Familial Factors Associated With Symptom Severity in Children and Adolescents With ADHD: A Meta-Analysis and Supplemental Review

Objective: Both genetic and environmental factors contribute to the development of ADHD, but associations between risk factors and ADHD symptom severity in affected children remain unclear. This systematic review and meta-analysis synthesizes evidence on the association between familial factors and symptom severity in children with ADHD (PROSPERO CRD42020076440). Method: PubMed and PsycINFO were searched for eligible studies. Results: Forty-three studies (N = 11,123 participants) were meta-analyzed. Five additional studies (N = 2,643 participants) were considered in the supplemental review. Parenting stress (r = .25), negative parenting practices (r = .19), broken parental partnership (r = .19), critical life events (r = .17), parental psychopathologies (r = .14-.16), socioeconomic status (r = -.10), and single-parent family (r = .10) were significantly associated with ADHD symptom severity. Conclusion: These results suggest that psychosocial familial factors show small but significant associations with symptom severity in children with ADHD. Implications are discussed.