The Effects of Lockdown on the Severity of Symptoms of Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders and on Children/Adolescents' Ability to Cope with Stress

Research Article




Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Coping Strategies, COVID-19 Pandemic, Lockdown


Introduction and Objective: The aim is to examine changes in the severity of symptoms during the lockdown period in patients diagnosed with attention deficit hyperactivity disorder (ADHD) and Disruptive Behavior Disorders (DBD), and to determine the relationship between the methods of coping with the stress experienced by the children and the severity of ADHD and DBD.

Method: 92 patients, between the ages of 6-18, who were diagnosed with ADHD were included in the study. Sociodemographic data form and the Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale were given to parents, and the Coping Styles of Stress Scale was given to children.

Results: It was found that ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) scores decreased significantly, compared to before the pandemic. There wasn’t a significant difference between pandemic-related features and ADHD, ODD, and CD scores. A significant relationship was not observed between stress-coping methods and ADHD and CD scores and as ODD scores increased, the rate of using the submissive approach increased.

Conclusion: Adaptation to acute changes such as a pandemic can be challenging for children and adolescents. During these processes, especially children and adolescents diagnosed with ADHD are at risk for developing additional mental problems. Evaluating the stress-coping methods of patients diagnosed with ADHD and DBD and their parents who apply to outpatient clinics in interviews and supporting them to develop healthy coping methods are important issues both during stressful situations and in terms of providing psychological resilience against subsequent stresses.


American Academy of Pediatrics Clinical Practice Guideline: Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics. 2000;105(5):1158–1170. doi:10.1542/peds.105.5.1158

Lecendreux M, Konofal E, Faraone SV. Prevalence of Attention Deficit Hyperactivity Disorder and Associated Features among Children in France. J Atten Disord. 2011;15(6):516–524. doi:10.1177/1087054710372491

Wang T, Liu K, Li Z, et al. Prevalence of Attention Deficit/Hyperactivity Disorder among Children and Adolescents in China: A Systematic Review and Meta-analysis. BMC Psychiatry. 2017;17:32. doi:10.1186/s12888-016-1187-9

Purper-Ouakil D, Wohl M, Michel G. Symptom Variations in ADHD: Importance of Context, Development and Comorbidity. Encephale. 2004;30(6):533–539. doi:10.1016/s0013-7006(04)95467-x

Mengin A, Allé MC, Rolling J, et al. Psychopathological Consequences of Confinement. Encephale. 2020;46(3S):S43-S52. doi:10.1016/j.encep.2020.04.007

Soron TR, Ashiq AR, Al-Hakeem M, Chowdhury ZF, Ahmed HU, Chowdhury CA. Domestic Violence and Mental Health during the COVID-19 Pandemic in Bangladesh. JMIR Form Res. 2021;5(9):e24624. doi:10.2196/24624

Duan L, Shao X, Wang Y, et al. An Investigation of Mental Health Status of Children and Adolescents in China during the Outbreak of COVID-19. J Affect Disord. 2020;275:112–118. doi:10.1016/j.jad.2020.06.029

Xie X, Xue Q, Zhou Y, et al. Mental Health Status among Children in Home Confinement during the Coronavirus Disease 2019 Outbreak in Hubei Province, China. JAMA Pediatr. 2020;174(9):898-900. doi:10.1001/jamapediatrics.2023.0846

Jose PE, Ryan N, Pryor J. Does Social Connectedness Promote a Greater Sense of Well-being in Adolescence Over Time?. J Res Adolesc. 2012;22(2):235–251. doi:10.1111/j.1532-7795.2012.00783.x

Allen K, Kern ML, Vella-Brodrick D, Hattie J, Waters L. What Schools Need to Know About Fostering School Belonging: A Meta-analysis. Educ Psychol Rev. 2018;30:1-34. doi:10.1007/s10648-016-9389-8

Brooks SK, Smith LE, Webster RK, et al. The Impact of Unplanned School Closure on Children’s Social Contact: Rapid evidence review. Euro Surveill. 2020;25(13):pii=2000188. doi:10.2807/1560-7917.ES.2020.25.13.2000188

Loades ME, Chatburn E, Higson-Sweeney N, et al. Rapid Systematic Review: The Impact of Social Isolation Adolescents in the Context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020;59(11)1218–1239. doi:10.1016/j.jaac.2020.05.009

Turgay A. Çocuk ve Ergenlerde Davranım Bozuklukları için DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği. Kanada: Integrative Therapy Institute; 1995 (Turkish).

