Pernille Darling Rasmussen1, Ole Jakob Storebø2, Yael Shmueli-Goetz3, Jesper Pedersen4, Erik Simonsen2, Niels Bilenberg5
1University of Southern Denmark, Clinical Department, Odense, Denmark
2Psychiatric Research Unit, Region Zealand, Denmark
3Anna Freud National Centre for Children and Families, United Kingdom
4Child and Adolescent Psychiatric Department, Region Zealand, Denmark
5Region of Southern Denmark, Psychiatric Research Unit, Odense, Denmark
Background: It is widely held that ADHD is associated with poor prognosis in adulthood. Whilst a growing body of evidence suggests an association between a diagnosis of ADHD and problematic family functioning, the developmental trajectories of individuals with ADHD as well as the factors determining their long-term prognosis are poorly understood. However, current research findings have found substantial overlaps in symptomatology between ADHD and insecure attachment suggesting potential importance of relational factors for long-term prognosis in ADHD.
Objective: The aims of the study were twofold; to assess child and maternal attachment representations in a sample of children diagnosed with ADHD and to evaluate the impact of maternal and child attachment representations on treatment response.
Method: The sample consisted of 60 mother-child dyads with offspring ADHD. Maternal and child attachment representations were assessed using the Adult Attachment Interview and the Child Attachment Interview. Alongside an assessment of ADHD symptoms were continuously evaluated on the ADHD-RS for a period of one year following the baseline assessment.
Results: Of the 60 children, 18% were found to be securely attached compared to 62% in the general population. Among mothers, 26% were securely attached (Autonomous) compared to 55% in reported non-clinical samples. Furthermore, preliminary results in the follow-up period show a more moderate treatment response in insecurely attached children as well as in children of insecurely attached mothers.
Conclusions: We found the rate of insecure attachment to be significantly higher among children with ADHD as well as in their mothers compared to the normal population. Moreover, preliminary results suggest a correlation between attachment quality and treatment response highlighting the importance of future studies studying the role of relational factors such as attachment in treatment response and outcome.