ADHD Symptoms in Middle Childhood: The Role of Child Attachment and Maternal Emotional Availability in an Inpatient Clinical Sample

Abstract

Background: Child ADHD symptoms are highly prevalent in middle childhood, alongside impairment in social functioning. The parent–child relationship has been shown to play an important role; however, studies investigating specific facets of the parent–child relationship in ADHD symptomatology in middle childhood have been neglected. We assumed that higher ADHD symptoms were associated with both (1) lower maternal emotional availability (EA) and (2) lower child attachment security. Moreover, (3) we aimed to explore which specific EA dimensions were associated with ADHD symptoms. Methods: In a socio-pediatric clinic in Germany, 71 inpatient mother–child dyads (child age: M = 7.70, SD = 1.06; n = 54 boys) were assessed. Clinical data about child ADHD symptoms (Child Behavior Checklist 6–18 subscale “attention deficit/hyperactivity problems”), maternal EA (free play), and child attachment representation (Attachment Story Completion Task, GEV-B) were analyzed cross-sectionally. Results: Controlling for child oppositional behavior and sex, child ADHD symptoms were associated with overall maternal EA, and more specifically non-hostility, but not with child attachment representation. Conclusions: Our results imply that the role of parent–child interaction quality should be considered in the treatment of ADHD. Bidirectional effects cannot be ruled out.