Risk and protective factors for the development of ADHD symptoms in children and adolescents: Results of the longitudinal BELLA study

Anne Wüstner; Christiane Otto; Robert Schlack; Heike Hölling; Fionna Klasen; Ulrike Ravens-Sieberer

doi:10.1371/journal.pone.0214412

Risk and protective factors for the development of ADHD symptoms in children and adolescents: Results of the longitudinal BELLA study

PLoS One. 2019 Mar 25;14(3):e0214412. doi: 10.1371/journal.pone.0214412. eCollection 2019.

Authors

Anne Wüstner¹, Christiane Otto¹, Robert Schlack², Heike Hölling², Fionna Klasen¹, Ulrike Ravens-Sieberer¹

Affiliations

¹ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood worldwide, and causes significant impairments in overall functioning. In order to develop effective prevention and intervention programs, knowledge of the determinants that have an impact on the onset and development of ADHD symptoms is essential. So far, little is known about factors affecting ADHD symptoms in children and adolescents over time. Therefore, this study investigates potential psychosocial risk and protective factors for ADHD symptoms based on cross-sectional and longitudinal data of a German population-based study.

Methods: Data on children and adolescents (n = 1,384 aged 11 to 17 years) were collected at three measurement points (baseline, 1-year and 2-year follow-ups) covering a period of two years. We used latent growth modelling to investigate effects of parental mental health problems (risk factor) and self-efficacy, family climate and social support (protective factors) on symptoms of ADHD based on cross-sectional as well as longitudinal data. Sociodemographic factors, pre- and postnatal factors, and comorbid symptoms of internalizing and externalizing mental health problems were considered as covariates.

Results: At baseline, male gender, younger age, stronger aggressive behavior, and stronger parental mental health problems were related to more ADHD symptoms. Longitudinal analyses showed that female gender, migration status, increasing symptoms of generalized anxiety, increasing aggressive behavior and increasing parental mental health problems were associated with stronger increase of ADHD symptoms over time. However, improving family climate was related to decreasing ADHD symptoms over time. We further found moderator effects for social support.

Conclusion: The findings of the study provide important information concerning risk and protective factors in the context of ADHD. Hence, the results may be integrated into the planning and implementation of future prevention and early intervention strategies that target affected children and adolescents.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity / epidemiology*
Attention Deficit Disorder with Hyperactivity / psychology
Child
Cross-Sectional Studies
Female
Germany / epidemiology
Humans
Longitudinal Studies
Male
Mental Health
Parents / psychology*
Protective Factors
Self Efficacy
Social Support

Grants and funding

The baseline, 1-year follow-up and 2-year follow-up of the BELLA study have been financially supported by the German Science Foundation. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.