European Journal of Cardiovascular Medicine

Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopmental condition affecting 3.4% of children globally[1], disrupts academic and social functioning while imposing substantial caregiver burden. In India, societal stigma and limited mental health resources exacerbate parental stress, often leading to maladaptive coping strategies. Parenting approaches—authoritative, authoritarian, permissive, and negligent—significantly influence ADHD symptom trajectories and comorbid outcomes. While global studies highlight cultural variations in caregiving practices, data from low-resource settings remain sparse. This study investigates parenting styles and coping mechanisms among Indian caregivers, exploring socioeconomic, educational, and clinical moderators.

Study Design and Participants 

A cross-sectional analysis enrolled 100 primary caregivers (60 mothers, 40 fathers) of ADHD-diagnosed children (DSM-5 criteria) at Osmania Medical College, Hyderabad. Participants were recruited via convenience sampling from December 2020 to May 2023. 

Inclusion Criteria: 

- Children aged 6–14 years confirmed via VADPRS 

- Caregivers providing written consent 

Exclusion Criteria: 

- Child IQ <70 

Tools 

1. VADPRS: Assessed ADHD subtypes (inattentive, hyperactive, combined) and comorbidities (ODD, conduct disorder).
2. Parenting Style Questionnaire: Categorized caregivers into authoritative, authoritarian, or permissive styles.
3. Brief COPE Inventory: Evaluated emotion-focused, problem-focused, and avoidant coping.

Statistical Analysis 

SPSS v29 analyzed correlations (Pearson’s r) and multivariate regressions. Significance thresholds: p < 0.05 (), p < 0.01 (). 

Socio-Demographic Profile 

• Gender: 60% mothers, 40% fathers
• Education: 68% secondary education, 7% primary
• Socioeconomic Status: 90% lower-income households
• Family Structure: 88% nuclear families

Table 1: Socio-Demographic Characteristics

Parenting Approaches 

- Authoritarian: 70% (43 mothers, 27 fathers) 

- Permissive: 20% (11 mothers, 9 fathers) 

- Authoritative: 10% (6 mothers, 4 fathers) 

Figure 1: Distribution of parenting styles by caregiver gender. 

 Coping Strategies 

- Emotion-focused: 65% (e.g., self-blame, venting) 

- Avoidant: 20% (e.g., denial) 

- Problem-focused: 15% (e.g., planning, seeking support) 

 Significant Correlations 

1. Parenting Style ↔ Socioeconomic Status: r = 0.209, p = 0.039
2. Parenting Style ↔ Child’s Treatment Adherence: r = 0.455, p < 0.001
3. Coping ↔ Caregiver Age: r = 0.258, p = 0.010
4. Maladaptive Coping ↔ Family Psychiatric History: r = -0.405, p = 0.016

Dominance of Authoritarian Parenting 

Consistent with prior Asian studies, authoritarian approaches predominated (70%), reflecting cultural emphases on behavioral control. Lower socioeconomic status predicted harsher discipline (p = 0.039), aligning with resource scarcity models. 

Emotion-Focused Coping and Mental Health 

High emotion-focused coping (65%) correlated with caregiver depression (r = -0.231, p = 0.021), mirroring global patterns. Problem-focused strategies’ underuse (15%) highlights intervention targets. 

Clinical Implications 

1. Parent Training Programs: Integrate modules on authoritative communication and stress management.
2. Economic Support: Address poverty-linked stressors through community resources.
3. Family-Centered Care: Screen for psychiatric histories to mitigate intergenerational risks.

Authoritarian parenting and emotion-focused coping prevail among Indian caregivers of children with ADHD, shaped by education, income, and familial mental health. Targeted strategies promoting adaptive practices are critical for improving familial outcomes. Future studies should evaluate longitudinal impacts of caregiver interventions in low-resource settings.  

1. Craig F, Savino R, Fanizza I, et al. A systematic review of coping strategies in parents of children with ADHD. Res Dev Disabil. 2020;98:103578. doi:10.1016/j.ridd.2019.103578
2. Chang CC, Chen YM, Liu TL, et al. Affiliate stigma and related factors in family caregivers of ADHD children. Int J Environ Res Public Health. 2020;17(2):576. doi:10.3390/ijerph17020576
3. Moghaddam MF, Assareh M, Heidaripoor A. Parenting styles in ADHD vs. normal children. Arch Psychiatry Psychother. 2013;15(4):45-52.
4. Wong WC, Wong IYF. Burden and coping in parents of ADHD children. Nurs Open. 2021;8(6):3302-3311. doi:10.1002/nop2.868
5. Bhide S, Sciberras E, Anderson V, et al. Parenting style and socio-emotional functioning in ADHD children. J Atten Disord. 2019;23(5):546-558. doi:10.1177/1087054718825004
6. Tancred EM, Greeff AP. Maternal parenting and family adaptation in ADHD. Clin Soc Work J. 2015;43(4):442-456. doi:10.1007/s10615-014-0493-2
7. Robinson C, Mandleco B, Olsen SF. Authoritative, authoritarian, and permissive parenting practices. Dev Psychol. 1995;31(3):583-592.
8. Carver CS. You want to measure coping but your protocol’s too long. Int J Behav Med. 1997;4(1):92-100. doi:10.1207/s15327558ijbm0401_6
9. Karbalaei Sabagh A, Khademi M, Noorbakhsh S. Parenting styles in ADHD families. Indian J Pediatr. 2016;83(3):250-255. doi:10.1007/s12098-015-1854-8
10. Alizadeh H, Applequist KF, Coolidge FL. Parental self-confidence and corporal punishment in ADHD families. Child Abuse Negl. 2007;31(6):567-572. doi:10.1016/j.chiabu.2006.12.006
11. Cappe E, Bolduc M, Rougé MC. Quality of life in parents of ADHD children. Qual Life Res. 2017;26(5):1289-1304. doi:10.1007/s11136-016-1463-7