Effect of socioeconomic factors on parental stress in pediatric attention-deficit hyperactivity disorder
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a pervasive disorder which affects many domains of a patient’s life. Studies show that even with treatment, the behavior of many children with ADHD will fail to normalize. This can cause stress, and impair academic, social, emotional, and familial aspects of the child’s life. This stress can affect also have a deep impact on the parents, or caregivers, of children with ADHD, including occurrence of depression, social isolation, self-blame, marital discontent, alcohol-related dysfunction. This paper aims to investigate whether the stress caused by a child’s ADHD diagnosis changes with socioeconomic factors, such as parental education or income level. The stress of ADHD on parents or caregivers can be further impacted with a comorbid disorder, and literature suggests a comorbid disorder may be the norm rather than the exception, with up to 50% of children with ADHD displaying comorbid externalizing disorders, such as Oppositional defiant disorder or Conduct disorder. METHOD: A literature search was done to find relevant articles about pediatric ADHD, parental and familial stress, and socioeconomic factors. History, etiology, diagnostic evaluation and comorbid disorders were also examined. RESULTS: Parental stress resulting from their child’s ADHD seems to be greater at lower levels of parental educational and income levels. Furthermore, socioeconomic factors, such as marital status, impacts this stress, where parents without a partner present have greater stress levels. Parental stress levels are also greater when ADHD is comorbid with an externalizing disorder. CONCLUSIONS: Parents with children with ADHD experience more stress, especially at lower income levels, and especially when comorbid with an externalizing disorder. These parents need more resources and social support and special care should be paid to their mental health as well.