Irritability in preschool children with attention‐deficit/hyperactivity disorder: Analysis of family environmental factors

Abstract Background Irritability affects one‐third of children and adolescents with attention‐deficit/hyperactivity disorder (ADHD) and is associated with negative outcomes. The family environment plays a prominent role in the child's development, and therefore on the risk for irritability, especially during the preschool period. The aim of this study was to investigate the association between multiple family environmental factors and irritability in preschool children with ADHD. Methods This is a cross‐sectional analysis nested within a randomized clinical trial with preschool children with ADHD—the MAPPA study. Here, 128 children (107 males, 21 females) aged 3–5 years with complete data were included. Irritability was measured by the Affective Reactivity Index. Three dimensions of family environmental factors were considered: parenting, family environment, and maternal characteristics (comprising maternal psychopathology, temperament, and cognitive ability). Analyses were conducted to evaluate the association of individual factors with irritability, followed by a multiple linear regression model. Results Associations were found between irritability and both parenting and maternal characteristics, particularly psychopathology and temperament. The multiple linear regression model revealed a greater frequency of negative over positive comments in the Preschool Five‐Minute Speech Sample alongside less positive parenting practices and maternal ADHD symptoms as the family environmental factors significantly associated with child irritability. Findings remained significant after controlling for child sex and child ADHD symptom severity. Conclusion Our findings indicated that maternal individual characteristics and parenting practices are associated with irritability in preschool children with ADHD, supporting the importance of family environment in understanding this condition. A thorough assessment of parenting practices and parental psychopathology is relevant when planning interventions aimed at reducing irritability in preschoolers with ADHD.