Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?

Abstract Background 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 sugges...

Full description

Saved in:
Bibliographic Details
Main Authors: Marsida Hysaj, Mathilde R. Crone, Jessica C. Kiefte-de Jong, Robert R.J.M. Vermeiren
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-06537-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849774651517960192
author Marsida Hysaj
Mathilde R. Crone
Jessica C. Kiefte-de Jong
Robert R.J.M. Vermeiren
author_facet Marsida Hysaj
Mathilde R. Crone
Jessica C. Kiefte-de Jong
Robert R.J.M. Vermeiren
author_sort Marsida Hysaj
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusion 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.
format Article
id doaj-art-f7700d8d813a45b7bc52bf198a5c8d87
institution DOAJ
issn 1471-244X
language English
publishDate 2025-03-01
publisher BMC
record_format Article
series BMC Psychiatry
spelling doaj-art-f7700d8d813a45b7bc52bf198a5c8d872025-08-20T03:01:38ZengBMCBMC Psychiatry1471-244X2025-03-0125111010.1186/s12888-025-06537-5Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?Marsida Hysaj0Mathilde R. Crone1Jessica C. Kiefte-de Jong2Robert R.J.M. Vermeiren3Department of Child and Adolescent Psychiatry, Leiden University Medical CenterDepartment of Public Health and Primary Care / Health Campus the Hague, Leiden University Medical CenterDepartment of Public Health and Primary Care / Health Campus the Hague, Leiden University Medical CenterDepartment of Child and Adolescent Psychiatry, Leiden University Medical CenterAbstract Background 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. Methods 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. Results 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. Conclusion 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.https://doi.org/10.1186/s12888-025-06537-5ADHD symptomsProsocial behaviorFunctional impairmentResilienceClinical setting
spellingShingle Marsida Hysaj
Mathilde R. Crone
Jessica C. Kiefte-de Jong
Robert R.J.M. Vermeiren
Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?
BMC Psychiatry
ADHD symptoms
Prosocial behavior
Functional impairment
Resilience
Clinical setting
title Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?
title_full Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?
title_fullStr Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?
title_full_unstemmed Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?
title_short Can prosocial behavior buffer symptom severity and impairment in children and adolescents with ADHD symptoms in a clinical setting?
title_sort can prosocial behavior buffer symptom severity and impairment in children and adolescents with adhd symptoms in a clinical setting
topic ADHD symptoms
Prosocial behavior
Functional impairment
Resilience
Clinical setting
url https://doi.org/10.1186/s12888-025-06537-5
work_keys_str_mv AT marsidahysaj canprosocialbehaviorbuffersymptomseverityandimpairmentinchildrenandadolescentswithadhdsymptomsinaclinicalsetting
AT mathildercrone canprosocialbehaviorbuffersymptomseverityandimpairmentinchildrenandadolescentswithadhdsymptomsinaclinicalsetting
AT jessicackieftedejong canprosocialbehaviorbuffersymptomseverityandimpairmentinchildrenandadolescentswithadhdsymptomsinaclinicalsetting
AT robertrjmvermeiren canprosocialbehaviorbuffersymptomseverityandimpairmentinchildrenandadolescentswithadhdsymptomsinaclinicalsetting