Hysaj Marsida, Crone Mathilde R, Kiefte-de Jong Jessica C, Vermeiren Robert R J M
Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Department of Public Health and Primary Care / Health Campus the Hague, Leiden University Medical Center, The Hague, The Netherlands.
BMC Psychiatry. 2025 Mar 11;25(1):234. doi: 10.1186/s12888-025-06537-5.
Most research in children with ADHD has focused on risk factors and their outcomes, such as symptom severity as a risk factor for functional impairment. Yet, a small group of studies show that some children function well despite their symptom severity. Preliminary evidence suggests that social protective factors may protect children with ADHD against its negative impact across different domains. The purpose of this study was to evaluate whether prosocial behavior, as a protective factor, buffers the effects of symptoms on impairment in children and adolescents with ADHD symptoms.
In this cross-sectional study, we used routinely collected data from the Development and Well-Being Assessment (DAWBA). Reports were included from 822 mothers, 581 fathers, and 1109 teachers, who provided information on the children's symptoms, impairment and prosocial behavior (aged 5-18). To examine the effects of prosocial behavior on the relationship between symptoms and functional impairment, multiple regression analyses were conducted using data from these three perspectives.
Although we did not find buffering effects, regression analyses revealed that parent- and teacher-reported prosocial behavior demonstrated promotive effects on functional impairment, indicating that prosocial behavior may be beneficial in reducing impairment on daily life of children with ADHD. These results were consistent across raters and age-groups, except the mother-rated model for adolescents. Additionally, when investigating these effects by gender, we found that higher prosocial behavior, as observed by fathers, was related to lower impairment for girls.
Our results suggest that prosocial behavior should be considered in clinical practice when evaluating impairment scores for ADHD. Finally, our findings plead for more in-depth measures of social protective factors and across different levels, including individual, family, and community levels. This approach will help identify factors that, independently of risks, may positively impact the functioning of these children.
大多数关于多动症儿童的研究都集中在风险因素及其后果上，比如症状严重程度作为功能损害的一个风险因素。然而，一小部分研究表明，一些儿童尽管症状严重，但功能良好。初步证据表明，社会保护因素可能保护多动症儿童免受其在不同领域的负面影响。本研究的目的是评估亲社会行为作为一种保护因素，是否能缓冲症状对有注意力缺陷多动障碍（ADHD）症状的儿童和青少年功能损害的影响。
在这项横断面研究中，我们使用了从发育与幸福评估（DAWBA）中常规收集的数据。纳入了822名母亲、581名父亲和1109名教师的报告，他们提供了有关儿童症状、功能损害和亲社会行为（年龄在5至18岁）的信息。为了检验亲社会行为对症状与功能损害之间关系的影响，我们使用来自这三个视角的数据进行了多元回归分析。
尽管我们没有发现缓冲效应，但回归分析显示，家长和教师报告的亲社会行为对功能损害表现出促进作用，这表明亲社会行为可能有助于减少多动症儿童日常生活中的功能损害。除了青少年的母亲评定模型外，这些结果在不同评估者和年龄组中是一致的。此外，当按性别调查这些影响时，我们发现父亲观察到的较高亲社会行为与女孩较低的功能损害有关。
我们的结果表明，在临床实践中评估多动症的功能损害评分时应考虑亲社会行为。最后，我们的研究结果呼吁对社会保护因素进行更深入的测量，并涵盖不同层面，包括个体、家庭和社区层面。这种方法将有助于识别那些独立于风险之外可能对这些儿童的功能产生积极影响的因素。
