Conflict of interest statement: No conflicts declared.
The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence
Version of Record online: 26 NOV 2013
© 2013 The Authors Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journal of Child Psychology and Psychiatry
Volume 55, Issue 5, pages 436–445, May 2014
How to Cite
Russell, G., Ford, T., Rosenberg, R. and Kelly, S. (2014), The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence. Journal of Child Psychology and Psychiatry, 55: 436–445. doi: 10.1111/jcpp.12170
- Issue online: 8 APR 2014
- Version of Record online: 26 NOV 2013
- Manuscript Accepted: 30 SEP 2013
- ESRC's Secondary Data Analysis Initiative
- National Institute for Health Research (NIHR)
- ADHD ;
- child development;
- longitudinal studies;
- social class;
- sociocultural influence
Studies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link.
Secondary analysis of a UK birth cohort (the Millennium Cohort Study, N = 19,519) was used to model the association of ADHD with socioeconomic disadvantage and assess evidence for several potential explanatory pathways. The case definition of ADHD was a parent-report of whether ADHD had been identified by a medical doctor or health professional when children were 7 years old.
ADHD was associated with a range of indicators of social and economic disadvantage including poverty, housing tenure, maternal education, income, lone parenthood and younger motherhood. There was no evidence to suggest childhood ADHD was a causal factor of socioeconomic disadvantage: income did not decrease for parents of children with ADHD compared to controls over the 7-year study period. No clinical bias towards labelling ADHD in low SES groups was detected. There was evidence to suggest that parent attachment/family conflict mediated the relationship between ADHD and SES.
Although genetic and neurological determinants may be the primary predictors of difficulties with activity level and attention, aetiology appears to be influenced by socioeconomic situation.