Indirect and conditional associations between ADHD and risky internet use in elementary school children with parent-child conflict and maternal childhood trauma

Abstract

Prior work links Attention-Deficit/Hyperactivity Disorder (ADHD) with risky internet use (RIU), yet the family and intergenerational processes that might underlie this association remain uncertain. This study examined whether the ADHD-RIU association was statistically accounted for by parent-child conflict and whether maternal childhood trauma moderated these associations. The sample comprised 120 children aged 6-12 years (58% boys, M = 8.73, SD = 1.80), including 60 with a first-time ADHD diagnosis and 60 controls. Standardized parent- and self-report measures were used to assess RIU, parent-child conflict, and maternal childhood trauma. A dual first- and second-stage moderated mediation model (PROCESS Model 58) tested whether the ADHD-RIU association was linked to parent-child conflict and whether maternal trauma moderated both the ADHD-conflict and conflict-RIU associations. Analyses statistically controlled for child sex, age, parental education, and maternal depression and anxiety. ADHD status was significantly associated with parent-child conflict (0.75, 95% CI [0.42, 1.08]), which was significantly associated with RIU (0.42, 95% CI [0.22, 0.62]). Conditional indirect associations via conflict at low (-1 SD), mean, and high (+ 1 SD) levels of maternal childhood trauma were 0.17, 0.31, and 0.49, respectively, indicating a stronger association at higher trauma levels, while no significant direct ADHD-RIU association remained after accounting for conflict. Findings suggest that the ADHD-RIU link was largely shared with parent-child conflict, and this shared association was more pronounced when mothers reported higher trauma histories. These findings highlight potential relevance for trauma-informed, family-focused approaches that address conflict when considering RIU in children with ADHD.