Children with attention-deficit/hyperactivity disorder (ADHD) present a concern across clinical, academic, and social domains. However, a subset of these children does fairly well symptomatically and functionally. This article employs a resilience framework to organize the research on factors that promote favorable outcomes in ADHD. A PubMed search was conducted using key words: resilience and ADHD. Of particular interest were articles focusing on modifiable protective factors, such as parenting and pharmacotherapy. There is consensus that genetics strongly contributes to the etiology of ADHD. Parental, peer, and environmental factors may interact with genes to moderate the developmental expression of ADHD. Pharmacotherapy research reveals that medications exert positive effects of modest magnitude in academic achievement, social functioning and quality of life. However, there is insufficient evidence to determine whether treatment can modify developmental outcomes. Efforts to strengthen family support along with access to health and educational resources may also optimize outcomes.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC; American Psychiatric Association.
2.
Biederman J. , Petty CR, Evans M., Small J., Faraone SVHow persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Res. 2010;177: 299-304.
3.
Langley K., Fowler TA, Grady DL, et al. Molecular genetic contribution to the developmental course of attention-deficit hyperactivity disorder. Eur Child Adolesc Psychiatry. 2009;18:26-32.
4.
Realmuto GM, Winters KC, August GJ, Lee S., Fahnhorst T., Botzet A.Drug use and psychosocial functioning of a community derived sample of adolescents with childhood ADHD. J Child Adolesc Subst Abuse. 2009;18: 172-192.
5.
Steele M., Jensen PS, Quinn DMRemission versus response as the goal of therapy in ADHD: a new standard for the field? Clin Ther. 2006; 28:1892-1908.
6.
Hechtman L.Resilience and vulnerability in long term outcome of attention deficit hyperactive disorder. Can J Psychiatry. 1991;36:415-421.
7.
Molina BS, Hinshaw SP, Swanson JM, et al: The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009;48:484-500.
8.
Schubiner H. , Katragadda S.Overview of epidemiology, clinical features, genetics, neurobiology, and the prognosis of adolescent attention-deficit/hyperactivity disorder. Adolesc Med State Art Rev. 2008;19: 209-215.
Luthar SS, Cicchetti D., Becker B.The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71:543-562.
12.
Luthar SS, Sawyer JA, Brown PJConceptual issues in studies of resilience: past, present, and future research . Ann N Y Acad Sci. 2006;1094:105-115.
13.
Masten ASResilience in developing systems: progress and promise as the fourth wave rises. Dev Psychopathol. 2007;19:921-930.
14.
Deault LCA systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry Hum Dev. 2010;41: 168-192.
Barkley RA, Fischer M., Smallish L., Fletcher K.Young adult follow-up of hyperactive children: antisocial activities and drug use. J Child Psychol Psychiatry. 2004;45:195-211.
17.
Fischer M., Barkley RA, Smallish L., Fletcher K.Young adult follow-up of hyperactive children: self-reported psychiatric disorders, comorbidity, and the role of childhood conduct problems and teen CD. J Abnorm Child Psychol. 2002;30:463-475.
18.
McGough JJ, Smalley SL, McCracken JT, et al. Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry . 2005;162:1621-1627.
19.
Connor DF, Steeber J., McBurnett K.A review of attention-deficit/hyperactivity disorder complicated by symptoms of oppositional defiant disorder or conduct disorder. J Dev Behav Pediatr. 2010;31:427-440
20.
Chronis AM, Lahey BB, Pelham WE Jr, et al. Maternal depression and early positive parenting predict future conduct problems in young children with attention-deficit/ hyperactivity disorder . Dev Psychol. 2007;43:70-82.
21.
Steinhausen HCThe heterogeneity of causes and courses of attention-deficit/hyperactivity disorder. Acta Psychiatr Scand . 2009;120:392-399.
22.
Bussing R., Zima BT, Gary FA, Garvan CWBarriers to detection, help-seeking, and service use for children with ADHD symptoms. J Behav Health Serv Res. 2003;30: 176-189.
23.
Leslie LK, Plemmons D., Monn AR, Palinkas LAInvestigating ADHD treatment trajectories: listening to families’ stories about medication use. J Dev Behav Pediatr. 2007;28:179-188.
