Association Between Caregiver Responses to the Six-Item Adult ADHD Self-Report Scale (ASRS-5) and Caregiver-Reported Adverse Childhood Experiences in Their Children.

AIM: To examine associations between caregiver ASRS-5 summed item scores, caregiver-reported anger/irritability and adverse childhood experiences (ACEs) reported for their children. METHODS: A cross-sectional, anonymous online survey (February 2022-March 2025). Adults who identified as the caregiver of a child were recruited through posters and QR codes through paediatric inpatient, outpatient, community and developmental services in Western Sydney. Caregiver ASRS-5 responses were summed (range 0-24); ≥ 14 was defined as a higher ASRS score. Caregivers also completed an ACE checklist. RESULTS: Among 162 caregivers (mean age 36.8 years, SD 8.5; 84.2% mothers/maternal figures), 66 (40.7%) had an ASRS-5 summed item score ≥ 14. An ACE score ≥ 4 was reported for 35% of children of these caregivers versus 17% of the remainder (OR 2.7; p = 0.012). Compared with caregivers ASRS-5 scoring 0-9, the adjusted odds of child ACE burden ≥ 4 were higher among those scoring 10-19 (OR 2.7, 95% CI 1.00-7.10) and ≥ 20 (OR 6.7, 95% CI 1.82-24.67). Each additional ACE was associated with a 0.45-point higher ASRS-5 summed item score (p < 0.001). Anger/irritability was associated with ACE burden ≥ 4 (OR 2.25, 95% CI 1.11-4.56), and exploratory stratified analyses showed an association between ASRS-5 summed item score and ACE score only in the higher anger/irritability stratum (p = 0.020). CONCLUSIONS: In this self-selected sample, higher caregiver ASRS-5 item sums were associated with greater caregiver-reported ACE burden in their children. Further research should evaluate whether caregiver ASRS-5 response patterns and anger/irritability have potential utility in family-centred support.