsky JR, Hinshaw SP. Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD. Child Neuropsychol. 2011;17(4):368–90.PubMedPubMedCentralCrossRef

25.

Coghill D, Danckaerts M, Sonuga-Barke E, Sergeant J, Group AEG. Practitioner review: quality of life in child mental health – conceptual challenges and practical choices. J Child Psychol Psychiatry. 2009;50(5):544–61.PubMedCrossRef

26.

Mattejat F, Remschmidt H. Assessing the quality of life of children and adolescents with psychiatric disorders – a review. Z Kinder Jugendpsychiatr Psychother. 1998;26(3):183–96.PubMed

27.

Bastiaansen D, Koot HM, Ferdinand RF. Psychopathology in children: improvement of quality of life without psychiatric symptom reduction? Eur Child Adolesc Psychiatry. 2005;14(7):364–70.PubMedCrossRef

28.

van der Kolk A, Bouwmans CA, Schawo SJ, Buitelaar JK, van Agthoven M, Hakkaart-van RL. Association between quality of life and treatment response in children with attention deficit hyperactivity disorder and their parents. J Ment Health Policy Econ. 2014;17(3):119–29.PubMed

29.

Faraone SV, Buitelaar J. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur Child Adolesc Psychiatry. 2010;19(4):353–64.PubMedCrossRef

30.

Fredriksen M, Dahl AA, Martinsen EW, Klungsoyr O, Haavik J, Peleikis DE. Effectiveness of one-year pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD): an open-label prospective study of time in treatment, dose, side-effects and comorbidity. Eur Neuropsychopharmacol. 2014;24(12):1873–84.PubMedCrossRef

31.

Hinshaw SP, Arnold LE. For the MTA Cooperative Group. ADHD, multimodal treatment, and longitudinal outcome: evidence, paradox, and challenge. Wiley Interdiscip Rev. Cogn Sci. 2015;6(1):39–52.

32.

Mikami AY, Lerner MD, Griggs MS, McGrath A, Calhoun CD. Parental influence on children with attention-deficit/hyperactivity disorder: II. Results of a pilot intervention training parents as friendship coaches for children. J Abnorm Child Psychol. 2010;38(6):737–49.PubMedPubMedCentralCrossRef

33.

Abikoff H, Gallagher R, Wells KC, Murray DW, Huang L, Lu F, et al. Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. J Consult Clin Psychol. 2013;81(1):113–28.PubMedCrossRef

34.

Deault LC. A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry Hum Dev. 2010;41(2):168–92.PubMedCrossRef

35.

Van Roy B, Groholt B, Heyerdahl S, Clench-Aas J. Self-reported strengths and difficulties in a large Norwegian population 10–19 years: age and gender specific results of the extended SDQ-questionnaire. Eur Child Adolesc Psychiatry. 2006;15(4):189–98.PubMedCrossRef

36.

Goodman R. The Strengths and Difficulties Questionnaire. J Child Psychol Psychiatry. 1997;38:5.CrossRef

37.

Hollingshead AB. Two factor index of social positions. New Haven, CT: Yale University; 1958.

38.

World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization; 1992.

39.

Norwegian Directorate of Health. Veileder i diagnostikk og behandling av AD/HD. [ADHD diagnostic and treatment guideline]. Oslo: Norwegian Directorate of Health; 2014.

40.

Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management, Wolraich M, Brown L, Brown RT, DuPaul G, et al. ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007–22.PubMedCentralCrossRef

41.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4^th edition, revised version. Washington DC: American Psychiatric Association; 2000.

42.

Gomez R. ADHD and hyperkinetic disorder symptoms in Australian adults: descriptive scores, incidence rates, factor structure, and gender invariance. J Atten Disord. 2013. doi:10.1177/1087054713485206

43.

Barkley RA, Murphy K. R. Attention-deficit hyperactivity disorder. A clinical workbook. 3rd ed. New York: The Guilford Press; 2006.

44.

Becker A, Steinhausen HC, Baldursson G, Dalsgaard S, Lorenzo MJ, Ralston SJ, et al. Psychopathological screening of children with ADHD: Strengths and Difficulties Questionnaire in a pan-European study. Eur Child Adolesc Psychiatry. 2006;15 Suppl 1:I56–62.PubMedCrossRef

45.

Goodman R. Psychometric properties of the Strengths and Difficulties Questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45.PubMedCrossRef

46.

Van Roy B, Veenstra M, Clench-Aas J. Construct validity of the five-factor Strengths and Difficulties Questionnaire (SDQ) in pre-, early, and late adolescence. J Child Psychol Psychiatry. 2008;49(12):1304–12.PubMedCrossRef

47.

Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M. A new rating scale for adult resilience: what are the central protective resources behind healthy adjustment? Int J Methods Psychiatr Res. 2003;12(2):65–76.PubMedCrossRef

48.

Jozefiak TMF, Remschmidt H. Inventory of life quality in children and adolescents manual, Norwegian version. Stockholm: Hogrefe; 2012.

49.

Mattejat FRH. Das Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK) [The inventory of quality of life in children and adolescents (ILC)]. Bern: Hans Huber Verlag; 2006.

50.

Jozefiak T, Larsson B, Wichstrom L, Mattejat F, Ravens-Sieberer U. Quality of life as reported by school children and their parents: a cross-sectional survey. Health Qual Life Outcomes. 2008;6:34.PubMedPubMedCentralCrossRef

51.

Muthén LK, Muthén BO. Mplus user’s guide. 7th ed. Los Angeles: Muthén & Muthén; 1998–2012.

52.

Raykov T, Marcoulides GA. Model-testing and fit evaluation. In: Raykov T, Marcoulides GA, editors. A first course in structural equation modeling. New Jersey: Lawrence Erlbaum Associates; 2006. p. 38–51.

53.

Yu CY. Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes. PhD thesis. University of California, Graduate School of Education and Information Studies; 2002.

54.

Egeland J, Johansen SN, Ueland T. Do low-effort learning strategies mediate impaired memory in ADHD? J Learn Disabil. 2010;43(5):430–40.PubMedCrossRef

55.

West SG, Taylor AB, Wu W. Model fit and model selection in structural equation modeling. In: Hoyle RH, editor. Handbook of structural equation modeling. New York: The Guilford Press; 2012.

56.

Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH. Executive dysfunction in school-age children with ADHD. J Atten Disord. 2011;15(8):646–55.PubMedCrossRef

57.

Jacobson LA, Williford AP, Pianta RC. The role of executive function in children’s competent adjustment to middle school. Child Neuropsychol. 2011;17(3):255–80.PubMedPubMedCentralCrossRef

58.

Langberg JM, Dvorsky MR, Evans SW. What specific facets of executive function are associated with academic functioning in youth with attention-deficit/hyperactivity disorder? J Abnorm Child Psychol. 2013;41(7):1145–59.PubMedPubMedCentralCrossRef

59.

Ostrander R, Crystal DS, August G. Attention deficit-hyperactivity disorder, depression, and self- and other-assessments of social competence: a developmental study. J Abnorm Child Psychol. 2006;34(6):773–87.PubMedCrossRef

60.

Dan O, Raz S. The relationships among ADHD, self-esteem, and test anxiety in young adults. J Atten Disord. 2012. doi:10.1177/1087054712454571

61.

Shaw-Zirt B, Popali-Lehane L, Chaplin W, Bergman A. Adjustment, social skills, and self-esteem in college students with symptoms of ADHD. J Atten Disord. 2005;8(3):109–20.PubMedCrossRef

62.

Thompson MJ, Laver-Bradbury C, Ayres M, Le Poidevin E, Mead S, Dodds C, et al. A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry. 2009;18(10):605–16.PubMedCrossRef

63.

Rapport MD, Orban SA, Kofler MJ, Friedman LM. Do programs designed to train working memory, other executive functions, and attention benefit children with ADHD? A meta-analytic review of cognitive, academic, and behavioral outcomes. Clin Psychol Rev. 2013;33(8):1237–52.PubMedCrossRef

64.

Evans SW, Owens JS, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal J Clin Child Adolesc Psychol. 2013. doi:10.1080/15374416.2013.850700.

65.

Knouse LE, Safren SA. Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. Psychiatr Clin North Am. 2010;33(3):497–509.PubMedPubMedCentralCrossRef

66.

Mitchell JT, McIntyre EM, English JS, Dennis MF, Beckham JC, Kollins SH. A pilot trial of mindfulness meditation training for ADHD in adulthood: impact on core symptoms, executive functioning, and emotion dysregulation. J Atten Disord. 2013. doi:10.1177/1087054713513328.

67.

Young S, Bramham J. Cognitive-behavioural therapy for ADHD in adolescents and adults: a psychological guide to practice. 2nd ed. Oxford: Wiley-Blackwell; 2012.CrossRef

68.

Hoza B. Peer functioning in children with ADHD. J Pediatr Psychol. 2007;32(6):655–63.PubMedCrossRef

69.

Heiman T. An examination of peer relationships of children with and without attention deficit hyperactivity disorder. School Psych Int. 2005;26(3):330–39.CrossRef

70.

