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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.

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The hypothesis testing behaviors of 50 boys with Attention-Deficit Hyperactivity Disorder (ADHD) were compared to those of 50 boys without ADHD. The two groups were randomly assigned to one of two feedback conditions: a) boys in the "instruction and rule" condition learned additional strategies to aid their performance on the Wisconsin Card Sorting Test (WCST); b) children in the "verbal only" condition learned no additional strategies. There were no significant group or condition differences between the boys on the primary dependent measures used. The results from the WCST were also evaluated according to five aspects of problem solving: (a) selective attention, (b) stimulus differentiation, (c) response generation, (d) response execution, and (e) responding appropriately to feedback. The study showed a tendency for the children with ADHD to respond according to a position or hypothesis set. Similarly, children in the "verbal only" condition tended to respond to feedback less appropriately than did children in the instruction and rule condition. These tendencies however, did not differentiate between the boys with ADHD and boys without ADHD.

The current study discussed the development and validation of the Checklist for Differential Diagnosis of Attentional Problems (CDDAP), a tool for use with adults seeking diagnosis and treatment of an Attention Deficit Hyperactivity Disorder. Normative data are provided on three subject groups (ADHD adults, controls, and adults with other psychiatric disorders). Convergent validity was established with the SCL-90, and criterion validity established through comparing scaled scores with final diagnoses. Overall, this measure was accurate at differentiating adults with ADHD from controls and adults with other psychiatric disorders. Results indicated that the CDDAP was also able to identify other psychiatric disorders with 71 to 92% accuracy, depending on the disorder.

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