Family Stress and ADHD Inattentive

stress and adhd inattentive
Children in Brazil with Attention Deficit Hyperactivity Disorder (ADHD-PI) are more likely to live in a household with a significant amount of household disruption or stress. These were the findings of a new study published in the March, 2011, Journal of European Child and Adolescent Psychiatry.

Household or Family stress included having a parent who had been in Jail, having a parent with a mental health diagnosis, being poor and being divorced or separated. This particular study looked at 100 school age children and 100 non-ADHD-PI controls. They rated the cases and the controls of the level of family stress and concluded that the ADHD-PI families were under more stress than the control families.

The Journal of European and Child and Adolescent researchers were quick to point out that these findings did not indicate that the stress caused the ADHD-PI but it is not too difficult to infer that family stress has something to do with Inattentive symptoms.

This study looked only at kids with ADHD-PI but we know from many other studies that many kids with ADHD come from homes that are poorer and that they kids also live in homes with more family stress than non-ADHD kids. What is not clear is if the biology of ADHD is somehow caused by these stressors (as in an ADHD epigenetics model where the genes for these disorders are present but the environment turns them on) or if the culprit is nothing more than the stress itself.

Anxiety and Depression are seen more in children and adults with ADHD-PI but these disorders commonly co-exist in all patients that are diagnosed with ADHD. We know from sleep deprivation as well as anxiety studies that stress can worsen attention but does family stress make kids with out ADHD look like kids with ADHD-PI? Do ADHD-PI kids improve if they live in stress free family environements?

These questions have not been answered as these studies have not been performed in humans but animal studies have shown that eliminating stress improves the brain functioning and the inattention that is caused by stress and fatigue. An interesting study performed in Taiwan demonstrated that rats exposed to stress had considerable brain changes at the cellular level that corresponded with decreased cognitive performance and decreased attention. When the stress was removed the brain changes corrected themselves as did the cognitive deficits and the Attention Deficits.

The application to Attention Deficit Hyperactivity Disorder Inattentive type is clear. Limiting family stress and the control and management of all stress is essential to improving the symptoms of inattention seen in ADHD-PI. Luckily there are many therapies that have been found to be effective for stress reduction. These include therapies such as Cognitive Behavioral Therapy, exercise therapy, yoga, meditation, breathing exercises and relaxation instruction.

European Child and Adolescent Psychiatry. 2011 Mar;20(3):137-45. Epub 2011 Feb 3.Are family variables associated with ADHD, inattentive type? A case-control study in schools.
Pheula GF, Rohde LA, Schmitz M.
Brazil.

Neuroscience. 2009 Jul 21;161(4):1104-13. Epub 2009 Apr 17.
Fatigue reversibly reduced cortical and hippocampal dendritic spines concurrent with compromise of motor endurance and spatial memory.
Chen JR, Wang TJ, Huang HY, Chen LJ, Huang YS, Wang YJ, Tseng GF.
Taiwan.

Journal of Clinical and Experimental Neuropsychology. 1996 Dec;18(6):864-82.
Computerized assessment of sustained attention: interactive effects of task demand, noise, and anxiety.
Ballard JC., Emory University, Atlanta, Georgia, USA.

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