24.
Thapar A., Stergiakouli E.An overview on the genetics of ADHD. Xin Li Xue Bao. 2008;40:1088-1098.
25.
Gizer IR, Ficks C., Waldman IDCandidate gene studies of ADHD: a meta-analytic review. Hum Genet. 2009;126:51-90.
26.
Thapar A., Langley K., Owen MJ, O’Donovan MCAdvances in genetic findings on attention deficit hyperactivity disorder. Psychol Med. 2007;37:1681-1692.
27.
Coghill D., Banaschewski T.The genetics of attention deficit-hyperactivity disorder. Expert Rev Neurother. 2009;9:1547-1565.
28.
Li J., Kang C., Zhang H., et al. Monoamine oxidase A gene polymorphism predicts adolescent outcome of attention deficit-hyperactivity disorder. Am J Med Genet B Neuro-psychiar Genet. 2007;144B:430-433.
29.
Ficks CA, Waldman IDGene-environment interactions in attention deficit-hyperactivity disorder . Curr Psychiatry Rep. 2009;11:387-392.
30.
Brookes KJ, Mill J., Guindalini C., et al. A common haplotype of the dopamine transporter gene associated with attention deficit-hyperactivity disorder and interacting with maternal use of alcohol during pregnancy. Arch Gen Psychiatry. 2006;63:74-81.
31.
Langley K., Holmans PA, van den Bree MB, Thapar A.Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of attention deficit hyperactivity disorder and associated antisocial behaviour: investigation in a clinical sample. BMC Psychiatry. 2007;7:26.
32.
Laucht M., Skowronek MH, Becker K., et al. Interacting effects of the dopamine transporter gene and psychosocial adversity on attention deficit/hyperactivity disorder symptoms among 15-year-olds from a high-risk community sample. Arch Gen Psychiatry. 2007;64:585-590.
33.
Shaw P., Eckstrand K., Sharp W., et al. Attention-deficit/ hyperactivity disorder is characterized by a delay in cortical maturation. Proc Natl Acad Sci U S A. 2007;104: 19649-19654.
34.
Shaw P., Lerch J., Greenstein D., et al. Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder . Arch Gen Psychiatry. 2006;63:540-549.
35.
Weiss G., Minde K., Werry JS, Douglas V., Nemeth E.Studies on the hyperactive child. VIII. Five -year follow-up. Arch Gen Psychiatry. 1971;24:409-414.
36.
Biederman K. , Mick E., Faraone SVNormalized functioning in youths with persistent attention-deficit/ hyperactivity disorder. J Pediatr. 1998;133:544-551.
37.
Owens EB, Hinshaw SP, Kraemer HC, et al. Which treatment for whom for ADHD? Moderators of treatment response in the MTA. J Consult Clin Psychol. 2003;71: 540-552.
38.
Daley D.Attention deficit hyperactivity disorder: a review of the essential facts . Child Care Health Dev. 2006;32:193-204.
39.
Daley D., Jones K., Hutchings J., Thompson M.Attention deficit hyperactivity disorder in pre-school children: current findings, recommended interventions and future directions. Child Care Health Dev. 2009;35: 754-766.
40.
Lin YF, Chung HHParenting stress and parent’s willingness to accept treatment in relation to behavioral problems of children with attention-deficit hyperactivity disorder . J Nurs Res. 2002;10:43-56.
41.
Hanisch C., Freund-Braier I., Hautmann C., et al. Detecting effects of the indicted prevention Programme for Externalizing Problem behavior (PEP) on child symptoms, parenting, and parental quality of life in a randomized controlled trail. Behav Cogn Psychother . 2010;38:95-112.
42.
Chronis AM, Chacko A., Fabiano GA, Wymbs BT, Pelham WE Jr.Enhancements to the behavioral parent training paradigm for families of children with ADHD: review and future directions. Clin Child Fam Psychol Rev. 2004;7:1-27.
43.
Miranda A., Grau D., Rosel J., Meliá A.Understanding discipline in families of children with attention-deficit/ hyperactivity disorder: a structural equation model. Span J Psychol. 2009;12:496-505.
44.
