Journal of Child and Family Studies https://doi.org/10.1007/s10826-018-1137-x REVIEW Children’s ADHD Interventions and Parenting Stress: A Meta- Analysis Jennifer Theule 1 ● Kristene Cheung 1 ● Kelsey Aberdeen 1 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract In order to increase our understanding of parenting stress, this study examined underutilized data on the effect of interventions for child ADHD on parenting stress. This project employed meta-analytic techniques to evaluate whether interventions for a child’s attention-deficit hyperactivity disorder (ADHD) reduce parenting stress in families of children with ADHD, as reported on the Parenting Stress Index (PSI) or its variants. This study also assessed whether this efficacy varies based on whether the intervention is pharmacological or psychosocial, and within the psychosocial domain whether parents are directly involved or targeted in some way by the intervention. A number of parent, child, and study characteristics were also evaluated as potential moderators. A comprehensive search identified 43 (29 published, 14 unpublished) manuscripts relevant to the meta-analysis. Thirty-three studies compared levels of total parenting stress before and after treatment (within-subjects), producing a moderate effect size, d = 0.50, 95% CI [0.42, 0.59], p < .001. Nine studies compared total parenting stress between treatment and control groups (between-subjects), d = 0.53, 95% CI [0.33, 0.72]. Parent gender was the only statistically significant moderator, with studies with a larger proportion of mothers showing a larger effect, Q = 5.44, p = .02, k = 17. This study advances our understanding of parenting stress and identifies areas for future research, including research on fathers and longitudinal studies of families of children with ADHD. Keywords Attention-deficit hyperactivity disorder ● Parenting stress ● Meta-analysis ● Motherhood ● Families Introduction Parenting stress (PS) is a distinct type of stress that arises when a parent’s perceptions of the demands of the role of parenting outstrip his or her resources for dealing with them (Deater-Deckard 2004a). Abidin’s theory of PS (Abidin 1976, as cited in Abidin 1995), although dated, continues to dominate the literature (Theule 2010). Abidin holds that PS is determined by parent factors (e.g., sense of competence), child factors (e.g., adaptability), and situational factors (e.g., role restriction). Life stressors are seen as factors that can exacerbate PS without having any direct effects on it. Extensive prior research has concluded that parents of children with attention-deficit/hyperactivity disorder (ADHD) experience greater levels of PS than parents of children without ADHD (for a meta-analysis see Theule et al. 2013). Elevated levels of PS have been found to negatively affect the parent-child relationship, sense of parental efficacy, and parenting practices (Abidin 1992; Belsky 1984; Crnic and Ross 2017; Morgan et al. 2002; Rodgers 1998; Webster-Stratton 1990). ADHD has prevalence rates of ~5% (Polanczyk et al. 2014), making it one of the most commonly diagnosed childhood disorders (American Psychiatric Association [APA] 2013). ADHD is a chronic, pervasive condition characterized by inattention, impulsivity, and hyperactivity that typically arises during childhood (APA 2013). In childhood especially, boys are more likely to be diagnosed with ADHD than girls (APA 2013; Kessler et al., 2006). Until recently, ADHD was considered a childhood disorder; however, recent research indicates that in most cases, ADHD is a lifelong disorder, existing in at least a partial remission form into adulthood (Barkley et al. 2002; Faraone et al. 2006). Current research points to strong genetic influences on the development of ADHD (Levy et al. 2006) and family studies have consistently found elevated rates of ADHD in the relatives of children with ADHD (e.g., Far- aone et al. 2000). A recent meta-analysis indicated that 20% * Jennifer Theule jen.theule@umanitoba.ca 1 University of Manitoba, Winnipeg, MB R3T 2N2, Canada 1234567890();,: 1234567890();,: