The bidirectional link between ADHD behavior and attachment (in)security in middle childhood: A longitudinal study

Research has consistently suggested an association between ADHD behavior and insecure attachment, yet longitudinal data assessing this relation in middle childhood are largely absent. In particular, the directionality of this association, and the role of oppositional defiant disorder (ODD) behavior remains unclear. This longitudinal study examined the bidirectional relationship between ADHD behavior and attachment (in)security across three annual waves from a community sample of 614 children (Wave 1: Mage = 10.28, SD = 0.58, range 9–12; 44% boys, 54% girls), whilst also examining the role of ODD behavior. ADHD and ODD behavior were rated by mothers using the Child Behavior Checklist, and children’s attachment was assessed through both explicit (questionnaires) and implicit (secure base script knowledge) measures. Random Intercept Cross‑Lagged Panel Models revealed small to moderate associations between stable between‑child differences in ADHD behavior and attachment (in)security (β = –.550 to .367), which mostly remained significant after controlling for ODD behavior (β = –.517 to .295). Cross‑lagged effects were largely non‑significant. Together, these findings suggest that stable child-specific differences in ADHD and attachment (in)security are consistently associated in childhood.