Chronis-Tuscano A., Seymour KE, Stein MA, et al. Efficacy of osmotic-release oral system (OROS) methylphenidate for mothers with attention-deficit/hyperactivity disorder (ADHD): preliminary report of effects on ADHD symptoms and parenting. J Clin Psychiatry. 2008;69:1938-1947.
45.
Barkley RAAdolescents with attention-deficit/ hyperactivity disorder: an overview of empirically based treatments. J Psychiar Pract. 2004;10:39-56.
46.
Svanborg P. , Thernlund G., Gustafsson PA, Hägglöf B., Schacht A., Kadesjö B.Atomoxetine improves patient and family coping in attention deficit/hyperactivity disorder: a randomized, double-blind, placebo-controlled study in Swedish children and adolescents. Eur Child Adolesc Psychiatry. 2009;18:725-735.
47.
Hoza B.Peer functioning in children with ADHD. J Pediatr Psychol . 2007;32:655-663.
48.
de Boo GM, Prins PJSocial incompetence in children with ADHD: possible moderators and mediators in social-skills training. Clin Psychol Rev. 2007;27:78-97.
49.
Buitelaar J. , Medori R.Treating attention-deficit/ hyperactivity disorder beyond symptom control alone in children and adolescents: a review of the potential benefits of long-acting stimulants. Eur Child Adolesc Psychiatry. 2010;19:325-340.
50.
Carpenter Rich E., Loo SK, Yang M., Dang J., Smalley SLSocial functioning difficulties in ADHD: association with PDD risk. Clin Child Psychol Psychiatry. 2009;14: 329-344.
51.
Mikami AY, Hinshaw SPResilient adolescent adjustment among girls: buffers of childhood peer rejection and attention-deficit/hyperactivity disorder. J Abnorm Child Psychol. 2006;34:825-839.
52.
Owens JS, Goldfine ME, Evangelista NM, Hoza B., Kaiser NMA critical review of self-perceptions and the positive illusory bias in children with ADHD. Clin Child Fam Psychol Rev. 2007 ;10:335-351.
53.
Hoza B., Murray-Close D., Arnold LE, Hinshaw SP, Hechtman L.; MTA Cooperative Group.Time-dependent changes in positively biased self-perceptions of children with attention-deficit/hyperactivity disorder: a developmental psychopathology perspective. Dev Psychopathol. 2010;22:375-390.
54.
Mikami AY, Lerner MD, Griggs MS, McGrath A., Calhoun CDParental influence on children with attention-deficit/hyperactivity disorder: II. Results of a pilot intervention training parents as friendship coaches for children. J Abnorm Child Psychol. 2010 ;38:737-749.
55.
Abikoff H., Hechtman L., Klein RG, et al. Symptomatic improvement in children with ADHD treated with long-term methyphenidate and multimodal psychosocial treatment. J Am Acad Child Acolesc Psychiatry. 2004;43:802-811.
56.
Manos M., Frazier TW, Landgraf JM, Weiss M., Hodgkins P.HRQL and medication satisfaction in children with ADHD treated with the methylphenidate transdermal system. Curr Med Res Opin. 2009 ;25:3001-3010.
57.
Jensen PS, Hinshaw SP, Swanson JM, et al. Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers. J Dev Behav Pediatr. 2001;22:60-73.
58.
Frankel F., Cantwell DP, Myatt R., Feinberg DTDo stimulants improve self-esteem in children with ADHD and peer problems ? J Child Adolesc Psychopharmacol. 1999;9:185-194.
59.
Hechtman L. , Abikoff H., Klein RG, et al. Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. J Am Acad Child Adolesc Psychiatry . 2004;43:812-819.
60.
Barbaresi WJ , Katusic SK, Colligan RC, Weaver AL, Jacobsen SJModifiers of long-term school outcomes for children with attention-deficit/hyperactivity disorder: does treatment with stimulant medication make a difference? Result from a population-based study . J Dev Behav Pediatr. 2007;28:274-287.
61.
Biederman J. , Monuteaux MC, Spencer T., Wilens TE, Faraone SVDo stimulants protect against psychiatric disorders in youth with ADHD? A 10-year follow-up study. Pediatrics. 2009;124:71-78.
