Beyond ADHD Diagnosis: Oppositional Symptoms and Negative Parenting as Correlates of Problematic Media Use in Medication-Naïve Children With ADHD

Background Problematic media use in children with attention-deficit/hyperactivity disorder (ADHD) may reflect factors beyond core ADHD symptoms. Methods This cross-sectional study included 129 children aged 6–11 years: 42 comparison participants and 87 newly diagnosed, medication-naïve children with ADHD, including 34 without and 53 with comorbid specific learning disorder. Parents completed measures of problematic media use, ADHD and disruptive behavior symptoms, and parenting practices; children completed the Stroop Color–Word Test. Results Both ADHD groups showed higher problematic media use than the comparison group, although adding diagnostic group after demographics did not significantly increase explained variance. In the final regression model, older age, male sex, oppositional defiant disorder symptoms, and negative parenting were independently associated with problematic media use, whereas core ADHD symptoms and Stroop performance were not. Exploratory analysis showed a significant indirect association of negative parenting with problematic media use through oppositional symptoms (indirect effect = 0.231, 95% CI [0.082, 0.406]). There was no statistically significant evidence of moderation by diagnostic group. Conclusion In adjusted analyses, oppositional symptoms and negative parenting were associated with problematic media use, whereas core ADHD symptoms and Stroop performance were not; findings should be interpreted cautiously given measurement-method differences.