Gardner DM, Gerdes AC. A review of peer relationships and friendships in youth with ADHD. J Atten Disord. doi:10.1177/1087054713501552.

71.

McQuade, JD, Vaughn, AJ, Hoza, B, Murray-Close, D, Molina, BS, Arnold, LE, Hechtman, L. Perceived social acceptance and peer status differentially predict adjustment in youth with and without ADHD. J Atten Disord. 2014. doi:10.1177/1087054712437582

72.

Crea TM, Chan K, Barth RP. Family environment and attention-deficit/hyperactivity disorder in adopted children: associations with family cohesion and adaptability. Child Care Health Dev. 2013. doi:10.1111/cch.12112

73.

Hurt EA, Hoza B, Pelham Jr WE. Parenting, family loneliness, and peer functioning in boys with attention-deficit/hyperactivity disorder. J Abnorm Child Psychol. 2007;35(4):543–55.PubMedCrossRef

74.

Grenwald-Mayes G. Relationship between current quality of life and family of origin dynamics for college students with attention-deficit/hyperactivity disorder. J Atten Disord. 2002;5(4):211–22.PubMedCrossRef

75.

Wilmshurst L, Peele M, Wilmshurst L. Resilience and well-being in college students with and without a diagnosis of ADHD. J Atten Disord. 2011;15(1):11–7.PubMedCrossRef

76.

Jensen PS, Hinshaw SP, Kraemer HC, Lenora N, Newcorn JH, Abikoff HB, et al. ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. J Am Acad Child Adolesc Psychiatry. 2001;40(2):147–58.PubMedCrossRef

77.

Powell SG, Thomsen PH, Frydenberg M, Rasmussen H. Long-term treatment of ADHD with stimulants: a large observational study of real-life patients. J Atten Disord. 2011;15(6):439–51.PubMedCrossRef

78.

Meinzer MC, Pettit JW, Viswesvaran C. The co-occurrence of attention-deficit/hyperactivity disorder and unipolar depression in children and adolescents: a meta-analytic review. Clin Psychol Rev. 2014;34(8):595–607.PubMedCrossRef

79.

Ramtvedt BE, Aabech HS, Sundet K. Minimizing adverse events while maintaining clinical improvement in a pediatric attention-deficit/hyperactivity disorder crossover trial with dextroamphetamine and methylphenidate. J Child Adolesc Psychopharmacol. 2014;24(3):130–39.PubMedPubMedCentralCrossRef

80.

Skrove M, Romundstad P, Indredavik MS. Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study. Soc Psychiatry Psychiatr Epidemiol. 2013;48(3):407–16.PubMedCrossRef

81.

Cyranowski JM, Frank E, Young E, Shear MK. Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Arch Gen Psychiatry. 2000;57(1):21–7.PubMedCrossRef

82.

Emeh CC, Mikami AY. The influence of parent behaviors on positive illusory bias in children with ADHD. J Atten Disord. doi:2012. 10.1177/1087054712441831.

83.

Swanson EN, Owens EB, Hinshaw SP. Is the positive illusory bias illusory? Examining discrepant self-perceptions of competence in girls with ADHD. J Abnorm Child Psychol. 2012;40(6):987–98.PubMedCrossRef

84.

Barkley RA. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. New York: Guilford Press; 2006.

85.

Skogli EW, Teicher MH, Andersen PN, Hovik KT, Oie M. ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures. BMC Psychiatry. 2013;13:298.PubMedPubMedCentralCrossRef

86.

Dopfner M, Steinhausen HC, Coghill D, Dalsgaard S, Poole L, Ralston SJ, et al. Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study. Eur Child Adolesc Psychiatry. 2006;15 Suppl 1:I46–55.PubMedCrossRef

Title: Improved quality of life among adolescents with attention-deficit/hyperactivity disorder is mediated by protective factors: a cross sectional survey
Authors: Jorun Schei
Torunn Stene Nøvik
Per Hove Thomsen
Marit S Indredavik
Thomas Jozefiak
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-015-0491-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improved quality of life among adolescents with attention-deficit/hyperactivity disorder is mediated by protective factors: a cross sectional survey

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Primary prevention of psychosis through interventions in the symptomatic prodromal phase, a pragmatic Norwegian Ultra High Risk study

A comparison of clinical characteristics between adolescent males and females with eating disorders

Contribution of estradiol levels and hormonal contraceptives to sex differences within the fear network during fear conditioning and extinction

Psycho-education for substance use and antisocial personality disorder: a randomized trial

Roles of attachment and self-esteem: impact of early life stress on depressive symptoms among Japanese institutionalized children

Understanding recovery in the context of lived experience of personality disorders: a collaborative, qualitative research study