Parenting Stress and Youth Symptoms among Girls with and without ADHD.

Objective To examine the aspects of parenting stress-parental distress [PD] and parental stress due to dysfunctional interactions [PSDI]-reported by mothers of girls with attention-deficit/hyperactivity disorder (ADHD) in both childhood and adolescence and to understand their associations with internalizing and externalizing symptoms in adolescence. Design The diverse sample comprised 120 girls with ADHD and 81 age- and ethnicity-matched comparison girls, evaluated at ages 6-12 years and followed prospectively for 5 years. Basic demographics, oppositionality, childhood behavioral outcomes and symptoms, and key parenting practice were covaried in the analyses. Results Longitudinally, PD during the participants' childhood was positively associated with adolescent externalizing and internalizing behaviors, even when statistically controlling for parallel childhood behaviors. PSDI during adolescence was associated with contemporaneous adolescent depressive symptoms and externalizing behaviors, but PD was associated with only internalizing behaviors. With respect to moderation by diagnostic group, PSDI (in childhood) was associated with adolescent internalizing symptoms only in girls with ADHD. However, associations between PD in childhood and internalizing behaviors were stronger in the comparison than the ADHD sample. Conclusions Minimizing early dysfunctional interactions might reduce internalizing behaviors in girls with ADHD. Interventions targeting parental distress may be beneficial for girls, regardless of ADHD status.