Ercan ES, Amado S, Somer O, Çıkoğlu S. Dikkat Eksikliği Hiperaktivite Bozukluğu ve Yıkıcı Davranış Bozuklukları için Bir Test Bataryası Geliştirme Çalışması. Çocuk ve Gençlik Ruh Sağlığı Dergisi. 2001;8:132-144.

Şahin NH, Durak A. Üniversite Öğrencileri için Stresle Başa Çıkma Tarzları Ölçeği. Türk Psikoloji Dergisi. 1995;10(34):56-73.

Folkman S, Lazarus RS. An Analysis of Coping in A Middle-aged Community Sample. J Health Soc Behav. 1980;21(3):219-239. doi:10.2307/2136617

Lee J. Mental Health Effects of School Closures during COVID-19. Lancet Child Adolesc. 2020;4(6):421. doi:10.1016/S2352-4642(20)30109-7

Korpa T, Pappa T, Chouliaras G, et al. Daily Behaviors, Worries and Emotions in Children and Adolescents with ADHD and Learning Difficulties during the COVID-19 Pandemic. Children. 2021;8(11):995. doi:10.3390/children8110995

Bobo E, Lin L, Acquaviva E, et al. How Do Children and Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) Experience Lockdown during the COVID-19 Outbreak?. Encephale. 2020;46(3S):S85-S92. doi:10.1016/j.encep.2020.05.011

Dvorsky M, Breaux R, Cusick C, et al. Coping with COVID-19: Longitudinal Impact of the Pandemic on Adjustment and Links with Coping for Adolescents with and without ADHD. Res Child Adolesc Psychopathol. 2022;50(5):605-619. doi:10.1007/s10802-021-00857-2

Steinberg EA, Drabick DA. A Developmental Psychopathology Perspective on ADHD and Comorbid Conditions: The Role of Emotion Regulation. Child Psychiatry Hum Dev. 2015;46:951-966. doi:10.1007/s10578-015-0534-2

Breaux R, Dvorsky MR, Marsh NP, et al. Prospective Impact of COVID-19 on Adolescent Mental Health Functioning in Adolescents with and without ADHD: Protective Role of Emotion Regulation Abilities. J Child Psychol Psychiatry. 2021;62(9):1132-1139. doi:10.1111/jcpp.13382

Breaux R, Dvorsky MR, Becker SP. ADHD in COVID-19: Risk, Resilience, and the Rapid Transition to Telehealth. ADHD Rep. 2021;29(2):1–9. doi:10.1521/adhd.2021.29.2.1

Harpin V, Mazzone L, Raynaud JP, Kahle J, Hodgkins P. Long-term Outcomes of ADHD: A Systematic Review of Self-esteem and Social Function. J Atten Disord. 2016;20(4):295-305. doi:10.1177/1087054713486516

Becker SP, Mehari KR, Langberg J, Evans SW. Rates of Peer Victimization in Young Adolescents with ADHD and Associations with Internalizing Symptoms and Self-esteem. Eur Child Adolesc Psychiatry. 2017;26:201-214. doi:10.1007/s00787-016-0881-y

Rosenthal E, Franklin-Gillette S, Jung HJ, et al. Impact of COVID-19 on Youth with ADHD: Predictors and Moderators of Response to Pandemic Restrictions on Daily Life. J Atten Disord. 2022;26(9):1223-1234. doi:10.1177/10870547211063641

Sciberras E, Patel P, Stokes MA, et al. Physical Health, Media Use, and Mental Health in Children and Adolescents with ADHD during the COVID-19 Pandemic in Australia. J Atten Disord. 2022;26(4):549-562. doi:10.1177/1087054720978

Cortese S, Asherson P, Sonuga-Barke E, et al. ADHD Management during the COVID-19 Pandemic: Guidance from the European ADHD Guidelines Group. Lancet Child Adolesc Health. 2020;4(6):412-414. doi:10.1016/S2352-4642(20)30110-3

Babb K, Levine L, Arseneault J. Shifting Gears: Coping Flexibility in Children with and without ADHD. Int J Behav Dev. 2010;34(1):10–23. doi:10.1177/0165025409345070

Barra S, Grub A, Roesler M, Retz-Junginger P, Philipp F, Retz W. The Role of Stress Coping Strategies for Life Impairments in ADHD. J Neural Transm. 2021;128(7):981–992. doi:10.1007/s00702-021-02311-5




How to Cite

Çimen, İrem D., Altuğ Özboduroğlu, A., Erarkadaş, M., Annaç, N. B., & Yıldız Gündoğdu, Özlem. (2023). The Effects of Lockdown on the Severity of Symptoms of Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders and on Children/Adolescents’ Ability to Cope with Stress: Research Article. Acta Medica Ruha, 1(3), 239–249.



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