Oct. 24, 2008 -- Married couples who have a child with attention deficit hyperactivity disorder (ADHD) are nearly twice as likely to divorce by the time the child is age 8 than are couples who do not have children affected by the disorder, according to a new study.
"We've known that ADHD kids can be very stressful for their parents," says William E. Pelham Jr., PhD, professor of psychology and pediatrics at the University at Buffalo and the study's senior author. "What this [new study] shows is that stress occurs in the marriage as well as in other aspects of the parents' lives."
Having a child with ADHD "probably causes a lot of arguments" between the husband and wife about how to handle the situation, Pelham tells WebMD. ADHD affects 5% or more of U.S. children, with symptoms including an inability to concentrate and follow directions, forgetfulness, and a tendency to daydream.
"If they don't get together on how to solve the problem, the child's behavior is not going to improve," he says. "The situation gets worse, and if those arguments don't get resolved, not only does the child's parenting not improve but the marriage worsens -- and almost a quarter of the families get divorced."
Pelham and his colleagues collected data from the parents of 282 teens and young adults diagnosed with ADHD in childhood who were part of a larger research study, the Pittsburgh ADHD Longitudinal Study (PALS). They also evaluated the parents of 206 teens and young adults without the disorder.
The parents answered questions about how long they had been married, their educational levels, and any history of depression, substance abuse, or antisocial behavior.
The child's birth date, not the date of the parents' marriage, was the starting point. The parents of children with ADHD had been married nearly five years before the child with ADHD was born and the parents of the children without ADHD had been married a little over five years before the child was born.
Nearly twice as many parents of ADHD children had divorced by the time the child was age 8, the study showed. Although 22.7% of the parents with ADHD children had divorced by the time the affected child was 8, just 12.6% of parents whose children did not have ADHD had split by the time the child was 8.
Certain risk factors in the children and the parents made divorce more likely, researchers found. If the child had coexisting disorders, such as oppositional defiant disorder (ODD) or conduct disorder (CD), it boosted the risk. A father’s antisocial behavior, such as having a DUI, boosted divorce risk, as did a discrepancy in the amount of education between partners, such as a mother having a low level and a father a high level.
"The bright spot is, the majority did not get divorced, even though the rate is twice as high," Pelham tells WebMD. Previous research, done by others, has found that mothers of children with ADHD are three times more likely to split up with their husbands than are mothers of children without ADHD.
Another potentially bright spot: the proportion of parents who divorced after the child with ADHD turned 8 did not differ significantly.
That finding may simply mean that "people have learned to cope and deal with the situation," Pelham tells WebMD. ADHD is typically treated with medication, behavior therapy, or both.
The study is published in the October issue of the Journal of Consulting and Clinical Psychology. The first author is Brian Wymbs, PhD, a postdoctoral fellow at the University of Pittsburgh.
Parents of ADHD children have tremendous stress, says Pelham, who has researched that in other studies.
More stress can occur, he says, if parents disagree on what treatment to offer the child.
"One of the problems in families with ADHD kids is, one parent will be really concerned it's a problem and the other won't see it as a problem," Pelham says. A mother, for instance, may deal with school officials and hear their concerns, he says, while a father may dismiss the behavior in a son with ADHD as "He's just all boy."
"Sometimes you get differences in parental perceptions, leading to disagreements," he says.
The study findings come as no surprise to other experts. "We've suspected that marital discord and divorce are higher among families with children with ADHD, but this study shows that in a clear way," says Charlotte Johnston, PhD, professor of psychology and a long-time researcher on ADHD at the University of British Columbia, Vancouver, who trained with Pelham as a graduate student.
"I think what this really adds is looking at the predictors, showing there are child characteristics as well as parent characteristics."
The study findings seem to reflect anecdotal findings, says Bryan Goodman, a spokesman for CHADD, Children and Adults with Attention Deficit/Hyperactivity Disorder, a self-help organization that has more than 200 chapters for parents nationwide. "It's very stressful for families dealing with this disorder."
Often, he tells WebMD, parents simply are not on the same page. "You can have one parent who understands that the child has the disorder and that treatment is available and that it's important the child be treated. And you may have another parent having a hard time coming to terms with it and is reluctant to have the child treated."
Parents need to work together, says Pelham. They need to focus, he says, on learning better parenting skills. "Learning better skills as parents will not only improve a child's function, but help them resolve disagreements and reduce or minimize stress within the marriage."
Thinking long-term is crucial, he says. "Parent should not be thinking, 'I will solve this in the next four weeks," he says. They should be aware, too, that the core symptoms -- problems paying attention, impulse control -- tend to get better as a child gets older but that not all symptoms improve with age.
Help for parents is available through such programs as the University at Buffalo's Center for Children and Families, which Pelham directs, and organizations such as CHADD.