Introduction Parent-adolescent relationship quality is vital for youth’s emotional and behavioral development; yet, it may be adversely impacted by neurodevelopmental disorders like attention-deficit hyperactivity disorder (ADHD). This study aimed to examine whether ADHD diagnosis and medication status are associated with differences in specific dimensions of parent–adolescent relationship quality – namely open communication, positive relationship quality, and negative relationship quality – while accounting for internet addiction as a contextual covariate. Methods A total of 155 adolescents, aged 12–18 ( M = 14.23 years, SD = 1.83), participated in this study. The participants were categorized into three groups: adolescents without ADHD (control group, n = 58), those with ADHD not receiving medication ( n = 55), and adolescents with ADHD for at least 3 months ( n = 42). We evaluated the parent-adolescent relationship quality across three dimensions: positive, open, and negative relationship quality with both parents. Multivariate Analyses of covariance (MANCOVA) were utilized to assess the impact of ADHD diagnosis and pharmacological treatment on relationship quality, controlling for age, sex, and internet addiction (IA) as factors. Results After controlling for age and internet addiction, medication naïve adolescents with ADHD had significantly lower levels of open communication with mothers ( p = 0.002) and fathers ( p 0.001) compared to adolescents with ADHD on medication and the control group, with the latter two groups not differing significantly from one another in this sample. No significant group differences were observed in negative relationship quality, and other positive relationship dimensions largely converged across groups. A higher level of IA was associated with higher negative relationship quality with both parents ( p = 0.001) across the full sample; whether this association differs by ADHD diagnosis or medication status was not formally tested and cannot be determined from the present analyses. We identified age as a factor of lower father–adolescent relationship quality ( p = 0.022). Still, we found sex to be insignificant ( p 0.05). Discussion In conclusion, group differences were domain-specific: medication-naïve adolescents with ADHD reported significantly lower open communication with both parents, whereas no robust group differences emerged for positive or negative relationship quality. In contrast, adolescents receiving pharmacological treatment did not significantly differ from the control group on these dimensions in this sample. These findings suggest that pharmacological treatment status is associated with differences in open communication patterns in families with adolescents with ADHD; however, the cross-sectional and non-randomized nature of our design precludes causal inference. Also, the finding that IA showed a significant main effect on relationship quality across the full sample highlights the importance of considering internet usage patterns when working with families of adolescents with ADHD.
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