The Association Between Parental and Peer Attachment and Anxiety in Children and Adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) in King Chulalongkorn Memorial Hospital
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Abstract
Objectives: This study aimed to examine the associations between parental attachment and anxiety among children and adolescents with ADHD, with peer attachment serving as a mediator variable. Furthermore, the study investigated the prevalence of anxiety among children and adolescents with ADHD receiving outpatient treatment in Child and Adolescent Psychiatry Unit at King Chulalongkorn Memorial Hospital.
Methods: This cross-sectional analytical study employed consecutive sampling to recruit children and adolescents aged 10–15 years who were diagnosed with ADHD and receiving outpatient treatment in Child and Adolescent Psychiatry Unit at King Chulalongkorn Memorial Hospital. Data were collected from medical records, a demographic questionnaire, the Inventory of Parent and Peer Attachment–Revised (IPPA-R), and the Thai version of the Screen for Child Anxiety Related Emotional Disorders (SCARED). The mediating role of peer attachment in the relationship between parental attachment and anxiety was analyzed using a mediation model. Indirect effects were evaluated using bootstrapping method with bias-corrected confidence intervals, implemented in SPSS version 30.0 PROCESS macro, controlling for sex, age, educational level, type of school, number of friends, presence of siblings, birth order, closeness with family members, and being raised by parents before the age of five.
Results: A total of 125 participants were included, of whom 97 (77.6%) were male. Eighty-one participants (64.8%) screened positive for anxiety, with 56 participants (44.8%) indicating a higher specificity for anxiety disorders. The majority screened positive for separation anxiety disorder (n = 84, 67.2%). The findings indicated that parental attachment was negatively associated with anxiety symptoms in children and adolescents with ADHD, showing a significant direct effect but no significant indirect effect (Direct effect = -0.531, 95%CI [-0.897,-0.165]), Indirect effect = 0.031, 95%CI [-0.082,0.181]). However, peer attachment did not mediate the relationship between parental attachment and anxiety.
Conclusion: The findings highlighted the crucial influence of parental attachment in alleviating anxiety symptoms in children and adolescents with ADHD. Peer attachment did not serve as a mediating factor in the relationship between parental attachment and anxiety. Therefore, promoting secure attachment between children and their parents may help reduce anxiety in this population.
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