Is There a Difference in Parental Attitudes and Attachment for ADHD-Social Phobia Comorbidity?

Objective: Social phobia (SP) is one the commonest of comorbid anxiety disorders seen with ADHD. It is also known that Social phobia and ADHD patients have some differences in parental attitudes and attachment styles. We aimed to investigate the effects attachment status and parental attitudes in ADHD-social phobia comorbidity.

Method: 66 children and adolescents with ADHD were included for the study. the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (KSADS-PL-DSM5-T) was used for evaluating diagnosis. Socioeconomic status (SES) was scored with Hollingshead Redlich Scale. Sosyodemografic and clinical data were recorded. Adult Attachment Scale (AAS) and Parental Attitudes Research Instrument (PARI) were completed by the parents. The patients filled Kerns Security Scale (KSS). We compared the ADHD patients with and without SAD comorbidity in terms of scales used and sociodemographic-clinical variables.

Results: There were no differences between ADHD + SP group and ADHD without SP group in terms of age, gender, SES, family structure and family history of diagnosed psychiatric disease (p>0.05). Rate of inattentive subtype of ADHD (p=0.05) and comorbid psychiatric disease frequency (p=0.00) was higher in ADHD+SP group compared to ADHD without social phobia group. However, the groups did not differ according to their attachment styles, their parent's attachment styles and parental attitudes (p>0.05).

Conclusion: Parental attitudes and attachment styles may not play a role in the development of SP comorbidity in children and adolescents with ADHD. Other biological and environmental factors should be kept in mind when evaluating and treating children with ADHD who have SP. Biological treatments and individualized interventions such as CBT may be chosen as a first line treatment rather than psychotherapies targeting attachment and parenting styles in those children.